Does your BodyWork?

What is the Lymphatic System?

The lymphatic system consists of many vessels that carry lymph (a clear, colourless fluid containing water and a few blood cells) throughout the body. The lymphatic system helps to protect and maintain the fluid environment of the body by filtering and draining lymph away from each region.
Often during a lumpectomy or mastectomy, some or all of the lymph nodes under the arm may be removed. The lymph nodes under the arm drain the lymphatic vessels from the upper arms, the majority of the breast, the neck and the underarm regions. The lymph nodes help to filter excess fluid, bacteria and by-products of infections.

What is Lymphoedema?

Whenever the normal drainage pattern in the lymph nodes is disturbed or damaged (often during surgery to remove the lymph nodes or just simply by an infection), swelling of the arm may occur. Radiation and chemotherapy may also cause swelling of the arm. This swelling in the arm, leg or other extremity, caused by an abnormal collection of too much fluid, is called lymphoedema.
When the lymph nodes under the arm have been removed, a woman is at higher risk of lymphoedema. This may occur immediately following surgery, or months or years later. However, not every woman who has a mastectomy will experience lymphoedema.
The most common type of lymphoedema is slow and painless and may occur 18 to 24 months after surgery.

What can be done about Lymphoedema?

Traditionally, lymphoedema has been managed by surgeons, more recently by micro-vascular surgery. Unfortunately, only in a very small number of cases does surgery produce any long-lasting benefit and it is generally considered no better than conservative treatment.
Although research is ongoing, drug therapy still remains of limited value. As a result patients are often told nothing can be done and no positive steps are taken to improve matters

However, there are several things that can be done:

Manual Lymphatic Drainage (MLD)
a specialised form of massage carried out by a trained therapist to move the skin in specific directions based on the underlying anatomy and physiology of the lymphatic system. Recommended for people whose lymphatic system has been compromised but have not developed overt lymphoedema.

Decongestive Lymphatic Therapy (DLT)
DLT combines a package of treatments e.g. multi-layer lymphoedema bandaging, manual lymphatic drainage, skin care and exercise, thus improving long term results. Recommended for people who have developed lymphoedema.

External Support/Compression
in the form of elastic compression bandaging or garments to help prevent the swelling from building up in the limb.

A Programme of Exercise and Movement
to try and maximise lymph drainage without over exertion (this would cause the swelling to worsen).

Skin Care
to keep the skin and tissues in good condition and to prevent/reduce the risk of infection

Advice after Mastectomy or those with Primary or Secondary Lymphoedema

It is very important to seek advice as soon as possible not only for the peace of mind that this gives but importantly, to avoid many of the potential unwelcomed side affects.
Electronic information can be obtained from the British Lymphology Society whose internet address is www.lymphoedema.org. For more personalised advice, please make an appointment with your fully trained therapist, Sarah Wheatley,

What Can Be Offered

Sarah provides a continuing after-care service for those who have had a Mastectomy, removal of Lymph Nodes and for those with primary or secondary Lymphoedema.

Rehabilitation of the affected limb.
Complex decongestive therapy.
Manual lymphatic drainage.
Advice on prosthesis, bras etc.
Emotional support.