Tag Archives: mld

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?

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

Happy New Year!


Photo from American Tailgaters Association

Happy New Year, lymphies! I got a feeling that this year will bring on a lot of changes – good changes – and I can only hope you all are feeling similar positive vibes.

One of my resolutions for 2012 is to keep up with my MLD and wear my compression garments more regularly. I’ve been so, so bad about it recently (well, a little longer than recently) and I know better than that. You all have taught me, through your emails and comments, the consequences of slacking off in lymphedema maintenance, and I’d be really dumb – and a little hypocritical – not to heed your words as well as my own preaching on the blog. So this year, I’m going to work extra hard at wearing my garments and practicing MLD on a daily basis. Scout’s honor!

I think the reason I’ve been so bad about maintaining my lymphedema is denial. I feel like if I ignore it or don’t wear my compression garments, it just isn’t there. Obviously, this isn’t true – just a day or two without my garments and my leg feels swollen and heavy in protest – but I stupidly cling to the denial because I’m still really insecure about my lymphedema. I’ve definitely gotten better about it, a little more accepting, but it’s something I struggle with a lot. Acknowledging my condition by actively taking care of it will probably assuage these fears, I think.

So – here’s to a new year, and a new resolve to take better care of our health!!

What are your resolutions for the new year? Do you have any that relate to your lymphedema?

My first massage, and why it didn’t help my leg

Yesterday afternoon my girlfriend and I got massages. I had never had one before, so the experience was a new one for me.

I told my massage therapist that I had lymphedema, a chronic swelling in my leg. She nodded knowingly, saying that she would give me a deep tissue massage to help get the fluid moving. Once we got into the room, however, she began to ask me a series of strange questions.

“Do you have any allergies?” she asked.

“No,” I replied, a little confused.

“How do you know?” she pressed. “Have you been tested?”

“Uhmm.. yes,” I lied. Why was she asking me about allergies? I was beginning to feel a little uncomfortable, and I couldn’t see why this was relevant at all to the massage.

“Which test?”

“Uhm.. well I haven’t had an allergy panel before, if that’s what you mean. But I’ve also never had any allergic reactions, so.. I’m pretty sure I’m not allergic to anything.”

She smiled tersely. “You should have a blood test done, because they can detect more than a regular allergy panel. You might find that your swelling is related to that.”

What?! 

I’m sorry, lady, but if I tell you I have a medical condition, I’m fairly certain that I know what’s up. This is no “allergic reaction” – it’s a diagnosed medical condition shared by millions of people! There’s no need to question what I already know about my body.

Once her strange interrogation was over, I undressed and got onto the massage table. The massage itself was lovely, and I drifted off to sleep several times during the hour and a half appointment.

When she got to my legs, she focused mostly on my thighs. When she did do my lower legs, she began pushing downward rather than up. Her technique was different from MLD, and I was a little concerned if this was hurting rather than helping my leg. At one point, she even put a hot compress across my legs – something that you should never do if you have lymphedema, as heat can make the swelling worse. I was beginning to think that she was not as familiar with lymphedema as she had made it seem before the appointment.

My post-massage verdict? I would definitely do it again, although I would be more vocal about my special needs concerning the lymphedema. That, or I just wouldn’t get it below my waist at all.

How about you? What has been your experiences with lymphedema and massages?