Frequently Asked Questions on Diagnostics

Lymphedema pumps

What is Lymphedema?

Lymphedema is a chronic swelling in hands or feet due to an accumulation of lymphatic fluid. The condition occurs when lymph vessels, which normally carry excess fluid out of the limbs and back into central circulation, have had their flow interrupted.
How can lymphedema be treated?

Lymphedema can be treated with compression. It can be applied through:

  • Surgical compression stockings or sleeves
  • Manual Lymph Drainage (MLD) - performed by trained therapists. This is done utilizing a gentle massaging technique in conjunction with a pumping motion.
  • Compression pumps - The system consists of a pump and an appliance (sleeve) which fits over the extremity. Air pressure is applied to the appliance which, in turn, applies pressure to the extremity. The basic pump applies a uniform pressure over the extremity. Advanced devices consist of a pump and appliance with three or more segment which sequentially apply pressure along the extremity, distally to proximally.
  • What is a thermometer?
    The word 'thermometer' is derived from two smaller Greek words - 'thermo' which means heat and 'meter' which means to measure. It is a device used to measure temperature or temperature gradient.
    What are the types of thermometer?

    If classified by location, there are three types of thermometers that measure the body temperature. These are oral, rectal and ear and forehead.

  • Oral temperature may be taken from a patient who is capable of holiding the thermometer in his mouth correctly and safely. This type of device is not ideal for small children or people who are overcome by coughing fits or with a tendency to vomit. This holds good especially in the case of mercury thermometers.
  • Rectal temperature is said to be the most accurate. Temperature is taken by pushing the thermometer into the rectum via the anus. It can be a painful and uncomfortable method of taking temperature therefore, some kind of lubricant should be used. It is ideal when taking temperature of infants.
  • Ear and forehead thermometers which means the tympanic device which measures the temperature of the tympanum, or eardrum, by infrared measurement. The band thermometer is applied to the patient's brow.
  • How does a thermometer work?
    The traditional type of a thermometer is the mercury-filled one. Its method of functioning is the same as a meteorological maximum thermometer. There is a bulb attached to a tube and the bulb is filled with mercury. The neck close to the bulb is narrowed and with a rise in temperature the mercury in the bulb rises due to expansion. It goes up the tube. But with the lowering of temperature, the mercury level falls and breaks at the narrowed portion, remaining in the tube.
    What is the recent method of taking temperature?

    Mercury-based thermometers are now going out of fashion, being fast replaced with electronic digital thermometers. Apart from this, there are digital infrared contact or non-contact thermometers or scanner thermometers. Then, as an alternative to mercury, there are instruments based on liquids which are heat-sensitive liquid crystals.

    Is it okay to fly soon after a surgery?
    If you have had keyhole surgery, then you could allow a gap of one or two days. And if it is simple abdominal surgery, then you might need to keep a gap of 4-5 days before flying. A cataract or corneal laser sugery needs a gap of only 24 eyes, but more complicated eye surgery would need a week. A major surgery involving the chest or abdomen would need you to wait around 10 days before boarding a flight. However, it is always better to consult your doctor before taking any such decision.
    How is gradient vital?

    Calibrated gradient pressure on sequential pumps aid in effectively reducing lymphatic fluid from a limb. The criterion on which the functioning of these pumps is based is similar to how the muscle groups in our body function. In our body, the lymphatic fluid is moved through the channels with the 'pumping' or 'pushing' motion of the various muscle groups. The sequential pump uses a similar motion to reduce the fluid.

    How do I know when to change the pressure on the lymphedema pump?
    Setting pressure on a lymphedema pump or increasing and decreasing it should only be done as suggested on the information that came along with the pump. Or advice should be sought of a physician or therapist before such a change is made.
    How do I know when to reduce pressure on the lymphedema pump?
    Normally, you should not be making adjustments to the pressure on the pump unless as instructed or advised by your therapist. But if you do feel that the pump is no longer being effective and not achieveing any further reduction, then you may bring down the pressure and then keep an eye on the proceedings. Perhaps, this stop in further reduction could be happening due to excess pressure. But, it is always advisable to seek the opinion of a medical expert.
    How do compression garments help in lymphedema treatment?
    The nature of the compression garments prevent the accummulation of the fluid in the limb due to its tight resistance. But the garment should be applied in the morning before the fluid has had a chance to being pulled into the limb owing to gravity. If this does happen and if you were to wear the garment, then the fluid will get trapped and discomfort would result.
    When should I apply the compression garments?
    Compression garments, whose function is to support the limb and not to reduce its size, should be worn daily -first thing in the morning - and then removed at night. Also, when applying them, use rubber gloves to provide ease to the procedure.
    When should I replace my compression garment?
    These garments usually last you about six months after which you might start thinking of getting another one. But there are also signs which will tell you it is time for a new one - when you notice that your limb tends to swell slightly at the end of the day or when the fabric appears to have signs of stretches. And every time you get a new garment, ensure that you are re-measured. And also, if you hand-wash the garment, it will last longer.
    As a lymphedema patient, what care must I take?
    Hygiene is very important for a lymphedema patient. And if you have edema then you need to take special care of the skin. Such a skin is easily exposed to bacteria, infection and cellulitis and therefore, you must take special care of cuts, burns, bruises, hangnails, ingrown toenails, blisters, scrapes and even mosquito bites because these must easily develop into an infection.
    How to cope with lymphedema during pregnancy?
    Lymphedema and pregnancy is common and some pregnant women suffer it throughout the nine months and sometimes even after. Compression pantyhose provides some relief. When sitting down, the legs should be in an elevated position. A compression pump can be use during pregnancy but as per specified instructions.
    What is Manual Lymphatic Drainage?
    This is a procedure to stimulate the flow of lymph from the affected area so as to encourage the natural circulation of the lymph through the body.