Pumps for Lymphedema

This weblog on pumps for lymphedema isn’t meant to exchange an individualized evaluation and instruction by a Licensed Lymphedema Therapist. You probably have lymphedema, discover out out of your skilled if a lymphatic pump is best for you. In the event you don’t have a Licensed Lymphedema Therapist, then use this record of lymphedema resources to seek out one in your space.

This visitor weblog is written by Adie MacKenzie, Licensed Lymphedema Therapist. See her bio and get in touch with data under.

What’s a Lymphedema Pump?

Lymphedema pumps, are additionally is aware of as lymphatic pumps, arm pumps, legs pumps, lymphedema machines, compression pumps, compression machines, pneumatic compression machines, pneumatic compression remedy, however the technical, and correct time period is a sequential pneumatic compression gadget or a PCD. For simplicity sake, I’ll discuss with them right here as lymphedema pumps or pumps for lymphedema.

Pumps for Lymphedema – First Impressions

Throughout my coaching to turn into a Certified Lymphatic Therapist, I used to be inspired to keep away from using pneumatic compression pumps with my sufferers. I used to be instructed that they have been regarded as probably harmful, to squeeze too tight and to go away some areas untreated which could turn into fibrotic.

These have been severe issues. It was defined in my coaching, that pumps are not so good as guide lymphatic drainage by a Licensed Lymphedema Therapist. That’s as a result of, the therapist can really feel modifications in your lymphedema, ask you ways the remedy feels, direct the lymph fluid alongside a rigorously chosen pathway and a lymphatic pump can’t do any of this stuff.

Since my coaching, the detrimental side-effects that I used to be taught to worry weren’t a part of my expertise in working with my lymphedema shoppers who used a lymphatic pump. I additionally didn’t see these side-effects once I learn the analysis on lymphatic pumps for lymphedema.

As an alternative, I’ve observed that my sufferers are sometimes not capable of obtain the variety of classes that they require with me. Many are additionally both unwilling or unable to supply the every day self guide lymphatic drainage that’s wanted.

For these causes, I’ve turn into an enormous fan of lymphatic pumps. In my expertise, when the pump is correctly matched to the affected person, the outcomes are optimistic.

On this article, I wish to share with you what I’ve realized about pumps for lymphedema and their many advantages, in addition to contraindications and issues.

Full  Decongestive Remedy (CDT)

Full decongestive remedy, is also called advanced decongestive remedy is the remedy for lymphedema that’s the usual of care in most nations and lymphedema organizations.

Full decongestive remedy consists of 4 elements:

1. Handbook Lymphatic Drainage (MLD)

Handbook lymphatic drainage is a delicate, rhythmic, massage-like remedy that directs lymphatic fluid out of congested areas of the physique. Mild strain and stretch are utilized to the pores and skin and underlying tissues.

This promotes the motion of lymph, reduces swelling, will increase the variety of contractions of the lymph vessels, helps kind new pathways for the lymph fluid to maneuver, reduces ache, and produces a soothing feeling through the nervous system.

Initially, the Licensed Lymphedema Therapist will carry out this on you, and over time, you may study to do that for your self as a way to transfer the lymph by yourself between appointments together with your lymphedema therapist.

2. Compression Remedy

Compression remedy for lymphedema has two phases. The intensive part makes use of multi-layer compression bandaging with short-stretch bandages and supportive padding of assorted sorts. Like guide lymphatic drainage, the lymphedema therapist can educate you ways to do that for your self, as a way to apply your personal multilayer bandages between classes.

This remedy may be very efficient at lowering the amount of your lymphedema. Your lymphedema therapist will measure your progress at every appointment and as soon as your lymphedema is secure, then you may change to sporting a compression garment.

Section two of compression remedy known as the upkeep part. Your lymphedema therapist will advocate both round, flat knit or adjustable compression clothes. These might be both custom-made or ready-to-wear.

In addition to containing your lymphedema and protecting it from increasing once more, compression additionally breaks up and softens hardened tissue (fibrosis), makes train simpler by transferring extra lymph fluid, and massages the tissue.

