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Reminder:

The Dos And Don't of Lymphedema.

Prevention is better than cure for arm Lymphedema. Familiarize yourself with warnings and precautions and incorporate these guidelines, ignoring them are foolish. Skin care is your first line of defense. The skin acts as a barrier to infection. Learn to recognize the signs of infection: fever, redness, swelling, warmth or tenderness in the at-risk arm.


Preventive Guidelines:

1.Do moisturize your skin frequently and regularly with lotions to make your skin supple and prevent it from cracking.

2.Do keep your hand and arm extra-clean, but don't use harsh soaps (e.g. Dove). When drying be gentle but thorough (a hair-drier may help for difficult area).

3.Do use rubber gloves when you wash dishes or hand-wash clothes. Avoid any trauma (knocks, cuts, sunburn, insect bites). Be careful cutting nails; do not cut the cuticle or push back too hard (this can injure it and allow bacteria to enter, thus leading to infection). If you sewing wear a thimble; if gardening wear a glove and long sleeves. Never cut calluses (e.g. heel or sole). Use 10% urea cream or Lodema ointment. (it can use on minor burns, cut stings and bruises).

4.Do use an electric razor instead of a safety razor, depilatories or abrasive mitts to remove hair.

5.Do use insect repellents that don't dry out the skin. Avoid brands that contain alcohol. (Any ingredient that ends in "ol" is a type of alcohol.)

6.Do apply antibiotic ointment to any insect bites or torn cuticles. Any redness (infection) should be treated AT ONCE (keep antibiotics in your purse). All infections need antibiotics. Watch out for tinea (a slight redness and a peeling of the skin- need anti-fungal powder).

7.Do protect your arm from sunburn with sunscreen, minimum SPF 30. You can burn through many compression garments; particularly synthetic they do not protect you.

8.Do keep the arm as cool as possible in hot weather. If traveling for a long time in a car, drape a white shirt over a arm in the sun. Move it if possible when you have to sit for a long time, flex and stretch fingers or feet. Be careful of the water temperature in showers and spas. (No extreme hot to cold water temperatures) Don't go into high hot tubs, saunas or stream baths. Avoid applying heating pads to anywhere in the affected arm- this means if you have had a back or neck strain, use ice rather than heat.

9.Do rest your arm in an elevated position. Do not lie on an arm at risk when sleeping or resting.

10.Do control your blood sugars very carefully if you have diabetes, to minimize the danger of small blood vessel damage and infection.

11.Do wear compression bandages on the affected arm when flying in airplanes (if you already have arm edema- additional pressure bandages may be needed on a long flight).

12.Don't carry heavy objects with your at-risk arm, especially the arm hanging downward. Avoid shoulder bag and handbag on this arm.

13.Don't wear clothing with tight sleeves that restrains movement. No watch or other jewelry on the affected hand or arm. Brassieres should not be too tight around the ribs or over the shoulders. (Including underpants/panties) A wider shoulder strap is recommended.

14.Don't use heavy breast prosthesis after mastectomy. (It may put excessive pressure on alternative routes of lymphatic drainage that are already doing double duty; get a lighter model one)

15.Avoid vigorous activity. (Like: rubbing, scrubbing, pushing and pulling) Don't bring on muscle fatigue. Do household chores in small amounts at a time. Use moderation as your motto and pace yourself.

16.Avoid extended use of diuretics- it reduce swelling but they are not helpful with Lymphedema. As they don't does anything with the protein, bacteria and waste products that remain. In fact it will crate a higher concentration of protein. The high concentration levels can cause the tissue to become fibrotic and thickened, leading to increased problems with fluid removal.

17.Don't drink much alcohol (alcohol causes blood vessels to dilate and leak extra fluid into the tissues but there is no evidence that it worsens Lymphedema.)

18.Don't permit blood pressure testing, any piercing of the skin for injections, blood draws or vaccinations on your at-risk arm. (Not even your doctor) If you have had breast cancer in both breast use your non-dominant arm (if you are right-handed, use your left arm) or even a leg.

19.A normal balanced diet is the best. (With plenty of vitamins) Lymphedema is a high-protein edema, but eating too little protein will not help. Rather it weakens the connective tissue, thus making an edema worse. Reduction diets will not reduce Lymphedema, but are advisable only if patient is overweight.

20.If you are under severe stress, concentrate on relaxing the shoulders, back and neck. Extend your spine and 'stand straight'. Constant tension in these areas will worsen Lymphedema. Tension in the upper body may cause a "balance" tension in the leg at-risk may also develop Lymphedema.

 

If there is already Lymphedema

The above points must be observed, plus:


a.) Your way of life may need to be modified. Just need to be aware of the facts about your condition and to be sensible.

b.) Wear the compression garment at all times including at night. Bandages are often more comfortable at night. If garment does not cover your fingers and hand, and they swell, see a therapist at once. 'Lodema' (coumarin) powder can be safely used under the compression garment to assist with the reduction of lymphedema and helps you to put the garment on. Do not use the ointment under a garment use it under bandages, especially over fibrotic areas.

c.) Do exercise; but not too much (don't make the arm ache with tiredness, this can cause an increase in lymph fluid and make the lymphedema worse.


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