Lymphedema Treatment
Lymphedema treatment and home care focus on slowing the progression of the condition and reducing infection risk by minimizing stagnant fluid and reducing the size of the affected area.
Complex Decongestive Therapy (CDT) for lymphedema includes:
Skin care to maintain an effective barrier against infectious organisms.
Lymphatic drainage by skin manipulation—Manual Lymph Drainage (MLD) or Simple Lymph Drainage (SLD)—or pump therapy (intermittent pneumatic compression).
Compression using special bandages or garments to reduce swelling and prevent swelling from increasing.
Exercise moves the skeletal muscles which increases the pumping action of the lymphatic system, stimulates blood circulation, and improves digestive function. Diaphragmatic breathing also stimulates the pumping action of the central lymphatic vessels.
Other Lymphedema Health Care Considerations
Lymphedema is stressful and many people with lymphedema have multiple sources of stress. Chronic stress combined with a high sugar/fat diet results in significantly more abdominal fat and increased insulin resistance than does poor diet alone.
People with lymphedema can become trapped in a cycle of increasing weight and isolation coupled with declining health and quality of life. Breaking this cycle may require:
Training on healthier food choices (as outlined here).
Practical support for buying and preparing healthier foods.
Stress reduction and eating awareness training using techniques from mindfulness, positive psychology, cognitive-behavioral therapy, etc.
Social support for healthy eating, increasing activity, exercise, and engagement.
The eating pattern outlined here will typically result in noticeable improvement within six weeks. Weight loss can improve existing lymphedema. Risk of developing lymphedema increases with body mass and can be reduced by weight loss.
In addition, it may be appropriate to:
Test for gluten sensitivity and celiac disease before reducing gluten if there are either symptoms: a history of stomach pain, gas and bloating, diarrhea, weight gain or loss, anemia or other nutrient deficiencies, bone or joint pain; or risk factors: Turner syndrome, family members with celiac disease or gluten sensitivity, autoimmune thyroid disease, type 1 diabetes, or other autoimmune diseases.
Evaluate patients with wounds or skin ulcers for nutritional deficiencies, even if they are overweight or obese, and especially after bariatric surgery, which can decrease nutrient absorption. Additional protein, vitamins C and A, and zinc may be needed to support healing.
Monitor and adjust medications for other conditions–such as diabetes, hypertension, or heart failure—as needed during eating pattern changes.
Tightly control glucose levels in type 2 diabetes to minimize abnormal fat accumulation, inflammation, and other effects of excess glucose and insulin.
Address other issues that might accompany lymphedema such as insomnia, chronic pain, depression, anxiety, eating disorders, and body image concerns.
Review medications for possible side effects that include swelling and weight gain. Analgesics and many medications of other types can contribute to swelling including drugs for diabetes, hypertension, arrhythmia, preventing blood clots and stroke (anticoagulants), cholesterol, chemotherapy, and depression.
Use prebiotics (Inulin) and probiotics to maintain healthy gut microbes during and following antibiotic treatment to reduce the risk of weight gain, diarrhea, and other antibiotic side effects.
Portions adapted from Lymphedema and Lipedema Nutrition Guide, Lymph Notes 2016 by permission of the publisher.