Your precise compression prescription will range relying in your lymphedema. It’s also used for lipedema (with or with out the multi-layer bandaging part), and in most situations wherein your lymphatic system isn’t working correctly.

The lymphedema pump, ie. the sequential pneumatic compression gadget, is an alternative choice that may provide each lymphatic drainage and compression, offering two of the 4 elements of full decongestive remedy. I’ll go into this in additional element shortly.

3. Train

An important factor you are able to do to maintain your lymphatic system transferring is to maneuver your muscle groups. Our our bodies are designed to be in movement, and the lymphatic system wants this motion to assist transfer the lymph. After we transfer, our muscle groups and joints squeeze and launch the lymphatic vessels. That is necessary for transferring the lymph fluid.

This motion have to be tailor-made to your health stage and skills. Doing an excessive amount of directly might lead to extra swelling. However, when executed as really useful by your lymphedema therapist, train is a vital a part of lymphedema administration in addition to total good well being.

Train is among the 4 pillars of full decongestive therapies and is useful for lymphedema.Picture by Creativa Photographs through Canva.

4. Pores and skin Care

Conserving your pores and skin and nails in fine condition helps to scale back the chance of an infection. Lymphedema pores and skin tends to be dry pores and skin and dry pores and skin is liable to crack, which offers an entry for micro organism and fungus.

When you may have lymphedema, your physique isn’t be capable of reply to an infection as successfully. This could result in severe infections which could unfold quickly and probably require hospitalization.

Even a minor an infection can result in elevated swelling, so utilizing good hygiene, protecting your pores and skin hydrated and sustaining your nails in order that they’re trimmed and filed clean are necessary elements of lymphedema administration.

Conserving your pores and skin from drying out is a vital a part of full decongestive remedy. Select low pH merchandise on your pores and skin. picture by White Bear Studio through Canva

Sequential Pneumatic Compression Gadgets (PCDs)

Sequential pneumatic compression gadgets (lymphedema pumps) are mechanical, prescription-only medical gadgets that ship intermittent pneumatic compression. To make use of the pump, you’ll first placed on the gadget, very like you would possibly slip your self into pants that may resemble a sleeping bag or a big sleeve. The sleeves include particular person chambers that you simply connect with the pump with a plug.

In these gadgets, air-powered compression squeezes the physique in sequences out of your fingers or toes, in direction of your collarbone space. That is the traditional path of lymph movement.

The lymphatic gadgets are ready to do that as a result of the best compression (squeeze) is within the chamber that’s furthest away – both the toes or the fingers (referred to as the distal space). Because the compression sleeve inflates, the strain is lowest close to the trunk of the physique (the proximal space). This distinction in strain helps transfer the fluid within the path it must go.

The pump will transfer via inflation and deflation cycles with the quantity of strain that has been set and really useful by your therapist. There are a number of firms that manufacture pumps for lymphedema.

These gadgets have numerous options, together with the variety of chambers. The AIROS Medical lymphedema pump (pictured under) as an illustration, affords a 6-chamber “primary” pump and an 8 chamber “superior” mannequin. Each are totally efficient and most sufferers reply effectively to the fundamental mannequin.

Lymphedema pumps can be utilized at dwelling or in medical services. They’re used to maintain your lymphedema from getting worse and to keep up your enchancment after remedy.

Your lymphedema therapist will advise you which of them gadget is most applicable for you, what settings you must use, how usually you must use it and for the way lengthy. They may even enable you to to observe your outcomes and counsel any modifications to your remedy plan.

Lymphatic pumps are thought of complimentary therapies to finish decongestive remedy. Which means that if you happen to use a lymphatic pump, you’ll nonetheless have to put on your day and/or night time compression clothes, do guide lymphatic drainage, carry out skincare and train.

To search out out about different complimentary therapies akin to elastic taping, low stage laser and lymphatic yoga, take a look at this three-part webinar series.

Lymphedema Pump Advantages

There are various advantages to utilizing lymphatic pumps. They’re able to cut back and/or keep a discount of your swelling, which might additionally imply much less ache. They will additionally assist cut back the incidence of infections, enhance wound therapeutic and stop leg ulcers. As well as, lowering your lymphedema will normally result in elevated mobility and improved high quality of life.

