Shopping on line can be easy, simple and save you lots of money. It can also take a lot of your time, frustrate you, and result in unwanted purchases. Now the same can be said for regular high street shopping, but with the vast opportunity presented by the Internet it will pay you to spend a few minutes reading this and understanding how to better optimize your Lymphedema shopping experience:

1. Compare - without doubt the biggest advantage that the Lymphedema offers shoppers today is the ability to compare thousands of Lymphedema at a time. This is a great thing, but not necessarily all the time! Too much can be daunting at times so take advantage of the great comparison sites and where possible let them do the hard work for you.

2. Research - if it has been said it will be on the internet. Ignorance is no longer a justifiable reason for buying the wrong thing. Take the time to research in detail everything that you could possible want to know about

3. Testimonials - don't know anybody that has bought a Lymphedema? Wrong! If the Lymphedema is good the internet will let you know. Use the Internet as a friend and get testimonials before you buy.

4. Questions - Got a question about Lymphedema then search the Forums, FAQ's, Blogs etc. Don't be afraid to ask .....

5. Reputation - Never heard of the company selling Lymphedema? Don't worry, no reason why you should know every company in the world, but you know someone that does! Use the internet to find out what people are saying about Lymphedema and build up a picture of their reputation for sales, returns, customer service, delivery etc.

6. Returns - still worried that even after all of the above your Lymphedema wont be what you want? Check out the returns policy. There is so much competition now that someone, somewhere is bound to offer the terms that you are comfortable with.

7. Feedback - happy with your Lymphedema then let people know, after all you are depending on others people input in your buying decision, so why not give a little back.

8. Security - check for the yellow padlock on the Lymphedema site before you buy, and the s after http:/ /i.e. https:// = a secure site

9. Contact - got a question about Lymphedema, or want to leave a comment then check out the sites contact page. Reputable companies have them and respond.

10. Payment - ready to pay for your Lymphedema, then use your credit card or PayPal! Be aware of companies that don't accept them, there may be genuine reasons but given the huge amount of choice you have when buying online there is no reason at all not to buy via credit card or PayPal.

Lymphedema, Spelling_differences#Simplification_of_ae_.28.C3.A6.29_and_oe_.28.C5.93.29 lymphoedema, also known as lymphatic obstruction, is a condition of localized fluid retention caused by a compromised lymphatic system. The lymphatic system (often referred to as the body's "second" circulatory system) collects and filters the interstitial fluid of the body. Lymphedema has been barely recognized as being a serious health problem; however, this is slowly changing due to education and awareness. The danger with lymphedema comes from the constant risk of developing an uncontrolled infection in the affected limb. Still, physicians and medical staff who practice in fields where this disease is uncommon may fail to correctly diagnose the condition due to the apparent lack of information regarding this disease.

Causes Lymphedema (also see Elephantiasis) may be inherited (primary) or caused by injury to the lymphatic vessels (secondary). It is most frequently seen after lymph node dissection, surgery and/or radiation therapy, in which damage to the lymphatic system is caused during the treatment of cancer, most notably breast cancer. In many cancer patients this condition does not develop until months or even years after their therapy has concluded. Lymphedema may also be associated with accidents or certain diseases or problems that may inhibit the lymphatic system from functioning properly. In tropical areas of the world, a common cause of secondary lymphedema is filariasis, a parasitic infection.

While the exact cause of primary lymphedema is still unknown, it generally occurs due to poorly-developed or missing lymph nodes and/or channels in the body. Lymphedema may be present at birth, develop at the onset of puberty (praecox), or not become apparent for many years into adulthood (tarda). Some cases of lymphedema may be associated with other vascular abnormalities. In the lower extremity it will be unilateral or bilateral. If it is bilateral, one leg may be worse than the other.

Lymphedema affects both men and women. In women, it is most prevalent in the upper limbs after breast cancer surgery and lymph node dissection, occurring in the arm on the side of the body in which the surgery is performed. It may also occur in the lower limbs or groin after surgery for colon, ovarian or uterine cancer in which removal of lymph nodes is required. In men, lower-limb primary lymphedema is most common, occurring in one or both legs. Surgery and/or treatment for prostate, colon and testicular cancers may result in secondary lymphedema, particularly where lymph nodes have been removed or damaged.

