Lymphedema as a Medical Disorder
Lymphedema as a Medical Disorder
Lymphedema is a medical disorder caused by constant inflammation of limbs that is caused by the build-up of lymph fluid in the lymphatic system. It occurs if the lymphatic system doesn’t function properly, or it’s damaged thus lymph vessels are not able to drain the fluid under the arm or the legs. As a matter of fact, lymphedema may develop after cancer treatment. Ongoing research by Canadian cancer center postulates that causes of lymphedema are multifaceted. Additionally, factors that contribute to the Lymphedema and the nature of interaction with the chronic diseases such as cancer have not yet been identified by the current ongoing research. American Cancer and diagnostic society had carried out a study in the year 2014 which focused on the incidence of severity of lymphedema.
Consequently, the findings compounded the problem further by failing to affirm that “degree of arm and hand swelling may vary according to the severity of the disease.” Additionally, The National Institute of Lymphology had instituted a research study to address the co-relation between breast cancer and lymphedema. After rigorous study and diagnosis, they found that patients who may have gone through breast reconstruction procedures after being diagnosed with breast cancer are highly susceptible to lymphedema.
In April 2015, monthly publication, National Institute of Lymphology denoted that limb volume, arm circumference, frequency of infection and limb volume are the common variables followed to value accomplishment on intervention channeled in lymphedema care for lymphedema patients. Furthermore, researchers’ at Roper St. Francis Hospital in collaboration with specialists from Novadaq Technologies have invented Indocynide Green (ICG) mapping technique. Since it’s unveiling in January 2015, the method has been used in computerized imaging of lymphatic vessels. The doctors and physicians have asserted the technique as the most efficient method for detecting swollen lymph nodes. Research is still ongoing in major research institutes regarding lymphedema; however the above represent approved and acclaimed recent research on lymphedema.
The lymphatic system gives a vital duty in keeping your body healthy. As asserted by (Fu et al. 2013), it circulates lymph fluid rich in protein all through the body collecting the viruses, waste products, and bacteria. All harmful substances are carried by the fluid through the lymph vessels to the lymph nodes. The lymphocytes that live in the lymph nodes filter the wastes and ultimately flushing them out of the body. Lymphedema is caused by blockage and subsequent damage to lymph vessels.
Lymphedema occurs when lymphatic fluid is not able to flow the way it should be. Swelling of arms and legs are the possible signs of lymphedema. Swelling mostly occurs in toes and fingers while other patients may experience a change in the size of the limb, or else experience severe swelling in the whole arm or leg. If the swelling is extreme, affected individuals may find it hard to wear clothes, watches and fit into clothes or shoes. Individuals affected by lymphedema complain of prickling sensation in affected limbs. Additionally, cancer and consequent cancer treatment are risk factors that increase cause of lymphedema. Apart from legs and arms, swelling may occur in the head, chest and genitals. It may be a consequence of the surgical removal of lymph nodes in the groin region or the armpit area. Subsequently, their damage may be caused by the impairment resulting from radio and chemotherapy. Other organs can be affected such as the face, abdomen, and the neck.
Mechanism of Action in Homeostasis
Homeostasis is a self-regulating process in which human biological system maintain stability while on the other hand adjusting to conditions (internal and external) to ensure survival. Mostly, lymphedema causes blockage of lymph vessels ultimately disrupting homeostasis. Lymphatic vessels provide a crucial duty in fluid homeostasis. Most significantly, they are the conduit of draining excess liquid. On the instance they are blocked, waste material that is supposed to be removed off remain in the body consequently causing mass intoxication as denoted by (Green et al. 2012). As a consequence self-regulatory system of the body cannot be able to regulate biological functions of the body.
Essentially, individuals with damaged lymph nodes due to cancer therapy are highly susceptible to lymphedema. Fundamentally, lymphedema is not a contagious disease but preferably families with a history of cancer infection are most affected by lymphedema. Lymphedema is categorized into two: secondary and primary lymphedema. As a matter of fact, primary lymphedema can be hereditary. Meige Lymphedema expresses itself at early stages of puberty. Additionally, lymphedema tarda is prevalent around mid-ages (the 30s to 40s years of age).
Furthermore, primary lymphedema can also be congenital. It means lymphatic damage can occur during birth or in the uterus. On the other hand, secondary lymphedema is caused by damage or obstruction of the lymphatic system leading to interruption of the normal flow of lymphatic fluid.
