The lymphatic system is a network of tissues and organs that runs throughout the body. Primarily consists of lymph vessels, lymph nodes and lymph. The tonsils, adenoids, spleen and thymus are all part of the lymphatic system. The lymphatic system is like the blood circulation - the tubes (vessels) branch through all parts of the body like the arteries and veins that carry blood.

But the lymphatic system tubes are much finer and carry a colourless liquid called lymph. There are 600 to 700 lymph nodes in the human body that filter the lymph before it returns to the circulatory system. You can probably feel some of your lymph nodes. There are lymph nodes in many parts of your body including: Under the arms, in armpits, in each groin (at the top of your legs), in neck. There are also lymph nodes that you cannot feel in abdomen, pelvis, chest. There are two drainage areas that make up the lymphatic system. The right drainage area handles the right arm and chest. The left drainage area clears all of the other areas of the body, including both legs, the lower trunk, the upper left portion of the chest, and the left arm. The lymphatic system does several jobs in the body. It drains fluid back into the bloodstream from the tissues, filters lymph & the blood, fights infections Diseases of Lymphatic system:

The lymphatic system clears away infection and keeps your body fluids in balance. If it's not working properly, fluid builds in your tissues and causes swelling, called lymphedema. Lymphedema is a chronic swelling of the limbs caused by the accumulation of lymph fluid that occurs if the lymphatic system is damaged or not functioning properly. Many develop the disorder following cancer therapy — particularly breast cancer where the lymph nodes under the arms are removed — recurrent infections, injuries or vascular surgery. Hodgkin's lymphoma is a type of cancer that typically occurs when the white blood cells in the body become diseased or damaged. In elephantiasis, infection of the lymphatic vessels causes a thickening of the skin and enlargement of underlying tissues. Lymphangiosarcoma is a malignant soft-tissue tumor. The disorder of Lymphedema is lifelong.

What are the signs of lymph problems?

Lymph symptoms occur when your lymphatic system becomes inflamed, blocked or damaged. A lymphatic obstruction prevents lymphatic vessels from effectively draining fluids from the tissues in the body. There are two types of lymphedema: primary and secondary.

Types of lymphedema:

PRIMARY - from birth or developed later in life

• Birth - developmental abnormality of the lymphatic system
• women more prone than men, legs affected more than arms
• lymphatic vessels are impaired or missing
• Praecox - appears in puberty and occurs mostly in females; typically one leg is affected
• Tarda - appears later in life, can be male or female, sudden onset swelling with no apparent cause

SECONDARY - lymph nodes were removed or lymph vessels damaged due to one or more of the following

• Surgery and/or radiation treatment of breast, gynecological, head, neck, prostate, testicular, bladder, colon CA or melanomas
• Trauma, injury, or accident resulting in blocked/damaged lymph system
• Infections - interrupt normal lymph pathway function

Lymphedema may be caused by:

Infections such as chronic cellulites, trauma, tumors, certain surgeries (for cancers such as breast or testicular), blood vessel repair, radiation treatment

What to Expect?

Lymphedema may start 6 - 8 weeks after surgery or after radiation treatment for cancer. It can also start very slowly after your cancer treatment is over. You may not notice symptoms until 18 - 24 months after treatment. Sometimes it can take years to develop. Even a small infection or injury can cause lymphedema to start.

How do we treat lymphedema?

• One-on-one, hands-on, lasts 45-60 min in comfortable private treatment rooms
• Soft Tissue Mobilization, lymphatic drainage, scar mobilization
• Therapeutic exercises, including range of motion, stretching, and strengthening
• Patient education to maintain decreased edema, posture re-education, body mechanics, skin care
• Compression bandaging and garments

Goals:

•  Increased range of motion/flexibility
•  Decreased swelling
•  Decreased pain
•  Increased strength
•  Restore function and improve quality of life

All lymphedema therapists must be fully certified, experienced and qualified to treat all types of lymphedema.

Bibliography

“Lymphedema- Diagnosis and Therapy”, Horst Weissleder and Christian Schuchhardt

“Theory and Practice of Lymph Drainage Therapy”, Bruno Chikly.