Ask the Doctors: Lymphedema causes swelling, requires monitoring | Health, Medicine and Fitness

Dear Doctor: My 36-year-old son has recently been diagnosed with primary lymphedema. He has developed open wounds on both of his legs and is in a lot of pain. The condition limits his movement, and he has become depressed. Can you provide information about treatment, and where to seek it?

Dear Reader: Lymphedema is chronic and progressive swelling that occurs because the lymphatic system, which is part of the immune system, isn’t working properly.

The lymphatic system is made up of a network of minute, thin-walled tubes known as lymphatic vessels, and by hundreds of lymph nodes, which work together to carry and filter lymph throughout the body. Lymph is a clear fluid, rich in white blood cells, which helps fight infection and transport waste, toxins and debris.

If you’ve ever had a scrape and seen a clear, watery fluid seep out of the wound, that was lymph. Unlike the blood circulatory system, which uses the force of the heartbeat to propel blood, the lymph system is largely dependent on muscle movement to keep things flowing. 

Swelling that arises due to lymphatic injury or obstruction is called secondary lymphedema. It’s often seen in cancer patients whose treatment involved the surgical removal of lymph nodes. 

There is no cure for lymphedema at this time. Instead, the focus is on managing the condition. This includes specialized massage to help with drainage, the use of compression garments, light exercise focusing on muscle contraction to encourage lymph movement, limb elevation and pneumatic compression.

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