OLIWIA ZEBROWSKA(P4.)The lymphatic system is a network of tissues and organs that help rid the body of toxins, waste and other unwanted materials. The lymphatic system which drains lymph into the lymphatic vessels that are located at the spaces of tissues and organs. Then they are transported to thicker collecting lymphatics, which are surrounded with multiple lymph nodes. Fluid removal from tissues helps reducing development of edema (tissue swelling from increased flow of fluid into tissues) . The lymphatic system provides fatty acid absorption from the digestive system. During fat digestion, fatty acids are digested as well as converted into chylomicrons. The lymphatic system serves as a conduit for transport of cells involved in immune system function. White blood cells (lymphocytes) and antigen are transported to lymph nodes, where the immune system gets rid of pathogens, microbes, and other immune elicitors. Lymphatic system is made out of certains organs like: Bone marrow, Thymus, Lymph nodes, Spleen and Tonsils. If any of those organs are not functioning correctly, there are some disorders or diseases that may appear. Lymphedema:(lymphoedema and lymphatic edema) is a condition of fluid and tissue swelling caused by a compromised lymphatic system. Lymphedema is mostly caused by the removal of or damage to your lymph nodes by cancer treatment. It is because of blockage in your lymphatic system, which is part of your immune system. The blockage prevents lymph fluid from draining well, and the fluid building up leads to swelling. Lymphedema signs and symptoms:-Swelling of part or all of your arm or leg, including fingers or toes-A feeling of heaviness or tightness-Restricted range of motion-Aching or discomfort-Recurring infections-Hardening and thickening of the skin (fibrosis)In lymphedema swelling ranges from not even noticeable changes to hardcore ones, that move and take place in your whole arm or leg. Lymphedema caused by cancer treatment may not occur until months or years after treatment. Lymphedema occurs when your lymph vessels are unable to drain lymph fluid. Lymphedema can be primary or secondary. This means it can occur on its own in your body (primary lymphedema) or it can appear because of diseases or other conditions (secondary lymphedema). The most common one is secondary lymphedema.Causes of secondary lymphedema: -Surgery. Lymph nodes may be removed and lymph nodes may be injured in surgery. -Radiation treatment for cancer. Scarring and inflammation of your lymph nodes or lymph vessels may happen by radiation.-Cancer. If cancer cells block lymphatic vessels, lymphedema may result. -Infection. An infection of the lymph nodes or parasites can restrict the flow of lymph fluid.Causes of primary lymphedema:-Congenital lymphedema causes lymph nodes to form abnormally.-Lymphedema praecox causes lymphedema around puberty or during pregnancy, till age 35.-Lymphedema tardan occurs usually begins after age 35.Treatment: (m2)To reduce your risk of lymphedema, try to protect your arm or leg. Cuts, scrapes and burns can invite infection which means to protect yourself from sharp objects. It is good to avoid blood draws and vaccinations, in your affected piece of body.After cancer treatment you should exercise and stretch. Light exercises help to prepare you for everyday tasks, such as carrying groceries. Exercises shouldn’t be tire you but should focus on gentle contraction of the muscles in your arm or leg. Don’t apply ice or heat, such as with a heating pad, to your affected limb. Avoid tight clothing in the case of your arm, blood pressure cuffs. Make sure, that your hygiene level is very high eg. clean skin and nails. Case Study: (D2) Female, Ms. B.P, age 46 yo who has breast cancer in 1995. After she had radiation in March 1996 and chemotherapy from April 1995 to February 1996. The patient reports a sudden swelling in her right arm and hand in 1997. She was diagnosed with lymphedema. In the past, she has had MANUAL LYMPHATIC DRAINAGE and Complete Decongestive Physiotherapy , compression sleeves and takes benzopyrones. She used to have a home maintenance program, except to bandage at night and wear compression sleeve. The patient said that she had been treated in the past, but found it impossible to bandage her right arm because she is right handed. Every summer, she get an exacerbation, repeats MLD, and that each year it is more difficult to reduce edema. . Observations : The right arm and hand were optically larger than the left ones. The edema volume chart showed that it increased about 24.7% in the affected limb. The back of her right hand was extremely edematous. The edema was greater in the lower than the upper arm. The skin was warm, dry and had no infection. Treatment: The patient was told to do MLD/CDP daily X 20 treatments. During this time she was told how to do manual skin care, breathing and arm exercises. She was given a Lymphapress 201M compression pump, a ReidSleeve Optiflow SC insert to be worn under the pump sleeve during pumping time for stimulation of lymphatic system, and opening the collateral pathways. The ReidSleeve was substituted for compression bandaging at night. RESULTS: The patient had a really good results in MLD/CDP. After 5 treatments, her edema volume decreased about 70.6% down. Her hand continued to be puffy and edematous. Intense workout on the hand and arm was applied, which corrected its movement abilities. She received her ReidSleeve that day and wore it at bedtime. When she returned for her 10th treatment, her hand had visibly gone down to almost normal. When measured, her edema volume chart revealed a 97.8% reduction in volume in her right arm. The last two weeks of MLD therapy, the patient refused to wear banding, but rather to do her home maintenance program to help her to improve her daily activities. She finished her 20 treatments with her MLD therapy and she had a 91% reduction of volume. Later she was able to come back to her old job in library.