All patients who undergo lymph node dissection or radiation of the lymph nodes are at risk of developing lymphedema. Regeneration of the lymphatics does not occur so the risk is for life. Lymphedema can occur as soon as 3 months or as late as 30 years after surgery and/or radiation therapy.
Limb heaviness in the affected extremity(ies) is the most common symptom of lymphedema. Even though an unusual amount of swelling may not be visibly evident, the abundance of fluid that lies within the tissues of the arm(s) or leg(s) can be compared to that of a wet sponge.
Other signs of lymphedema include “pitting” edema. This is evident when the skin is depressed with your finger for a few seconds and the indentation does not immediately disappear. Patients may also experience tightness of the skin and notice that jewelry and clothing feel tighter in the affected extremity(ies).
The accumulation of this stagnant, protein rich fluid creates a high degree of discomfort and immobility for the patient, and provides a rich culture medium for bacterial growth. Lymphedema makes patients more prone to cellulitis or lymphangitis infections and with each infection, the lymphedema can get progressively worse.
Lymphedema manifests itself with the following signs and symptoms:
- Limb heaviness
- Aching limbs
- Fibrosis (thickening of the tissue that causes hardening of the skin)
- Skin changes (redness/purplish discoloration, dryness, increased warmth)
- Open skin areas or wounds (venous ulcers)
- Disfiguring edema (difficulty finding shoes or clothes)
- Decreased range of motion
- Decreased functional mobility
- Decreased muscular strength
- Excessive pain/discomfort
- Decreased quality of life