Lymphedema is a swelling that can happen after removal of lymph nodes or damage to lymph nodes as can happen during cancer treatment. Just a few years ago women and men had no instruction on how to reduce their risk of lymphedema. A great amount of effort has been recently placed on this subject and here is a brief summary.
Lymph nodes help filter out bacteria and reduce the risk of infection. When lymph nodes are removed or damaged during surgery or radiation, the ability to fight infection in the affected area decreases. For example, lymph nodes removed from the right armpit help drain the right arm and right chest and torso, front and back. Thus, the right arm, right chest, and right back are at higher risk for infection.
If you think you have an infection, due to signs of increased pain, swelling, redness, head, or pus in the area, or if you feel flu-like especially with any of those other signs, seek medical attention immediately. That means go to your doctor, ER, Urgent Care – do not pass go, do not collect $200. Early treatment with antibiotics may prevent the infection from causing swelling and lymphedema, not to mention you’ll feel better a whole lot quicker. Here are some tips for avoiding infection:
- Take care of your arm and chest
- Immediately wash any cut you get on your affected area (right arm and chest in the example above)
- Keep neosporin/bacitracin/antibiotic cream on hand with bandaids in your car and purse so they are with you at all times
- Keep your skin hydrated with dry skin lotion to prevent cracking especially during winter months
- Use sunscreen to prevent a sunburn
- Practice good hygiene like wearing gloves when gardening and using insect repellent (especially for the truck sized bugs we have in Minnesota)
Gradually Return to Exercise & Activity
Your end goal is to return to all activities (cleaning, working, exercising) that you were able to do prior to your surgery. But you need to remember that you had surgery, and give yourself time to slowly return to normal activities. Ask your doctor/surgeon and physical therapist when it is ok to start to return to activity, and ask for specific recommendations for you to help you along your way.
Once you start to return to activity, watch your arm/hand/chest at risk to monitor for any swelling. If you introduce a new activity and your arm/hand/chest feel & look the same, you know your body can handle that amount of activity. Maintain that level of activity for a week or so, then slowly increase again. Repeat until you are back to your normal activity level.
If any swelling occurs, back down on the amount of activity you do for a few days or until the swelling goes back down to normal. Do the exercises your lymphedema therapist taught you, wear a compression sleeve/glove if you have it, and contact your lymphedema therapist.
Maintain a Healthy Body Weight
Obesity at the time of diagnosis, defined as being overweight with BMI> 3 0 kg/m2 (for example height 5’5” weight > 180 pounds), can greatly increase your risk of lymphedema.
What you can do:
- Keep your body at a healthy weight
- Try to eat well balanced meals
- Exercise daily, at least 30 minutes of walking 5 days/week, and include weight training if recommended by a medical professional.
If for any reason your arm/chest wall feels full, heavy, achy, numb, or tingly, contact your lymphedema therapist immediately and perform lymphedema exercises and lymphedema massage, and / or wear the compression sleeve if you have it. Studies show that early treatment of swelling by a lymphedema therapist may be able to get rid of it in some cases. So don’t wait it out and just hope it goes away.
Hopefully these guidelines help. For more information, contact Renata Beaman, PT, MS, MA, OCS, CLT @ firstname.lastname@example.org or follow me on twitter @RenataBeamanPT.
Cancer Rehabilitation: Use of evidence-based manual therapy and exercise to help return people to their prior level of function during and after cancer treatment. This includes evaluationprior to surgery as well as treatment through chemotherapy, radiation, initial and reconstructive therapies, and years afterwards if difficulties persist.
Lymphedema: education, risk reduction, and treatment.
Orthopaedic Rehabilitation (neck, back, shoulder, hip, knee, and other injuries): Minimize pain and function (flexibility, strength, daily movement patterns) to allow people to lead their daily lives without being limited by pain.
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