Tag Archives: lymph nodes

My garments are in!

After three weeks of wrapping, my garments have come in: I’m now the proud owner of a brand-new Mediven stocking and a Solaris Tribute nighttime garment. Wahoo!

I’ve had both open- and closed-toe stockings before but I didn’t find either to be particularly comfortable, so I decided to go a different route with my new one. I’ve never had a stocking quite like this – I love my new Mediven! My new Medi is closed-toe but each toe is separately enclosed, with sort of a “toe socks” aesthetic. Having each toe separate gives it that much more individual compression, which I need because my toes and forefoot are my most affected areas. It’s super comfy, too – the team at GBMC and Caring Touch Medical did a great job measuring me for a custom fit. I’m looking forward to ordering these in a couple more colors when I go for my follow up appointment next week.

For nightwear, I got a Solaris Tribute. I’ve had a Tribute before and so I’m already pretty used to it, although my new one is a little different: it’s colorful! Solaris offers the Tribute in a small variety of colors now – a simple pleasure for us lymphies – and I got mine in a pretty shade of navy blue with two different sleeves: one jade green, and one red. I also got a set of toecaps to wear at nighttime for some extra compression. So far so good although I’ve been taking it off in the middle of the night, in my sleep. Not quite sure what that’s about but I think after a few more nights of wearing it I’ll get adjusted to the new fit!

I’ve been really consistent about wearing my stockings these past couple months, and getting new ones is strengthening my resolve to continue doing so. If I am able to wear my garment and have my leg wrapped during summer – the most difficult season for lymphies – then I can keep it up during the fall and winter!

What types of garments do you have? Which ones do you prefer?

All Wrapped Up

The other day I began a four week process in which my affected limb is wrapped in a series of bandages and foam padding to create compression. The goal is to get my leg down to the smallest size possible so that I can be measured for a new compression garment. The smaller the measurements, the tighter the garment will be – and the better the swelling will be managed!

So what exactly does wrapping entail?

First, the lymphedema therapist took out a large sheet of foam padding. The foam, when wrapped under tight bandaging, helps to contour and compress the leg. She measured alongside my leg and foot and cut out a couple different pieces: an arch pad, a front piece, and a back piece. (These will be used later.)

Next, she wrapped my leg in Artiflex cotton batting, like the kind you’d use to keep a cast in place. This went from the bottom of my toes all the way to my knee.

After that, she put the foam pieces on, wrapping them loosely in place with a regular Ace bandage.

After that, she individually wrapped the first four toes of my foot.

Next come the bandages! The lymphedema therapist used four rolls of Rosidal short stretch bandages – two 8 centimeter and two 10 centimeter rolls. She wrapped my leg with tighter compression at the bottom, the gradient compression helping to move the lymph upwards.

The final product:

I go to the clinic almost every day for four weeks, and each day we do the same: unwrap, perform manual lymph drainage, re-wrap. It’s only been three days but I’ve already noticed a difference when the bandages are removed – a lot of the swelling is down and I’m really excited to get fitted for my new garment. Wrapping is a worthwhile process to undertake, something I’d definitely recommend talking to a lymphedema specialist about!

What are your experiences with wrapping? Have you found it to be helpful?

Yesterday’s Overdue Appointment

I feel so fortunate to live near a lymphedema clinic, especially one as personable and competent as GBMC’s. My appointment yesterday went really well: they said that I had done a good job maintaining my swelling since my last visit three years ago, and that made me feel a lot more confident about my ability to take care of myself. I truly have made a daily effort to wear my garments and to have that recognized is super encouraging!

I met with a nurse, a doctor, and a lymphedema therapist, and between the four of us it was decided I’d start a physical therapy program where, in addition to the physical therapy itself, the therapist will be wrapping my leg in tight bandages each day for about a month. This process (“wrapping”) will allow for smaller measurements and a garment with tighter, more effective compression.

I’m excited to get this started; I did wrapping three years ago but am definitely overdue and in need of another new garment. I start sometime next week – hooray! Although I’m not relishing the idea of wearing layers of bandages in 90+ degree weather, I know it’s going to help me a lot in the long run.

