Lymphedema and Lymphatic Filariasis

IAD has developed a scientifically proven integrative medicine combining allopathy, yoga, ayurveda and diet to treat Lymphedema caused by different reasons.

Lymphedema is a chronic condition characterized by swelling caused by the accumulation of lymphatic fluid in the tissues. The lymphatic system, a part of the immune system, normally helps to remove excess fluid, waste, and toxins from the body. However, when the lymphatic system is impaired or damaged, lymphedema can occur.

There are two types of lymphedema – primary and secondary

Primary lymphedema is caused by congenital malformations or abnormalities in the lymphatic system. It can manifest at birth or later in life without any apparent cause.

Secondary lymphedema is more common and is caused when a normal lymphatic system in a person becomes damaged due to surgery for cancer, radiotherapy, infections like cellulitis, parasitic diseases like lymphatic filariasis.

Other causes are medical conditions that damage the lymphatic system, venous diseases, DVT (deep vein thrombosis) and  , obesity, accidental trauma and injury to the lymphatic system and lack of movement or exercise.

Breast cancer-related lymphedema

Breast cancer-related lymphedema (BCRL) is another most common secondary lymphedema of the upper limb. It is a common and possibly serious complication of breast cancer (BC) treatment and has been linked with the extent of breast and axillary surgery, and chemotherapy.  Patients with chronic BCRL have reduced quality of life which can be accredited to functional impairment or disability to continue routine work, discomfort, and repeated infection, which attributes to increased medical costs.

The patient also suffers psychologically, with anxiety, depression and embarrassment, and little or no social involvement.  Therefore, earlier intervention and management, reduce the development of the severe and irreversible symptoms of BCRL. Monitoring and management of BCRL reduce the rate of progression to chronic BCRL and helps the patient to lead a routine life.

At IAD, we provide Integrative Management of breast cancer-related lymphoedema.

Medical Counselling

Before any management begins, patients undergo a detailed counselling session with a dedicated counsellor in their native language. Patients and their relatives receive complete treatment program details, preferably using disease-specific slide presentations and videos. The session covers potential concordance issues and manages the patients queries, explaining the therapy, safety measures, documentation and review systems, possible risks and benefits, costs to be incurred, the various interactions with different members of the team, and the informed consent process.

Integrative management of Breast cancer-related Lymphoedema

We have designed a home-based self-care, that if followed diligently, can stop or decrease the frequency of repeated acute attacks and prevent the disease from worsening.

This simplified treatment comprises

• Indian manual lymph drainage
• Customized compression protocol for upper limb
• Yoga protocol that helps in lymph drainage and improves the range of movement in patients
• Integrative Skincare-prevention and treatment of entry points
• Patient Education: Patients are educated sufficiently through classes and written materials to continue treatment at home. Classes are conducted daily with the help of PowerPoint presentations, information and educative materials and audio-visual aids

Focused group discussions

• Practical demonstration of treatment aspects
• Actively involving patients and their bystanders

Diet and Nutrition

We provide patient-specific diet plan that helps manage Lymphedema. The diet plan is prepared based on recommendations from experts in dermatology, nutrition, dietetics, and Indian traditional medicine (AYUSH). It’s designed to be helpful for Lymphedema management.

What a breast cancer-related lymphoedema patient can expect after the Integrative treatment at IAD

• Improved quality of life pertaining to performing routine activities at ease
• Skin improvement with reduced secondary infections
• No acute attacks or reduced frequency of repeated acute attacks stopping the progression of the disease.

LYMPHATIC FILARIASIS

Lymphatic Filariasis (LF) is caused by microscopic worms that spread from person to person through the bite of an infected mosquito. The microscopic worms enter the body through the skin, travel to the lymph vessels, and grow into adults. The adult worms release millions of microscopic eggs called microfilariae into the blood. People with live filarial worms in their blood can transmit the infection to others through mosquito bites. The microfilariae damage the lymph nodes and lymphatic vessels, impairing the flow of lymph fluid and causing massive swelling (lymphoedema or elephantiasis) of the legs, arms, breasts, and genital area. There are no symptoms in the early stage of infection after receiving mosquito bites. This stage can last for several years. As the disease progresses, the skin becomes much thickened with overhanging folds resembling an elephant’s foot.

Major Symptoms:

• Cellulitis or Filarial fever (a common soft tissue infection affecting lymphoedema patients, often occurring in the lower leg)
• Fever
• Pain and tenderness
• Warmth in the affected region
• Redness (erythema)
• Increased swelling
• Local lymph node infection (lymphadenitis)

The integrative treatment at IAD for Lymphatic Filariasis

We have developed a scientifically-proved integrative treatment protocol combining modern medicine with ayurveda and yoga for successful treatment of lymphedema caused by Lymphatic Filariasis.

The diagnosis and treatment process at IAD

• Counselling session
• Examination by doctors and deciding the treatment protocol
• Blood and urine investigations
• Photo documentation
• Volume measurement
• Girth measurement (to monitor treatment outcomes)
• Duration of stay depends on the disease and associated complications (ranges from 7-28 days)
• Outpatient day-care (daily treatment lasts 2-3 hours)
• Treatment training for at least one family member on self-care and supporting the patient at home
• Patient follow-up after 30 and 60 days of discharge, and periodically thereafter
• Patients continue treatment
• Long-term home-based self-care supervision through WhatsApp
• Treatment components and duration may be simplified depending on the improvement of the affected limb.