The Second Circulatory System The Therapeutic Effects of Manual Lymphatic Drainage
body has another circulatory system that works in conjunction with the blood system. This is the lymphatic sys- tem, a mechanism for removing excess fluid protein and water from the spaces around the cells, and then returning this protein and water to the blood system.
W
Fluid Flow The main constituent in the human body is water, averaging approximately 60 percent of a man’s body weight and 55 percent of a woman’s. The fluids in the body contain solutes, which are dissolved solid substances known as electrolytes and non-electrolytes. Elec- trolytes are mineral compounds that carry an electrical charge; these include sodium, potassium, chloride and phos- phate. Non-electrolytes include glucose (simple sugar) and urea (metabolism of amino acids). Fluids are found in two compart-
ments through the body. Intracellular fluid is found within cells; extracellu- lar fluid is found outside of individual cells. Approximately two-thirds of the body’s fluid is intracellular, while one- third is extracellular. The fluid compart- ments in the body are separated by semi-permeable membranes that allow the movement of water and solutes by osmosis. While water and some small molecules can move easily between compartments, proteins do not cross the membrane with ease.
Lymphedema Edema is the swelling of tissue due to an accumulation of fluid. Ordinarily, edema indicates an expanded volume of interstitial fluid, or fluid between cells. This results from an obstruction in the veins, heart failure, inflammation or increased retention of sodium and water. Symptoms of edema may include swelling of the ankles, legs or fingers and puffiness around the eyes. Treat- ment can include restriction of sodium
hen we think of circulation, we typically think of blood and blood vessels. But the
fluids, use of support hose, diuretic therapy, manual lymphatic drainage (MLD) and, in extreme cases, the use of dialysis. Lymphatic vessels and lymph
nodes are found throughout the body, but they tend to be concentrated in cer- tain areas, like the hands, breasts, head, neck, armpits and groin. Lymphedema arises when those ves- sels or nodes are damaged and can- not transport lymph back to the blood circulation, causing swelling. When this happens, large protein and fat mol- ecules collect in the spaces between cells, resulting in chronic inflammation and scar tissue development. Since the normal flow is impeded, the lymphatic fluid backs up, causing the swelling called lymphedema. If the lymphatic system is dam-
aged, its normal functions are compro- mised. If the nodes are injured, they cannot filter toxins from the system or produce lymphocytes that fight infec- tion. If the nodes are removed, the body has fewer nodes to fight disease. If the vessels are damaged, they can no lon- ger transport lymph through the system as they should. A limb or body cavity experiencing these problems is very prone to infection and cellulitis (inflam- mation of cellular or connective tissue). The filtering mechanism of the
lymph nodes and the lymphatic vessels may be injured as a result of surgery, injury, infection, invading cancer cells, a congenital or acquired malformation, obstruction of the veins, or damage due to radiation therapy. A common scenario that can lead to damage is cancer surgery. If there is cancer in the body, its cells may enter the draining lymphatic vessels and be carried to other parts of the body. Often, doctors will determine if cancer is present or has spread by removing and examining the lymph nodes.
Treatments for Lymphedema One treatment for lymphedema is the compression garment—a daily neces-
by Marty Austin
sity for anyone with lymphedema. Wearing a compression garment is necessary for maximum success in reducing swelling and making sure that it stays reduced. Another part of effective and
long-lasting maintenance is manual lymphatic drainage, a light-touch mas- sage applied to the skin’s surface. This gentle massage prevents damage to the skin and tissues, thus easing the flow of lymph through the superficial lymphat- ic vessels beneath the skin into areas of the circulatory system that drain normally. MLD is an especially effective therapy for any post-surgical procedure because it promotes detoxification from drugs and anesthesia and reduces swelling, thus promoting the healing process of the body. It is important to seek out a certified therapist in MLD to assist proper lymph movement out of the affected limb. It is also important that needles
or blood pressure cuffs not be used on the limb suffering lymphedema, as this could cause further swelling and dam- age to the tissue. Even simple injuries, like paper cuts, a burn from the oven or iron, insect bites, sunburn or an infec- tion, should receive immediate medical treatment.
Symptoms that warrant immedi-
ate medical attention include pain or tenderness in any part of the affected limb; redness in any area of the arm, underarm or chest for upper-limb lymphedema, or the leg or genital area for lower-limb lymphedema; warmth to the touch of any area of the arm or leg; blotchiness of the skin; general mal- aise or a flulike feeling; any elevated temperature; a feeling of achiness or heaviness; or a strained feeling in the affected limb. Marty Austin is
certified in manual lymphatic drainage. For further information contact her at 865- 691-1565 or Gentle- TouchTherapeutic. com. See ad page 7.
March 2010 21
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