The onset of secondary lymphedema in patients who have had cancer surgery has also been linked to aircraft flight (likely due to decreased cabin pressure). For breast cancer survivors, wearing a prescribed and properly-fitted low-compression sleeve and gauntlet may help decrease swelling during flight.

Some cases of lower-limb lymphedema have been associated with the use of Tamoxifen, due to the blood clots and deep vein thrombosis (DVT) that can be caused by this medication.

Symptoms Symptoms may include severe fatigue (physical), a heavy Inflammation limb or localized fluid accumulation in other body areas, including the head or neck, discoloration of the skin overlying the lymphedema, and eventually deformity (elephantiasis).

Lymphedema should not be confused with edema arising from venous insufficiency, which is not lymphedema. However, untreated venous insufficiency can progress into a combined venous/lymphatic disorder which is treated the same way as lymphedema (see #Treatment below).

Treatment The most common and accepted treatments of choice for lymphedema are Sequential Gradient Pump Therapy and Complete Decongestive Therapy (CDT). CDT consists of manual lymphatic drainage (MLD), short stretch compression bandage, therapeutic exercise, and skin care. MLD was pioneered by Dr. Emil Vodder in the 1930s for the treatment of chronic sinusitis and other immune disorders, and is now recognized along with pneumatic pumps, and compression sleeves, as a primary tool in lymphedema management. Therapists can today receive certification through special classes conducted by various organizations specializing in MLD.

Sequential Gradient Pump Therapy has been utilized for over 30 years throughout the world. Lympha-Press helped pioneer and perfect this technology with by utilizing a 12 chambered pneumatic sleeve with overlapping cells, to gently move the lymph fluid. There are several other manufacturers of these devices such as Bio Compression Systems, and Wright Linear. All of these devices are recognized treatments and approved by Medicare and most insurance plans in the USA. Patients may often receive treatment on a pump for 10-15 minutes before an MLD session to help break up fibrotic (hard) tissue. By softening or breaking up the fibrosis, the MLD Therapist can be even more effective with the given treatment. After completion of the appropriate number of MLD sessions, some patients will benefit from a home use of a sequential pump. A recent Stanford University medical studyshowed that patients receiving the combined modalities of MLD/CDT and pneumatic pumping had a greater overall reduction in limb volume than patients receiving only MLD/CDT.

The MLD component of treatment consists of gentle, rhythmic massaging of the skin to stimulate the flow of lymph and its return to the blood circulation system. In the blood’s passage through the kidneys, the excess fluid is filtered out and eliminated from the body through urination. The treatment is very comfortable and nonaggressive. A typical session will involve drainage of the neck, trunk, and involved extremity (in that order), and lasts approximately 40 to 60 minutes, depending on the severity and extent of the lymphedema.

Compression bandaging, also called wrapping, is the application of several layers of padding and short-stretch bandages to the involved areas. Short-stretch bandages are preferred over long-stretch bandages (such as those normally used to treat sprains), as the long-stretch bandages cannot produce the higher tension necessary to safely reduce Lymphedema and may in fact end up producing a tourniquet effect. During activity, whether exercise or daily activities, the short-stretch bandages enhance the pumping action of the lymph vessels by providing increased resistance for them to push against. This encourages lymphatic flow and helps to soften fluid-swollen areas.

In addition, specific therapeutic exercise while compression bandaging is worn is a valuable part of therapy, not only because it aids in the elimination of excess fluid, but also because some patients with chronic lymphedema or large, swollen areas will have poor strength or range of movement. These patients benefit from exercise prescribed specifically for them by their therapist to help improve their function and comfort.

Skin care is an important component of CDT. People with lymphedema or who have had lymph nodes removed are at a higher risk for infections of the affected areas, and so need to be taught a specific regimen of thorough but gentle cleansing followed by moisturizing in order to keep the skin in the best health possible. Teaching higher risk sufferers about the signs and symptoms of infections is also important, since awareness is the key to early identification and treatment. Untreated infections can further damage an already impaired lymphatic system and lead to more severe lymphedema and skin ulcers.

Initially, CDT involves frequent visits to a certified therapist with a doctor's prescription. Once the lymphedema is reduced, increased patient participation is required for ongoing care, along with the use of compression garments to further reduce the swelling.

