The affects of lynmphoedema vary depending on its' severity. In its mildest form lymphoema can be just a slight swelling in the upper limbs, lower limbs or genitals. When more severe, the swelling can affect the mobility of joints - causing discomfort and heaviness. Severe lymphoedema can result in the leaking of lymph from the skin and occasionally it can allow the development of cellulitis - a skin infection. If the lymphoedema gets very severe it can even affect the patient's mobility.

The Patient's Story:

Mrs Ancans-Easter from Surrey has had successful treatment of a swollen right foot due to lymphoedema by Miss Catharine McGuiness at the The Whiteley Clinic. The first thing Mrs Ancans-Easter had noticed was a sudden swelling of the right ankle and foot following a week's holiday. The swelling was very painful and made putting on shoes almost impossible.

After visiting her GP she was told it was water retention and advised to rest and try support stockings - and maybe try buying larger shoes. There was no improvement using these measures and the swelling got worse. The discomfort increased and it started affecting her everyday life, leaving her feeling miserable and unwell. After visiting the GP several times Mrs Ancans-Easter asked for a 2nd opinion.

On arriving at the clinic, Mrs Ancans-Easter was given a full examination by a Consultant who suspected Lymphoedema clinically. A series of tests were carried out to confirm this diagnosis.

Tests:

The first - a nuclear scan called an Isotope Lymphogram test (Lymphoscintigraphy) was conducted to exclude anything else and to confirm diagnosis. Lymphoscintigraphy involves an injection of radio-isotope between the toes on both feet, which is preferably taken up by the lymphatics. After the injections the leg is scanned at 30 minute intervals up to 2 hours to see how far the isotope has travelled up the leg. This test shows if there is a hold up of the lymph drainage and if so, what level the blockage is.

An MRI scan was also done to check for any underlying cause of the swelling. According to the specialist, it was thought the lymphoedema was triggered by previous abdominal surgery. A full explanation of the condition was given to Mrs Ancans-Easter, who had never heard of the condition previously, and a description of the affects and treatments available.

The Specialist Treatment Options:

Treatments currently available for Lymphoedema vary depending on the severity.

Some of the conservative measures include compression stockings, regular foot care, regular foot exercises and avoiding repetitive hard exercises.

For the more advanced stages Manual Lymphatic Drainage (MLD, a sort of specialised massage), intensive bandaging and pneumatic compression can be used. Patients are taught to do their own manual lymphatic drainage using a massage technique and are given dietary advice.

Very occasionally, in the more severe cases, a surgical operation can be required. Operations can be used to reduce the size of the limb and to remove abnormal areas of skin or, rarely, they can involve the formation of a lymphatic bypass. Sometimes the correction of the original problem through surgery can help.

The Patient's Treatment: