What is Lymphoedema?

Today I had some fantastic training at our student forum. This was run by two wonderful, passionate Lymphoedema nurses as part of the Birmingham Community Healthcare NHS Trust training sessions. So, as always, I am going to tell you everything I have learnt today and hope that this will help others and help patients to get better care for their Lymphoedema.

What does the Lymphatic system do?

lymph

(Google Image 2019)

  • Fluid balance
  • Immune response
  • Absorption of lipids

It sends 3 litres of lymph fluid around the body. This fluid is made up of; proteins, salts, glucose and fats. It also contains B and T cells and other white blood cells. Did you know you have around 600-700 lymph nodes in your body? You can read more about what this incredible system does here – https://lymphoma-action.org.uk/about-lymphoma-what-lymphoma/lymphatic-system

What is Lymphoedema?

This is a long term and chronic condition – it can not be cured. Instead nurses educate the patient to manage their condition from home or assist in the management of the condition.

This condition causes swelling in the bodies tissues as a result of the lymphatic system not working or failing. If not treated, this will get worse.

Primary Lymphoedema: Caused by genetics and usually people are born with this.

Secondary Lymphoedema: Caused by damage or failed lymphatic system.

You can read more about Lymphoedema here – https://www.nhs.uk/conditions/lymphoedema/causes/

What causes Lymphoedema?

  • Obesity (one of the biggest causes)
  • Infections
  • Having removal of lymph nodes
  • Immobility
  • Radiotherapy
  • DVT / vein damage
  • Cancer and trauma
  • Certain medications such as amlodipine

Signs and symptoms:

pitting-edema-image-credit-james-heilman-md-2017-february-1

Pitting of Oedema (google image 2019) 

  • Pitting
  • Chronic inflammation
  • skin changes
  • Swelling
  • Pressure / stiffness
  • Tightness
  • Pins and needle feeling
  • Aching but not painful
  • Itching

Lymphoedema can be misdiagnosed as cellulitis as it resembles its appearance. However, Cellulitis is only present in ONE leg. Cellulitis is an infection and shouldn’t spread to both legs.

Management:

  • Washing of the legs daily (most important)
  • Wraps
  • Compression dressings
  • Biompendance / fluoroscopy
  • Electro-stimulation
  • Psycho-social
  • Lymph draining
  • Losing weight
  • Low level light therapy
  • Blood screening
  • Hosiery
  • Kinesio-taping
  • Lebed
  • Negative suction
  • Self management
  • Encouraging clearance of fluid from body tissues

What should healthcare professionals be doing?

Encouraging and motivating your patient on a daily basis to take charge of their condition – This is their condition to manage as much as they can. Get your patient to wash / scrub their legs on a daily basis to keep them clean, clear and free from infection and ensure they are dry enough before covering them up. This will also prevent any fungal infections as well as things such as cellulitis. If your patient struggles to bend down to do this, assist were you can.

Encourage and motivate your patient to exercise daily. This will help with circulation and shifting that fluid around and if your patient suffers with obesity, this will help with weight loss.

Referral to Lymphoedema nurse specialists if you are unable to manage this condition and book into training sessions for more awareness on how to manage this condition.

Compression bandaging and use of hosiery which is all available on prescription for the patient. But patient should be assessed first for the right size, type of compression etc. The wrong type of dressing and compression could make things a lot worse for the patient! Always seek advice first.

All in all this was an amazing morning of learning. Really useful to see what these nurses do and how to manage future patients in my care. And on one last little note, I thought I would share some photos of what Lymphoedema looks like.

Thanks for stopping by. Goodbye for now and have a great weekend everyone! 🙂

 

About

34 years old and finally achieving my dream of becoming a nurse.

4 Comments

  • Margaret Sneddon April 8, 2019 at 7:05 pm Reply

    Great that your programme included this and you have taken so much from it. If you are interested in Lymphoedema visit the British Lymphology Society website and sign up as a Friend to get regular updates and access lots of resources – no cost!

    • DiaryOfTheStudentNurse April 8, 2019 at 8:46 pm Reply

      Thank you so much! That’s great! I’ll look into that now 🙂

  • Ann-Marie Dodson April 7, 2019 at 9:05 pm Reply

    Great effort as always.A very useful summary.👌Lipoedema & the differences are interesting to explore& treatments.I had a long conversation with Garry about this👌Hope you don’t mind an edit🤔
    It’s amilodopine & cellulitis is not an infection itself but swelling of the cells and deeper tissues caused by an infection.Well done as always Claire⭐️⭐️⭐️

    • DiaryOfTheStudentNurse April 7, 2019 at 9:07 pm Reply

      Thank you Ann-Marie! 🙈 this is why you should always get someone to proof read haha!
      I found it so interesting to learn. Really enjoyed this 🙂 maybe another pathway in the future! 🌻

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