I have secondary lymphoedema in both legs but a year ago my right leg got worse and although I have gone to class 2 compression tights it’s no better, in fact it seems to be getting worse. At my local lymphoedema clinic in November I was given a six week course on a Lymph Assist machine. They said it wouldn’t reduce volume but soften up the leg and this unfortunately was the case – softer but the same size.
I would like to reduce the volume of the leg and then use bandaging/ wraps to keep it less swollen. I’m sure I’ve read in the LSN magazine about people using compression pumps or something called Hivamat? Presumably this is different from Lymph Assist if they reduce the volume? I would be grateful for any information/ ideas. I realise any reduction won’t be permanent and that I might have to keep using a pump plus continue to wear compression tights.
Hi Caroline, Pneumatic compression pump is a tool in the lymphoedema treatment arsenal, it’s not used instead of compression. A high quality pump attempts to simulate Manual Lymphatic Drainage (MLD) to move congested lymph out of the effected limb. However, without proper patient preparation for 5-10 minutes before every single pump session then using a pump can cause complications in the long term. The most common complication is Lymphoedema ‘spreading’. Preparation for a pump session includes lymphatic diaphragmatic breathing to stimulate drainage to the thoracic duct which is the main lymphatic drain back to the heart. Diaphragmatic breathing should be repeated after every pump session.
Many lymph therapists and nurses are not keen on pumps because they can lead to problems when a patient doesn’t utilise it properly, and in conjunction with all the other conservative treatment measures eg therapeutic compression, lymph friendly exercises/physio exercises, sensible eating and weight management (as excess weight adds huge stress on the lymphatics), meticulous skin care, etc.
Limb volume reduction won’t be achieved with a pump, only Complete Décongestive Therapy (CDT) eg bandaging, lymph drainage, and fresh measured compression garments will effectively reduce limb size. Sustaining reduced volume will only occur if daily self treatment is adhered to. Using a pump correctly can help with this
You refer to Hivamat which is a device that delivers Deep Oscillation Therapy (not a pump). The Hivamat DOT device is the larger unit used in clinic/hospital settings whilst the smaller DOT device for home and portable use is called the Personal. DOT is a completely different technology than a pump to undertake lymph drainage, and to address/prevent fibrosis.
Pumps are large/bulky while DOT Personal is a light and portable. Some NHS clinics have DOT Personal devices available on loan. Check with your clinic. DOT is German technology that has been used in Lymphoedema & Lipoedema treatment on the Continent for decades. PhysioPod UK brought DOT to the UK ten years ago. It’s widely used with very good results.
I’ve had a DOT Personal device for nearly 7 years, and a compression pump for 5 years. The Personal set me back 2k and the pump 5k Sterling. I got the market leading pump with the most clinical data behind it, including independent clinical research.
I have the luxury of having both modalities. Personally, if I had to choose only one modality I would forgo the pump and stick with DOT as I find it has benefits over the pump.
To find out more about DOT contact Julie and Mary at PhysioPod UK which is the official UK distributor of DOT. They are lovely and extreme knowledgeable about DOT for Lymphoedema. physiopod.co.uk
Only consider reputable pump brands such LymphaPress, Haddenham LymphFlow, etc (speak to your lymph clinic).
If you join Lymphoedema United lymphoedemaunited.com/
then you can access their fab special offer from Compression Therapy UK : free 14-day trial of Lympha Press with no obligation to purchase from 1-31 Jan 2022. Contact: naomi@compressiontherapyuk.com
LymphaPress is the international market leader in specialist compression pump for Lymphoedema. The free trial is a brilliant way to see how you get on with a LymphaPress at home.
Not all pumps are created equal. Don’t go cheap or you risk having irreversible complications. It’s always advisable to ensure the pump garment/trousers comes up to your waist, rather than the pump garment stopping at the top of the legs. LymphaPress does come up to the waist. Take care, Catherine x
Thank you very much for your detailed and helpful reply, particularly regarding the free trial.