Lymphedema Pump Therapy Areas

Areas that may be handled with lymphatic pumps embody ft, legs, arms and arms. Even head and neck edema might be handled with a lymphedema pump. As well as, the trunk and stomach are treatable as is the pelvis. Your lymphedema therapist will advocate the areas to be handled and the corresponding garment might be despatched together with your pump order.

Who Ought to Use a Lymphedema Pump?

Figuring out when and if you happen to ought to use a lymphedema pump is as much as your prescribing doctor and/or your lymphedema therapist.

There are various causes of lymphedema together with main lymphedemas akin to Milroy’s Illness, lymphedema praecox or tardum and quite a few different genetic alterations related to main lymphedema.

Secondary lymphedema can happen because of most cancers remedies together with surgical procedure, some kinds of chemotherapy and/or radiation.  Traumas, invasive procedures, burns and infections also can trigger lymphedema.

All of all these lymphedema might be handled with the help of a lymphedema pump. To see all of the totally different causes of lymphedema, take a look at this infographic from the Lymphedema Therapy Act (this act is now handed into legislation…yeah!).

Persistent venous insufficiency, venous stasis ulcers, different wounds and transient peripheral edema situations can profit from compression pumps. The truth is, the commonest explanation for lymphedema within the legs is phlebolymphedema.

Lipedema and lipo-lymphedema also can profit. Communicate to your physician or lymphedema therapist to see if a lymphedema pump is best for you.

When You Ought to Not use a Lymphedema Pump

There are occasions, that you must keep away from using a lymphedema pump. This consists of when you’ve got an an infection, when you’ve got lymphangiosarcoma or energetic deep vein thrombosis additionally referred to as a DVT or blood clot.

You probably have one among these situations, you shouldn’t use a lymphedema pump till you might be secure and correctly handled and given medical clearance. Congestive coronary heart failure (CHF) could also be secure to deal with relying in your doctor’s approval.

Inflammatory phlebitis or pulmonary embolism, untreated or contaminated wounds, gangrene, current pores and skin grafts and dermatitis are additionally not applicable for a lymphedema pump.

Basically, the identical contraindications exist for full decongestive remedy and lymphatic pumps. If unsure, converse together with your physician or lymphedema therapist.

Challenges When Utilizing a Lymphatic Pump

There are potential challenges with using a lymphatic pump. One problem is that edema or lymphedema within the legs can transfer up and result in lymphedema within the pelvic, belly or genital areas. One solution to stop that is the deal with the pelvic space together with the legs. Your lymphedema therapist will advise you if it’s essential to do that.

Equally, when you’ve got arm lymphedema and are utilizing a lymphatic pump, it might probably transfer lymph fluid into the chest or breast space. To forestall this, you will want to be evaluated by your lymphedema therapist and prescribed the suitable garment option to go together with your lymphatic pump.

Lastly, insurance coverage protection is usually a problem, as every insurance coverage firm has specific guidelines concerning the protection of the gadgets, and that is an ever-changing panorama. A lot of the firms offering lymphedema pumps work laborious that can assist you navigate this.

In the USA, typically non-public insurance coverage and Medicare will cowl lymphatic pumps with some limitations, relying on the analysis and your historical past of remedy. If so, your out of pocket price is normally within the vary between $1,000-$8,500 USD.

In Canada, some non-public insurance coverage and a few provincial well being care plans cowl lymphatic pumps. Remember to discuss this together with your lymphedema therapist.

Ordering a lymphatic pump on-line or from out-of-country is NOT RECOMMENDED since these are Class II gadgets that require a doctor’s prescription.

