Why is lymphoedema therapy so important?

Claire Boyce, physiotherapist and lymphoedema therapist, chats to us about why lymphoedema treatment is so vital to people’s well-being.

Q: How do you treat lymphoedema?

A: We start with education about the lymphatic system. This is really important as it provides the knowledge needed for people to manage their symptoms. Aerobic exercise and muscle strengthening is vital for optimising lymphatic drainage - both teaching the person/family, and having a thorough drainage performed for them. Skin care is important, as are compression garments and fabrics that provide a micro-massage to break down thickened tissue.

Q: How important is lymphoedema treatment?

A: Treating lymphoedema makes a phenomenal impact to a person’s quality of life. It reduces their risk of infection, improves the sensation of heaviness in the affected area and increases movement and use of the limb. By improving the appearance or shape of the affected area it also gives them back confidence in themselves.

Q: How important is early intervention?

A: Extremely important, as it can prevent secondary complications arising (such as infection).

One of the biggest themes of people presenting later, when the limb is already quite large, is that they feel embarrassed by the attention they feel it draws and they stop participating in social activities. So it not only affects people physically, but there’s a huge emotional toll.

Q: What happens if lymphoedema goes untreated?

A: It can continue to deteriorate. As the limb tissue becomes fuller or more congested, the skin is put under more pressure. It can start cracking and leaking lymph fluid, putting the body at a high risk of infection which can deteriorate very quickly once bacteria enters the lymphatic system.

More load on a limb also puts more stress on the joints due to the weight of fluid.

Q: What’s the worst case you’ve seen? Why was it so bad?

A: I once treated a lady who had arm and breast lymphoedema following her mastectomy and lymph node dissection several years prior. Her arm function had deteriorated to the point she couldn’t dress her upper body herself, she couldn’t knit for her grandchildren (which she’d previously enjoyed), and she avoided family get-togethers for fear of frightening the young children with her arm. To segregate yourself from the people that love you most - I can’t imagine the emotions she must have experienced to make that decision.

Q: What have your patients told you about living with lymphoedema?

A: Initially it’s scary. There’s a lot of information to take on board, they wonder if they did something wrong or is there someone to blame. They say, “Why me?”, and “I just want to go back to normal.” Dealing with lymphoedema following a diagnosis of cancer can be overwhelming. It takes time and daily work (eg skin care, self-lymphatic drainage, compression) to look after the limb or breast, then, a year or so later, they know their new body. They can tell what’s going to cause an exacerbation and how they’ll going to manage it: they’ve regained control of their body.

Q: Can lymphoedema lead to other conditions?

A: Yes, there is a correlation between lymphoedema and depression and anxiety. Also shoulder issues (joint and muscle) due to the load on the shoulder joint when a limb is more severely affected by lymphoedema.

Q: What’s the most rewarding part of your job?

A: Seeing them smile; their happiness at being able to move and function more normally again, and no longer feeling like they want to isolate themselves.

Q: What’s the best feedback you’ve ever had from a patient?

A: That I gave them their life back! In the worst case I mentioned above, she could get dressed on her own again, and she went back to attending family events and knitting for the grandkids.