Compression pumps are often used in the treatment of lymphedema, but special care needs to be taken to ensure that the involved trunk quadrant is properly treated with manual lymphatic drainage before the application of a compression pump. If adequate treatment of the trunk is not carried out beforehand, the edema may be pushed into the upper portion of the arm or leg, or into the genitals. If a patient's lymphedema worsens during a course of compression pump therapy, reassessment for adequate trunk MLD is necessary. However, newer compression pump garments provide compression well into the trunk and/or abdomen and groin areas. Although very beneficial, many patients find it inconvenient or expensive to attend regular MLD treatment sessions. A 2002 Stanford University article suggests that for patients with upper-limb lymphedema, those who received both MLD and compression pump therapy experienced greater overall limb reduction.

Even after MLD, the patient may only be bandaging or receiving compression up to the axilla (arm pita area) or groin. Unless the patient is monitored during post MLD self bandaging, there is a possibility of the lymph fluid pooling in the truncal regions. For this reason, reassessment for adequate trunk MLD may need to be re-evaluated as necessary.

A new adjunct treatment is being taught to therapists utilizing a special type of tape called Kinesio Taping. It is used to help soften edemas.

Surgical techniques

Surgical techniques for correcting lymphedema may be excisional or physiological. Excisional techniques include:

Physiological techniques include:



Complications When the lymphatic impairment becomes so great that the lymph fluid exceeds the lymphatic system's ability to transport it, an abnormal amount of protein-rich fluid collects in the tissues of the affected area. Left untreated, this stagnant, protein-rich fluid causes tissue channels to increase in size and number, reducing the availability of oxygen. This interferes with wound healing and provides a rich culture medium for bacterial growth that can result in infections: cellulitis, lymphangitis, lymphadenitis, and in severe cases, skin ulcers. It is vital for lymphedema patients to be aware of the symptoms of infection and to seek treatment at the first signs, since recurrent infections, in addition to their inherent danger, further damage the lymphatic system and set up a vicious circle.

Very rarely, in certain exceptionally severe cases, lymphedema untreated over many years can lead to a form of cancer known as Lymphangiosarcoma.

Since lymphedema is disfiguring, causes difficulties in daily living and can lead to lifestyle becoming severely limited, it may also result in psychological distress.

Staging and severity Whether primary or secondary, lymphedema develops in a number of stages, from mild to severe:









Lymphedema can also be categorized by its severity (usually referenced to a healthy extremity):











Diagnosis, assessment and monitoring The diagnosis or early detection of lymphedema is difficult. The first signs may be subjective observations such as "my arm feels heavy" or "I have difficulty these days getting rings on and off my fingers". These may be symptomatic of early stage of lymphoedema where accumulation of lymph is mild and not detectable by any difference in arm volume or circumference (see severity above). As lymphedema develops further then definitive diagnosis is commonly based upon an objective measurement of difference between the affected or at-risk limb at the opposite unaffected limb, e.g. in volume or circumference. Unfortunately, there is no generally accepted world-wide criterion of difference definitively diagnostic although a volume of difference of 200 ml between limbs or a 4 cm (at a single measurement site or set intervals along the limb) is often used. Recently the technique of bioimpedance measurement (a method that measures the amount of fluid in a limb) has been shown to have greater sensitivity than these existing methods and holds promise as a simple diagnostic and screening tool (see ). Impedance analysers specifically designed for this purpose are now commercially available.

Similarly assessment and monitoring of lymphedema progression or its response to treatment is usually based on the changes in volume, circumference or impedance over time.

Illustration Presented here is a case of unilateral hereditary lymphedema which had been present for 25 years without treatment:

Image:04 Jan 2003 (9).jpg|Comparison of normal and swollen limbImage:04 Jan 2003 (10).jpg|Size of swollen foot, toes underneathImage:04 Jan 2003 (11).jpg|Another view of lymphedemic footImage:04 Jan 2003 (12).jpg|Foot and leg (held vertically)

Presented here is a case of combined primary lymphedema and lipedema(Stage 3) before and after treatments:Below photos courtesy of Amy's Lymphedema Story

Image:Amyslegsfront.JPG|Stage 3 lymphedema front view before treatmentsImage:Amyslegsback.JPG|Stage 3 lymphedema back view before treatmentsImage:100_0587.JPG|Stage 3 lymphedema front view after treatments, 65 pounds lost in 14 daysImage:100_0583.JPG|Stage 3 lymphedema back view after treatments, 65 pounds lost in 14 days

