Although lymphedema is a chronic (long-term) condition without a cure, it can be well-managed with Complex/Complete Decongestive Therapy (CDT). This means that non-surgical treatments such as compression therapy, lymphatic drainage, exercise, skin care, and self-management are usually sufficient to treat the signs and symptoms. Lymphedema surgery, such as lymph node transfer, might be appropriate in some cases.
What it takes to cope with lymphedema
What is complex/complete decongestive therapy?
Complete Decongestive Therapy (CDT), sometimes also referred to as Complex Decongestive Therapy, is the gold standard for management of lymphedema. As the name suggests, the main aim is to decongest, to reduce swelling and moreover to improve skin condition and mobility. CDT consists of two phases:
- Phase I – Decongestion: Intensive treatment phase which usually lasts 2-4 weeks. In case of a mild lymphedema this phase might not be necessary, and the patient could go straight into Phase II
- Phase II – Maintenance and Optimization: In this phase the goal is to gain long-term control over your lymphedema by maintaining and maximizing the achievements of Phase I. Depending on the course and severity of your condition, it might be necessary to go back into Phase I from time to time.
Both phases consist of several elements.
What it takes to cope with lymphedema
Compression Therapy is the cornerstone of both phases, though in Phase I the compression needs to be more adaptable as the swelling will be reduced significantly over time. Therefore short-stretch bandages, often as part of a multi-layer bandage system, or adaptive wrap systems are used. In Phase II usually flat-knit garments maintain the achieved success.
Lymphatic drainage further supports the effect of compression therapy. It is a specific massage technique with gentle, skin-stretching movements applied by a therapist and then called Manual Lymphatic Drainage (MLD). It could also be learned by the patient and self-applied, which is rather the case in Phase II of CDT. This is then referred to as Simple/Self Lymphatic Drainage (SLD).
Exercise is an element of both phases, too. In lymphedema treatment it is necessary to maintain and improve mobility as well as to increase the lymphatic flow. In Phase I this is usually supported by a therapist, while in Phase II your active role is required more.
Skin Care and Self-Management are essential in both phases of CDT. With lymphedema you are more prone to local infections and even small skin injuries can cause bacterial infections which might further worsen your condition. Taking good care of your skin is only one element of Self-Management. It also means that you take a leading role in your condition and that you gain a deep understanding of lymphedema in general. This will support you in working with your healthcare professional in partnership and on eye level.
