Daily News: Disease

Low-key condition affects high patient numbers

Lubbock Avalanche-Journal (TX)

07-03-13

July 03--A few months after having surgery to remove breast cancer, Glenda Enderson began noticing an unexplained heaviness and aching in her arm.

She'd heard the word "lymphedema" but never gave it a meaning or expect a diagnosis, she said.

Belinda Alexander, occupational therapist and certified lymphedema therapist at the Covenant Health Lymphedema Treatment Center, said Enderson's case is similar to many others she treats because the patients are generally not aware they have the condition.

"I still get patients that say 'Hey, I've had this swelling for years,' " Alexander said. "Nobody knows what to do with it."

Enderson first mentioned her discomfort at a checkup in March after having surgery in November, she said.

"Nobody said anything really, particularly about it," Enderson said. "When I really got to see the surgeon at the checkup, the nurse said it was swollen. It had been paining me. I was very uncomfortable. It was quite a bit larger than the other arm already. It was a sign that I was beginning to have a problem."

The condition can affect all of the body and is caused when lymph node fluid builds, Alexander said.

"The easiest way (to describe it) is a swelling that involves the lymphatic system," Alexander said. "Lymphatic fluid over time became very protein-rich, causing problems for risk of infections. It's not an accumulation of blood, but a swelling within the lymphatic system."

The impact of the condition varies case by case, both externally and internally, she said. Swelling and/or discomfort in the affected region may be more severe or visible in one case than others.

Statistics show the condition often appears in people who have been treated for cancer, Alexander said.

"In the United States, the most common reasons are associated with cancer and cancer's treatment," she said. "Folks, particularly those with breast cancer, have lymph nodes removed or lymph nodes radiated. It damages structure of the lymphatic system. ... Any surgeries that remove lymph nodes, you affect that area's ability to clear fluid. Your lymphatic system helps your circulatory system. They work together."

Alexander said symptoms usually appear after surgery or trauma. The time frame ranges from days to years after the event. Once the symptoms show, there are a few treatments to control the effects, but no cures to permanently rid them.

"Once you have it, you have it," she said. "You're always at risk. Nobody else may know you have it."

Alexander often prescribes a compression sleeve for treatment and weekly therapeutic massages to the affected area to help manipulate the fluid build-up.

Enderson is one of Alexander's patients who receives lymphedema massage treatment weekly.

"I lie on a comfortable table and gently, it's not a pressure massage, a gentle massage that stretches my skin," Enderson said. "I can feel her pushing the fluid up and over to my side that's not affected. ... It's very relaxing and you can feel the fluid begin to move."

There are no specific doctors to treat the conditions, just specially trained therapists, Alexander said.

Alexander said even fewer severe cases are fatal.

ellysa.gonzalez@lubbockonline.com

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