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Lymphedema

Definition

Lymphedema is the build-up of fluids in your body. It can cause an arm or leg to swell up and become painful. The disorder is lifelong.

What to Expect

Lymphedema may start 6 - 8 weeks after surgery or after radiation treatment for cancer.

It can also start very slowly after your cancer treatment is over. You may not notice symptoms until 18 - 24 months after treatment. Sometimes it can take years to develop.

Even a small infection or injury can cause lymphedema to start.

Ways to Help Relieve the Swelling

Use your arm with lymphedema for everyday activities, such as combing your hair, bathing, dressing, and eating. But, be careful not to overwork your arm or leg. Rest this arm above the level of your heart 2 or 3 times a day while you are lying down.

  • Stay lying down for 45 minutes.
  • Rest your arm on pillows to keep it raised.
  • Open and close your hand 15 - 25 times while you are lying down.

Take Good Care of Your Skin

Clean the skin of your arm or leg every day. Use lotion to keep your skin moist. Check your skin every day for any changes.

Protect your skin from injuries, even small ones:

  • Use only an electric razor for shaving underarms or legs.
  • Wear gardening gloves and cooking gloves.
  • Wear gloves when doing work around the house.
  • Use a thimble when you sew.
  • Be careful in the sun. Use sunscreen with an SPF of 30 or higher.
  • Use insect repellent.
  • Avoid very hot or cold things, such as ice packs or heating pads.
  • Stay out of hot tubs or saunas.
  • Have blood draws, intravenous therapy (IVs), and shots in the other arm or in another part of your body.
  • Do not wear tight clothing or wrap anything tight on your arms or legs that have lymphedema.

Take care of your feet:

  • Cut your toenails straight across. If needed, see a podiatrist to prevent ingrown nails and infections.
  • Keep your feet covered when you are outdoors. Do not walk barefoot.
  • Keep your feet clean and dry. Wear cotton socks.

Do not put too much pressure on your arm or leg.

  • Do not cross your legs while you are sitting.
  • Wear loose jewelry. Wear clothes that do not have tight waistbands or cuffs.
  • Where a loose-fitting bra.
  • If you carry a handbag, carry it with the unaffected arm.
  • Do not use elastic support bandages or stockings with tight bands.
  • Do not sit in the same position for more than 30 minutes.

Taking care of cuts and scratches:

  • Wash the wound gently with soap and water.
  • Apply an antibiotic cream or ointment to the area.
  • Cover the wound with dry gauze or a bandage, but do not wrap tightly.
  • Call your doctor right away if you have an infection. Signs of infection are a rash, red blotches, swelling, heat, pain, or fever.

Taking care of burns:

  • Use a cold pack or cold water on a burn for 15 minutes, then wash gently with soap and water.
  • Put a clean, dry bandage over the burn.
  • Call your doctor right away if you have an infection.

Living with lymphedema can be very hard. Ask your doctor about a special physical therapist who can tell you about:

  • Ways to prevent lymphedema
  • How diet and exercise affect lymphedema
  • How to use to massage to decrease lymphedema

Wear your compression sleeve during the day, but you may remove it at night. Always make sure you get the right size.

Wear a compression sleeve when traveling by air if you fly a lot, or for long flights. If possible, keep your arm above the level of your heart during long flights.

When to Call the Doctor

Call your health care provider if you have any of these symptoms:

  • New rashes or skin breaks that do not heal
  • Feelings of tightness in your arm or leg
  • Rings or shoes that become tighter
  • Weakness in your arm or leg.
  • Pain, aching, or heaviness in the arm or leg
  • Swelling that lasts longer than 1 - 2 weeks
  • Redness, swelling, or other signs of infection
  • Fever over 100.5 °F

References

Towers A. Lymphedema. In: Walsh D, Caraceni AT, Fainsinger R, et al, eds. Palliative Medicine. 1st ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 87.

Gamble GL. Lymphedema: Nonoperative treatment. In: Cronenwett JL and Johnston W., eds. Rutherford's Vascular Surgery. 7th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 66.

Davidson N. Breast cancer and benign breast disorders. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier;2011:chap 204.


Review Date: 6/7/2012
Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington; and Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Inc.
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