Treating Lymphedema

INELASTIC BANDAGING is the treatment of choice to compress the affected limb to improve venous return and move the fluid out of the affected limb.  Currently, COMPRESSION is the ONLY TREATMENT for lymphedema.  If a patient wishes to use methods other than bandaging to affect COMPRESSION on the affected limb, my best practice of providing devices and counseling for people who suffer from this disorder is the use of the LYMPHA PRESS® and the REIDSLEEVE®.  Compression garments, that are properly fitted, are comfortable for the patient to wear and with the CORRECT COMPRESSION for the condition are VERY beneficial.  The garments must be comfortable enough to wear or the patient may not remain compliant.  Patients also need to remain compliant with their treatment regimen or the limb will swell again and the garments will no longer fit.  Patients have told me, if they do not wrap or use their pump and or the ReidSleeve®, the limb quickly refills with fluid and more time is required using these devices to get the limb back into shape.

Lymphedema is a condition that afflicts more than 250,000 people in the United States.  Breast cancer patients generally have either mastectomy or lumpectomy with radiation, and between 12 and 35% of patients develop clinically significant lymphedema.  Lymphedema is the result of disruption in the lymphatic system, resulting in obstructed lymphatic flow, swelling, pain, and susceptibility to infection.  Similar problems arise in the lower extremities due to surgeries in the legs or abdomen.  Lymphedema is generally a lifelong disability that frequently worsens over time.  There are not effective surgical or medical treatments for this condition.  The mainstay treatment is compressive therapy, usually by wraps and bandages or mechanical compression devices.  However, these compressive treatments are expensive, confining, and difficult to use properly and consistently.  The ReidSleeve® overcomes these limitations.

Compressive Wraps:

Compressive wraps are difficult and time consuming to apply properly.  If the wrap is too tight it will be painful and obstruct lymphatic and venous outflow.  If the wrap is too loose it will not be effective.  Consequently, compressive wraps are difficult to apply properly.  Unfortunately, there is no mechanism to determine the pressure that is applied by wraps.  As a result, the patient cannot be certain that the applied pressure is either correct or consistent.  In many cases a trained nurse or dedicated and well-trained partner must assist the patient, impeding the patient's sense of independence.  For many patients, experienced help is not available.

Mechanical Pumps:

Pumps are expensive, often costing between $4,000 and $12,000.  The patient's mobility is limited by the machine, hoses and compression chambers.  Many patients complain of pain, numbness and tingling due to the high pressure generated by the mechanical pumps.  Finally, for many patients the mechanical pumps are ineffective.  Unfortunately, many patients have no alternative and simply live with this problem.