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Sanford Health program features certified
Jacobson’s lymphedema resulted from cellulitis,
a potentially serious bacterial skin infection appearing
as swollen, red areas that feel hot and tender.
During a trip to Fargo in November 2007, the
Bismarck woman’s right arm began to itch, and red
blotches appeared. “By the time my husband, Rod,
and I arrived at a Fargo emergency room an hour and a half later, I was nauseated and shaking from severe chills,” Jacobson said.
Lymphedema caused Carol Jacobson’s right arm to swell to nearly twice its normal size. Sanford Health’s lymphedema
treatment program helped eliminate the swelling and home care has helped Jacobson prevent a relapse.
||After two bouts of severe bacterial infections in
her right arm, Carol Jacobson was diagnosed
with lymphedema, a chronic condition that caused
her right arm to swell to twice the size of her left.
Six months after completing lymphedema therapy
at the Sanford Rehabilitation Center, her right
arm had returned to its normal size.
Lymphedema is an accumulation of a fluid in
tissues that causes swelling and other skin concerns.
Primary lymphedema may develop at birth or later in
life and is caused by a defect or malformation of the
lymphatic system—a system of organs, ducts and
nodes designed to transport and balance the body’s
fluids. Jacobson’s was secondary lymphedema, the
more common type, that results from cancer, surgery,
trauma or infection.
The swelling occurs when a disruption in the
lymphatic system causes abnormal lymph drainage.
As the fluid accumulates, the swelling continues.
Lymphedema most commonly occurs in the arms
Cancer and its related surgeries and radiation are
the most common causes of secondary lymphedema.
Jacobson had undergone a mastectomy in 1992
but showed no symptoms of lymphedema until
her first infection.
|She had developed septicemia, a serious
life-threatening infection that required her to be
hospitalized for five days for IV antibiotic therapy.
The cellulitis recurred the next month, requiring
a two-day hospital stay.
In January 2008, Kent Martin, MD, an infectious disease specialist at
Sanford Clinic, referred Jacobson for therapy.
“There is no cure for lymphedema, but it can be controlled,” said Jen
Newman, occupational therapist and certified lymphedema therapist with the
Sanford Rehabilitation Center. Treatment usually ranges from two to
six weeks in length, with patients coming in three to five times a week.
There are four types of treatment:
- Manual lymphatic drainage. This gentle, hands-on treatment helps
redirect the lymphatic fluid from the limb or affected area into other
unaffected areas of the body.
- Compression bandaging and garments. Compressing the swollen
area with short stretch bandages creates pressure that helps return the
fluid to the lymphatic system.
- Lymphatic exercises. Exercises performed daily while wearing
compression bandages or garments increases muscle pump activity and
- Skin and nail care. Therapists provide care to prevent skin infections.
Depending on the stage of lymphedema, there may be skin issues
requiring additional treatment.
Kent Martin, MD
“Lymphedema can be treated at any stage,” Newman said.
Jacobson saw Newman five days a week for six weeks and said the results
were dramatic. “Jen washed and wrapped my arm every day and taught me
exercises to do at home, which I faithfully followed,” Jacobson said. “I was
shocked to see how much the swelling had gone down by the end of the first
week. Every time she unwrapped my arm, I could see a difference.”
In addition to a compression sleeve worn during the day, Jacobson also
wears a custom sleeve at night, a practice she’ll continue the rest of her life.
After four weeks of therapy, the swelling in Jacobson’s arm had reduced
by 35 percent. At her six-month evaluation, it had reduced by 50 percent.
“The therapy has made all the difference,” she said. “Jen was fantastic.”
Jacobson stresses to others with lymphedema the importance of getting
swelling under control. “I wanted to do whatever necessary to help my
arm return to normal size,” she said.
Jacobson’s results speak for themselves. The size of her arm has not
increased since completing treatment nearly two years ago.
Click here for more information on Sanford Health’s lymphedema program, or call