Lymphedema is the swelling due to failure of the lymphatic system.
Lymphedema is swelling of an arm of leg due to issues of the lymphatic system. Chronic lymphedema is the term used for lymphedema that has been present for more than 6 months and is likely permanent. It may result in minor swelling and discomfort. Occasionally, it leads to a disability and disfigurement. In severe cases, the affected limb can be debilitating.
The most common areas of the body that are affected are the arm or leg. There are two types of lymphedema. Primary lymphedema is usually determined from birth and is often hereditary. Secondary lymphedema is usually caused by damage to valves or the removal of the lymph nodes. Sometimes secondary lymphedema is caused by an accident or severe infection. Moreover, some primary lymphedema does not occur until later in life thus it is difficult to find a reason why it happened.
Lymphedema may be made worse by a skin infection. Conversely, skin infections can be difficult to treat in someone with pre-existing lymphedema. Many people with lymphangitis are misdiagnosed with cellulitis, or chronic cellulitis, so their lives revolve around antibiotics and leg wraps to stop their legs from weeping (draining fluid). Unless managed properly, these infections will never go away and lead to further medical involvement, including hospitalization and possible amputation.
With this in mind, it is the management of lymphedema that is the main area of focus. It seems daunting and can be confusing at times. It shouldn't be. Lymphedema is like any other medical condition, in that you can maintain it by managing it. We will first assess you for conditions that may mimic lymphedema to ensure that we are being thorough. Once cleared, we proceed with a goal of home-management. If necessary, Dr. Parisi works with specialists to remove excess skin that is the result of lymphedema.
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Grade 1 –
When the skin is pressed the pressure will leave a pit that takes some time to fill back in. This is referred to as pitting edema. Sometimes elevating the limb for a few hours can reduce the swelling. There is little or no fibrosis (hardening) at this state, so it is usually reversible.
Grade 2 –
When the swollen area is pressed, it does not pit, and the swelling is not reduced very much by elevation. If left untreated, the tissue in the limb gradually hardens and becomes fibrotic.
Grade 3 –
The lymphedema is often called elephantiasis. It occurs almost exclusively in the legs after progressive lymphedema. At this stage, are likely to be gross changes to the skin and it may protrude and bulge. There may be some leakage of fluid through the tissue in the affected area, especially if there is a cut or sore. While lymphedema will respond to treatment at this state, it is rarely reversible.