Understanding Lymphedema Treatment
The speeding up of movement of lymph fluid along your lymph vessels is how the volume of fluid in your arm starts to be reduced. As the fluid moves faster along your lymph vessels in your arm, it allows more room for fluid from your arm to move into the lymphatic system, thus slowly but surely reducing the fluid volume in your arm. The light touch of manual lymph drainage can often feel a little too soft; and I’m sure some of you out there are nodding your head, yes, it does feel very soft and sometimes this can be a little frustrating when you are just dying to dig in and have all that fluid drained away from your arm as quickly as possible. But in fact, this light touch is extremely important. Your lymph vessels in your arm start just below the surface of your skin and so if the manual lymph drainage is performed too deeply, then all you end up doing is massaging the muscles of your arm rather than the very lymph vessels that you’re trying to affect; and this will not do you any good at all. Your arm may feel great, but the lymph fluid will not have reduced in volume at all. So just to reiterate this very important point: The lymphatic system, the lymph vessels in your arm start just below your skin and that’s why you want your therapist to have a very gentle touch, because if they press really hard, they will go right through the layers of your skin down onto your muscle and they will actually squash closed the lymph vessels that they’re actually trying to feed the lymph fluid in and the treatment will not be effective.
Another difficult mind obstacle to overcome during treatment is the fact that treatment can be slow and seem to reduce fluid in very small increments; and this can be incredibly frustrating. I know so well because I treat this condition every day. But the reason why it is a slow process is because lymph fluid is a dense fluid made up mostly of proteins and so because of the density of the fluid, there is a lot of inertia. In other words, the fluid does not flow like water; it flows almost like a jell-oey type substance. So it does take quite a lot of manual work to move that through the lymphatic vessels and out of your arm. But if it’s done correctly, slowly but surely the fluid will be moved and you will begin to notice some changes, so I really encourage you don’t give up.
Automatically once lymph fluid moves into the lymph vessels, it moves to your lymph nodes. Normally lymph fluid in the arm mostly drains to the lymph nodes in your underarm, in your axilla. However, the axilla is now exactly where the trauma and the compromise is, and so it is very important that you lymph fluid is directed away from your axilla by your therapist, never into your underarm, always away. The lymph fluid in your arm should be directed along alternate routes to the unaffected lymph nodes, which are typically in your neck area. This is really an important fact to know because many of you will find that if you try to do your own lymph drainage massage at home, it is always very tempting to pull the fluid of the inside of your arm into your underarm, into your axilla; and if you are doing this, please, I encourage you don’t because you are pushing the very fluid into the area where you have a blockage from your surgery or from your radiation and you will not be as effective as you wish to be.
Once the fluid is moved to your healthy lymph nodes, in other words, nodes in your neck or nodes in other areas of your body, your body will takeover and cleanse the fluid before allowing it to reenter your bloodstream and essentially that is where lymph fluid drains to. It drains right back into our venous system, into the blood within our veins and it just becomes part of our fluid volume in our body. The lymph nodes serve a very important purpose of cleansing the fluid of unwanted proteins or unwanted material from your arm before allowing it back into the bloodstream. So it is a very remarkable system.
If you are taught to do your own lymph drainage massage at home, here are a few pointers for you: You should always use your flat hand to move fluid along vessels and you should press as softly as you would as if you were stroking a cat, because remember, the lymph vessels start just below your skin. So if you are doing your own lymphatic massage and you are pressing really hard, then you are squeezing those lymph vessels shut and you are simply massaging your muscles. So I really urge you, use your flat hand and gently, gently, gently, as if you were stoking a small delicate cat, move the fluid along your arm, not into your underarm, but up over the top of your shoulder and into your neck area. Also, what is important is: as you move your hand along your arm, you want to perform a skin stretching kind of technique, just underneath the palm of your hand or if you are using your fingers, the flat portions of your fingers. The more you can stretch your skin and get a gentle little snap back of your skin in your arm and hand as you perform your massage, the more you will stimulate the lymph fluid to move from your limb into the lymph vessels and therefore into the nodes and back into your bloodstream.
Many therapists routinely will use compression wrapping, also known as bandaging, once they have completed their lymph drainage on the arm with you. What is important to know about bandaging is that you should never use Ace bandages with which to bandage. Ace bandages have too much stretch in them and they don’t provide the right compressive forces to help you reduce your lymphedema. If your therapist has you doing your own bandaging at home, then you should be using a set of bandages suggested by him or her. The correct bandages to use are what we call “Short stretch lymphedema bandages” and there are two common brand names. The first one is called Comprilan and that is spelled C-0-M-P-R-I-L-A-N. The second one is Rosidal, which is R-O-S-I-D-A-L. You can purchase these types of bandages from bandaging type companies on the Internet and the company that I most commonly use is a company called Bandagesplus.com. These bandages are much less stretchy than an Ace bandage and will provide the right compressive forces to help you reduce your lymphedema.