Lymphatic Pumps Myths vs Realities:

Listed below are some myths that I come throughout in my work:

• Lymphatic pumps will worsen my situation: Really, we are inclined to see that gaining access to a tool will improve your self-management and result in higher outcomes. Utilizing a pump is simple and obtainable. In distinction, I discover that the probability one among my sufferers attending remedy a number of occasions every week and fascinating in every day self guide lymphatic drainage is low.
• Lymphatic pumps will result in fibrotic bands on the prime of your garment: This might occur however there’s little literature to assist that this has been noticed. When it is a concern, the answer can be to get a leg pump garment which might be hooked up to a pelvic/belly piece and an arm garment to a trunk part. Once more, that is why a skilled skilled have to be concerned in prescribing and decision-making.
• Lymphatic pump leg clothes will at all times trigger genital edema if no belly part: These are cheap issues and must be thought of on the time of matching you to the appropriate pump and elements. As talked about above, the selection of clothes to go together with your pump will deal with this concern. In case your lymphedema therapist thinks it is a threat for you, then a sleeve plus a chest garment might be ordered to scale back the chance of backflow from the arm into the breast or chest.
• Lymphatic pumps are troublesome to make use of: They might have been up to now, however all the brand new pumps that I’ve seen lately are quite simple to make use of after the preliminary arrange and coaching. I, like many others, discover any new machine daunting at first, together with my new fridge! However after a few makes use of, they turn into second nature with a easy push of a button.
• Lymphatic pumps shouldn’t be used along with full decongestive remedy: I don’t imagine this to be true, in reality, some research present that guide lymphatic drainage or full decongestive remedy is definitely extra profitable along with using the lymphatic pump.
• Lymphatic pumps shouldn’t be used with wounds/venous leg ulcers: Really, the alternative is true. Whereas an untreated or contaminated wound is a no-go, when the wound is correctly handled, using the pump may help shorten the therapeutic time and enhance the result.
• Lymphatic pumps solely transfer water, not different lymph elements: Modern imaging has disproven this. Indocyanin Inexperienced binds to the proteins in lymphatic fluids (Aldrich, 2017), and there have been imaging research demonstrating that the pump strikes this each the lymph fluid and the protein effectively.

Lymphatic Pump Analysis

A research was executed that I discovered very impactful. Carried out over 5 years by 3 college medical facilities and following over 700 lymphedema sufferers, outcomes of using compression remedy with lymphatic pumps confirmed (Karaca-Mandic, 2015) :

• 75% discount in cellulitis episodes amongst non-cancer sufferers
• 79% discount of cellulitis episodes in most cancers sufferers
• 54% much less inpatient hospitalizations amongst non-cancer sufferers
• 36% discount in well being prices associated to lymphedema for all sufferers
• 29% discount in outpatient hospital visits for most cancers sufferers
• 40% discount of outpatient visits for non-cancer sufferers
• 30% or higher discount in variety of bodily remedy visits for all sufferers

Lymphatic Pump Success Tales

Listed below are some sufferers that I’ve labored with and their expertise with utilizing a lymphatic pump.

Jessica F.          Peak: 5’2”    Weight: 200 lbs.     Situation: Lipo-lymphedema

“Utilizing my AIROS 8 has actually helped me handle the lymphedema even on the times I’ve flare ups. I additionally was capable of go on a cruise again in July and this pump was my finest buddy.”

Joseph T.          Peak: 6’1”    Weight: 200 lbs.     Situation: Lymphedema

“I really feel higher bodily with little or no ache and am capable of placed on and put on sneakers I couldn’t use for a very long time. To say that this gadget has been life-changing is an understatement. My ankles and ft have gone again to nearly what they’d been earlier than my analysis!”

Stefon J.           Peak: 6’2”    Weight: 240 lbs.     Situation: Lymphedema Praecox

“My expertise to date has been excellent. I’ve seen an increasing number of discount each time I take advantage of the pump. I’m able to transfer quicker and prepare tougher with much less ache which is unbelievable.”

Susan H.           Situation: Breast Most cancers Associated Lymphedema

“Pneumatic gadgets are an efficient remedy when I’ve elevated lymphedema swelling. In my expertise, common use prevents lymphedema flare-ups.  Pneumatic gadgets are extra helpful than compression clothes for treating hard-to-treat areas, notably axillary and shoulder.”

I want pneumatic gadgets have been much less restrictive for motion and exercise whereas in use. I want pneumatic gadgets have been extra transportable for journey.”

