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What is CDT ?

Complete Decongestive Therapy is the gold standard for lymphedema management. There are four components of CDT, and all are essential for the best possible outcomes. Lifelong management of lymphedema with CDT can give you independence, empowerment, and an improved quality of life.

COMPLETE DECONGESTIVE THERAPY (CDT)

Complete Decongestive Therapy (CDT) is an intensive therapy program that is divided into two phases: Phase I, the Decongestion phase, and  Phase II, the Maintenance phase.

Phase I – Decongestion

The goal of Phase I is to decrease the swelling in the limb to normal size, or as close to normal as possible, while maintaining healthy skin. There are four basic components to Phase I:

› Manual Lymph Drainage (MLD)
› Compression Therapy
     › Multi-Layer Bandaging
     › 2-Layer Bandaging
› Short Stretch Compression Wraps
› Exercise
› Skin Care

Phase II – Maintenance

Once the swelling has decreased from your limb, it is essential to continue your care at home to maintain this reduced size. Unfortunately, the swelling will come back if not managed correctly. The goal of Phase II is to preserve the results of all your hard work in Phase I. Just like the Decongestion Phase, there are four components of Phase II:

› Manual Lymph Drainage (MLD)
› Compression Therapy
     › Compression Garments
     › Short Stretch Compression Wraps
     › Chipped Foam-based Products
› Exercise
› Skin Care

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Manual lymph drainage (MLD)

What is MLD?

 

MLD is a light, skin stretching massage that helps promote the movement of lymphatic flfluid out of the swollen limb. It should not be confused with a traditional massage you may receive at a spa. MLD is specifically focused on the lymph vessels to help the flow of lymphatic fluid. Therapy is applied to your unaffected areas first, making it possible for the fluid to move out of the affected area, or as we say, “decongest.” MLD helps open the remaining functioning lymph collectors and move protein and fluid into them, as well as to help speed up lymph fluid flow through the lymphatics.

Deep breathing techniques call diaphragmatic breathing are usually done at the beginning and end of a therapy session to help open your deep lymphatic pathways. It’s not only relaxing, but it helps increase movement of fluid toward your heart. Laughing naturally causes diaphragmatic breathing, so go ahead; laugh as often as you can! It’ll help move your lymphatic fluid and can help release stress, anxiety, and even depression.

A Certifified Lymphedema Therapist (CLT) who has been specially trained in MLD should perform this therapy. There are medical reasons that MLD might not be used, called contraindications, so it’s important to see your CLT and discuss any changes in your medical history before you start therapy each time.

SELF-MLD

Once you have completed Phase I of Complete Decongestive Therapy (CDT) and have entered into the Maintenance phase, you will be in charge of your MLD! That’s right, Self-MLD is a large part of maintaining your reduced limb size. It is important to continue MLD on your own to help keep your lymph vessels working as best as they can. Your CLT will teach you how to perform Self-MLD and how often.

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Exercise

Exercise promotes lymphatic flow

In recent years exercise has been proven to help with lymphedema, but there are still a lot of questions about it. When you are wearing compression, exercise can further promote fluid drainage. The compression works with your muscles to help push fluid up and out of your limb. Your CLT will direct you in the correct exercises for your specific case of lymphedema, and it is recommended that you do not begin any exercise program without consulting your physician or therapist first.

When you have lymphedema, the general rule for starting any exercise program is “Start Low, Go Slow!” You need to allow your body and your lymphatic system to adjust to the new level of activity and you need time to monitor how your body is handling it. This can especially be hard if you used to exercise a lot before you were diagnosed with lymphedema.

Make sure to start with a low level of resistance and shorter amounts of time than you would normally. Even if you think you’re going too slowly or taking it too easy, don’t be impatient! Start Low, Go Slow! You can build up to any level of activity that you and your therapist feel is appropriate for you, just take your time getting there.

 

 

Compression therapy

 

COMPRESSION IS AN IMPORTANT PART OF LYMPHEDEMA TREATMENT

Once your lymphatic vessels have been “awakened” with MLD, compression is applied to help move the extra fluid out of the limb, and to keep it from coming back into the limb. The idea behind compression therapy is to assist the tissue by applying pressure from the outside, which helps move the fluid into the lymphatic system, where it is filtered, concentrated, and returned to your body.

There are many difffferent types of products that are used for compression. In the Decongestive phase of CDT, the compression types commonly used are:

› Multi-Layer Bandaging
› 2-Layer Bandaging
› Short Stretch Compression Wraps

Once the level of decreased edema has been achieved in Phase I, medical compression garments help maintain that decreased level. Since we know the swelling will come back without compression, it is imperative to wear some sort of gradient compression product. There are many different options offered to manage edema during the Maintenance phase:

› Compression Garments
› Short Stretch Compression Wraps
› Chipped Foam-based Products

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