- Question from Janita: Exactly what is lymphedema?
- Answers - Saskia Thiadens Lymphedema is the swelling of a limb, usually the arm, but it can develop in the shoulder, neck, hand and fingers, or breast or trunk area. It occurs because the lymph nodes have been removed from the armpit, so there's an imbalance in the lymphatic system: more fluid is going into the arm than the lymphatic system can carry out.
- Marisa Weiss, M.D. It's like a plumbing problem. More fluid is coming into the arm than can leave the arm. So the fluid builds up in the soft tissues of the affected area. That's why the arm gets bigger, swollen with fluid.
- Saskia Thiadens The job of the lymphatic system is to remove impurities from the body's tissues through the circulatory system.
- Marisa Weiss, M.D. All fluid in your body needs to circulate; that is, it needs to keep moving. Fresh blood comes to your arm through the arteries, and the old blood leaves through the veins. In addition, some fluid comes out of the very tiny arteries and nourishes your tissues and brings a fluid with immune cells that help protect your tissues from infection. This fluid is lymph. The lymph fluid also needs to keep moving. After it leaves your tissues, it moves out of the area through the lymphatic channels. Lymph nodes are filters along the lymphatic channels. When lymph nodes are removed, the fluid drainage pipes can be disrupted. The fluid may not flow through them as easily as it did before surgery. This is how the fluid can get backed up.
- Sara Cohen, OTR/L, CLT-LANA The lymph system has a deeper system and a superficial system that's close to the surface of the skin, and one of the goals of treatment is to stimulate the superficial vessels to help move the fluid out of the area that's swollen.
On Wednesday, July 17, 2002, our Ask-the-Expert Online Conference was called Arm Lymphedema Prevention and Management. Sara Cohen, O.T.R./L., C.L.T.-L.A.N.A., Saska Thiadens, R.N. and Marisa Weiss, M.D. answered your questions about preventing and managing arm lymphedema.
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