Larkin O:          Situation: Unilateral Decrease Extremity submit Ovarian Most cancers progressing to Bilateral

“I like that I can relaxation and skim or paint or write whereas I obtain my remedy. I respect that I can obtain remedy every day with out having to go anyplace as journey in automotive is troublesome for me, and longer journey completely results in flareups. Flights are merely not attainable.”

Jennifer G:        Situation: Breast Most cancers Associated Lymphedema

“I’ve been utilizing the Flexi Contact Pneumatic Machine for over three years. The machine has allowed me to handle my arm congestion in order that I’m not fully reliant on bandaging and MLD.  It makes me really feel like I can handle my arm alone and use it together with garment compression and common MLD.  The draw back is that the machine is massive and ponderous and laborious to move.”

Backside Line on Pumps for Lymphedema

All of this data ought to assist to show that when used appropriately, a lymphatic pump is usually a big profit to managing all kinds of swelling situations, together with lymphedema, lipedema and lipo-lymphedema.

Know-how has led to huge enhancements in design and performance in lymphatic pumps and we will anticipate this pattern to proceed to enhance the know-how in addition to to make them simpler to make use of and extra transportable for journey.

As a lymphedema therapists I rejoice this chance to supply choices that enhance the standard of life for you as you reside together with your persistent swelling situation. Thanks for studying and please assist me unfold the phrase!

Ms. MacKenzie is a Nationwide Board-certified Well being and Wellness Coach and a Licensed Lymphedema Therapist. She has over 40 years of expertise in guide therapies, together with medical therapeutic massage and bodily remedy. She presently treats lymphedema sufferers and other people with persistent ache and persistent diseases as a part of her private practice and through medical hours on the Osher Center for Integrative Health in Nashville, Tennessee Shortly after her personal remedy for breast most cancers in 2010, she obtained her certification as a Lymphatic Therapist and handed the LANA examination. She loves utilizing artistic ideas to work with sufferers who’re managing persistent situations and maximizing their high quality of life. 

Extra Nice Content material on Lymphedema

In the event you loved this weblog, then you’ll get pleasure from studying:

References for Pumps for Lymphedema

Karaca-Mandic P, Hirsch AT, Rockson SG, Ridner SH. The Cutaneous, Net Clinical, and Health Economic Benefits of Advanced Pneumatic Compression Devices in Patients With Lymphedema. JAMA Dermatol.2015;151(11):1187–1193. doi:10.1001/jamadermatol.2015.1895

Aldrich MB, Gross D, Morrow JR, Fife CE, Rasmussen JC. Effect of pneumatic compression therapy on lymph movement in lymphedema-affected extremities, as assessed by near-infrared fluorescence lymphatic imaging. J Innov Decide Well being Sci. 2017 Mar;10(2):1650049. doi: 10.1142/S1793545816500498. Epub 2016 Sep 28. PMID: 29104671; PMCID: PMC5665410.

Zaleska M, Olszewski WL, Durlik M. The effectiveness of intermittent pneumatic compression in long-term therapy of lymphedema of lower limbs. Lymphat Res Biol. 2014 Jun;12(2):103-9. doi: 10.1089/lrb.2013.0033. PMID: 24927065; PMCID: PMC4062105.

Atilla Soran, Osman Toktas, Ariel Grassi, and Efe Sezgin. Adding Pneumatic Compression Therapy in Lower Extremity Lymphedema Increases Compliance of Treatment, While Decreasing the Infection Rate. Lymphatic Analysis and Biology. Jun 2022.315-318

Hyperlinks to sources used to jot down this weblog.

1. https://lymphaticnetwork.org/symposium-series/myth-busters-regarding-pneumatic-compression-devices
2. https://lymphapress.com/clinicians/clinical-studies/
3. https://tactilemedical.com/clinicians/clinical-evidence/?activeFilters=region-all
4. https://www.biocompression.com/the-science/lymphedema-studies/
5. https://ariahealth.com/blogs/clinicians/clinical-evidence
6. https://ariahealth.com/scientific-evidence/
7. https://www.mediusa.com/healthcare-professional/venous-health-solutions/products-for-venous-health/medi-pcs-brio-2/
8. Webinar from the Lymphatic Education and Resource Network discussing the myths and realities on lymphedema pumps