Lymphedema - Diagnosis & Therapy

Lymphedema: diagnosis & therapy

The diagnosis of lymphedema is carried out using various examination methods. The treatment often requires patience because it is time-consuming and lengthy, and in some cases even necessary for life. In many cases, a wide variety of processes must be combined. A complete cure of lymphedema is not possible.

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• How is the diagnosis made?
• How is lymphedema treated?
• Whom can I ask?
• How are the costs going to be covered?

How is the diagnosis made?

Lymphedema can usually be determined based on the medical history and physical examination (e.g. ankle circumference, skin folds can be lifted off). A volume measurement of the edema is helpful for precise diagnosis, but also for monitoring the success of long-term therapy (e.g. using water displacement methods). Further examinations such as ultrasound, dye tests, lymph scintigraphy or lymphography may be necessary. These procedures belong in the hands of experienced specialists.

How is lymphedema treated?

The aim is to achieve the best possible normalization of the lymphatic transport, a reduction in the severity of the disease and a lasting relief of the symptoms. The treatment of lymphedema requires patience because it is time-consuming and lengthy, and may even be necessary for life. In most cases, different methods are used in combination.

Complex physical decongestion therapy (KPE)

This basic treatment for lymphedema consists of two phases:

• Phase I aims to mobilize the accumulated edema fluid and initiate the reduction of an existing increase in connective tissue. This usually requires a stay of several weeks in a facility specializing in the treatment of lymphedema.
• Phase II - also known as the maintenance phase - serves to optimize and maintain the therapeutic success achieved. It can be done on an outpatient basis.

The KPE consists of the following therapeutic components:

• Manual lymph drainage: This special, gentle massage of the skin promotes the removal of tissue fluid. It is carried out by specially trained masseurs or physiotherapists.
• Compression therapy with special compression bandages or medical compression stockings.
• Decongesting movement and breathing exercises, sporting activity (Nordic walking, cycling, swimming, cross-country skiing, medical training therapy / strength training).
• Skin care: Natural and skin-related fats and oils are recommended against dry skin, ideally in combination with urea and ceramides.

Apparatus intermittent compression (AIK)

The decongestion by means of mechanical pumps should, if at all, only be used in addition to the basic therapy, for a limited time under medical supervision.

surgery

If none of the above measures are successful, the lymph flow can be improved surgically. For this purpose, connections between the lymphatic and venous systems are created.

Whom can I ask?

A complete cure of lymphedema is not possible. The longer the lymphedema lasts, the less likely it is to be treated. Therefore diagnosis and therapy as early as possible are important. Therefore, if you suspect lymphedema, contact your general practitioner or a specialist in internal medicine immediately. They will refer you to a special facility or hospital if this is necessary. Specialists in plastic and reconstructive surgery and physical medicine also play an important role in the management of lymphedema.

How are the costs going to be covered?

The costs of diagnosing lymphedema are covered by the social security authorities. There are different regulations with regard to the assumption of costs for therapies and rehabilitation measures. Therefore, find out more from your social security agency.