Good day my friends, I am your physical therapist and “swelling” specialist. Today I’ll be writing about the basic understanding of what “Lymphedema” is really all about. For some it’s a very intimidating word, yet it simply means: swelling of the lymphatic vessels! Lymphedema is often the swelling of the arm and quadrant (upper chest and back) where surgery was performed, in which lymph nodes were removed in an effort to stop cancer cells from spreading. The greater the number of lymph nodes removed during your breast cancer surgery, the greater the chance of developing Lymphedema, due to the accumulation of lymph fluid and it having no place to readily go.
Lymphedema occurs in more than 8% of women after their surgery, and that number increases to 35% in women who have radiation treatment following surgery. Lymphedema in most cases happens right after surgery, but it can even begin up to 30 years later. This obviously is different for everyone. That is why it’s important to know the indications, care, and precautions of Lymphedema, to understand at what risk level your are.
A good understanding of what you can do to prevent Lymphedema or control it is all you really need. Don’t let it control you! You control it! Like everything, educating yourself is the key.
The most important factor in protecting yourself from Lymphedema is recognizing it early. How? If you just had surgery, ask your doctor how many lymph nodes were removed? This will help you determine if you are at a low, medium or high risk. Remember this only means that you need to be more aware of it, but it still shouldn’t alarm you since you will be taking control!
We all have an average of 25 to 30 axillary lymph nodes in each axilla (underarm), and so the greater the number removed the more awareness to the precautions you will need to take. If radiation is part of your treatment, the intensity and areas radiated will also be a determining factor.
Ask your doctor if your at risk for Lymphedema, he/she should be able to answer your questions/concerns and refer you to a Lymphedema therapist as needed.
But do not just rely on your doctor. Be proactive! Here are a couple of suggestions. Within the first four weeks after surgery, go to a physical therapist who is certified specifically in lymphedema so they can guide you in the proper direction overall in performing range of motion activities and exercises in an effort to keep moving and stay strong. Also get in a habit of comparing your arms. After surgery it is normal for the affected side to be swollen over the quadrant, occasionally the arm will stay this way until you start moving it and regaining your range of motion and strength as mentioned. Now if the affected arm or quadrant does not decrease in swelling within a month, have it reassessed by your doctor or therapist.
Here are a few symptoms that you can be on the lookout for:
- Swelling of the fingers and arm
- Sores in the skin
- Not easy to wear fitted clothing
- Your arm feels tight (full)
- It’s not easy to move your affected joints
- Your shoulder is sore due to your arm having increased weight
- Your old rings, bracelets, or watches are tight
Additionally, follow these precautions: No heavy lifting until swelling is resolved/addressed, and review with your Lymphedema/physical therapist if you can begin exercising with weights or not? Again, this will depend on your risk level. There are other precautions but they do not apply to everyone, and so an individualized program is recommended. Nevertheless, I will mention a few for these for those who already know or suspect they have the signs & symptoms of Lymphedema.
These precautions apply to the arm/upper trunk area on the side of the surgery ONLY:
- No heavy lifting until you control the swelling (remember to talk to your Lymphedema/physical therapist)
- No withdrawal of blood from that arm
- No blood pressure checks on that arm
- Avoid cuts and insect bites (If you do sustain one, use an antibacterial topical cream, such as Neosporin and observe it. If it doesn’t heal or looks worse, go to your doctor for follow-up, prescribed antibiotics may be necessary.)
- Use an electric shaver for underarm. NO Razors!
- No cutting of cuticles with manicures
- Use your compression garment (sleeve) while exercising and/or when traveling in a plane
- Maintain your ideal body weight
- Exercise (ask your physical therapist to guide you in an appropriate program for you)
- Don’t wear anything with tight sleeves, cuffs or tight jewelry
- Move: Don’t sit in any one spot for more than 20 minutes
- As much as possible, keep your arm positioned above your heart for periods at a time
- Carry your purse on the opposite shoulder
- Do not use a heating pad on the affected arm
I encourage everyone to get informed, the more you understand the less intimidating it ALL is. It will help you put your mind at ease knowing that you are doing things properly. Remember this “Lymphedema” is only a condition. You can control it, don’t let it control you!
If you need further information on Lymphedema contact us at Lymphedema Foundation of South Florida at 305.740.7292 or visit our website at: http://lymphedemafoundationsf.org
Cheers
Follow Pat
