Complete Decongestive Therapy
Complete Decongestive Therapy is the combination of several specific therapies that, when used together in a specific sequence, provide significant relief from swelling and fibrosis (hardened tissue) caused by Lymphedema. In complex cases where wounds or leaking vessels are present prior to treatment, these conditions often resolve over time and tissue heals and returns to a healthy state.
Complete Decongestive Therapy is divided into 3 main parts: Lymphatic Drainage (Manual or Electro), Compression Bandaging, and garment fitting.
1) Lymphatic Drainage
Lymphatic Drainage is a very specialized technique that moves fluid from a swollen (edatamous) area and returns it to the circulatory system (the blood) where it can be removed from the body (peed out).
Lymphatic Drainage can be the traditional Manual Lymphatic Drainage (MLD) that is done entirely by hand, or it can be Electro-Lymphatic Therapy where it is done through the use of a machine (not a pump) that causes lymph to become less sticky so that it flows more easily through the system.
Lymphatic Drainage is done in the initial phase of treatment, throughout the reduction process, and is done periodically to help maintain the size of the affected area after the Complete Decongestive Therapy process is complete.
2) Compression Bandaging
Compression Bandaging is an important part of decongestive therapy because it is super effective in reducing swelling when done immediately following a lymphatic drainage session.
In more severe cases of swelling such as late stage Lymphedema, Lipedema, or Chronic Venous Insufficiency (CVI), compression bandaging can make a world of difference in the speed of reducing swelling.
There is probably no one who enjoys wearing a compression bandage as it is usually quite large and bulky, making getting dressed and getting around more complicated. That being said, it is a temporary part of the therapy and its effectiveness can’t be understated. If compression bandaging is part of your recommended therapy, be sure to work with your therapist to make a bandaging plan that will work for you. The results are absolutely worth the temporary discomfort.
3) Garment Fitting
The final stage of Complete Decongestive Therapy is being fitted for a garment once the maximum amount of swelling reduction has been achieved.
Compression garments come in all kinds of shapes and sizes and for virtually every part of the body. Your therapist will guide you in what type of garment will work best for your condition.
There are two main kinds of garments: “Off-the-shelf,” pre-made garments and custom-made garments.
If your condition is not severe you may be able to be fitted for an “Off-the-shelf” pre-made garment. These garments are far cheaper than custom-made garments, but good quality ones (which are worth what you pay for them) are a little pricy.
Custom-made garments are necessary for many people who are in later stages of disease where limbs have become very large or have proportions that do not match standard models. Custom-made garments do cost quite a bit. Sometimes it is possible to get insurance coverage for them (usually only with breast cancer-related Lymphedema), but most custom garments must be paid for out-of-pocket. There are organizations that help people to purchase garments.
Regardless of which kind of garment you require, it is strongly recommended that you obtain at least two so that one can be worn while the other is washed. Swelling can happen in a very short period of time when the garment has been removed, so waiting for your garment to dry (they shouldn’t be put into a dryer) can mean that your swelling may increase significantly in the meantime.