The first topic covered the components of Complete Decongestive Therapy (CDT), which is the most common non-invasive lymphedema treatment. CDT is the first thing that the National Lymphedema Network recommends. Overall, a lot of people found CDT to be effective but difficult. Nicole Stout noted that using compression garments and taking good care of yourself can reduce the number of sessions needed. “CDT has many components and requires intervention from a skilled therapist. After treatment, patients keep up with CDT on their own,” she added. Complete Decongestive Therapy has four components: Manual Lymph Drainage (MLD), compression bandaging, skin care and exercise.

Manual Lymph Drainage is a big part of lymphedema care. It is very time consuming, but can make patients feel a lot better. Depending on the patient, some do their MLD routinely, others use pumps at home, and some don’t practice MLD at all. Using compression garments and pump therapy are very beneficial, as well as practicing deep breathing to help stimulate the lymphatic system. Check out this video on manual lymphatic drainage for more information. Remember to stay hydrated before and after MLD to avoid feeling sick or tired.

There are a lot of compression options you can use to manage lymphedema, including elastic/day garments, bandages and bandage alternatives. One #LymphChat participant shared that a custom Juzo armsleeve and glove work well during the day, and wears the JoViPak armsleeve at night. Compression armsleeves help to prevent and treat lymphedema in the arm, but brands like Juzo, JoViPak, and Solaris offer compression garments to treat lymphedema in other body parts – including the legs and trunk area. lebontadipio offers tons of brands, colors and compression levels to choose from so you can find the perfect garment for you.

Skin care is also extremely important for Complete Decongestive Therapy and preventing infections. You can also wear silver liners, or compression stockings that are made with silver to fight off bacteria and prevent infections. During the day, you can use Medi Day Gel to moisturize your skin. Apply it before you put on your compression garment to make it easier to don. Don’t worry, this gel will not damage your garments like other lotions may. Some moisturizers break down the material due to the lycra in the garment and reduce its effectiveness and breathability, so make sure you use a garment-friendly gel! Medi Day Gel quickly absorbs into your skin to avoid sticky or greasy residue. At night, you can sooth your legs with Medi Night Creme. It also helps to treat venous insufficiency.

The last component of CDT is exercising, which helps to stimulate the lymphatic system. Lymphedema patient, Amy Santiago says that opening up the Lymph channels (neck/collar, armpits, stomach and breathing) help her before starting cardio or training. One way to open up these channels before exercising is with Manual Lymphatic Drainage (MLD). Swimming, yoga and snowshoeing are all great exercises for lymphedema patients.

Towards the end of the #LymphChat, participants discussed surgical treatments for Lymphedema. According to Dr. Jay Granzow, Suction-Assisted Protein Lipectomy (SAPL), Lymphatic Venous Anastomosis (LVA) and Vascularized Lymph Node Transfer (VLNT) are the most effective lymphedema surgeries. SAPL greatly reduces excess volume in chronic lymphedema patients, and is generally performed in later cases when solids accumulate in the leg or arm. Frequently after SAPL, the use of a compression garment allows you to significantly cut down on CDT, or eliminates the need for it altogether. Other patients, usually in the earlier stages of lymphedema, undergo LVA and VLNT due to excess fluid buildup. You can also combine VLNT and LVA after healing from SAPL to treat solid and fluid components. Compression therapy after these procedures are vital.

Dr. Jay Granzow believes that depending on the patient, each type of surgery can be a success, based on the stage they’re in. As Nicole pointed out, “not just any surgeon can perform these surgeries. Special expertise is needed.” There is a limited number of surgeons that are trained in lymphedema surgery. Although most of Dr. Jay Granzow’s patients have had their surgeries covered by insurance, it depends on your insurance plan. To determine if you qualify for surgery, see a surgeon that specializes in these treatments for an evaluation, as well as a lymphedema therapist to figure out what the best treatment options are for you. Click here for more information on SAPL, VLNT and LVA procedures.

On the first Tuesday of every month, the National Lymphedema Network will continue to host a Twitter Chat, so make sure you follow them on Twitter at @lymphnet and include #lymphchat in your tweets to participate! If you think of any other questions that you would like to ask, email [email protected]. The next Twitter Chat will be on Tuesday, May 5th, 2015 about lymphedema and exercise. Don’t miss it!