Sources

External links General Links



Lymphedema Patient Websites

Lymphedema, Spelling_differences#Simplification_of_ae_.28.C3.A6.29_and_oe_.28.C5.93.29 lymphoedema, also known as lymphatic obstruction, is a condition of localized fluid retention caused by a compromised lymphatic system. The lymphatic system (often referred to as the body's "second" circulatory system) collects and filters the interstitial fluid of the body. Lymphedema has been barely recognized as being a serious health problem; however, this is slowly changing due to education and awareness. The danger with lymphedema comes from the constant risk of developing an uncontrolled infection in the affected limb. Still, physicians and medical staff who practice in fields where this disease is uncommon may fail to correctly diagnose the condition due to the apparent lack of information regarding this disease.

Causes Lymphedema (also see Elephantiasis) may be inherited (primary) or caused by injury to the lymphatic vessels (secondary). It is most frequently seen after lymph node dissection, surgery and/or radiation therapy, in which damage to the lymphatic system is caused during the treatment of cancer, most notably breast cancer. In many cancer patients this condition does not develop until months or even years after their therapy has concluded. Lymphedema may also be associated with accidents or certain diseases or problems that may inhibit the lymphatic system from functioning properly. In tropical areas of the world, a common cause of secondary lymphedema is filariasis, a parasitic infection.

While the exact cause of primary lymphedema is still unknown, it generally occurs due to poorly-developed or missing lymph nodes and/or channels in the body. Lymphedema may be present at birth, develop at the onset of puberty (praecox), or not become apparent for many years into adulthood (tarda). Some cases of lymphedema may be associated with other vascular abnormalities. In the lower extremity it will be unilateral or bilateral. If it is bilateral, one leg may be worse than the other.

Lymphedema affects both men and women. In women, it is most prevalent in the upper limbs after breast cancer surgery and lymph node dissection, occurring in the arm on the side of the body in which the surgery is performed. It may also occur in the lower limbs or groin after surgery for colon, ovarian or uterine cancer in which removal of lymph nodes is required. In men, lower-limb primary lymphedema is most common, occurring in one or both legs. Surgery and/or treatment for prostate, colon and testicular cancers may result in secondary lymphedema, particularly where lymph nodes have been removed or damaged.

The onset of secondary lymphedema in patients who have had cancer surgery has also been linked to aircraft flight (likely due to decreased cabin pressure). For breast cancer survivors, wearing a prescribed and properly-fitted low-compression sleeve and gauntlet may help decrease swelling during flight.

Some cases of lower-limb lymphedema have been associated with the use of Tamoxifen, due to the blood clots and deep vein thrombosis (DVT) that can be caused by this medication.

Symptoms Symptoms may include severe fatigue (physical), a heavy Inflammation limb or localized fluid accumulation in other body areas, including the head or neck, discoloration of the skin overlying the lymphedema, and eventually deformity (elephantiasis).

Lymphedema should not be confused with edema arising from venous insufficiency, which is not lymphedema. However, untreated venous insufficiency can progress into a combined venous/lymphatic disorder which is treated the same way as lymphedema (see #Treatment below).

Treatment The most common and accepted treatments of choice for lymphedema are Sequential Gradient Pump Therapy and Complete Decongestive Therapy (CDT). CDT consists of manual lymphatic drainage (MLD), short stretch compression bandage, therapeutic exercise, and skin care. MLD was pioneered by Dr. Emil Vodder in the 1930s for the treatment of chronic sinusitis and other immune disorders, and is now recognized along with pneumatic pumps, and compression sleeves, as a primary tool in lymphedema management. Therapists can today receive certification through special classes conducted by various organizations specializing in MLD.

