Elsebeth Petersen (Perry)DRM, DLT, CDT, DIP ED
LYMPHOEDEMA COURSES (Casley-Smith method) and CLINICAL THERAPY
Member of Australasian Lymphology Association
Member of the National Lymphoedema Practitioner Register
Certified Instructor of Decongestive Lymphatic Therapy (Casley-Smith method)
Secretary, Casley-Smith International
What does the lymphatic system do?
The lymphatic system is an exquisite network of fine vessels and filtering structures (nodes), that help maintain fluid balance in the tissue spaces. The lymphatics have a relationship to just about all tissue. All cells in the body need nutrients, and all cells produce waste. This cellular waste has to be picked up, broken down, recycled and/or eliminated from the body.
The lymphatics start in almost every tissue as many tiny vessels (invisible to the human eye), that gradually join together into bigger ones. Cellular waste, excess fluid and proteins enters the tiny vessels and begins it's journey in the lymphatic network. Contractions in the vessel walls and the movement of nearby muscles encourages the lymph to move onward and towards the nodes. Eventually the vessels empty this filtered/cleansed fluid back into the blood stream. The return of fluid assists in keeping blood pressure constant.
The lymphatic system also plays a big part in immunity.
What is lymphoedema?
Oedema is swelling. Lymphoedema is swelling related to a problem or interruption of the lymphatic vessels or lymph nodes. In the Western world it is largely caused by treatments relating to cancer.
What is manual lymph drainage and how does it help?
The objectives of manual lymph drainage are three-fold:
The techniques of this treatment are dictated by the anatomy of the lymphatic system. Pressure is light, because we are working on the superficial lymphatic system that lies just below the skin. It is slow work, because the fluid in the tissues needs encouragement to move from one region to another. The flow of lymph within the vessels is also slow.
The method uses repetitive strokes, with either a light on-off pressure or gentle skin stretching effect so that lymph and tissue fluid is directed to its destination. Lymph drainage should not cause any pain. Areas of congestion are often accompanied by tenderness and should feel more comfortable following manual drainage.
Where does the fluid go?
Fluid is returned to the blood stream. Some excess fluid will be eliminated as urine.
How many days of manual drainage or bandaging will I need? The number of days depends on the severity and condition of the swelling. Even in the most successful cases, the region is still considered to be "at risk", so some treatment may be needed periodically. Bandaging programmes are most successful if done on consecutive days for a period of approximately 2 - 3 weeks. Where this is not possible alternatives will be discussed with your therapist.
How many treatments will I need?
The number of treatments will depend on the particular case. If swelling has developed over a long period, it is unreasonable to expect it to go in one session.
How much does it cost to have manual drainage?
A one hour appointment is $85.
How much does it cost to have daily bandaging?
A set of bandages will vary in cost depending on the quantity and variety used. Allow approximately $45 - $90 per set. Sessions where bandaging is a daily committment over a number of days, are $55 (per session), and will include a short amount of manual drainage when necessary.
How much do garments cost?
This varies enormously. An off-the-shelf or ready-made garment is less expensive than one that has to be made to measure. Apart from the health of the limb, it may be sound economics to considering a programme of bandaging so that off-the-shelf garments can be used. A rebate may be possible with private health insurance. Some hospitals amy not charge any profit over the cost of the garment. There are some garment suppliers that you can go to directly for garments. These may also have a fitting fee, plus the retail price.