Dear OncoLink "Ask The Experts,"
I've had lymphedema for 7 years, following removal of a tumor in the right axilla. I've had recurring cellulitis and was hospitalized last month. Is it true that each episode of cellulitis makes the lymphedema worse? I've had MLD in the past, but according to my insurance company, I've exhausted therapy coverage for my arm. Also, I wear a compression sleeve and glove all day, and a Reid sleeve at night.
Linda McGrath Boyle PT, DPT CLT-LANA, Cancer Rehab Specialist and OncoLink Lymphedema Team Editor, responds:
It is not unusual for people with lymphedema to have recurrent cellulitic infections.
It is true that lymphedema can progress as a result of these infections. This may manifest itself in increased arm size or increased firmness of the tissue. Lymphedema is staged from stage 0 through stage 3. Stage 3 (skin changes apparent) lymphedema is not often seen in arms. Most people with arm lymphedema progress to stage 2 (skin becomes firm from chronic inflammation) only.
Some insurance companies are less generous than others in paying for complete decongestive therapy. You should call your insurance company directly and discuss your need for physical therapy, especially due to your recurrent cellulitic infections. Intervention by a certified lymphedema therapist may help to avoid future episodes of infection; having said that, it is not unusual for someone to have an episode of infection during their course of care. This may be due to moving the lymph fluid that contains bacteria away from the swollen limb.