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Lymphoedema is a condition characterized by swelling, that can affect any body parts, due to the accumulation of lymph fluid. This can happen when the lymphatic system, which helps maintain fluid balance and supports the immune system, is not functioning properly.
There are a series of reasons why someone can develop Lymphoedema. This presentation could have a genetic component, where the lymphatic system didn’t form properly. That’s what we refer to as Primary Lymphoedema, a mono-lateral swelling (at the leg, most often) that start distal and moves proximally (it start lower and move up).
On the other hand, infections, surgeries, specifically cancer removal, and related radiotherapy can lead to the formation of Lymphoedema and in this case, we would call it a Secondary Lymphoedema compared to the primary one, the swelling would start proximal and move distally (start at upper move lower). That said, any oedema that lasts longer than 12 months can be classified as Lymphoedema.
To know more about how Giovanni can assist you with your Lymphoedema, book a 15 minutes free phone consultation.
The skin in a Lymphoedema has several distinguished characteristics, and based on the typology, primary or secondary, and the time passed since the initial swelling, they may vary case by case.
The skin would initially get rigid, and an accumulation of fibery tissue could occur between the skin and the muscle layer. Along with the rigidity of the skin, there are the dangers of abrasions, which, given the rich protein fluid sitting in the edema, could get easily infected.
When the presentation reaches more advanced stages, and this is again, a case-by-case presentation, we can observe Hyperkeratosis, Epidermal papillomatosis and hyperplasia or Telangiectasia. In some cases, before any hands-on therapy and or compression can be applied, antibiotic therapy has to be prioritised, especially if infections are already manifesting.
In order to differentiate the different presentations of a Lymphoedema, here is a simplification of the different stages:
Stage 0: No visible swelling, but abnormal lymphatic transport detected (e.g., via lymphoscintigraphy).
Stage 1: Early edema that improves with limb elevation.
Stage 2: Persistent pitting edema that does not resolve with elevation.
Stage 3: Fibroadipose tissue deposition and skin changes occur.
At Melbourne Massage and Treatment, in Fitzroy North, Giovanni would ensure the best of care for his patients by offering tailored treatment that best metch each individual Lymphodema presentation. Giovanni did his training with the Vodder Academy, the world leader institute for lymphatic drainage and CDT therapy.
Lymphoedema management can be divided into acute care and extended care.
For acute care, Giovanni refers to swelling reduction, which would be achieved initially by Manual Lymphatic Drainage (MLD) treatment and Combine Decongestive Therapy (CDT), movement therapy and breathing exercises.
MLD is a hands-on treatment that can boost the movement of fluid, and CDT is a bandaging technique that would ensure constant pressure in the limb/s affected. To obtain the quickest limb size reduction, a series of daily sessions would be needed. You will receive guidance about the treatment plan along your first face to face visit. In between the visits, you will be instructed by Giovanni on movement therapy and breathing exercises that you can do to keep improving the presentation on your own time.
Past the severe swelling, we step into extended care, which aims to minimize the risk of the return of swelling. Part of the extended care includes, still movement therapy, tailored diet, skincare, and garment wear with occasional MLD session and CDT bandaging. Along with those, Giovanni can keep assist you with MLD, CDT, movement therapy, garment wear recommendations, and skin care. Still, he will gladly refer you elsewhere for services that step out of his duties, such as diet advice.
When a lymphoedema is present, as already mentioned above, we have to be aware of the risk related to it, such as ulcers, infections, or underlying causes. The 15 min free phone call is an opportunity to start knowing how Giovanni can help you, based on your personal and close family medical history, and this time would allow you and Giovanni to understand if a referral from your GP or other practitioner is needed to proceed with the treatment, or if other interventions need to be prioritized before any Manual Lymphatic Drainage, or Bandaging are applicable.
The initial face-to-face consultation for Lymphodema treatment at Melbourne Massage and Treatment is 90 minutes.
This appointment would give you and Giovanni the opportunity to revise your personal and close family medical history to evaluate in more detail the treatment plan needed to proceed with the Lymphoedema management.
Once the revised medical history is completed, objective measurement follows to draw a baseline for your presentation.
Then it is time to pass to hands-on treatment with Manual Lymphatic Drainage, where needed and possible mobilization, to improve joint mobility, which is essential to keep you mobile and functioning.
At Melbourne Massage and Treatment, you can get a private health insurance rebate for Remedial Massage and Myotherapy, which would also cover your Lymphoedema Therapy. The rebate percentage may vary based on your contract with your private health insurance. Giovanni also offers services as an unregistered NDSI provider, so you can claim Giovanni’s services if you are on an NDSI plan.
To overcome the lymphoedema presentation, it is essential to stimulate that part of the lymphatic system that is still intact and operative. Indeed, Lymphoedema is a condition that is present due to a failure of the lymphatic system.
Therefore, the first step in Lymphoedema therapy is a detailed Clinical History:
In case of an initial consultation, measurements of the limb would be taken.
After a detailed clinical history, we can recommend Lymphoedema management with MLD and CDT.
Giovanni’s experience with lymphatic drainage started back in November 2021, when he completed a certificate in Applied MLD, which is a Vodder Academy certification, where he learned to work with patients presenting with an intact lymphatic system.
In October 2024, after completing the BCHs in Clinical Myotherapy, he undertook Certificate IV with the Vodder Academy for Lymphoedema and Lipoedema Management. During this course, Giovanni learned how to work with patients with a damaged lymphatic system, providing MLD and CDT therapy.
1/175 Holden St, Fitzroy North, 3068, VIC