Avoid Developing Lymphedema, How To
How to Prevent Lymphedema
Lymphedema refers to the buildup of fluids in the body's soft tissues due to blockage or removal of the lymph nodes. Lymphedema is most commonly caused by the removal of the lymph nodes following cancer treatment, but may also be caused by environmental factors or genetics. Most lymphedema appears within three years of surgery. Lymphedema can also be caused by the abnormal development of the lymph system at birth, though symptoms may appear later. The best way to prevent lymphedema is to recognize its symptoms and treat it early.
Consult your doctor as soon as you notice signs of lymphedema.Signs of lymphedema include swelling in the arms, legs, hands, fingers, neck or breast. If you notice swelling or other signs (see below) make an appointment with your doctor immediately.
- Getting to know the early signs of lymphedema is one of the best ways of preventing the condition from worsening.
- There isn't a cure for lymphedema, but early treatment can minimize its symptoms and prevent others from occurring.
- Lymphedema can occur within days, weeks, months, or even years following treatment for cancer.
Avoid having blood drawn from arms at risk for lymphedema.Lymphedema commonly develops in the same quarter of the body in which surgery was done. Avoid receiving any injections, or IV injections, in the arm at risk for developing lymphedema.
- When taking your blood pressure, put cuff on the arm less likely to be affected by lymphedema.
- You might want to purchase a medical alert bracelet to alert others not to take blood, insert IVs, or receive injections in the affected arm.
Avoid taking long, hot baths or showers.Don't immerse the limbs likely to be affected by lymphedema into hot water, steam baths or other high heat areas. If you decide to take a hot bath, avoid putting your arms into the water.
- Don't use heating pads or other heat treatments.
- Avoid getting deep body massage on the affected area.
- Heat and massage draw increased body fluid into the area, which can trigger lymphedema.
- Keep your arm out of the sunshine when possible.
Don't carry heavy objects or shoulder bags.For the recovery following a surgery or cancer treatment, avoid using the affected side of the body to carry heavy things. Be careful to avoid heavy weight-bearing exertion with the arm at risk of developing lymphedema.
- When you're carrying heavy objects, keep the arm raised above the waist.
- As you strengthen over time, you can gradually return to carrying heavier objects.
Avoid wearing constricting clothes or jewelry.If your watch, rings, bracelets or other jewelry feel tight, either loosen them or stop wearing them. Make sure your clothing is loose-fitting and doesn't constrain movement.
- Avoid wearing tops with tight necklines if you're at risk for developing head or neck lymphedema.
- Constriction around the neck, arm, leg, wrist or other body part can contribute to fluid buildup in that area.
Elevate your limb.If you are at risk for getting lymphedema, one way to prevent it is to keep the at-risk limb elevated when possible. This will prevent body fluid from settling into the limb and causing swelling.
- This preventative measure is most effective in keeping lymphedema from developing in the arms, hands or fingers.
- You can choose to sleep with your leg elevated above your heart, if you sleep on your back. Place a pillow beneath your knees or feet.
Change your position.Try not to sit or stand for long periods of time. Instead, remind yourself to change your position regularly. Don't cross your legs when you're seated, and prop yourself into a more upright position in bed.
- Being upright in bed improves the drainage of lymph fluids in the body.
- You might need to set regular alerts on your phone or timer to remind you to move regularly. Take advantage of naturally occurring reminders as well. If you watching television, make sure to change positions during every commercial break, for instance.
Wear protective clothing.Cuts, sunburn or other burns, insect bites, and cat scratches can all bring fluid to the affected area, thus raising the likeliness of lymphedema. Wearing loose long sleeves and pants may help guard against skin injury.
- Make sure your clothing is loose, not tight.
- Never wear athletic arm sleeves, as they constrain the arm.
Protect your extremities from any kind of injury.Any cuts, open wounds, scrapes, or burns to the affected arm or limb can cause infection. Presence of infection prevents the lymphatic fluid from filtering out bacteria and viruses. Signs of infection include: swelling, pain, redness, warmth, and fever. If these symptoms are present, go to the nearest hospital for treatment and management.
