Duke Vascular Surgery has a multidisciplinary team of providers and resources to help patients with arm and leg edema. Led by Daniel F. Geersen, PA-C, MPAP, the Multidisciplinary Lymphedema and Limb Swelling Clinic seeks to educate and treat patients suffering from limb swelling from many causes.
An estimated 10 million Americans suffer from edema, including lymphedema, lipedema, and venous disease, but diagnosis may be difficult. “Our scheduling hub helps providers determine if the patient is a good candidate,” says Geersen. “We have all the resources in our clinic to help diagnose and treat patients, whether the disease is of a short duration or has lasted for years.”
Patients can be referred to the Lymphedema Clinic at Duke Vascular Surgery and Vein Center at Brier Creek or can schedule directly by calling 919-681-2884.
Lymphedema and lipedema
The lymphatic system is integral to circulation and vital for moving fluid out of the limbs and throughout the body. The system can be damaged by injury, including surgery or previous infection, or by inflammatory and genetic causes. Typically, lymphedema presents in unilateral swelling which may spread to the other limbs. Lipedema, a genetic predisposition to place fat in the extremities, is often unrecognized or confused with lymphedema. It can be seen in conjunction with these inflammatory causes.
As the affected limb swells, infection, skin damage, and pain become more likely. Additionally, a damaged venous system from venous reflux disease, blood clots, or immobility can burden the lymphatic system. “It’s not uncommon to have all three types combined: phlebolipolymphedema,” says Geersen. Receiving care from a provider who specializes in edemas is vital to reduce swelling and avoid complications.
Advanced treatments across modalities
At the clinic, specialists perform a full workup and patient history to rule out central etiologies and to determine the cause for the edema. Patients see a provider, physical therapist, and durable medical equipment representatives for a thorough evaluation.
“Our goal is to educate patients and allocate the resources they need to put them into the driver’s seat,” says Geersen. “Then we work to improve the overall mass effect and fluid accumulation.” Treatment modalities include a combination of compression, massage, and medicinal therapies. If surgical considerations should be evaluated, patients can be referred quickly.
Although the condition is not curable, treatment can reduce swelling. “We’re working to improve patients’ quality of life, increase their ability to do the activities of daily living, and recover their functional and recreational activities,” says Geersen.