While I talked about the lymphatic system earlier (http://breastcancerreaper.blogspot.com/2012/02/lymphedema-another-for-rest-of-your.html), as well as lymphedema (http://breastcancerreaper.blogspot.com/2012/09/and-onward-against-lymphedema.html), I recently started to feel that my education was LESS than complete for me as a layperson. So, here’s MORE on lymph and lymphedema.
As to the FIRST article, I wasn’t clear on that until today. According to my current research, the lymph vessels PRIMARILY move lymph around the body due to something called “peristaltic action”. What that means is that the fluid is moved around in a way similar to the way food gets moved through your intestines – muscles slowly tighten up and push the food along while acids and enzymes act on it to break it down.
Lymph is pushed along through the body by tiny muscles in the lymph ducts that slowly contract and move the fluid from the smallest vessels to the nodes and from there into the bloodstream.
OK – we’re clear on that.
What I was REALLY unclear on and what caused a major problem for us recently, is that the history of lymphedema treatment begins a mere three decades ago. Before the RECOGNITION that lymphedema was a treatable condition, doctors just laughed at it, shrugged their shoulders and said, “Oh, well.”
That was mostly because the doctors were males and the victims of secondary lymphedema caused by node excision in the treatment of breast cancer was a “woman’s problem”. I imagine it would have received a bit more attention from the medical community if cancer node excision had caused the shrinkage of another extremity near and dear to the heart of every man...
At any rate, with the founding of the National Lymphedema Network and their pioneering work in the treatment of lymphedema, more and more doctors are recognizing that not only is lymphedema treatable – it NEEDS to be treated rather than ignored.
What IS lymphedema you ask?
“Lymph is formed from the fluid that filters out of the blood circulation to nourish cells…and maintain tissue fluid balance. [T]his fluid [is] pumped by a rhythmic peristaltic-like action by smooth muscle cells within the lymphatic vessel walls…The fluids collected are pumped into continually larger vessels and through lymph nodes, which clean out debris and police the fluid for potential threats from dangerous microbes. The lymph ends its journey in the thoracic duct, where it re-enters the blood circulation.”
When the nodes are removed, “...a condition of localized fluid retention and tissue swelling caused by a compromised lymphatic system..” occurs when lymph leaks out through the vessel walls and accumulates in the areas between cells (interstitial areas).
Extremely common in patients treated for breast cancer, it wasn’t until the mid-1980s that the medical establishment began to both study the problem and establish treatment criteria. “My first encounter with the relatively unknown syndrome, “lymphedema,” was in 1985.I ran Aurora Manor, a post-operative care facility opened in 1980 in San Francisco, where I saw a patient with an extremely enlarged swollen arm. She had undergone breast reconstruction after a mastectomy and it appeared that she had an allergic reaction from the intravenous. As a Registered Nurse/Caregiver, I immediately called her surgeon and expressed my concern. He laughed and told me she had the swelling in her arm for nine years, and there was nothing that could be done to improve it. I was puzzled—and inquisitive—as to the underlying cause/s and possible treatment. I reached out to local colleagues; they each told me that it was lymphedema as a result of her breast cancer surgery, and no effective treatment was available.” (emphasis mine)
Lest you think that doctors in the early 21st Century are more educated and better equipped than that, I’ll disabuse you of the notion. Within twenty miles of each other are two hospitals. They belong to THE SAME HEALTH CARE SYSTEM. Yet the physicians in one, renowned for its treatment of breast cancer loudly professed that “nothing is wrong”. The physicians at the other nodded and got to work treating it.
After a week of treatment that MY WIFE HAD TO REQUEST and for which she had to SEEK OUT HER OWN PROGRAM, the swelling has been reduced! A week!
If you are reading this and lymphedema has entered your life – either as a patient or in your spouse, mother, girlfriend or sister – then YOU NEED TO FIND SOMEONE WHO BELIEVES IT IS A PROBLEM.
The longer you wait, the worse it will get...and I’m not even exaggerating.
Resource: http://www.lymphnet.org/
Image: http://www.lymphedemapeople.com/images/LymphedemaArm.jpg
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