Lymphedema - Eighteen Steps To Prevention - UPPER Extremities
WHO IS AT RISK?
Those at risk are anyone who has had either a simple mastectomy, lumpectomy or modified radical mastectomy in combination with axillary node dissection and/or radiation therapy. Lymphedema can occur immediately postoperatively, within a few months, a couple of years, or 20 years or more after cancer therapy. With proper education and care, lymphedema can be avoided, or, if it develops, kept well under control. The following instructions should be reviewed carefully pre-operatively and discussed with your physician or therapist.
- Absolutely do not ignore any slight increase of swelling in the arm, hand, fingers, or chest wall (consult with your doctor immediately).
- Never allow an injection or a blood drawing in the affected arm(s). Wear a LYMPHEDEMA ALERT bracelet.
- Have blood pressure checked on the unaffected arm, or on the leg (thigh), if bilateral lymphedema/at-risk arms.
- Keep the edemic or at-risk arm(s) spotlessly clean. Use lotion (Eucerin, Lymphoderm, Curel, whatever works best for you) after bathing. When drying it, be gentle, but thorough. Make sure it is dry in any creases and between the fingers.
- Avoid vigorous, repetitive movements against resistance with the affected arm (scrubbing, pushing, pulling).
- Avoid heavy lifting with the affected arm. Never carry heavy handbags or bags with over-the-shoulder straps on your affected side.
- Do not wear tight jewelry or elastic bands around affected fingers or arm(s).
- Avoid extreme temperature changes when bathing or washing dishes, and it is recommended that saunas and hot tubs be avoided (at least keep arm out of the hot tub). Protect the arm from the sun at all times.
- Try to avoid any type of trauma (bruising, cuts, sunburn or other burns, sports injuries, insect bites, cat scratches) to the arm(s). (Watch for subsequent signs of infection.)
- Wear gloves while doing housework, gardening or any type of work that could result in even a minor injury.
- When manicuring your nails, avoid cutting your cuticles (inform your manicurist).
- Exercise is important, but consult with your therapist. Do not overtire an arm at risk: if it starts to ache, lie down and elevate it. Recommended exercises: walking, swimming, light aerobics, bike riding, and specially designed ballet or yoga. (Do not lift more than 15 lbs.)
- When traveling by air, patients with lymphedema (or who are at risk) must wear a well-fitted compression sleeve. Additional bandages may be required on a long flight. Increase fluid intake while in the air.
- Patients with large breasts should wear light breast prostheses (heavy prostheses may put too much pressure on the lymph nodes above the collar bone). Soft padded shoulder straps may have to be worn. Wear a well-fitted bra: not too tight, ideally with no underwire.
- Use an electric razor to remove hair from axilla. Maintain electric razor properly, replacing heads as needed.
- Patients with lymphedema should wear a well-fitted compression sleeve during all waking hours. At least every 4-6 months, see your therapist for follow-up. If the sleeve is too loose, most likely the arm circumference has reduced or the sleeve is worn.
- Warning: If you notice a rash, itching, redness, pain, increase of temperature or fever, see your physician immediately. An inflammation (or infection) in the affected arm could be the beginning or worsening of lymphedema.
- Maintain your ideal weight through a well-balanced, low sodium, high-fiber diet. Avoid smoking and alcohol. Lymphedema is a high protein edema, but eating too little protein will not reduce the protein element in the lymph fluid; rather, this may weaken the connective tissue and worsen the condition. The diet should contain easily digested protein (chicken, fish, tofu).
Unfortunately, prevention is not a cure. But, as a cancer and/or lymphedema patient, you are in control of your ongoing cancer checkups and the continued maintenance of your lymphedema.
Revised (c) January 2003 National Lymphedema Network. Permission to print out and duplicate this page in its entirety for educational purposes only, not for sale. All other rights reserved. For more information, contact the NLN: 1-800-541-3259.