| DO's and Don'ts: DO'S and DON'TS of LYMPHEDEMA: Outdoors DO protect your arm from sunburn. Always wear sunscreen. DO avoid insect bites. Wear something to guard yourself from insect bites whether it be bug repellent or long sleeves and pants. DO wear gloves when gardening, shovelling, and yard work. DO exercise and do stretches before outdoor work. Be careful you don't over exert. DO NOT allow outdoor pets to scratch or bite you. Be sure if you do happen to get scratched, you clean it properly and quickly to avoid infection and make sure your tetnus shots are up to date. DO NOT expose your affected areas in outdoor hot tubs. DO NOT play sports that can injury you with falling, bumps, bruises, etc. Indoors DO wear gloves when doing housework or cooking. If you do happen to get cleaning products on yourself, wash immediately and look for irritation. Apply antibacterial or necessary ointment to prevent infection from any breaks in the skin. This also applies to burns. The OVGlove works wonders for taking pans out of the oven for those with arm/hand lymphedema. DO NOT allow pets to bite you or scratch you even in play. Always be careful when handling any pets. DO NOT iron or sew without proper hand protection whether it be a thimble or glove when ironing. Hygiene DO make sure you keep your affect areas clean and use moisturizing lotions to keep the skin supple. DO make sure you wash and apply any ointments, lotions, and antibacterial remedies immediately after a cut or scratch. DO dry your body thoroughly after bathing, and be sure the water is warm, not hot. It is good practice to do skin brushing wet work or dry work before or after bathing. Skin brushing helps remove dead dry skin and also stimulates the superficial lymph nodes under the skin to promote lymph flow. While in the tub, you can make it a practice to save time (for women) to do breast exams. Everyone can also check their body over for any odd moles or patches of skin (skin cancer check). You can also save time by doing some self massage as well. Grooming and Accessories DO wear a well fitted bra. There are actually bra's made for lymphedema, one company makes a compression bra. The company is named Bellise. Be sure the straps on your bra do not cut in your shoulders and the edges of the bra don't have anything to irritate the skin (sharp edges on lace, etc). Some prefer to go bra-less. Some also use stick on patches. Be careful of the adhesive on these as it can irritate the skin. If you wear a prosthetic, be sure it's a light weight one. DO NOT use a disposable razor if you can help it. Electric razors give a smoother shave which is less likely to harm the skin with little cuts or abrasions. Be careful with cutting finger and toe nails as well. Cutting the cuticles isn't advised with arm/hand lymphedema. If you have hard, brittle nails (Toe or Finger) please see your doctor or podiastrist. You may have a fungal or some type of infection that should be treated. (Lamisol is the treatment of choice). DO NOT wear tight jewelry of any kind on your affected areas. For abdominal lymphedema, body piercing is not an option, it's a danger. Anklets, bracelets, rings and other jewelry can cause irritation and become tight with swelling. It is also advised not to carry a heavy purse, bag, laptop bag or briefcase over the shoulder of an affected arm. Travel DO wear compression garments when travelling. Make sure you get up and move around as much as you can. Remember to stretch and do range of motion exercises if possible, and to deep breathe. Also remember to take your special supplies (Soap, creams, bandages, etc) with you. Medical DO NOT allow blood to be taken from any arm affected with lymphedema, nor allow vaccines or shots to be given in the arm. IV's are also troublesome, as well as blood pressure cuffs. The vaccine or shot causes a prick in the skin which is a risk for infection as well as trauma to the area. The blood pressure cuff exerts a force on the area traumatizing it as well. |
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| LYMPHLAND |
| How to Avoid Lymphedema
At a Glance If you've had breast cancer in both breasts: Since you must protect both of your arms against lymphedema, you'll have to be an especially watchful advocate for yourself. Not all medical professionals know the precautions for avoiding lymphedema. If you need to have your blood pressure measured or blood drawn, try to have these procedures done on your leg or foot. If this is not possible, have the procedure done on your non-dominant arm. If one side had no lymph node dissection, use the arm on that side, regardless of whether it's your dominant arm. In an emergency, however (such as a car accident), if an intravenous line must be started, let medical workers do what they need to do to start the IV as soon as possible. Current methods of breast cancer treatment lower the risk of developing lymphedema. But if you had a radical mastectomy many years ago, you may have had arm swelling, or you may still be at risk for the condition. Prevention is very much in your best interest. Even the safest and most effective therapy may only delay the condition or keep it from worsening. Immediate care is essential with any trauma or infection. Prevention is the best tool against arm lymphedema. Learn the warning signs and the precautions to take. Make these guidelines and a heightened awareness a regular part of your life. Skin care is your first line of defense. Since the skin acts