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Patient Information
Lymphedema Therapy
What is lymphedema?
Lymphedema is a collection of fluid that causes swelling
(edema) in the arms and legs.
What causes lymphedema?
One of the causes of lymphedema is surgery to remove lymph
nodes ,
usually during cancer treatment. Normally, lymph nodes
filter fluid as it flows through them, trapping bacteria,
viruses, and other foreign substances, which are then destroyed
by special white blood cells called lymphocytes. Without
normal lymph drainage,
fluid can build up in the affected arm or leg, and lymphedema
can develop. Medicines such as tamoxifen (Nolvadex), radiation
therapy, and injury to the lymph nodes can also cause
lymphedema. This type is called secondary lymphedema.
Primary lymphedema can be present at birth or develop during
puberty or adulthood. The cause of primary lymphedema is
not known.
What are the symptoms?
Symptoms of lymphedema include feeling as though your clothes,
rings, wristwatches, or bracelets are too tight; a feeling
of fullness in your arms or legs; and less flexibility in
your wrists, hands, and ankles.
How is lymphedema treated?
Treatment for lymphedema depends on its cause and includes
wearing compression garments such as stockings or sleeves,
proper diet and skin care, and fluid drainage.
Elevating an arm or leg that has swelling can help ease
the drainage of lymph from the affected limb. Whenever possible,
rest a swollen arm or leg on a comfortable surface, above
the level of your heart. Don't put pressure on your armpit
or groin area, and don't hold a limb up without support for
very long since this can increase swelling.
Gentle exercise can help reduce swelling. The use of muscles
during exercise naturally helps lymph fluid to circulate,
which can reduce swelling. However, exercise also increases
blood flow to the muscles being used, which can increase
the amount of lymph fluid present. If you have swelling,
it is important to properly bandage an affected limb before
exercising. Ask your health professional how to use a bandage
for this purpose and what exercises are appropriate for your
condition.
After surgery or radiation treatment
If you have had lymph nodes removed or have had radiation
therapy as part of cancer treatment, you may be able to avoid
lymphedema or keep it under control by following the tips
below.
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Contact your doctor promptly
if symptoms of an infection—such
as redness, pain, or increased swelling—develop
in your arm, hand, leg, or foot.
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Protect the area below the surgery from injury, even
many years after surgery.
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If you have had lymph nodes removed from under your arm:
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Do not have blood drawn from the arm on the side
of the lymph node surgery.
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Do not allow a blood pressure cuff to be placed on
that arm. If you are in the hospital, make sure you
notify your nurse and other hospital staff of your
condition.
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Wear gloves when gardening or doing other activities
that may lead to cuts on your fingers or hands.
- If you have had lymph nodes removed from your groin:
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Bathe your feet daily in lukewarm, not hot, water.
Use a mild soap, preferably one that has moisturizers,
or use a moisturizer separately.
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Wear comfortable and supportive shoes that fit properly.
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Wear the correct size panty hose and stockings. Avoid
wearing constricting garters or knee-high or thigh-high
stockings.
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Ask your doctor how to handle any cuts, scratches, insect
bites, or other injuries that may occur.
- Use sunscreen and insect repellent when outdoors to protect
your skin from sunburn and insect bites.
- Do not ignore a feeling of tightness or swelling in or
around your arm, hand, leg, or foot. Let your health professional
know about it immediately.
- Ask your doctor to refer you to a physical therapist
who specializes in lymphedema. Many insurance companies
will not pay for physical therapy evaluations and treatments
without a doctor's referral.
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