- Don’t allow sharp objects to puncture your skin.
- You should always use a thimble when sewing, wear thick gloves when gardening, and apply insect repellents when outside.
- Keep skin moist by applying mild moisturizers to prevent it from drying and cracking.
- Take extra precaution during shaving if you are using a regular razor.
- If you get manicures, don't cut or pull your cuticles. Try to find a manicurist who's familiar with your health history and can work with your special needs.If you're going to a new manicurist, check their health history online. Never go to a place with reports of unsanitary practices, or if clients have experienced bacterial, fungal, or viral infections.
- Wear gloves while doing housework or garden work to avoid injury to the hands, fingers or nails.
- Wearing comfortable, closed-toe shoes reduces risk to injury of the foot and toes.
Eat a well-balanced, low-sodium diet.Include two to three servings of fruit, three to five servings of vegetables daily. Eat foods that are high in fiber, including whole-grain breads, cereals, pasta, rice, fresh fruits and vegetables. For best results, avoid alcoholic beverages or limit your intake to one per day.
- Avoid high-calorie, nutritionally inadequate fast foods or junk foods. In addition to being high-calorie and low-nutrition, these foods are often very high in sodium.
- Cut back on red meat and processed meat products like hot dogs, sausage or bacon.
Maintain a healthy body weight.Being overweight or obese contributes to the risk of developing lymphedema. This is because it puts additional pressure on areas that are already swollen and causes further interruption of lymphatic fluid drainage.
- Proper diet, exercise, and discipline are key to maintaining the ideal body weight.
- If you need help with this, ask your medical health care provider. She can offer suggestions and local resources based on her understanding of your condition.
Cultivate a healthy lifestyle.Getting to a healthy weight and staying there can help prevent lymphedema from developing. Following healthy eating habits and including regular exercise are part of overall healthy living.
- Getting enough sleep will help maintain a strong immune system, and reduce your risk of developing lymphedema.
- Work with your medical health care provider to establish healthy exercise routines. Strenuous exercise may not be recommended, but try to include exercise as part of your daily routine.
Don't smoke.Smoking narrows the capillaries and small blood vessels, which makes it harder for fluids to flow freely around the body. It depletes the skin of oxygen and other needed nutrients found in healthy blood flow. Smoking also damages the elasticity of the skin.
- If you need help quitting smoking, ask your doctor or healthcare provider. There are many supports to help people quit smoking.
- Quitting smoking also helps minimize risk for developing other cancers and health problems.
Recognizing the Symptoms
Notice swelling in the arms, legs, breast or hand.Swelling in the soft tissue of the arms or legs is one of the most common signs of lymphedema. In early stages, the skin remains soft. Pressing on the swollen area may leave a dent.
- Your doctor may want to measure the affected area using a tape measure in order to monitor swelling.
- In later stages of lymphedema, the swelling will become firm and hard. Pressing the swollen area won't leave a dent.
Pay attention to heaviness in arms or legs.In addition or before noticing swelling, you may feel the weight of fluid buildup in the arms and legs. Your limbs may feel difficult to move. If you are at risk for developing lymphedema, this may be an early symptom.
- If you’ve had any type of surgery, radiation treatment, or lymph nodes removed, take a close look at your body in a full-length mirror and check for swelling.
- Compare both sides of your body, and check for differences.
Be aware if you have trouble moving joints.Stiffness in your fingers, toes, knees, elbows or other joints can be a sign of increased fluid buildup due to lymphedema. While there are many reasons for stiffness in joints, pressure on joints due to buildup in body fluids can be a sign of lymphedema.
- Symptoms of lymphedema may occur gradually, or they may come about all at once.
- Get to know your body well, and notice what's normal for you.
Notice itching or burning in toes or legs.This may be a sign of cellulitis, a non-contagious infection of the skin. Because of the way lymphedema affects the immune system, it's important to see your doctor immediately if you notice symptoms of cellulitis.
- Cellulitis may be triggered by insect bites or scratches.
- Your doctor will treat the infection with antibiotics. Do not delay attending to the infection, because it can quickly become life-threatening.
