Understanding Lymphedema

Lymphedema generally occurs in one of your arms or legs. Although lymphedema tends to affect just one arm or leg, sometimes both arms or legs may become swollen.

The condition is characterised by swelling and a blockage in your lymphatic system, an important part of your immune and circulatory systems. The blockage prevents lymph fluid from draining well, and as the fluid builds up, the swelling continues.

Causes

Your lymphatic system is crucial to keeping your body healthy. It circulates protein-rich lymph fluid throughout your body, collecting bacteria, viruses and waste products. Your lymphatic system carries this fluid and harmful substances through your lymph vessels, which lead to lymph nodes. The wastes are then filtered out by lymphocytes, infection-fighting cells that live in your lymph nodes and are ultimately flushed from your body.

Lymphedema occurs when your lymph vessels are unable to adequately drain lymph fluid, usually from a leg. Lymphedema can be either primary or secondary. This means it can occur on its own (primary lymphedema), or it can be caused by another disease or condition (secondary lymphedema).

Causes of primary lymphedema

Primary lymphedema is a rare, inherited condition caused by problems with the development of lymph vessels in your body. Primary lymphedema occurs most frequently in women. Specific causes of primary lymphedema include:

• Milroy's  disease (congenital lymphedema)—This is an inherited disorder that begins in infancy and causes a malformation of your lymph nodes, leading to lymphedema.

• Meige's  disease (lymphedema praecox)—This hereditary disorder often causes lymphedema in childhood or around puberty, though it can occur in your 20s or early 30s. It causes your lymph vessels to form without the valves that keep lymph fluid from flowing backward, making it difficult for your body to properly drain the fluid from your limbs.

• Late-onset lymphedema (lymphedema tarda)—This occurs rarely and usually begins after age 35.

Causes of secondary lymphedema

Any condition or procedure that damages your lymph nodes or lymph vessels can cause lymphedema. Causes include:

• Surgery, if your lymph nodes and lymph vessels are removed or cut. For instance, surgery for breast cancer may include the removal of one or more lymph nodes in your armpit, to look for evidence that cancer has spread. If your remaining lymph nodes and lymph vessels can't compensate for those that have been removed, lymphedema may result in your arm.

A Curable Cause of Severe Chronic Leg Swelling - Dr Colin ...

And dots like freckles all over the front of the legs. This is called " hemosiderosis " (too much iron in the tissue from the blood), which occurs as blood leaks out of weak veins and just sits in the tissue. Your body's defense system gradually eats up all the material from the red blood cells, but leaves the iron behind. In general, diuretic medications do not  help chronic venous insufficiency that much. The big problem is that the stronger diuretics, which are needed, also take too much fluid out of the rest of your circulatory system, and leaves you feeling weak and dizzy. At this point you have to stop the diuretic. In the long term, once the veins have really failed, the only thing that may offer additional help is vein-stripping surgery. (benign or malignant) can also put pressure on the veins and cause the same kind of edematous fluid back up. The good news is that in adults, tumors that block veins tend to occur on one side or the other but not both. Fortunately this is relatively rare.  In both these cases, a fluid pill (diuretic) will not help if the cause of the obstruction is not relieved. In pregnancy, you get that nice dramatic relief of obstruction when the baby is born. . In this condition, which usually occurs in people who have already had coronary artery disease, a heart attack, or severe hypertension, the heart muscle becomes weak and is no longer able to pump out the normal amount of blood with each beat. Slowly fluid starts to back up in the veins. When it backs all the way up into the lung veins, then you get acutely short of breath in a condition called ." This is an unusual and very severe form of leg swelling. It is not really a true 'edema' as in the other conditions described, but rather is a ' lymphedema .' Here the problem is abnormal formation of the lymph vessels in growth and development with the result that the flow of lymph fluid is blocked and just slowly accumulates in the deep tissues of the leg. This kind of edema causes the feet to swell so that they look like wooden blocks at times, and the swelling tends to extend all the way up to the knees. This swelling also has a very different feel to it when you touch it; it is very hard and you can feel fibrous scarring in the subcutaneous tissue, whereas common edema is soft and leaves little impressions, indentations, when you press on it gently with your finger. The worst news of all is that .

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