Lymphoedema

Lymphoedema is an accumulation of fluid and protein in the tissues. It is a chronic condition which can occur when the lymph system is unable to fulfil its function, or when lymph vessels are absent, underdeveloped or obstructed. Lymphoedema can be Primary (no known cause) or Secondary (due to trauma, removal of lymph nodes, radiation therapy, etc.).

Lymphoedema Treatment

You will be asked to bring a letter from your Doctor or Consultant to your first treatment.

There are 4 cornerstones of treatment for lymphoedema:

  • MLD – 3-5 times weekly (intensive phase), or as required (maintenance phase)
  • Compression – MLLB (multi-layered lymphoedema bandaging) or cohesive bandaging during the intensive phase when volume reduction is rapid, or compression garments during the maintenance phase
  • Exercise – done at home yourself, to further promote lymphatic flow
  • Skincare – again, done at home yourself, to keep the skin soft and supple and to minimise the risk of infection

Treatment involves an intensive phase of 2-4 weeks, followed by maintenance.

Intensive Phase

The goal of the intensive phase is to reduce the swelling as much as possible, and to promote the flow of lymph. Where necessary, lymph is re-directed to unaffected lymph nodes. This involves MLD treatment 3-5 times weekly, followed by the application of MLLB (multi-layered lymphoedema bandaging). In some cases, a less bulky cohesive bandaging is used. Instruction is given on exercise, skincare, fluid intake and good nutrition. The limb is regularly re-measured and treatment continues until maximum reduction is achieved. This course of treatment is also known as CDT (combined decongestive therapy or complete decongestive therapy), or DLT (decongestive lymphatic therapy).

In some cases MLLB is unsuitable (e.g. frailty, or complex medical problems) or unwarranted (e.g. a less severe lymphoedema) so MLD without MLLB (or cohesive bandages) may be advised.

Maintenance Phase

Once the intensive phase is complete, maintenance begins. The goal of maintenance is for you to keep your limb volume down yourself. You will be fitted with appropriate compression garments, and will continue by yourself with exercises, skincare, good fluid intake and good nutrition. You will be re-measured every 6 months for new compression garments, and to make sure your volume does not increase again. More severe lymphoedemas may require further CDT treatment.

Compression Bandaging

We are trained to use multi-layer lymphoedema bandaging. We are also trained to use a less bulky cohesive bandaging system.

Compression Garments

We are trained to measure for custom-made and off-the-shelf medical compression garments from Medi, Jobst, Elvarex, Juzo and Jobskin. We are also trained to assess and fit you for the Circaid and Readywrap compression systems.

Severe Cases

Severe lymphoedemas are treated here and may also be referred for treatment abroad, where treatment is done in a hospital setting twice daily. Maintenance treatment is continued here following your treatment abroad.

Payment

Treatment here can be paid for privately. Your private health insurer may reimburse some of the cost. Check your own plan to see what cover is available to you.

Tax relief may be claimed for any payment which is not reimbursed by your healthcare insurer. Complete form MED1 and send to your normal tax office to apply.

Medical card holders may be covered for treatment, bandages and compression garments. Your Doctor should apply to your normal HSE office for the full cost of treatment, bandages and compression garments prior to your commencing treatment. You may benefit from attending here for an assessment before applying.

Medical card holders are usually entitled to two compression garments per annum. We measure for these garments here.

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