Methods of Diagnosis
(Kisner & Colby 2012), suggests that the physician should examine the lymphatic system by imaging techniques to determine the severity of Lymphedema infection. Firstly, physical examination of the patient with swollen limb marks the first step of diagnosis. The Stemmer sign shows the first diagnostic indicator of lymphedema. A Stemmer sign is thickened fold of skin at the base of a finger or a toe. At later stages, it may develop into secondary lymphedema. To test for Stemmer sign, an individual should pinch the skin fold on the upper surface of the second finger or toe. When the skin cannot be lifted, it’s with no reasonable doubt that this is a positive test for lymphedema.
Additionally, another diagnostic method positively used to diagnose lymphedema is pitting edema. In this test, a physician presses his/her finger against the swollen limb or arm. If it leaves fingerprint identification, then that is a positive indicator of lymphedema presence in its initial stage. Moreover, other technologically based diagnostic techniques include:(a) Computerized tomography (CT scan).An X procedure produces pictures that are detailed and cross-sectional images that may reveal the blocked areas in the lymphatic system.(b) Magnetic Resonance Imaging (MRI).Radio waves and Magnetic playgrounds get used to producing 3-D images of high resolution. The procedure gives the physician a better view of the tissues of arms and legs. Also, the technique can be used to get a look of lymphedema characteristics.(c) Bioimpedance testing. During bioimpedance testing, small metal plates in the form of electrodes are positioned on different body parts. Using their stored energy, they release light and painless electric charge that’s quantified using a handheld device. If there any changes in the power of the current, then the fluid presence in the tissue is detected.
Symptoms and Complications of Lymphedema
The symptoms range according to the level of infection of the disease. Swelling can sometimes be mild, and it will be hard to notice any changes in the size of the leg. When the disease becomes severe, the swelling makes it impossible to use the foot. However, the common symptoms include:
Thickening and hardening of the skin on legs and arms.
One experience is aching and discomfort in the legs and arms.
The range of motion in your leg and arm is restricted.
There is a feeling of heaviness and firming of arms and legs.
Your entire arms and legs start to swell including toes and the nail fingers.
Lymphedema can be a result of cancer therapy, and one may not note the swelling until after several months or years of treatment.
Diagnostic Findings from Imaging
The C.T scan combined with the Doppler ultra-scan can track blood flow and pressure. When the MRI technique is applied, images are displayed in such way that the blocked lymph vessels are highlighted as outlined by (Schlogel et al. 2015).
Current Treatment Options for Lymphedema
The primary aim of treatment is to control swelling and related problems caused by the disease. Some of the treatment practices include the following:
Wearing pressure garments. The clothes are made of a material that can control the amount of pressure on the arm or the leg to aid moving of fluid and keep it from building up. It’s advisable to wear the pressure garments when exercising as they will prevent swelling of the affected limb. The disorder can be chronic at high attitudes that are why it’s important to use the garments when using air travel.
Practicing -Physical exercising: Both aerobic exercise and light are using aid the lymphatic vessels to filter out the lymph out of the affected body parts and thus decreasing the swelling.Bandaging: Wrapping prevents the lymph fluid from refilling the limb once it’s moved out. Also, they increase the capability of lymph vessels to ooze the lymph out.Combined therapy: It is a program of massaging, bandaging and skin caring practices conducted by a qualified and trained therapist. The therapists are obliged to offer many treatment programs at a short time. Subsequently, the patient continues with the exercises at home to help keep swelling at bay.
Methods of Prevention
To reduce the risks of having Lymphedema, (Zimmerman et al. 2012) advice on exercising on the following practices:
Protect your legs and arms by avoiding injuries to your affected limbs. It`s advisable to protect yourself from sharp objects such as razors and needles. If it can be possible, it can be desirable to avoid surgery and vaccinations.
Shun is wearing tight clothing. Tight clothes restraints individuals arm and legs from being flexible. It would be wise to avoid them to allow the pressure not to build up.
Rest your leg while recovering from surgery. If you have gone through surgery, avoid involving your leg with heavy activity until your leg fully heals.
Lymphedema is caused by blockage of lymph vessels. Exercising is the best intervention practice to alleviate this disorder. Future research has been promising as new methods such as the radionuclide imaging of the lymphatic system are currently been developed. In the process that is still in trial stages, one is injected with a radioactive dye then it’s scanned by a machine. When scanning is over the resulting images, depict the dye moving through the lymph vessels hence highlighting the blocked areas.
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