Acute versus gradual-onset lymphedema

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Acute versus gradual-onset lymphedema

There are four types of acute lymphedema.

Type One Acute Lymphedema

The first type of acute lymphedema is mild and lasts only a short
time, occurring a few days after surgery to remove the lymph nodes or
after injury to the lymphatic vessels or veins just under the
collarbone. The affected limb may be warm and slightly red, but is
usually not painful and gets better within a week by keeping the
affected arm or leg supported in a raised position and by contracting
the muscles in the affected limb (for example, making a fist and
releasing it).

Type Two Acute Lymphedema

The second type of acute lymphedema occurs 6 to 8 weeks after surgery
or during a course of radiation therapy. This type may be caused by
inflammation of either lymphatic vessels or veins. The affected limb
is tender, warm or hot, and red and is treated by keeping the limb
supported in a raised position and taking anti-inflammatory drugs.

Type Three Acute Lymphedema

The third type of acute lymphedema occurs after an insect bite, minor
injury, or burn that causes an infection of the skin and the lymphatic
vessels near the skin surface. It may occur on an arm or leg that is
chronically swollen. The affected area is red, very tender, and hot
and is treated by supporting the affected arm or leg in a raised
position and taking antibiotics A compression pump should not be used
and the affected area should not be wrapped with elastic bandages
during the early stages of infection. Mild redness may continue after
the infection.

Type Four Acute Lymphedema

The fourth and most common type of acute lymphedema develops very
slowly and may become noticeable 18 to 24 months after surgery or not
until many years after cancer treatment. The patient may experience
discomfort of the skin; aching in the neck, shoulders, spine, or hips
caused by stretching of the soft tissues or overuse of muscles; or
posture changes caused by increased weight of the arm or leg.
Lymphedema PDQ

Proposed Type Five Acute Lymphedema

This is my own personal opinion, but from my experience in my own life
as well as other lymphedema patients, I feel a fifth type of acute
lymphedema needs to be recognized.

Type Five occurs when a chronic lymphedema patient experiences a
sudden and unexplainable change in the amount of swelling they are
experiencing.

I have heard many lymphedema patients, share that they have an
enormous amount of additional swelling in their affected limbs or that
suddenly they are experiencing abdominal, or truncal that they have
not experienced before.

In this situation it is paramount that additional medical test be
undertaken to find out “why” this sudden change in edema.

Treatment for this additional acute swellin should be started
immediately to forestall further complications and further permenant
damage to the lymphatic system.

If this acute phase involves the chest and/or lungs and the patient is
experiencing difficulty in breathing, tests must be performed to
ascertain whether or not there is a pleural effusion.

In this acute phase any treatment program must be customized to the
exact situation of the patient. Additional treatment may include a
thoracentesis and/or the short term use of diuretics.

Pat O’Connor