What is Lymphedema?

The term edema refers to the accumulation of an excessive amount of fluid in cells, tissues, or organs and is clinically characterized by swelling. A variety of conditions can produce edema including chronic venous insufficiency, infection, and trauma. Lymphedema is a progressive condition that occurs when the lymphatic transport system falls below the capacity needed to handle the fluids that normally leak from the blood vessels into the lymph system. The accumulation of fluids leads to the swelling of subcutaneous tissue as a result of obstruction of lymphatic vessels or lymph nodes. Any disease process that interferes with or disrupts the normal mechanical process by which the lymphatic system collects, filters, and returns lymph fluid back into the circulatory system can result in excessive accumulation of lymph fluid in the area affected by the blockage. Since the arterial capillaries continue to function normally and deliver fluid to the tissue, the volume of fluid increases significantly until the venous capillaries are no longer able to compensate for the defective lymph vessels. At the point where drainage has been reduced by 80% or more, symptoms of lymphedema become apparent.

Although lymphedema can develop in any area where the normal flow of lymph fluid has been interrupted, it is most commonly seen in the extremities and almost always takes place at the most superficial level of the lymph vessels, namely under the skin (subcutaneous). Other areas where lymphedema can develop include the head/neck region, chest, body cavities, pelvic region, and genitals. When lymph fluid accumulates due to blockage, it can reduce the amount of nutrients that reach the cells and can interfere with wound healing, which results in increased risk of infection.

There are varying degrees of severity of lymphedema, from mild to extreme swelling which can cause life-threatening complications. Initially, patients may notice that one limb is slightly larger than the other. Approximately 50% of patients with mild lymphedema report feelings of heaviness or fullness in the affected limb. As the swelling progresses, it may become difficult to fit clothing over the affected limb. Eventually, the size and weight of the edematous limb may cause fatigue, embarrassment, and have a significant impact on the quality of life. Maximal girth of the limb is usually reached within the first year of onset of symptoms. The earlier the diagnosis of lymphedema is established and treatment initiated, the lower the risk of developing a large distorted limb and multiple skin changes.

Lymphedema may develop immediately after many surgical procedures. It is usually mild and resolves within a couple of weeks. If lymphedema develops approximately 6-8 weeks following a surgical procedure or radiation therapy, it also typically resolves within a few weeks following treatment for the lymphedema. The most common form of lymphedema, however, develops very slowly over time and may become manifest many months or years following the original procedure. Regardless of severity, lymphedema must be treated as soon as possible and as aggressively as possible to prevent further complications. Treatment of lymphedema is most effective when it is initiated at an early stage.

Lymphedema differs from edema. Edema is a secondary symptom of an underlying medical condition that is the result of too much fluid being released from the capillaries into the tissue, overwhelming the capacity of the lymphatic system. In lymphedema, on the other hand, it is the lymphatic system itself which is compromised. The arterial capillaries continue to function normally and continue to release their fluid in the interstitial spaces, but that fluid is not being drained away from the site because of a "faulty" lymphatic system. Although compensatory mechanisms may develop at early stages of faulty drainage, at some point, the increasing lymph load becomes too great for any compensatory mechanisms to be effective. This is why lymphedema may be latent for many years before the symptoms become evident.

If lymphedema is left untreated, complications ensue and may result in:

• Repeated infections, such as cellulitis (skin infection) and lymphangitis (inflammation of lymph vessels)
• Progressive trophic changes to the skin such as skin thickening, hyperkeratosis (scaly, warty growth), deepening skin creases, and difficulty picking up skin folds between the fingers or toes
• Progressive decline in quality of life and activities of daily living

Knowledge is Critical when Dealing with a Life-Altering Condition such as Lymphedema

If you or a loved one has been diagnosed with lymphedema, it's critical to learn everything you possibly can about this condition so that you can make informed decisions about your treatment. That's why we created the Medifocus Guidebook on Lymphedema, a comprehensive 160 page patient Guidebook that contains vital information about lymphedema that you won't find anywhere in a single source.

The Medifocus Guidebook on Lymphedema starts out with a detailed overview of the condition and quickly imparts fundamentally important information about lymphedema, including:

• The underlying causes of lymphedema.
• The risk factors that can increase a person's chances for developing lymphedema.
• The signs and symptoms of lymphedema.
• A detailed overview of lymphedema following breast cancer surgery.

• The secondary complications that may develop as a consequence of lymphedema, including:

  • Recurrent infections
  • Cellulitis
  • Cosmetic and structural alterations
  • Deep vein thrombosis
  • Lymphoangiosarcoma - a cancer of the lymphatic system

• How lymphedema is diagnosed based on factors such as signs/symptoms, patient history, physical examination, and imaging studies.

• The International Society of Lymphology's classification system that is used by doctors to grade the severity of lymphedema.
• Other underlying medical conditions that may be confused with lymphedema and must be taken into consideration in the differential diagnosis of lymphedema.

Understanding the Standard Treatments... and the Treatment Options

The primary goals of treatment for patients with lymphedema include:

• Control swelling and other symptoms associated with the condition.
• Promote the flow of lymph and prevent secondary complications.
• Help patients to better cope with the psychological aspects of lymphedema.
• Prevent progression of lymphedema.
• Enable patient's to lead a reasonably good quality of life.

Understanding the standard treatments - and the treatment options - is critical for successfully achieving the goals of treatment for lymphedema. As you read through the section of the Guidebook that focuses on the treatments for lymphedema, you will specifically learn about:

• The role of complete decongestive physiotherapy (CDP) in the management of patient's with lymphedema, including strategies such as:

  • Meticulous skin and nail care
  • Manual lymphatic drainage
  • Multi-layer compression bandaging
  • Exercise therapy

• The role of medications in the management of lymphedema, including:

  • Antibiotics
  • Benzopyrones
  • Corticosteroids

• The surgical treatment options that are currently available for the treatment of lymphedema, including:

  • Excisional (debulking) surgery
  • Liposuction
  • Reconstructive microsurgery
  • Derivative microsurgery

• The role of complementary and alternative therapies in the management of lymphedema.

• Recommendations for specific lifestyle modifications that can help people with lymphedema to better control their symptoms.
• The prognosis (outlook) for people with lymphedema and the important factors that have a significant impact in predicting the overall chances of recovery.
• Quality of life issues that often confront people with lymphedema and how to minimize their impact and cope better with these issues.
• Important questions to ask your doctor about lymphedema.

A "One-of-a-Kind" Reference Guidebook on Lymphedema that Goes Way Beyond the Fundamentals

Since 1996, when Medifocus was founded, we've learned that many people with Lymphedema are seeking more specific information that goes beyond the fundamentals, such as the causes, diagnosis, standard treatments, and treatment options. That's why we developed a "one-of-a-kind" reference Guidebook that goes way beyond the basics and also includes the following sections:

• A Guide to Recent Medical Literature on Lymphedema - This section of the Guidebook contains an extensive bibliography of over 100 references to recently published articles about Lymphedema in authoritative, peer-reviewed medical journals with links to the absracts (summaries) of the articles. These articles represent the latest advances in the field and focus on cutting-edge research, new developments, and the lessons learned from recently published studies involving patients with Lymphedema. This is the same level of that is used by doctors who treat people with Lymphedema to keep abreast of the latest developments and breakthroughs in this specialized field of medicine.

• Centers of Research for Lymphedema - We've compiled a unique directory of doctors, hospitals, medical centers, and research institutions with special interest and, in many cases, clinical expertise in managing people with Lymphedema. The "Centers of Research" directory is a valuable resource for quickly identifying and locating leading medical authorities and medical institutions both within the United States and other countries who are considered to be at the forefront in clinical research and treatment of Lymphedema. You'd have to spend days - or even weeks - attempting to compile your own list of doctors and medical centers but, with the "Centers of Research" directory, the information is already right at your fingertips. All you have to do is act on the information by selecting and contacting the experts or medical institutions listed in the directory by state and country.

• Organizations and Support Groups for Lymphedema - The Guidebook also includes a directory of organizations and support groups whose goal is to help people with Lymphedema by providing access to information, resources, and services. Many of these organizations can answer your specific questions, enable you to "network" with other patients, and provide guidance in areas such as financial, social, or medical-legal issues. This valuable directory of organizations and support groups includes complete contact information, including phone numbers and E-mail addresses.

Look Inside the Guidebook

The Guidebook is a Value-Added Proposition that Comes with a Risk-Free Satisfaction Guarantee so that...You have Nothing to Lose and Everything to Gain

Still not sure if you'll benefit from the Medifocus Guidebook on Lymphedema? Still not convinced that the information included in the Guidebook is worth the minimal cost? If that's the case, then please consider the following value-added proposition that comes standard with your purchase of the Guidebook:

• Free Updates for One Year - Along with your initial purchase of the Guidebook, you also receive free updates for one-full year.

• 20% Discount - For a limited time, you can purchase the Medifocus Guidebook on Lymphedema at a special 20% discount off the regular list price. Your 20% discount will automatically be applied when you go to "Checkout".

• Risk-Free Satisfaction Guarantee - Your purchase comes with our RISK-FREE satisfaction guarantee. If, for whatever reason, you are not totally satisfied with the content of your Guidebook, simply contact us within 30-days of your purchase for a prompt, full refund. We are so confident that you will be satisfied with your Guidebook that we offer this RISK-FREE satisfaction guarantee unconditionally - no questions and no hassles.

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