So, what exactly is Lymphedema? Well, to get a full understanding, you really need to know what the lymph system is and what it does. Lymph is a fluid which is rich in protein. It flows through vessels in your body and ends up in your blood stream. This process removes excess water and proteins from the tissues for balance in your body, removes toxins, wastes and viruses, takes the fat from your digestive tract to the bloodstream to be used or stored, and is essential for immunity; defending against infection as it makes and stores immune cells in the lymph nodes.
Lymph fluid moves through the body by muscle contraction, pulsation of the arterial system, abdominal breathing, and contractions of the intestines. The lymph vessels also contract through the actual action of fluid entering the vessel itself.
Lymphedema is swelling that occurs when the lymph fluid, collects in a part of the body in the tissues just under the skin. This is caused when the flow of the lymph fluid is interrupted by damage to the lymph nodes which are oval shaped structures located along the vessels. Damage can be a result of rare inherited conditions which affect the development of the lymph vessels (primary lymphedema) or by cancer itself, infection, or treatments such as surgery to remove lymph nodes and radiation therapy (secondary lymphedema) Lymph nodes and vessels can be cut, removed or damaged with the affected area forming scar tissue during the healing or from infection. It is the scarring that can block or slow the flow of lymph fluid.
When the lymph system is compromised, it takes longer to get nutrients in and waste products out of the body. Oxygen to the cells decreases so it can take longer for cuts and wounds to heal, it puts tissues at risk of inflammation and increases the chance of infection.
Armstrong, Carol, BA RMT. “LYMPHEDEMA” Power Point presentation, Victoria, BC, February 27, 2013
Lymph fluid, if it’s movement through the body has been blocked can slowly build up or pool and may go unnoticed for a long time. It can be compared to a leaking pipe under your kitchen sink. The water may have been dripping ever so slowly for weeks until one day, you open the cupboard door and find a big wet mess. If the accumulation in your limb is left untreated, it can greatly limit your daily activities. Lymphedema can be painful, restrict movement and look very unsightly.
So, in my case, I had a lumpectomy for a 2.1 cm tumour but the cancer had spread to 10 of the lymph nodes in my armpit. Because of this, I had an axillary node section to remove them. As I mentioned in my previous post, I had asked my surgeon about my risk of getting lymphedema when he was briefing me on my impending surgery. I had read the book he gave me, The Intelligent Patient Guide to Breast Cancer, which had a section on lymphedema and I have to say, it scared me. At first, he did put me at ease somewhat when he said that none of his patients had ever gotten it. However, being an “intelligent” patient, I also knew that if one got lymphedema, they would not likely phone up their surgeon and say, “hey doc, what’s the deal with my inflating arm?” especially if they were experiencing it years after the surgery. In fact, I had read multiple sources which indicated the average onset of lymphedema is within 2 to 3 years after breast cancer treatment. It was after my surgery that January 2013, dealing with cording, (fibrosis to the lymph vessels under my arm), facing my next, “hoop”, chemo, and after that, radiation, that I started to get more anxious about the possibility I could get lymphedema. In fact, I started to obsess about it. I had conversations with myself along the lines of, “why on earth are you worrying about this when you have a lot more on your plate at the moment?” I still don’t have an answer to that question but what I did end up doing was looking in earnest for a registered massage therapist. Specifically, one who was trained in the management of lymphedema.
I wanted to be proactive. I needed to, “arm” myself, (no pun intended,) with knowledge so that I could fully understand what I needed to do to mitigate my risks and keep lymphedema at bay or at least recognize the early warning signs and lessen its severity should I get it.