Primary Lymphedema is typically related to an abnormal formation of the lymphatic system in utero. The symptoms may be noted at any point in the life of the person, however many we see have some commonalties.
Often female patients notice lymphedema during puberty or pregnancy. Typically edema associated with pregnancy occurs in the last trimester and usually will resolve within 2-3 weeks after birth. If one limb, in particular, does not reduce, check with your physician. This could be related to the venous system but may also be the onset of congenital lymphedema. I once saw a client whom with her first pregnancy her right leg began to swell. With her second pregnancy her right arm and left leg began to swell. This is an extreme case. Most often, a client will note one swollen extremity or a combination of two with one most often worse than the other.
A typical age, for both men and women, for adult onset lymphedema is around 35-40 years old. People often ask why now, why did I not swell much younger. The lymphatic’s developed adequately enough to maintain the lymph workload for many years, but as we age the body’s abilities slowly decline. At some point the decline reaches the lymphatic maximal capabilities and edema becomes evident.
What are some causes of Secondary Lymphedema?
This is lymphedema that is caused by many other sources, but not related to a defect in lymphatic formation. Secondary lymphedema can be related to many causative factors such as; trauma, surgery related to cancer, radiation, venous insufficiency etc. Many of the clients we see have undergone mastectomies with lymph node removal and often radiation. Lymph nodes are responsible for processing lymphatic fluid. If these nodes are removed leaving less ‘workers’ to carry on the extra workload, a backup can occur. As an example, if you have 10 factories processing multiple orders a day and you close 5 of these factories without reducing the amount of orders, production slows and factories back up.
Radiation and the surgical procedure itself can also lead to scarring. Radiation can scar some of the lymph nodes that are remaining leaving the system further compromised. Scarring associated with the surgical incisions can further block lymphatic fluid.
No! It is not your physician’s fault that you are swollen. Your physician did all he/she was able to do to save your life, to rid you of your cancer. Lymphedema, unfortunately, is a side effect of the treatment, but the treatments had to be done.