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This guide is for you, our patient, and any caregivers who may be involved in your care.
This guide explains how we can help you to help your lymphedema and wound. It is full of information to help you to understand what is going on with your body when you have lymphedema and a wound and what your body needs to heal the wound or, if it can’t heal, to feel better.
Lymphedema is a swelling of a body part, most often an arm or leg, caused by an abnormal build-up of lymph fluid.
A blockage in the lymph system can cause lymphedema. A blockage can result from:
Most people know that we have a system that circulates our blood that includes veins and arteries. But you might be surprised to learn that we also have another circulation system called the ‘lymphatic system’ that carries lymphatic fluid.
This is the system that removes fluid, bacteria, viruses and waste products from our bodies, like dead cells and bacteria. The superficial lymph vessels are just under the skin.
Our body contains about 2 – 4 liters of lymph fluid that is constantly flowing through it. The lymph fluid circulates through the tissues, to the lymph nodes that are often in groups or chains all over the body especially in our throat, groin and arm pits. Then it continues to the heart and to the kidneys where it is cleaned and then is recirculated.
When a lymph node is swollen, it is a sign there is inflammation in the body. You may have noticed your neck lymph nodes swelling whenever you have a cold.
When damage has been done to the lymph system, the fluid cannot be drained and instead builds up as swelling. If nothing is done, this soft swelling becomes worse and eventually becomes hard. This can lead to a skin infection called cellulitis.
Sometimes you can get repeated skin infections needing antibiotics or even hospitalization. With each infection the size of the limb does not go down to its previous size and so the limb becomes larger and larger. As it does, the weight increases and the limb becomes harder to lift; it may become harder to find clothes that fit and harder to exercise.
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Skin Care
Pay special attention to keeping your skin clean, especially in the creases. Use a non-perfumed pH balanced soap, rinse and dry well without rubbing. Moisturize your skin while still damp using a hypoallergenic lotion or oil like coconut oil. When applying lotion or oil, gently massage from the toes or fingers up the limb.
Compression
Lymphedema will not go away on it’s own. It is a perment condition. You will need active treatment to remove the fluid from the limbs. Compression is one technique used to treat lymphedema by applying pressure to the affected area using specialized garments or bandages. This pressure helps to reduce swelling, improve flow, and prevent the buildup of lymphatic fluid.
Compression comes in many forms: bandaging wraps, stockings, or sleves, to name a few. There are many options available and you and your health team will work to find the best suitable choice for you and your lifestyle.
Manual Lymphatic Drainage (MLD)
There is a special type of massage that can be used by specially trained massage therapists on the superficial lymph vessels to move fluid. This very light sweeping action, called manual lymph drainage (MLD), can also help to move fluid past a blockage by establishing a new route. The massage therapists will apply bandaging after the treatment to encourage the fluid they have moved to stay out of the limb.
MLD may be covered by private insurance plans. For further information on coverage speak to your insurance provider.
Pain Management for Lymphedema
Many people find that pain is reduced as the swelling is reduced. Generally analgesics such as Motrin, Tylenol or Asprin are helpful in managing the pain. Elevation of the limb, relaxation techniques, stretching and yoga can all be helpful in lessening some of the swelling.
The Government has a program that assists with the ongoing cost of compression management. This is called Assistive Devices Program – ADP. There is a process to go through to get this coverage:
Complete this section with your nurse. Check off as many of the things you think you can try to do to help keep yourself healthy and heal your wound.
I will wear my compression wraps or garments as suggested by my health care professional.
I will try to maintain a healthy weight.
If OK with my doctor or nurse, I will start a regular stretching or yoga program _____ x week for _____minutes each day
I will use pH balanced soap, rinse well and pat my skin dry.
I will moisturize daily after my bath or shower.
I will make sure any infections are treated quickly. At the first sign of an infection, I will contact my doctor.
I will learn how to wrap my limb as demonstrated by my nurse or other health professional.
I will wear loose clothing.
I will elevate my limb with lymphedema at night.
I will make sure that blood for blood tests is only taken from a limb that does NOT have lymphedema.
I will talk to my family and let them know about my condition and how they can assist me.
I will ask for assistance with heavy lifting.
I will find out about support groups for people living with lymphedema and think about joining.
