All patients with lymphoedema are different with regards to the type of lymphoedema they have, the stage of it, the limbs affected, their lifestyle, their work and family life and if they have other medical conditions. It is important to understand the limitations a patients might have and support them taking the best care of their lymphoedema in their daily life. While an individual plan can be created there are standard practices which are needed including how they can take care of their skin, concordance to the use of compression, exercise options and performing manual lymphatic drainage. Incorporating these practices will reduce the risk of complications such as infection, skin break down and increased swelling.
Skin is the body's largest organ, and it's also our first line of defense against infection. Skin has the unique ability to give us insight into patient health, but it's often overlooked as part of the assessment and treatment process. Skin is essential to patient vitality and critical for good health. Good skin care is essential at preventing deterioration and ulceration therefore, it is important to encourage patients to take an active role in their own care.
Skin care also includes not taking any unnecessary risks such as shaving with a manual razor as it can nick the skin and spread bacteria. Or walking barefoot on the beach. A healthy diet is also important for maintaining skin integrity as well as smoking cessation.
My name is Marielena and I am a proud Greek woman, with primary lymphedema. In the summer despite the high temperatures in Greece I enjoy the sun and the sea, I enjoy swimming, doing water sports, going out, listening to music and dancing with my friends under the stars. I do not let it stop the flow of my dreams. In the future I would like to study more about the lymphatic system and help other patients with lymphedema to live the life they dream of. Living with primary lymphedema since I was 17 years old is not easy, but I am still doing it! It has taught me to love myself and to feel the flow every moment of my life.
Wearing long-sleeved shirts, long pants, shoes and wide-brimmed hats when outside to protect against skin tears, bug bites or animal scratches
Consider wearing two layers to protect forearms, legs or feet when doing yardwork or gardening, common areas for minor injury to the skin.
Avoiding prolonged sun exposure. Always using a good sunscreen lotion with a high factor when in the sun.
Avoid long baths as they dry the skin.
This non-invasive massaging technique supports the movement of lymph fluid. According to The Vodder School, "the skin is stretched and torqued in a specific manner, based on scientific, physiological principles that have proven to encourage lymph flow. If performed correctly with the correct pressure, direction and speed, this can greatly enhance recovery and facilitate drainage."
Patients can learn to do a simple manual lymphatic drainage with the help of their therapist or instructions from videos or manuals.
Exercise is vital for overall health and well being. Patients should be encouraged to exercise to encourage the lymphatic system and increase venous return.
Compression bandages and stockings are often prescribed to help keep the swelling from building up around the ankles. It is important to exercise while wearing compression. In fact, blood flow back to the heart is better when calf muscle pumping exercises are done with compression bandages or stockings.
Exercise types depends on the patient's current physical activity level, age, personality and their oedema. There are patients with lower limb oedema who run marathons and others who compete in body building. Exercise types that stimulates the lymphatic system using deep breathing are yoga and pilates. Walking is low impact and easy and uncomplicated for many. Swimming, aqua jogging, aqua aerobics are excellent ways of moving as not only does the water act as a natural compression but it is low impact for joints.
Feeling comfortable, wearing normal shoes and bandage slippage are common challenges for patients in compression bandage systems.
Studies show less than half of patients wear their compression bandages. Most often, patients remove their bandages due to pain and slippage, which interferes with their activities of daily living and disrupts healing of a venous leg ulcer and also increases swelling. Patients need to understand the importance of remaining concordant with their compression therapy.
If the patient experiences any of the following signs and symptoms while wearing compression, they should contact their healthcare provider straight away.
• Pain or excessive tightness
• Fingers or toes are blue or white
• Any tingling or numbness
• Excessive itching and/or a rash
Once the patient has gone through a reduction phase to reduce swelling they can move into compression hoisery. For lower limb swelling these can include stockings, socks, tights, bermudas for swollen legs and ankles. For swollen toes it is possible to get either standard size or made to measure toe caps. It is also possible to bandage the toes depending on the condition and the ability of the patient. For upper limb swelling arm sleeves and gloves are available as well as special breast and trunk compression garments.