Additional Resources

• Lymphedema Products
• Find Treatment Options In Your Area
• NLN Educational Videos
• Full transcript of the first #LymphChat
• Mark Goldstein’s Inspirational Story
• The 25th World Congress of Lymphology Conference

Chat with us on Twitter! #LymphChat

lebontadipio | Nicole Stout | Dr. Jay Granzow | National Lymphedema Network

Britta Vander Linden writes an inspiring blog about her experience with lymphedema. She was diagnosed with primary lymphedema when she was 23 years old. Since then, she has juggled a demanding job and keeping up with her blog, Lymphedema Diary.com, in her spare time. She was inspired to start a blog to connect with others struggling with the same illness. Her blog serves as a network for her and her readers to support and comfort one another. “I felt it was time to share my experiences with others in an effort to try to make their life easier. I hoped to make Lymphedema Diary the resource I wish I had when I was first diagnosed.” Each month, thousands of readers spanning across over 100 countries read her blog. Check out her inspiring story and get tips on how to manage lymphedema.

Before she started Lymphedema Diary, Britta turned to local support groups for help, but they didn’t regularly meet and were located at inconvenient places. A lot of them were made up of breast cancer survivors, so she had a hard time connecting with them because she didn’t feel like they were going through the same thing. Once she got involved on social media, she was able to connect with people all around the world to share tips on anything from finding good therapists to lymphedema management.

Lymphedema Diary is full of compression tips in posts like, “A Leg Up: Compression Stocking Tips–What the Doctors Don’t Tell You.” Those with lymphedema use compression garments every day to manage their condition. Britta says, “No matter the difference in type or severity of lymphedema from one person to another, all of us are struggling to deal with compression garments.  I think that’s why the series has been so popular.”

Britta has been a customer with us because we have all “Four P’s,” or what she refers to as the four key things every stocking dealer should have: people, price, perks and policies. Juzo Soft Pantyhose in 30-40mmHg is her go-to compression garment because of how soft the fabric is, and because they don’t look like compression tights. According to her, the fabric is very susceptible to snags, however. Britta also suggests the Juzo Dynamic Pantyhose for exercising because they are much more durable. The downside is that they aren’t as fashion-friendly as the Juzo Soft pantyhose, and the thickness of the fabric makes it harder to get the stockings off.

Some other things that Britta has found that help her to manage her lymphedema are regular exercise, getting a healthy amount of sleep, eating a low-sodium diet and staying hydrated. “If I don’t keep up on any one of these habits, I feel it in my legs. For exercise, I prefer swimming, yoga and anything that gets me lifting the legs up and down. In the winter, I enjoy snowshoeing.” She developed a few techniques that help keep her legs stay happy and healthy during a long day at work.

Check out Britta snowshoeing! This is one of her favorite ways to keep lymph fluid flowing in the winter.

When she was first diagnosed, she underwent six weeks of complete decongestive therapy (CDT). Although she is happy that she did this therapy on both of her legs, the process was exhausting. Between waking up early in the morning and the long commute before work, it wasn’t a good long-term solution. Overall, it was beneficial because she learned a lot about lymphedema care. One thing she doesn’t believe helped her was the acupuncture treatments she tried at about the same time.

There are hundreds of millions of people around the world who are suffering from lymphedema, but there is no cure. LE&RN has done an amazing job over the years in the advocacy, research and education of this condition. You can become a member for only $5 a month and help support the cause year-round. March is a very important month for spreading the word about lymphedema. Many doctors and patients do not know what symptoms to look for in the early stages of lymphedema. LE&RN is working to change this through education. Many people are not aware that the most common cause of lymphedema is cancer treatment. The removal of lymph nodes significantly increases your risk, but there are a couple of things that you can do after cancer treatment that can reduce your risk of lymphedema.

Thanks for reading!

Flat knit fabrics provide the highest containment. Flat knit is just as it sounds – a flat piece of fabric that is sewn together with a seam, unlike the circular knit compression garments seen in most stores, which have no seam.  This is the fabric that custom compression stockings and armsleeves are made from.

Custom flat knit stockings are typically prescribed for individuals with large or unusual limb shapes that can’t fit into the ready-to-wear sizes available online or in stores. Custom compression garments are also prescribed for those who have acute or chronic edema or lymphedema.  For upper extremity lymphedema, we do offer one non-custom option in this flat knit fabric – the Medi Mondi Esprit armsleeve. This armsleeve provides the best arm containment and is available in 5 sizes and two lengths.

Another option for high containment, is alternative compression wraps.  These are strips of non-elastic fabric that wrap around your leg, held in place by velcro.  On some brands, like the Juxta line from CircAid, the compression level can be adjusted.  Compression wraps provide dynamic compression, which means they are only working when your muscles are pushing back against the fabric.  This allows them to be worn round-the-clock if necessary.  Other examples of compression wraps are ReadyWrap by Solaris, FarrowWrap, and CompreFit by Biacare.

However, for most people, a ready-to-wear circular knit compression stocking (the type you would buy from us) will provide all the compression and containment necessary to treat your condition.   In the circular knits, there are options that provide a high level of containment.  They are Juzo Dynamic, Sigvaris 500 Rubber Series, and Mediven Forte. Talk to your doctor to see if one of these options are right for you.