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"Complete Decongestive Therapy CDT - Phase 2  Manual Lymphatic Drainage for Maintenance"

Lymphedema Management

Improving  the lives of people with Lymphedema, Edema, lipedema & CVI

Treatment for Primary & Secondary Lymphedema, Edemas,Chronic Venous Insufficiency edemas, and Lipedema.

Lymphedema Therapy for the treatment of swelling from breast cancer surgery, or any other cancer surgery of the Upper or Lower extremity 


Lymphedema is the swelling of the soft tissue caused by a build-up of lymph fluid (proteins and water). Depending on the type of surgery and other cancer treatments,  it is possible for lymphedema to happen in the arm, hand, breast, trunk, leg, or abdomen. if left untreated the high protein content of this fluid can cause additional problems such a fibrotic tissue or hardening of the tissue and infections.

Lymphedema is a long-term (chronic) condition, can't be cured, but it can usually be well controlled. Patients need to know how to reduce their chances of getting it or managing it in the early stages. Patients need to know how to reduce their chances of getting it or know the ways to prevent it or manage the early stages. 

Primary Lymphedema or congenital is the damage to the lymph vessels and is present at birth. It occurs in the lower extremities.     

Some patients who have had lymph nodes removed or damaged nodes for radiation, because of cancer treatment/surgery, (Secondary lymphedema) place them at risk for lymphedema. whether the nodes were removed or damaged from the radiation the risk of getting lymphedema is slight, especially after the first 2 years after treatment.   

Manual Lymphatic Drainage is an effective treatment that uses slow, rhythmic strokes that help the body increase lymphatic circulation and decrease excess fluid (edema), helping to move fluid from an area where the lymphatic system may be compromised, such as following lymph node dissection or radiation treatment for cancer, to an area with healthy lymphatics. Certified Lymphedema therapists are skilled at doing this work right

Symptoms of lymphedema

The most common symptom of lymphoedema is swelling

  • You have a feeling of fullness or heaviness 
  • Your skin feels tight 
  • Your hand, wrist, foot, or ankle is less flexible 
  • Your clothes feel tighter in one specific area
  • Your ring, watch, bracelet, or shoe feels tighter some people also feel heaviness, tension, or aching in the involved area. 

Symptoms can appear any time after cancer treatment, days, months, or even years following cancer treatment. If you've recently had cancer surgery involving your lymph nodes - your doctor may diagnose lymphedema based on your signs and symptoms.

If you notice any of these symptoms, please let your doctor know. You may benefit from a referral to a lymphedema therapist. 

Lymphedema Treatment


The "gold standard" of treatment for lymphedema is Complete Decongestive Therapy.  There are two-phase: Phase 1  and Phase 2.  Our goal is to reduce the swelling and maintain the reduction, that is, to bring the lymphedema back to stage 1 or latency. 

Phase 1 - Intensive Phase

This will consist of daily treatments for 2-4 weeks to get the limb swelling back to its normal or closest to normal size with everyday bandages on it. This will include skin and nail care, MLD, bandaging, and exercises. Usually, you do this phase through your oncology team care, and most insurances cover the minimum daily treatments and garments.  Most patients realize that what the insurance covers is not enough to keep the swelling reduction in some cases.

Phase 2- Manual Lymphatic Drainage for Maintenance

This is the phase I offer my services. 

Once the swelling of your limb has decreased, it is essential to continue your care to maintain the reduction of swelling. Phase 2 is an ongoing part of CDT in which the patient assumes the responsibility of maintaining and improving the treatment results achieved in Phase 1 through  Manual Lymph Drainage (MLD) - either self or provided by a Certified Lymphedema Therapist. 

What I offer in this Phase 2 Lymphatic Drainage for Maintenance:

  • Advanced Manual Lymph Drainage (MLD) to decongest the area or keep reduction.
  • Advice on Compression garments (if you need it)  - wearing the right and good quality compression garment helps you keep swelling from returning.
  • Exercise Advice- This includes doing specific exercises to do to help push fluid up and out of your limb.
  • Skin Care advice - The purpose is to keep skin moisturized to avoid cracking. 

Stages of Lymphedema

  1. STAGE 0 (Non-Visible or Latency Stage)
    Lymph fluid transport is already impaired during this stage, but no physical effects are apparent yet. It can take months or even years before any symptoms appear.
  2. Stage 1 (Mild or Spontaneously Reversible Stage)
    The arm, leg, hand, foot, or other area looks slightly swollen as lymph fluid builds up, but elevation or compression of the affected arm or leg will help reduce or even reverse it. Pitting or sinking of the skin in the affected area may occur.
  3. Stage 2 (Moderate or Spontaneously Irreversible Stage)
    Swelling and dermal fibrosis (uncontrolled formation of scar tissue) continue to develop. The swelling is managed with the daily wearing of compression garments, both during the day and at night. Prolonged non-surgical treatments may provide relief from symptoms but will usually not be as effective as surgical procedures.
  4. Stage 3 (Severe or Lymphostatic Elephantiasis Stage)
    The affected limb becomes large and misshapen, and the hardened skin takes on a leathery, wrinkled appearance. Lymph fluid may leak from breaks or folds in the skin and should be kept clean and dry to avoid infection. The continued fibrosis also causes the muscle and fat to solidify, making it very difficult to move the limbs. 

Contact me if you need my service or even an advice, I will be happy to guide you to your best wellness path.

Pictures courtesy of Lymphedema Management book and LERN

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