Understanding Lymphedema

What is Lymphedema?

The lymphatic system is responsible for transporting protein-rich lymph fluid back into the circulatory system. When lymph vessels are unable to transport this fluid properly, a build-up occurs, resulting in swelling and the thickening of the skin.

Lymphedema is a highly under-diagnosed disease that affects the lymphatic vessels. Medical schools give little attention to the subject, and unfortunately patients with abnormal swelling (usually in an arm or leg) often have more information than their medical professionals.

Who is at risk?

Primary lymphedema is genetic, resulting from lymph nodes or vessels that either aren't adequately developed or are missing altogether. If you have had a mastectomy, lumpectomy, radiation treatment, lymph node removal, surgeries, infections, trauma or chronic venous insufficiency to your limbs, you may be at risk for developing secondary lymphedema.

How can I tell?

Indentations that do not immediately disappear after pressing down on your skin with your hand or fingers are a common indicator. A medical professional will evaluate and may diagnosis you by ordering an image test. Swelling is usually found in the legs and arms; however, it can affect any region of the body. People are often mislabeled as overweight, but the swelling has nothing to do with fat storage.

A medical professional will evaluate your disease based on the following stages:

Stage 0 (also called subclinical or latent):
Numbness, tingling or puffiness in a limb, with slight discomfort and heaviness. No visible changes to the arm, hand, or upper body. You can have stage 0 for months or years before obvious symptoms develop.

Stage 1 (mild):
A small, temporary dent (or pit) forms when you press the skin. This early-stage is considered reversible with treatment because the skin and tissues haven’t been permanently damaged. You will experience mild swelling in this stage, but elevating your limb may reduce swelling.

Stage 2 (moderate):
Not defined by size, but rather by the consistency of the tissue. This stage is primarily identified by tissue proliferation with subsequent thickening and hardening of the soft tissues. The affected area is even more swollen. Elevating your limb does not reduce swelling/edema, and pressing on the skin does not leave a pit. Stage 2 can be managed with treatment, but any tissue damage can’t be reversed.

Stage 3 (severe):
The affected limb or area of the body becomes very large and misshapen, and the skin takes on a leathery, wrinkled appearance. Left untreated, it can lead to a decrease or loss of functioning of the affected extremity, skin breakdown and sometimes irreversible complications.