DEAR DR. DONOHUE: Two years ago I had surgery for breast cancer, and lymph nodes were also removed during the surgery. I recently developed lymphedema and am quite upset about it. I don’t think I ever read where you (or anyone else) discussed it. I didn’t know what it was until I saw something about it on TV. It seems to be under control, but I must wear an arm sleeve, which I hate. Please comment on it. – J.R.

ANSWER: We have two circulatory systems. Everyone knows the blood circulatory system. Few know the lymph circulatory system. Lymph is the watery part of blood that oozes out of blood vessels and bathes all body cells and tissues. It provides nutrition and protection. Lymph vessels – similar to arteries and veins but more delicate – are open-ended affairs that suction lymph fluid and eventually return it to the circulation. On its journey back to the main circulation, lymph fluid passes through lymph nodes, which remove from it foreign material and germs.

Anything that disrupts the return of fluid back to the circulation causes swelling – lymphedema. In your case, the disruption was breast surgery with removal of lymph nodes. About 15 percent of women who undergo such breast surgery develop lymphedema of the arm on the side of the removed breast.

Early treatment of lymphedema prevents permanent changes from happening. Arm elevation encourages drainage out of the arm. Elastic garments squeeze lymph fluid back into the main circulation. Compression pumps are another way to mobilize the fluid.

A special kind of massage, performed by a trained therapist, can effectively promote drainage of lymph fluid. It’s called manual lymphatic drainage, and practicing therapists are found in about every section of the country. The National Lymphedema Network can put you in touch with such a therapist and can provide you with information on this condition. You can reach the network at 800-541-3259 and on the Web at www.lymphnet.org.