"Complete Decongestive Therapy CDT - Phase 2 Maintenance"

Lymphedema Management

Improving  the lives of people with Lymphedema

Lymphedema, Lipedema & CVI Treatment


What is lymphedema?

 Some patients who have had lymph nodes removed or damaged nodes for radiation, because of cancer treatment/surgery, 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.   

Lymphedema is a long-term (chronic) condition that causes swelling in the body's tissues. It 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. 

Lymphedema can affect any part of the body but usually develops in the arms or legs.  It develops when the lymphatic system does not work properly. The lymphatic system is a network of channels and glands throughout the body that helps fight infection and remove excess fluid.

In some people, lymphedema is primary or congenital.  In others, cancer treatments, such as surgery or radiotherapy to lymph nodes, can cause lymphoedema. For some people, lymphedema can be due to cancer-causing changes in the lymphatic system Lymphedema mostly affects the arms or legs. But it can develop in other body areas such as the: chest or back, abdomen (tummy area), genitals, head, neck or face, breast, armpit, pelvic area

Symptoms of lymphedema

The most common symptom of lymphoedema is swelling. Some people also feel heaviness, tension, or aching in the involved area. Symptoms can appear any time after 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. 


The Complete Decongestive Therapy consist of 4 component of treatment:

  1. Specialized Manual lymphatic drainage (MLD), performed with varying degrees of pressure to encourages the fluid to move from the congested area to a functioning area.
  2. Compression bandaging and/or garments of the involved areas
  3. Education on skin care and precautions
  4. Lymphatic exercises with compression

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. 

Treatment of Lymphedema 

COMPLETE DECONGESTIVE THERAPY (CDT)

The "gold standard" of treatment for lymphedema is Complete Decongestive Therapy.  There are two-phase: Phase 1  and Phase 2.

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.


Phase 2- 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 Maintenance:

  • Advanced Manual Lymph Drainage (MLD) to decongest.
  • Advice on Compression garments  - wearing the right 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.