A Patient Guide to Understanding and Managing Chronic Swelling - Tactile Medical
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A Patient Guide to Understanding and Managing Chronic Swelling
W H AT I S
LY M P H E D E M A ?
Most of us know the circulatory system pumps blood from the heart
to the rest of the body. But many people are not aware that the
body has a second transport system—the lymphatic system. The
lymphatic system consists of the tissues and organs that produce
and store cells that fight disease and infection. They include the bone
marrow, thymus and spleen, as well as the nodes and vessels that
carry protein-rich fluid called lymph.
Lymphedema is a chronic, progressive condition in which excessive
protein-rich fluids accumulate in the interstitium, the space between
the cells. The condition occurs from impairment of the lymphatic
system’s ability to drain fluids and proteins from the spaces in
between cells and transport this fluid, known as lymph, back to the
circulatory system. A compromised or non-functioning lymphatic
system places the patient at risk of medical complications including
recurrent skin infections known as cellulitis.
“ U N T R E AT E D LY M P H E D E M A M A K E S L I F E
M I S E R A B L E F O R T H O S E I T A F F E C T S . W H E N PAT I E N T S
R E C E I V E A T I M E LY D I AG N O S I S A N D E F F E C T I V E
T R E AT M E N T, H E A LT H I M P R O V E S A N D
H I G H E R H E A LT H C A R E CO S T S C A N B E AV O I D E D.”
— D R . A L A N T. H I R S C H
F O R M E R D I R E C TO R O F T H E VA S C U L A R M E D I C I N E P R O G R A M AT
T H E U N I V E R S I T Y O F M I N N E S OTA
W H AT I S
CHRONIC SWELLING?
As a normal part of your blood circulation,
your vascular system leaks fluid into the
surrounding tissues. Your body’s lymphatic
system is responsible for collection of this
fluid. Edema, or swelling, occurs when
an abnormal buildup of fluid occurs in
the body. Mild, temporary edema can be
caused by many factors, but lasting edema may be a sign of a more
serious underlying medical condition. Diseases that may cause
lasting or chronic edema include congestive heart failure, kidney
and liver disease, chronic venous insufficiency, and lymphedema.
LY M P H E D E M A : I T’S M O R E CO M M O N T H A N YO U T H I N K
+
MUSCULAR MULTIPLE PARKINSON’S AIDS COMBINED LYMPHEDEMA
DYSTROPHY SCLEROSIS DISEASE 2.7 5+
MILLION MILLION
LY M P H E D E M A A F F E C T S M O R E T H A N 5 M I L L I O N A M E R I C A N S .
T H AT ’S M O R E T H A N M U S C U L A R DYS T R O P HY,
M U LT I P L E S C L E R O S I S, PA R K I N S O N’S D I S E A S E
A N D A I D S — CO M B I N E D.
T Y P E S O F LY M P H E D E M A
P R I M A R Y LY M P H E D E M A • Late-onset lymphedema
Primary lymphedema is often (lymphedema tarda). Seen in
called congenital lymphedema, patients with under developed
as it may be caused by congenital lymphatics. Usually begins after
(hereditary) malformations age 35 as existing lymphatics
of the lymphatic system. lose the ability to compensate
Although primary lymphedema over time.
is largely attributed to genetic
causes, lymphedema is also S E CO N D A R Y LY M P H E D E M A
classified as primary when no Secondary lymphedema is more
known cause can be identified. common, affecting more than
Some specific forms of primary five million people in the United
lymphedema are: States. It is an acquired condition
• Milroy’s disease (congenital caused by a physical disruption
lymphedema). This disorder to the lymphatic system. Main
begins in infancy and causes3 include:
causes lymph nodes to form • Chronic venous insufficiency
abnormally. • Cancer treatments (removal of
• Meige’s disease (lymphedema lymph nodes and/or radiation
praecox). This disorder therapy), benign or malignant
often causes lymphedema tumor growth
around puberty or during • Accident, trauma or surgery
pregnancy, though it can • Infection
occur until age 35. • Obesity
• Filariasis (infiltration by insects
or parasites)
PAT I E N T S S U F F E R I N G F R O M LY M P H E D E M A
S Y M P TO M S T R E AT M E N T
• Unusual swelling (edema) There is currently no cure
• Swelling of dorsum of foot for lymphedema. Untreated
• Swollen and squared-off toes lymphedema can worsen,
• Heaviness or tightness in the leading to increased swelling
affected limb and pain, progressive
• Restricted range of motion hardening of affected tissues
• Lymph fluid discharge from (fibrosis), and recurrent
the skin (lymphorrhea) infections (cellulitis).
