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Lymphoedema Clinic The physiotherapists run a lymphoedema clinic with Dr William Grech who is based at Shrewsbury and Meryl Price, a nurse who is based at Newtown, Powys. The Lymphatic System Normally, fluid passes out of the blood circulatory system to bathe the cells and tissues of the body. The fluid carries nutrients and oxygen, and carries away debris. Most of this fluid passes back into the blood vessels and is then taken up to the heart and lungs via the veins. The small amount of fluid that is left is carried away via the lymphatic system which consists of vessels similar to blood vessels, and nodes which help to filter and clean the fluid. The fluid is called lymph fluid and will eventually empty back into the blood circulatory system near the heart. Lymphoedema Lymphoedema is a condition which occurs when the normal lymphatic drainage system of the body is damaged or disrupted. When this happens the lymph fluid does not drain as quickly as it should so the fluid builds up in an area of the body which produces swelling (oedema). There are two main categories of Lymphoedema: Primary Lymphoedema This can become apparent at various times during a persons life but is due to the lymphatic system not being formed properly. It may be apparent at birth, but often is not noticed until puberty or later. This form of lymphoedema can be inherited. Secondary Lymphoedema This occurs when the lymphatic system is damaged by an outside force, e.g following cancer and subsequent treatment, trauma or infection. It may occur immediately or sometime after the event. Lymphoedema cannot be cured as at present it is not possible to replace the damaged or inadequate areas of the system. However lymphoedema can be improved and managed in most circumstances. If you suspect you may be developing lymphoedema you should contact your GP, consultant or specialist nurse to ask them to refer you to a specialist clinic.
Prevention Although sometimes lymphoedema occurs with no apparent cause, often it becomes obvious after a trigger e.g. an insect bite, therefore it is important, particularly if you have had surgery or treatment which affects the lymph nodes, to take care of the area of the body which may be affected. For example, if you have had breast surgery and radiotherapy treatment for cancer of the breast you should take particular care of the arm and chest on the side of the surgery. This means: 1.Good Skin Care – apply cream at least once a day, aqueous cream is cheap and easy to use.
2.Make sure you do not have injections, or have blood taken on that side.
3.If you do cut or scratch yourself apply antiseptic cream and contact your GP if the area becomes red and hot.
4.Use the limb on that side normally, but don’t carry anything heavy on that side. Treatment
Although lymphoema cannot be cured there are treatments which can help and precautions to take to prevent secondary lymphoedema occurring.
1.Skin Care Good skin care can help everyone. Apply cream to the swollen area daily, keep the skin clean and try to prevent cuts and scratches.
2.Compression Compression, usually in the form of a support stocking or sleeve, or sometimes bandages, will help your body to pump the lymph fluid in the correct direction at a more normal speed.
3.Exercise Gentle exercise will help the compression with the flow of lymph fluid.
4.Massage A massage called Manual Lymphatic Drainage (MLD) may help some people. A simple version (SLD) which you can do yourself at home often helps.
Severn Hospice Lymphoedema Clinic
At Severn Hospice we can offer the full range of treatments for both Primary and Secondary Lymphoedema Most first appointments are at Severn Hospice, Shrewsbury with a physiotherapist and Dr Grech. Follow up appointments may be held at Shrewsbury, Portway Day Unit, Telford, or Hafan Day Unit, Newtown. Referrals may be made in writing to The Lymphoedema Clinic, Severn Hospice, Shrewsbury, by GP’s, Consultants or Specialist Nurses. |
