2015 March is Lymphedema Awareness Month Know the Symptoms and the Solutions

LymphaticSystem_FemaleSmMarch is Lymphedema awareness month. That means it is our call to educate you, our clients, so you can spread the word about Lymphedema. Lymphedema happens when the lymphatic system is not complete or is disturbed. The lymphatic system is a system that consists of tissue such as the lymph vessels, lymph nodes and lymph and organs primarily the tonsils, adenoids, spleen and thymus.  Lymph is a colorless, transparent fluid which originates in the tissue space through out the body. Its responsibility is to remove excess body fluids, bacteria, viruses, proteins and waste products from the body tissue. Lymph nodes (small bodies scattered along lymph vessels) act as cleaning filters to destroy pathogens, inactivate toxins and remove particulate matter and aid in your body’s immune system to fight infection. The lymph nodes, thymus gland, tonsils, and spleen produce lymphocytes which enhance the body’s immunity. Lymph flows in one direction urged along its journey by contraction of skeletal muscles and smooth muscle fibers in the walls of the lymphatic vessels and movement of the diaphragm until it dumps its cargo back into the circulatory system. Lymph flow in this system is very slow (3 liters per day) compared to our circulatory system (5 liters per hour). When the lymphatic system is disrupted, the lymph pools in the interstitial spaces and swelling occurs.

There are two types of Lymphedema- Primary and Secondary

 Primary Lymphedema happens seemingly without cause. It may be present at birth, become apparent at puberty or after age 35. Primary Lymphedema occurs more frequently in women than in men.

Secondary Lymphedema is caused by injury, accident, surgery, or radiation to an area of lymph nodes. There are approximately 2 million cases of secondary Lymphedema. It may develop months, even years after injury, surgery, or radiation. It has even occurred over 20 years later.

Factors that contribute to Lymphedema:

  • Surgery and/or radiation therapy
  • Post operative infections
  • Obesity
  • Infections (insect bites, athletes foot, parochial-bacterial or fungal infection where the nail and skin meet at the side or the base of a finger or toe)
  • Sedentary lifestyles
  • Dependent limb position
  • Recurrent tumor
  • Trauma to remaining lymphatics
  • Untreated edema from venous insufficiency can progress to venous/lymphatic disorder which is treated as Lymphedema

Many treatments have been tried to control Lymphedema. Diuretics only stimulate the kidneys to remove more fluid which results in a higher protein concentration and hardening of the tissue. Some success has been shown in lymph node transplants, but this is a very slow process to grow the lymphatic system and the final decision on the effectiveness of this treatment is still out. The one tried and true treatment is initiated by a therapist doing Manual Lymphedema Drainage (moving lymph to areas where lymph nodes can collect the lymph and transport it), teaching special exercise, and wrapping the effected area. Once the therapist determines the maximum reduction has been reached, then compression garments can be worn. Sometimes these can be ready to wear and sometimes they must be custom measured.

Once Lymphedema has developed, it is a lifetime of management with

  • Meticulous hygiene and topical skin products
  • Manual lymph Drainage (MLD) – which you may be able to learn to do your self
  • Special Exercises to help move the lymph along
  • Compression garments to help maintain you hard worked for size

There are times when a Lymphedema patient will need to return to bandages for a night or so just as a tune-up to maintain the reduction that was achieved.

I would like to leave you with the awareness of what Lymphedema is and the fact that if you have venous insufficiency and do not wear your compression stocking, it can progress and become a disease that is much harder to control.

Please call one of the SupportHosePlus.com Certified Fitters on our toll-free number,  1-844-472-8807, who are able to assist you in the selection of a compression garment that will meet your lifestyle needs.

 Vanda

2015 March is DVT Awareness Month

March is DVT Awareness Month. We have discussed DVT (Deep Vein Thrombosis) many times and it is such an important topic, it is time to review again. Your veins are thin-walled blood vessels that carry oxygen-depleted blood from the tissues back to the heart and lungs to be re-oxygenated. In order to move the blood back up against gravity, the calf muscles in the leg squeeze the deep veins to move the blood back to the lungs and heart. The human body has three types of veins; Superficial Veins which are the veins that are close to the skin (the ones that you can see), Deep Veins which lie within the muscle structure within the body and Perforating Veins which connect the deep veins to the superficial veins. The veins contain one-way valves for the return of the blood back to the heart and lungs. When these valves do not close properly, stagnation of the blood can occur and a deep vein thrombosis (DVT) can form, most often near a venous valve. The DVT can permanently damage the vein wall and valves with scarring or fibrosis, which can cause them to become incompetent, or non-working, resulting in reflux (backward) flow of blood and venous congestion. The DVT can break loose and become a life-threatening Pulmonary Embolism (PE).