Sequential Gradient Pump Therapy has been utilized for over 30 years throughout the world. Lympha-Press helped pioneer and perfect this technology with by utilizing a 12 chambered pneumatic sleeve with overlapping cells, to gently move the lymph fluid. There are several other manufacturers of these devices such as Bio Compression Systems, and Wright Linear. All of these devices are recognized treatments and approved by Medicare and most insurance plans in the USA. Patients may often receive treatment on a pump for 10-15 minutes before an MLD session to help break up fibrotic (hard) tissue. By softening or breaking up the fibrosis, the MLD Therapist can be even more effective with the given treatment. After completion of the appropriate number of MLD sessions, some patients will benefit from a home use of a sequential pump. A recent Stanford University medical studyshowed that patients receiving the combined modalities of MLD/CDT and pneumatic pumping had a greater overall reduction in limb volume than patients receiving only MLD/CDT.

The MLD component of treatment consists of gentle, rhythmic massaging of the skin to stimulate the flow of lymph and its return to the blood circulation system. In the blood’s passage through the kidneys, the excess fluid is filtered out and eliminated from the body through urination. The treatment is very comfortable and nonaggressive. A typical session will involve drainage of the neck, trunk, and involved extremity (in that order), and lasts approximately 40 to 60 minutes, depending on the severity and extent of the lymphedema.

Compression bandaging, also called wrapping, is the application of several layers of padding and short-stretch bandages to the involved areas. Short-stretch bandages are preferred over long-stretch bandages (such as those normally used to treat sprains), as the long-stretch bandages cannot produce the higher tension necessary to safely reduce Lymphedema and may in fact end up producing a tourniquet effect. During activity, whether exercise or daily activities, the short-stretch bandages enhance the pumping action of the lymph vessels by providing increased resistance for them to push against. This encourages lymphatic flow and helps to soften fluid-swollen areas.

In addition, specific therapeutic exercise while compression bandaging is worn is a valuable part of therapy, not only because it aids in the elimination of excess fluid, but also because some patients with chronic lymphedema or large, swollen areas will have poor strength or range of movement. These patients benefit from exercise prescribed specifically for them by their therapist to help improve their function and comfort.

Skin care is an important component of CDT. People with lymphedema or who have had lymph nodes removed are at a higher risk for infections of the affected areas, and so need to be taught a specific regimen of thorough but gentle cleansing followed by moisturizing in order to keep the skin in the best health possible. Teaching higher risk sufferers about the signs and symptoms of infections is also important, since awareness is the key to early identification and treatment. Untreated infections can further damage an already impaired lymphatic system and lead to more severe lymphedema and skin ulcers.

Initially, CDT involves frequent visits to a certified therapist with a doctor's prescription. Once the lymphedema is reduced, increased patient participation is required for ongoing care, along with the use of compression garments to further reduce the swelling.

Compression pumps are often used in the treatment of lymphedema, but special care needs to be taken to ensure that the involved trunk quadrant is properly treated with manual lymphatic drainage before the application of a compression pump. If adequate treatment of the trunk is not carried out beforehand, the edema may be pushed into the upper portion of the arm or leg, or into the genitals. If a patient's lymphedema worsens during a course of compression pump therapy, reassessment for adequate trunk MLD is necessary. However, newer compression pump garments provide compression well into the trunk and/or abdomen and groin areas. Although very beneficial, many patients find it inconvenient or expensive to attend regular MLD treatment sessions. A 2002 Stanford University article suggests that for patients with upper-limb lymphedema, those who received both MLD and compression pump therapy experienced greater overall limb reduction.

Even after MLD, the patient may only be bandaging or receiving compression up to the axilla (arm pita area) or groin. Unless the patient is monitored during post MLD self bandaging, there is a possibility of the lymph fluid pooling in the truncal regions. For this reason, reassessment for adequate trunk MLD may need to be re-evaluated as necessary.

A new adjunct treatment is being taught to therapists utilizing a special type of tape called Kinesio Taping. It is used to help soften edemas.

Surgical techniques

Surgical techniques for correcting lymphedema may be excisional or physiological. Excisional techniques include:

Physiological techniques include:



Complications When the lymphatic impairment becomes so great that the lymph fluid exceeds the lymphatic system's ability to transport it, an abnormal amount of protein-rich fluid collects in the tissues of the affected area. Left untreated, this stagnant, protein-rich fluid causes tissue channels to increase in size and number, reducing the availability of oxygen. This interferes with wound healing and provides a rich culture medium for bacterial growth that can result in infections: cellulitis, lymphangitis, lymphadenitis, and in severe cases, skin ulcers. It is vital for lymphedema patients to be aware of the symptoms of infection and to seek treatment at the first signs, since recurrent infections, in addition to their inherent danger, further damage the lymphatic system and set up a vicious circle.

