Life-long lymphedema precautions

by Tami Gebel, OTR/L, Veterans Memorial Hospital Occupational Therapist
Lymphedema is the chronic or persistent swelling of a body part due to an obstruction of the lymphatic system. The lymphatic system lies underneath the skin and works closely with the blood circulation system as it transports fluids throughout the body to lymph nodes. While in the lymph nodes, the fluid is “cleaned” of bacteria, viruses, and other unwanted materials. The “clean” fluid is then sent to the blood and re-circulated throughout the body. Lymphedema occurs when the lymphatic system is damaged and unable to move the fluid, therefore the fluid collects in the body part and swelling develops. Damage to the lymphatic systems occurs when there is surgery, mastectomy, lymph node removal, radiation, or injury to skin tissue (such as a burn).
Lymphedema can cause other related problems such as decreased ability to move the arms or legs, decreased strength, impaired sensation, difficulty walking, fatigue and overall inability to complete daily activities such as dressing, bathing, eating, cooking, cleaning and other work tasks.
Early signs of lymphedema that patients should watch for are increased swelling in the area around an incision or scar; skin changes (such as thicker or dryer skin when compared to opposite side of body); and the swollen arm or leg feels slightly warmer than the other.
Lymphedema can be treated by an occupational therapist. Some of the treatment techniques used by occupational therapists are manual lymph drainage, which is a gentle skin massage; compression bandaging to assist the lymphatic system in keeping the excess fluid out of the area; and exercises.  The occupational therapist also provides education on skin care and other lymphedema precautions. Patients must first speak with their doctor to determine if lymphedema treatment would be beneficial.
Here are some life-long precautions that lymphedema sufferers should follow:
• Do not have blood pressure taken on the affected extremity
• Do not have needle sticks, injections, or blood draws on affected extremity
• Refrain from wearing jewelry on the affected extremity
• Wear sunscreen and bug repellent
• Wear gloves when gardening
• Immediately treat all open sores or cuts with antibiotic spray and keep the area covered and clean. If the area around the cut becomes red and warm, contact your doctor immediately.
• Keep shirts, blouses and other clothing loose on the affected extremity
• Avoid saunas and Jacuzzis
• Don’t carry a purse or other strapped bags on the affected extremity
• Be careful when trimming or manicuring nails.
For more information or to begin treatment for lymphedema, contact the Occupational Therapy Department at Veterans Memorial Hospital at 563-568-5528.