Compression socks and stockings work as a secondary pump and along with the calf muscles to close the venous valves, assisting to move the blood back to the heart and lungs. There are many ways to develop a DVT, but we can take many steps in helping prevent DVTs, especially when we travel, whether by airplane or by a long car or truck ride.

It seems natural for the average airline passenger has greater concern about the airline crashing than about developing a life threatening DVT, that is likely due to knowledge of DVTs, or more specifically, our lack of it.  While the chances of developing either of these conditions is very small, some people when they fly or take long car or truck trips, may be more prone to developing a DVT than others.

High Risk Groups Include:

  • Frequent Fliers
  • Truckers
  • Older people (over 60)
  • Pregnant Women
  • Those who have recently had surgery
  • Women who are taking oral contraceptives or hormone replacement therapy
  • Travelers with medical conditions which would predispose to develop a blood clot (cancer, heart disease, diabetes, or family history of DVT)
  • Young, healthy, & athletic

The picture to the right represents one of our many clients. He is in his mid 60’s and is preparing to go on an airplane trip which is not a long haul…his trip may only last 3 hours, but OlderManPuttingOnSupportSocks2what he is doing may save his own life. A study by Aviation Health Institute has shown that 17% of DVTs occurred in association with short flights. A British newspaper published findings that the occurrence of DVT in short-haul flights was more prevalent than expected…4.3% of 568 passengers developed clots which were detected by ultrasound. Two of the passengers actually developed a pulmonary embolism. This has led the researchers to hypothesize that blood clots develop in the first 2 to 3 hours of flight and become larger and more dangerous with longer flights. Not all blood clots are symptomatic and some small ones do resolve on their own.

MerinoWoolImage2The picture to the left represents a group of individuals who you would not normally associate with developing a DVT; the young, fit and healthy. Again, these individuals may actually be helping to saving their own lives by wearing support socks during outdoor activities and during air travel. Athletes and especially endurance athletes show a high incidence of developing a DVT. This may be due to their efficient cardio system pumping blood more slowly. It has been claimed that up to 85% of flight DVT victims fall into the athletic category. One study has shown the near elimination of DVTs in the young, fit and healthy category when they wear compression hose or support socks. Many athletic teams require their members to wear compression socks when they fly.

There are several things you can do to assist in preventing DVTs:

  • Wear compression socks or hosiery
  • Flex your foot and calf muscles while seated every half hour
  • Don’t sleep when flying
  • Keep hydrated with electrolyte-balanced solutions and or water.
  • Avoid alcohol
  • Get up and walk once an hour ensuring you flex your calf muscles
  • Choose an aisle seat if possible, more easily facilitating movement
  • Do not allow the front of your seat cushion to cut into the back of your knee
  • Check with your health care practitioner to determine if he/she has additional recommendations

All these can be discussed with your physician; wearing properly fitting support hose or support socks may be a very effective preventive measure.

Following is a list of factors that increase the risk of developing DVT:

  • Injury to a vein, often caused by:
    • Fractures
    • Severe muscle injury
    • Major surgery (especially of the abdomen, pelvis, hip, or legs)
    Slow blood flow, often caused by:
    • Confinement to bed (possibly due to a medical condition or after surgery)
    • Limited movement (a cast on an extremity to help heal a injured bone)
    • Sitting for a long time, especially with crossed legs
    • Paralysis
    • Sedate lifestyle
  • Increased estrogen:
    • Birth control pills
    • Hormone replacement therapy, sometimes used after menopause
    • Pregnancy, for up to 6 weeks after giving birth
  • Certain Chronic medical illnesses:
    • Heart disease
    • Lung disease
    • Cancer and its treatment
    • Inflammatory bowl disease (Crohn’s disease or ulcerative colitis)
Other facts that increase the risk of DVT include:
  • Previous DVT or PE
  • Family history of DVT or PE
  • Age (risk increases as age increases)
  • Obesity
  • A catheter located in a central vein
  • Inherited clotting disorders
  • Varicose veins

Know the Signs and Symptoms of DVT and if these develop seek medical attention immediately.

  • Pain in the leg or pelvis region
  • Tenderness and swelling of the leg
  • Discoloration of the leg (reddish)
  • Areas of the leg or pelvis region that feel warm to touch
  • Whole leg swelling
Symptoms of DVT can be similar to other conditions, like a pulled muscle or “Charlie horse” and can delay diagnosis. Some people may have no symptoms. Blood clots are more common in the left leg, possibly because the femoral artery in that leg passes anterior to the vein, and may compress the vein. Symptoms of a DVT from travel do not always develop immediately after travel, but more likely within three days of arrival at your destination.Symptoms may not manifest themselves for up to two weeks after a long trip.

Call one of SupportHosePlus.com’s Certified Fitters toll-free, 1-844-472-8807, for assistance with selection and sizing of support hose or support socks for to aid in the prevention of DVT, especially during travel.

Happy & Safe Travels!

Vanda