What’s your experience with physical therapy and wrapping?

Self Care for Lymphedema Management – Get To Know Your Neck!

As a Certified Decongestive Therapist trained in manual lymphatic drainage, and a Registered Physiotherapist, I’m often asked by my lymphedema patients why I am so focused on the neck during my lymphatic massage treatments, even when the Lymphedema is presenting in an arm or leg.   The reason is simple:  there is a huge collection of cervical lymph nodes located in the neck region that can be capitalized upon to stimulate the lymphatic system to improve its overall flow.  The number of lymph nodes located in the neck region is approximately 300, far greater than in the armpit, groin, or abdomen, and may represent over half of the total number of lymph nodes in the body. This is not surprising given that it is at the neck where lymphatic fluid rejoins the cardiovascular system via the subclavian vein.

The neck represents a great target for improving overall lymphatic flow, not just because of the total number of lymph nodes present, but also because of the infrequency of functional limitations in the lymphatics at the neck.  Patients with Secondary Lymphedema which arises due to radiation to, or removal of, lymph nodes in the armpit region from their breast cancer treatment (for example), typically retain full functional capacity at the neck.  Similarly, in the case of Primary Lymphedema, the nodes at the neck typically retain sufficient functional capacity as well.

In manual lymphatic drainage massage, we always begin the massage series with several strokes specific to the neck region, to draw lymphatic fluid from other regions of the body, and send this fluid back into the cardiovascular system.  Such stimulation contributes considerably to the results we see with manual lymphatic drainage.  We encourage all of our Lymphedema patients, be they Primary or Secondary, to incorporate self-massage of the neck into their daily self-management strategies.  The entire series of neck strokes should only take about 5 minutes to perform, and is easy and comfortable to do.  A certified Lymphedema therapist would be able to show you the appropriate technique. You can also learn more by visiting our website where we have posted a short video demonstrating lymphatic drainage self-massage at the neck.  Best of luck!

Lindsay Davey, PT, MScPT, MSc, CAFCI, CDT
Toronto Physiotherapy

Lymphedema vs Edema

When I was in treatment for my eating disorder, the doctors warned me that I may experience edema as a side effect of the “re-feeding process,” meaning I may have some swelling in addition to the chronic swelling I already had with lymphedema. I was scared, because I thought it would permanently affect my leg – both of them, even – and make things worse. I didn’t realize at the time that edema and lymphedema aren’t necessarily overlapping conditions.

So what exactly delineates the two? Both lymphedema and edema are conditions that involve swelling, but they have different causes and therefore need different treatment. Check out this chart from LymphNotes.com:

          EDEMA     LYMPHEDEMA
Edema is the body’s normal response to an injury such as a sprain. As healing progresses, the excess fluid leaves the area and the swelling goes down. Lymphedema is condition that occurs when the lymphatic system is impaired to the extent that the amount of lymphatic fluid within a given area exceeds the capacity of the lymphatic transport system to remove it.
Edema is usually caused by excess tissue fluid that had not yet returned to the circulatory system. Lymphedema is swelling caused by excess protein-rich lymph trapped within the tissues.
Edema due to an injury, such as bumping into something, is caused by additional tissue fluid coming into the area to help with healing. Lymphedema  impaired tissues respond to injury with slow healing and/or a potentially serious infection.
Edema is also caused by circulatory system problems, such as chronic venous insufficiency, and this swelling usually occurs in the lower areas of the body. Lymphedema  is caused by damage to the lymphatic system and this swelling occurs near the affected area.
Edema swelling does not leave a mark when a finger is pressed into it. This is known as nonpitting edema. Lymphedema  swelling leaves a mark when a finger is pressed into it. This is known as pitting edema. This occurs only in the early stages of lymphedema.
Edema due to some causes can be relieved with diuretics. Lymphedema is harmed, not helped, by treatment with diuretics.

Chart above is credited to LymphNotes.com.