Check for thickening of the skin (hyperkeratosis).Fluid retention can cause thickening of the skin. If you notice thicker skin developing on your arms, hands, legs or feet with or without other skin changes such as blisters or warts, this can be a sign of lymphedema.
- Keeping your skin meticulously clean is essential for people with hyperkeratosis.
- Use a therapeutic-based moisturizer daily, and avoid lanolin-based or fragrant lotions.
Pay attention when clothing or jewelry doesn't fit.Many people with lymphedema report feeling uncomfortable in their bras, even though they've not gained weight. If your rings don't fit, or your watch and bracelet feel uncomfortably snug, this may be a sign of lymphedema.
- You might notice that you have trouble fitting your arm into your sleeve on one side of your body.
- Because symptoms of lymphedema may develop gradually, you may not notice swelling in your shoulders or arms until you have difficulty fitting into your clothes. If your clothing starts to feel tighter on one side, or if you have trouble putting on a close-fitting shirt or jacket, look for signs of lymphedema.
Observe tight, shiny, warm or red skin.The skin might appear "glossy" or "stretched". This may be a sign of cellulitis. If your skin coloration or texture changes in this way, see a doctor immediately.
- The affected area may spread rapidly once observed.
- You may also notice fatigue, fever, aches and other flu-like symptoms. Or, you may not experience any of these other signs.
Recognizing Signs in the Head/Neck
Notice swelling in the eyes, face, lips, neck, or area below the chin.Symptoms of head and neck lymphedema typically appear 2-6 months following cancer treatment in the area of the head. Lymphedema sometime develops in the larynx and pharynx (the mouth and throat). It may also develop externally in the neck and face, or a combination of both, depending on which lymphatic channels are obstructed.
- See your doctor if you notice any signs of lymphedema in the head or neck.
- Unmanaged swelling may result in a series of additional inflammations that rapidly become more difficult to manage.
Feel for tightness or swelling in affected areas.Because it may be difficult to detect visual cues of swelling in the head and neck, the first symptoms of lymphedema in these areas are likely to be felt sensations. Notice any sign of tightness in your head and neck.
- You may experience difficulty moving your head, neck or face. Your skin may feel stiff or uncomfortable, though you can't see any apparent signs of swelling.
- Your doctor may want to conduct additional tests to check for lymphedema, including lymphoscintigraphy or another imaging technique that relies upon injection of contrast dyes to show lymphatic fluid flow abnormalities.
Be aware if you experience changes in vision due to eye swelling.Blurred vision, excess or unexplained tearing and redness of the eye, feeling pain behind the eye are all possible signs of lymphedema-distichiasis syndrome. This is a genetic condition present at birth, but signs may not appear before puberty onset.
- The growth of additional eyelashes along the interior lining of the eyelid are also signs of lymphedema-distichiasis syndrome.
- Other eye problems resulting from this condition include irregular curvature of the cornea, and corneal scarring.
Observe if you have a hard time swallowing, speaking or breathing.In more severe cases of lymphedema, swelling of tissue in the neck and throat will affect basic bodily functions. You may notice drooling or spilling food from the mouth.
- Swelling may also result in nasal congestion or inner-ear pain. It might affect sinus glands and passages.
- To confirm presence of lymphedema in the neck and head, the doctor may perform an ultrasound or an MRI. These tests can show placement of lymphatic fluids within the head cavity.
QuestionIs it advisable to wear compression leggings when you have Lymphedema?
Family Medicine PhysicianFamily Medicine PhysicianExpert AnswerYes, I would highly recommend wearing compression stockings to reduce the swelling. Some women after breast cancer surgery develop lymphedema of the arm and this is one of the treatments to reduce this type of swelling.Thanks!
Do you find patients get lymph edema after having total knee surgery?
- Even if you are at risk for developing lymphedema, make sure your medical provider rules out other causes for lymphedema's symptoms.
- Immediately report any signs of infection to your physician, including fever over 100°F (or 38°C), sweating, persistent chill, skin rashes, or other skin anomalies such as tenderness, redness or swelling.
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Video: Mayo Clinic Minute: Reducing lymphedema risk with exercise
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