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Treating lymphedema

Sanford Health program features certified
lymphedema therapists
Carol Jacobson's right arm is back to normal size thanks to Medcenter One's lymphedema program.
Lymphedema caused Carol Jacobson’s right arm to swell to nearly twice its normal size. Sanford Health’s lymphedema treatment program helped eliminate the swelling and home care has helped Jacobson prevent a relapse.
  After two bouts of severe bacterial infections in her right arm, Carol Jacobson was diagnosed with lymphedema, a chronic condition that caused her right arm to swell to twice the size of her left.

Six months after completing lymphedema therapy at the Sanford Rehabilitation Center, her right arm had returned to its normal size.

Lymphedema is an accumulation of a fluid in tissues that causes swelling and other skin concerns. Primary lymphedema may develop at birth or later in life and is caused by a defect or malformation of the lymphatic system—a system of organs, ducts and nodes designed to transport and balance the body’s fluids. Jacobson’s was secondary lymphedema, the more common type, that results from cancer, surgery, trauma or infection.

The swelling occurs when a disruption in the lymphatic system causes abnormal lymph drainage. As the fluid accumulates, the swelling continues. Lymphedema most commonly occurs in the arms and legs.

Cancer and its related surgeries and radiation are the most common causes of secondary lymphedema. Jacobson had undergone a mastectomy in 1992 but showed no symptoms of lymphedema until her first infection.

Jacobson’s lymphedema resulted from cellulitis, a potentially serious bacterial skin infection appearing as swollen, red areas that feel hot and tender. During a trip to Fargo in November 2007, the Bismarck woman’s right arm began to itch, and red blotches appeared. “By the time my husband, Rod, and I arrived at a Fargo emergency room an hour and a half later, I was nauseated and shaking from severe chills,” Jacobson said.

She had developed septicemia, a serious life-threatening infection that required her to be hospitalized for five days for IV antibiotic therapy. The cellulitis recurred the next month, requiring a two-day hospital stay.

In January 2008, Kent Martin, MD, an infectious disease specialist at Sanford Clinic, referred Jacobson for therapy.

“There is no cure for lymphedema, but it can be controlled,” said Jen Newman, occupational therapist and certified lymphedema therapist with the Sanford Rehabilitation Center. Treatment usually ranges from two to six weeks in length, with patients coming in three to five times a week.

There are four types of treatment:

  • Manual lymphatic drainage. This gentle, hands-on treatment helps redirect the lymphatic fluid from the limb or affected area into other unaffected areas of the body.
  • Compression bandaging and garments. Compressing the swollen area with short stretch bandages creates pressure that helps return the fluid to the lymphatic system.
  • Lymphatic exercises. Exercises performed daily while wearing compression bandages or garments increases muscle pump activity and fluid redirection.
  • Skin and nail care. Therapists provide care to prevent skin infections. Depending on the stage of lymphedema, there may be skin issues requiring additional treatment.
  Dr. Kent Martin
Kent Martin, MD
Infectious disease

Jen Newman
Jen Newman
Occupational therapy

“Lymphedema can be treated at any stage,” Newman said.

Jacobson saw Newman five days a week for six weeks and said the results were dramatic. “Jen washed and wrapped my arm every day and taught me exercises to do at home, which I faithfully followed,” Jacobson said. “I was shocked to see how much the swelling had gone down by the end of the first week. Every time she unwrapped my arm, I could see a difference.”

In addition to a compression sleeve worn during the day, Jacobson also wears a custom sleeve at night, a practice she’ll continue the rest of her life.

After four weeks of therapy, the swelling in Jacobson’s arm had reduced by 35 percent. At her six-month evaluation, it had reduced by 50 percent.

“The therapy has made all the difference,” she said. “Jen was fantastic.”

Jacobson stresses to others with lymphedema the importance of getting swelling under control. “I wanted to do whatever necessary to help my arm return to normal size,” she said.

Jacobson’s results speak for themselves. The size of her arm has not increased since completing treatment nearly two years ago.

Click here for more information on Sanford Health’s lymphedema program, or call
(701) 323-6373.

 

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