Oedema

###  What is Oedema and Lymphedema?

Oedema is swelling that we can see from fluid that has been accumulating in body tissues. This most commonly occurs in the feet and legs, where it is referred to as ‘peripheral oedema’. The swelling is a result of the gathering of excess fluid under the skin in the spaces within the tissues. All tissues in the body are made up of cells with connective tissues that hold the cells together. These connective tissues around the cells and blood vessels are known as the interstitium. Usually most of the body’s fluids that are outside the cells are stored in two places; the blood vessels and the interstitial spaces. In people with oedema, the fluid keeps on accumulating in either one or both of these components causing the disease. Oedema can be localized, afflicting only one part of
the body; generalized, afflicting the whole body; cerebral, afflicting the
brain; pulmonary, afflicting the lungs; or lymphatic, which is a type of oedema
known as lymphedema. Lymphedema is a result of a blockage in the lymphatic
system which prevents lymph fluid from draining to the lymph nodes and causes a
build-up of the fluid. This build-up of fluid sometimes result in heavy swelling
most common in the arms or legs.

### How does Lymphedema Affect the Lymphatic System?

The blockage which causes lymphedema restricts the
lymph fluid from bringing viruses, bacteria, and waste products to the lymph
nodes to be filtered. This is very crucial in order to keep the body healthy.
Lymphedema leaves the body susceptible to both infections of the skin and
infections of the lymph vessels.

### Signs and Symptoms

The symptoms or lymphedema may be almost unnoticeable
or extremely severe. Commonly, there is swelling and ‘puffiness’ in the arms,
legs, fingers, or toes. The skin may feel tight and thick, and limbs may feel
heavy. There may be discomfort or restricted range of motion, and recurrent
infections.

### Causes

Lymphedema can be either primary (occur on its own) or
secondary (caused by another disease/condition) and is often most common in
women. Primary lymphedema is primarily caused by a problem with the development
of lymph vessels in the body and is rare. Secondary lymphedema is significantly
more common and typically results from cancer related treatments. It can result
from the surgical removal of lymph nodes to check for certain types of cancers.
Lymph nodes/vessels may also be disrupted accidentally during surgeries of any
kind. Cancer cells are also another cause of lymphedema; a tumor growing near a
lymph vessel could grow large enough to eventually block the flow of lymph.
Radiation treatment for cancer can cause scarring or inflammation in the lymph
nodes/vessel and result in lymphedema as well. Lastly, most common in
developing countries, infection of the lymph nodes or parasites can also block
the flow of lymph.

### Diagnosis

If one notices any signs of lymphedema, schedule an
appointment with the doctor immediately. If the cause of the swelling in the
arms/legs isn’t obvious (recent surgeries, etc.) There are many tests that can
be done to identify the cause: MRI scan, CT scan, Doppler ultrasound (similar
to ultrasounds, but for blood flow), or a lymphoscintigraphy may be conducted.
A lymphoscintigraphy is when radioactive dye is injected into the lymph vessels
and images show it moving throughout the system. It identifies the area of
blockage.

### Treatment

As with many diseases, there is no cure for
lymphedema. However, there are various methods can be used to reduce swelling
and pain. Most methods work by compressing the effected limb(s) and encouraging
the drainage of lymph throughout the system. This includes: wrapping the
effected limb in cloth; wearing compression garments; pneumatic compression,
which is a sleeve that inflates to put pressure on the limb; massages which are
only to be carried out by a trained professionals; and lastly, light exercise.

### Prevention

As lymphedema most often occurs during or after cancer
treatment/surgery, it is important to take appropriate care of the limb at
risk. Avoid any injury to the limbs which can put them at risk of infection,
and avoid heat, tight clothing, and strenuous activity. As often as possible,
elevate the limb above the level of the heart. Even though taking these
precautions can help reduce the risk or lymphedema, they will not prevent it.