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Ongoing lymphatic care · South Berkeley
You already know the feeling of a limb filling up.
People with lymphedema know their own bodies in a way almost nobody else does. You feel it before it shows. You know when a ring is tighter than it was on Tuesday. When I work on someone with lymphedema they will often tell me, while they are still on the table, that they can feel it moving. That is the best part of my week.
- Method
- Dr. Vodder MLD, certified 2009
- Best suited to
- Ongoing maintenance care
- Also needed
- Diagnosis and compression
- First step
- A free phone call with me
The distinction that matters
Edema is not lymphedema.
Edema is swelling, and anyone can have it. Sprain your ankle and you have edema. It resolves.
Lymphedema is chronic swelling caused by a damaged lymphatic system, and it does not resolve on its own. Primary lymphedema means you were born with vessels missing or malformed, and it often surfaces at a hormonal turning point: puberty, pregnancy, menopause, or after an ordinary injury that simply never settled. It is frequently bilateral and typically starts at the foot and works upward.
Secondary lymphedema is caused by injury or surgery, most often lymph node removal and radiation. It usually affects one side only, in the quadrant that was operated on, and unlike primary it starts nearer the nodes and works outward: the upper arm before the hand, the thigh before the lower leg.
The name of the game is always staying ahead of the fluid. It is far easier than letting it get away and trying to bring it back.
How this works
What I do, and what I do not.
Most of my lymphedema clients are in the maintenance phase. They know what they need and how often.
Maintenance care
Regular sessions to keep fluid moving and stop things progressing. This is the bulk of what I do and what I am best suited to.
Early signs
Heaviness and tightness usually arrive before anything is visible. Being told it looks fine is not the same as it being fine.
Working with your garments
I will not prescribe compression, but I can tell you whether yours is doing its job and help you work out what to ask for.
Home devices
If you have a pneumatic pump such as a FlexiTouch, we work out how it fits alongside sessions here.
Skin protection
A limb at risk has a compromised barrier. This part genuinely matters and I will go through it with you.
Knowing what to ask for
Sometimes what people most need is permission to be a squeaky wheel. You will not get what you do not insist on.
Getting properly set up
Diagnosis first, then everything else.
If nobody has diagnosed you, that is the first job, because a diagnosis is what unlocks compression garments and often insurance coverage. People sometimes arrive certain they have lymphedema having never seen a doctor about it.
If you are newly diagnosed with a large amount of fluid, or you need wrapping and intensive decongestive therapy, tell me. If there is a clinic your insurance will cover, my advice is always the same: get everything you can while you can get it. I will help you work out what to ask for.
Then maintenance. That is the long game, and it is where consistent care makes the difference between managed and progressing.
Please read this one
Cellulitis, and why it matters.
Your skin is the first line of defence
A limb affected by node removal or radiation has a weakened barrier. A cut washing dishes, an insect bite, a scratch from going barefoot.
It can become serious quickly
An infection there can turn into cellulitis, and cellulitis can progress to sepsis, which is life threatening. It can begin feeling like nothing more than flu.
So
Gloves for washing up and gardening, shoes on outdoors, and prompt attention to any break in the skin. Red, warm, swollen, or feeling unwell means calling your doctor the same day.
And one piece of vocabulary
Cellulitis is a serious bacterial infection. Cellulite is dimpled fat on the thighs. They are entirely unrelated, and people confuse them constantly.
Before you call
Questions I get asked.
What is the difference between edema and lymphedema?
Edema is swelling, which anyone can have and which usually resolves. Lymphedema is chronic swelling caused by a damaged lymphatic system, which does not resolve on its own and needs ongoing management.
Can lymphedema be cured?
No, and be wary of anyone who says otherwise. It is managed rather than cured. Consistent, skilled care keeps fluid moving and keeps the condition from progressing, which makes an enormous difference to daily life.
Do I need a diagnosis before seeing you?
It is strongly preferable, because a diagnosis is what gives you access to compression garments and often to covered care. If you are not sure what is going on, come and talk to me and I will help you work out who to see, but I cannot diagnose you myself.
What are the earliest signs?
Heaviness and tightness, usually before any visible swelling. Rings, watches or sleeves becoming snug. Many people feel it well before anyone can see it.
Do you take intensive or wrapping cases?
I mostly work with people in the maintenance phase. If you need intensive decongestive therapy and wrapping, particularly if insurance will cover a clinic, take that first and use me for maintenance afterwards.
How often should I come?
It depends on your situation and what you can sustain. Regular and predictable beats occasional and heroic. We will settle something realistic on the call, including realistic for your budget.
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The next step
Tell me what is going on.
Fifteen free minutes on the phone with me. Tell me what you are dealing with, whether you have been diagnosed, and what you already have in place, and I will tell you honestly how I can help and what else you should be asking for.