• Skin changes such as: Lymphedema can decrease
– “Orange peel” skin appearance mobility, dexterity, range
– Thick, rigid skin of motion and the ability to
(hyperkeratosis and fibrosis) perform daily activities.
– Bumpy wrinkling of the skin It also may significantly increase
(papillomatosis) the cost of healthcare. However,
– Ulcerations of the skin effective management of
• “Ski
jump” toenails symptoms is possible. Proper
(hypoplastic and concave) diagnosis of the condition
is often critical to achieving
S T E M ME R’S SI GN: AN effective treatment.
INDIC ATION OF LYMPHEDEMA
I N 10 S E CONDS OR LESS Management of lymphedema
The Stemmer’s sign test results is usually achieved with a
in either a positive or negative combination of therapist-
indicator for lymphedema. directed in-clinic treatment and
To perform it, simply try to pinch at-home self-management
and lift a fold of skin at the base with a proven pneumatic
of the second toe or middle finger. compression device like the
If you can pinch and lift the skin, Tactile Medical Flexitouch®
the Stemmer’s sign is negative. system. With effective
If you can’t, the sign is positive. treatment, patients can manage
False positives are rare, however, their symptoms, minimize
a negative does not always rule infections, improve their health
out lymphedema. and quality of life, and reduce
overall healthcare costs.1–3SEE H OW W E ’ R E B R I N G I N G T H E F U T UR E OF HEALING
H OM E AT TAC T I L EM ED I C A L.COM
Tactile Medical is a leader in developing and marketing at-home therapy
devices that treat chronic swelling conditions such as lymphedema and
chronic venous insufficiency. Our mission is to help people suffering
from chronic diseases live better and care for themselves at home.
Our unique offering includes advanced, clinically proven pneumatic
compression devices, as well as continuity of care services provided by
a national network of product specialists and trainers, reimbursement
experts, patient advocates and clinicians. This combination of products
and services ensures that tens of thousands of patients annually receive
the at-home treatment necessary to better manage their chronic
conditions. Tactile Medical takes pride in the fact that our solutions help
increase clinical efficacy, reduce overall healthcare costs and improve
the quality of life for patients with chronic conditions.
Individual results may vary.
Indications/contraindications: Indications, contraindications, warnings, and instructions for use can be found in the
product labeling supplied with each device.
Caution: Federal (USA) law restricts these devices to sale by or on the order of a licensed healthcare practitioner.
References:
1. R
idner SH, McMahon E, Dietrich MS, Hoy S. Home-Based Lymphedema Treatment in Patients with and Without
Cancer-Related Lymphedema. Oncology Nursing Forum. July 2008; Vol. 35(4): 671–680.
2. M
uluk SC, Hirsch AT, Tafe EC. Pneumatic Compression Device Treatment of Lower Extremity Lymphedema Elicits
Improved Limb Volume and Patient-reported Outcomes. EJVES. 2013; Vol. 46(4): 480–487.
3. B
rayton KM, Hirsch AT, O’Brien PJ, Cheville A, Karaca-Mandic P, et al. (2014). Lymphedema Prevalence and Treatment
Benefits in Cancer: Impact of a Therapeutic Intervention on Health Outcomes and Costs. PLoS ONE 9(12): e114597.
doi:10.1371/journal. pone.0114597
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