Lymphedema Therapy
Treatment offered by Ria Keinert

What is Lymphedema?

Lymphedema means "swelling of fluid". This can be in the arm, hand, leg, foot, face, genitalia, or trunk. The fluid is lymph, which is made of water plus proteins. The lymph is carried to the core of the body via lymphatic vessels, which are tiny and right under the skin.

Lymphedema can be primary, which means the lymphatic vessels aren't working right, or secondary, which means it was caused by cancer, radiation, injury, surgery, or disease. Left untreated, lymphedema can lead to infections, disfigurement, and loss of function. There is no known cure for this condition. Even surgery is a poor solution because the scars of surgery interrupt the fragile lymph vessels, so they end up making the swelling worse. Complex decongestive therapy is the management strategy of choice. It must be performed by a certified lymphedema therapist. Ria Keinert was trained in the Casley-Smith School of Lymphedema Therapy in Adelaide, Australia.

Lymphedema Therapy

Complex lymphedema therapy consists of six distinct parts:

Specialized massage called manual lymph drainage (MLD)
Skin care to prevent infections
Compression in the form of low-stretch bandages
Patient education for safety, avoiding infections, training the partner in home MLD, etc
Specialized lymphedema exercises to enhance the flow of lymph to the trunk
Fitting of special sleeve, glove, garment, or stocking to prevent recurrence of swelling

Lymphedema of the Arm

Lymphedema of the arm can strike either gender, but a typical arm lymphedema patient is a woman breast cancer survivor who has had some of her lymph nodes removed or irradiated (sometimes 40 years ago) and begins to notice that her arm is growing tighter, larger, or feeling strange. She may have been told by doctors not to expect to get any better, that at least she doesn't have cancer, and to learn to live with the swelling.

A patient may be treated 2-5 times a week for 2 to 4 weeks. They will receive gentle MLD massage to the trunk and arm. The arm and hand will be wrapped in low-stretch bandages most of the time for the next few weeks. The patient will learn the special exercises and gradually take over more of the bandaging herself, and may have a friend or family member learn how to do some massaging at home. Limb volumes may be calculated weekly, in order to track the reshaping of the limb. The patient will be fitted with a sleeve and/or glove to wear in order to hold the shape once therapy is finished.

Lymphedema of the Leg

A typical leg lymphedema patient has had "bad veins" (varicose) for a long time, or has had lymph nodes removed from the groin. There may be some swelling and infections, and one or both legs become larger than before. Often the tissues will be hard and leathery in places. Aching and tenderness in the leg may worsen as the day goes on.

This patient may be treated 2-5 times a week for 2 to 4 weeks. They will receive gentle MLD massage to the trunk and leg, and then the leg and foot will be wrapped in low-stretch bandages most of the time for the next few weeks. The patient will learn the special exercises and gradually take over more of the bandaging, and may have a friend or family member learn how to do some massaging at home. Leg volumes may be calculated weekly, in order to track the reshaping of the leg. The patient will be fitted with an appropriate compression stocking to wear during the day in order to hold the shape once therapy has finished.

Lymphedema Supplies

Ria Keinert can fit and order the following products for you:

	Jovi lymphedema sleeves
	Medi® compression garments
	Barton-Carey® compression garments