Very rarely, in certain exceptionally severe cases, lymphedema untreated over many years can lead to a form of cancer known as Lymphangiosarcoma.

Since lymphedema is disfiguring, causes difficulties in daily living and can lead to lifestyle becoming severely limited, it may also result in psychological distress.

Staging and severity Whether primary or secondary, lymphedema develops in a number of stages, from mild to severe:









Lymphedema can also be categorized by its severity (usually referenced to a healthy extremity):











Diagnosis, assessment and monitoring The diagnosis or early detection of lymphedema is difficult. The first signs may be subjective observations such as "my arm feels heavy" or "I have difficulty these days getting rings on and off my fingers". These may be symptomatic of early stage of lymphoedema where accumulation of lymph is mild and not detectable by any difference in arm volume or circumference (see severity above). As lymphedema develops further then definitive diagnosis is commonly based upon an objective measurement of difference between the affected or at-risk limb at the opposite unaffected limb, e.g. in volume or circumference. Unfortunately, there is no generally accepted world-wide criterion of difference definitively diagnostic although a volume of difference of 200 ml between limbs or a 4 cm (at a single measurement site or set intervals along the limb) is often used. Recently the technique of bioimpedance measurement (a method that measures the amount of fluid in a limb) has been shown to have greater sensitivity than these existing methods and holds promise as a simple diagnostic and screening tool (see ). Impedance analysers specifically designed for this purpose are now commercially available.

Similarly assessment and monitoring of lymphedema progression or its response to treatment is usually based on the changes in volume, circumference or impedance over time.

Illustration Presented here is a case of unilateral hereditary lymphedema which had been present for 25 years without treatment:

Image:04 Jan 2003 (9).jpg|Comparison of normal and swollen limbImage:04 Jan 2003 (10).jpg|Size of swollen foot, toes underneathImage:04 Jan 2003 (11).jpg|Another view of lymphedemic footImage:04 Jan 2003 (12).jpg|Foot and leg (held vertically)

Presented here is a case of combined primary lymphedema and lipedema(Stage 3) before and after treatments:Below photos courtesy of Amy's Lymphedema Story

Image:Amyslegsfront.JPG|Stage 3 lymphedema front view before treatmentsImage:Amyslegsback.JPG|Stage 3 lymphedema back view before treatmentsImage:100_0587.JPG|Stage 3 lymphedema front view after treatments, 65 pounds lost in 14 daysImage:100_0583.JPG|Stage 3 lymphedema back view after treatments, 65 pounds lost in 14 days

Sources

External links General Links



Lymphedema Patient Websites



Lymphedema - Wikipedia, the free encyclopedia
Lymphedema, also spelled lymphoedema, also known as lymphatic obstruction, is a condition of localized fluid retention caused by a compromised lymphatic system.

UK Lymphedema Information: Lymphoedema - lymphoedema uk, lymphedema ...
Provides a basic description of the condition, treatments available, and a message board.

UK Lymphedema Information: Lymphoedema Treatments - lymphoedema uk ...
We are a UK-based support group for sufferers of primary and secondary lymphoedema. We provide information on lymphedema and lymphodema treatments.

Lymphedema
This information is intended mainly for use by doctors and other health care professionals. If you have questions about this topic, you can ask your doctor, or call the Cancer ...

Definition: lymphoedema from Online Medical Dictionary
lymphedema -->

Arm Lymphedema
lymphedema after breast cancer treatment ... Lymphedema (pronounced LIMF-eh-DEE-ma) is a side effect that can begin during or after breast cancer treatment.

Lymphedema - MayoClinic.com
Lymphedema b Comprehensive overview covers symptoms, causes, treatment of this condition associated with limb swelling.

eMedicine - Lymphedema : Article by Don R Revis, Jr
In the United States, the highest incidence of lymphedema is observed following breast cancer surgery, particularly amon

The National Lymphedema Network -
Non-profit provides education and guidance on the prevention and management of this condition. Headquartered in Oakland, California.

Lymphedema
Lymphedema . Academy of Lymphatic Studies-Vodder. American Lymphedema Institute - promotes public awareness of lymphedema and its treatment. British Lymphology Society

 

Lymphedema



 
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