as a barrier to infection, any disruption of the skin can spell trouble. Burns, chafing, dryness, cuticle injury (such as hangnails), cracks, cuts, splinters, and insect bites are immediate risks for infection. Learn to recognize the signs of infection: fever redness swelling, warmth, or tenderness in the at-risk arm Infection and inflammation can escalate quickly. Redness, tenderness, and warmth can spread from the injury up your arm. Call your doctor as soon as you suspect infection. You may need to start antibiotics immediately with any early sign of trouble. If you already have swelling, or if you have diabetes (whether or not you have swelling) you may need antibiotics after just the smallest of injuries—even without any sign of trouble. If you already have significant arm edema, sometimes a dental procedure may trigger an arm infection. This is because the work a dentist does on the tissues in your mouth may increase the number of bacteria circulating in your bloodstream. Vulnerable areas in the body, like the compromised drainage of a swollen arm, may become hangouts for the bacteria. If you've already had an arm infection following dental work, talk to your doctor about whether you should take prophylactic (preventive) antibiotics before future dental procedures. (People with heart valve disease take prophylactic antibiotics before or right after a dental procedure for the same reason.) Do's and Don'ts: Preventing Lymphedema Do moisturize your skin frequently and regularly. Use lotions such as Moisturel, Eucerin, Vaseline Intensive Care, or your own favorite brand to make your skin supple and prevent it from cracking. Do keep your hand and arm extra-clean, but don't use harsh soaps such as Ivory (despite Ivory's advertised image as a gentle soap) or Dial. Use Dove instead. Do use rubber gloves when you wash dishes or hand-wash clothes. Do wear protective gloves when you garden or do outside chores. Do take more frequent rest breaks when scrubbing, mopping, cleaning, or while doing other vigorous or repetitive activities, especially if your arm feels tired, heavy, or achy. Do wear oven mitts when handling hot foods. Do use an electric razor instead of a safety razor. Do use insect repellents that won't dry out the skin, such as Avon's Skin-So-Soft, which actually moisturizes the skin. Avoid brands that contain a significant amount of alcohol. (Any ingredient that ends in "ol" is a type of alcohol.) Do apply antibiotic ointment (like Bactroban) to any insect bites or torn cuticles (as long as you are not allergic to its contents). Do protect your arm from sunburn with sunscreen. Use a product with a minimum SPF of 15, although SPF 30 is much better. Do use a thimble when you sew. Do REST your arm in an elevated position. But don't hold up your arm without support for a long time because your muscles will tire. Do control your blood sugars very carefully if you have diabetes, to minimize the danger of damage to the small blood vessels and infection. Do wear compression bandages or a compression sleeve and glove on the affected arm when flying in airplanes (if you already have arm swelling). Don't take unusually hot baths or showers. Don't go from extreme hot to cold water temperatures when you bathe or wash dishes. Don't go into high-heat hot tubs, saunas, or steam baths. Don't apply heating pads or hot compresses to the arm, neck, shoulder, or back on the affected side. Also, be cautious of other heat-producing treatments provided by physical, occupational, or massage therapists, such as ultrasound, whirlpool, fluidotherapy, or deep tissue massage. Heat and vigorous massage encourage the body to send extra fluid into the compromised area. Don't carry heavy objects with your at-risk arm, especially with the arm hanging downward. Don't wear heavy shoulder bags on the affected side. Don't wear clothing that has tight sleeves or that restrains movement. Don't wear your watch or other jewelry on your affected hand or arm. Don't use a heavy breast prosthesis after mastectomy. It may put excessive pressure on alternative routes of lymphatic drainage that are already doing double duty. Find a lightweight model or make one yourself. Don't drink much alcohol. Alcohol causes blood vessels to expand and leak extra fluid into the tissues. Don't smoke. Smoking narrows the small blood vessels, lessening the flow of fluids in the arm. Don't get manicures that cut or overstress the skin around the nails. Don't permit blood pressure testing on your at-risk arm. If you've had breast cancer in both breasts, ask that your blood pressure be tested on your thigh. If this is not possible, ask that the person measuring your blood pressure inflate the cuff only slightly above your normal systolic pressure (the first, higher number of your blood pressure). Don't permit the skin of your at-risk arm to be pierced for any reason: injections, drawing blood, or vaccinations. (Don't trust anyone, not even your personal physician, to remember which is your at-risk arm.) If you've had breast cancer in both breasts along with underarm lymph node dissections, blood should be drawn from another part of your body. If blood must be drawn from your arm, use your non-dominant arm (your left arm, if you are right-handed; your right arm, if you are left-handed). If one side had no lymph node dissection, use the arm on that side, regardless of whether it's your dominant arm. Arm Lymphedema - |
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