Reminder:
The
Dos And Don't of Lymphedema.
Prevention
is better than cure for arm Lymphedema. Familiarize yourself with warnings
and precautions and incorporate these guidelines, ignoring them are foolish.
Skin care is your first line of defense. The skin acts as a barrier to
infection. Learn to recognize the signs of infection: fever, redness,
swelling, warmth or tenderness in the at-risk arm.
Preventive Guidelines:
1.Do moisturize
your skin frequently and regularly with lotions to make your skin supple
and prevent it from cracking.
2.Do keep your hand and arm extra-clean, but don't use harsh soaps (e.g.
Dove). When drying be gentle but thorough (a hair-drier may help for difficult
area).
3.Do use rubber gloves when you wash dishes or hand-wash clothes. Avoid
any trauma (knocks, cuts, sunburn, insect bites). Be careful cutting nails;
do not cut the cuticle or push back too hard (this can injure it and allow
bacteria to enter, thus leading to infection). If you sewing wear a thimble;
if gardening wear a glove and long sleeves. Never cut calluses (e.g. heel
or sole). Use 10% urea cream or Lodema ointment. (it can use on minor
burns, cut stings and bruises).
4.Do use an electric razor instead of a safety razor, depilatories or
abrasive mitts to remove hair.
5.Do use insect repellents that don't dry out the skin. Avoid brands that
contain alcohol. (Any ingredient that ends in "ol" is a type
of alcohol.)
6.Do apply antibiotic ointment to any insect bites or torn cuticles. Any
redness (infection) should be treated AT ONCE (keep antibiotics in your
purse). All infections need antibiotics. Watch out for tinea (a slight
redness and a peeling of the skin- need anti-fungal powder).
7.Do protect your arm from sunburn with sunscreen, minimum SPF 30. You
can burn through many compression garments; particularly synthetic they
do not protect you.
8.Do keep the arm as cool as possible in hot weather. If traveling for
a long time in a car, drape a white shirt over a arm in the sun. Move
it if possible when you have to sit for a long time, flex and stretch
fingers or feet. Be careful of the water temperature in showers and spas.
(No extreme hot to cold water temperatures) Don't go into high hot tubs,
saunas or stream baths. Avoid applying heating pads to anywhere in the
affected arm- this means if you have had a back or neck strain, use ice
rather than heat.
9.Do rest your arm in an elevated position. Do not lie on an arm at risk
when sleeping or resting.
10.Do control your blood sugars very carefully if you have diabetes, to
minimize the danger of small blood vessel damage and infection.
11.Do wear compression bandages on the affected arm when flying in airplanes
(if you already have arm edema- additional pressure bandages may be needed
on a long flight).
12.Don't carry heavy objects with your at-risk arm, especially the arm
hanging downward. Avoid shoulder bag and handbag on this arm.
13.Don't wear clothing with tight sleeves that restrains movement. No
watch or other jewelry on the affected hand or arm. Brassieres should
not be too tight around the ribs or over the shoulders. (Including underpants/panties)
A wider shoulder strap is recommended.
14.Don't use heavy breast prosthesis after mastectomy. (It may put excessive
pressure on alternative routes of lymphatic drainage that are already
doing double duty; get a lighter model one)
15.Avoid vigorous activity. (Like: rubbing, scrubbing, pushing and pulling)
Don't bring on muscle fatigue. Do household chores in small amounts at
a time. Use moderation as your motto and pace yourself.
16.Avoid extended use of diuretics- it reduce swelling but they are not
helpful with Lymphedema. As they don't does anything with the protein,
bacteria and waste products that remain. In fact it will crate a higher
concentration of protein. The high concentration levels can cause the
tissue to become fibrotic and thickened, leading to increased problems
with fluid removal.
17.Don't drink much alcohol (alcohol causes blood vessels to dilate and
leak extra fluid into the tissues but there is no evidence that it worsens
Lymphedema.)
18.Don't permit blood pressure testing, any piercing of the skin for injections,
blood draws or vaccinations on your at-risk arm. (Not even your doctor)
If you have had breast cancer in both breast use your non-dominant arm
(if you are right-handed, use your left arm) or even a leg.
19.A normal balanced diet is the best. (With plenty of vitamins) Lymphedema
is a high-protein edema, but eating too little protein will not help.
Rather it weakens the connective tissue, thus making an edema worse. Reduction
diets will not reduce Lymphedema, but are advisable only if patient is
overweight.
20.If you are under severe stress, concentrate on relaxing the shoulders,
back and neck. Extend your spine and 'stand straight'. Constant tension
in these areas will worsen Lymphedema. Tension in the upper body may cause
a "balance" tension in the leg at-risk may also develop Lymphedema.
If
there is already Lymphedema
The above points must be observed, plus:
a.) Your way of life may need to be modified. Just need to be aware of
the facts about your condition and to be sensible.
b.) Wear the compression garment at all times including at night. Bandages
are often more comfortable at night. If garment does not cover your fingers
and hand, and they swell, see a therapist at once. 'Lodema' (coumarin)
powder can be safely used under the compression garment to assist with
the reduction of lymphedema and helps you to put the garment on. Do not
use the ointment under a garment use it under bandages, especially over
fibrotic areas.
c.) Do exercise; but not too much (don't make the arm ache with tiredness,
this can cause an increase in lymph fluid and make the lymphedema worse.
Circle
of Hope
|