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LYMPHEDEMA

(ELEPHANTIASIS DUE TO MASTECTOMY)
Lymphedema

WHAT YOU NEED TO KNOW:

What do I need to know about lymphedema? The lymphatic system contains fluid, vessels, tissue, and organs. This system removes and carries fluid throughout the body. It also helps the body fight infection. Lymphedema is the buildup of lymph fluid in fat tissue under your skin. The buildup causes the area to swell. Lymphedema can happen any time that lymphatic vessels are blocked or damaged.

What increases your risk for lymphedema?

  • Surgery to remove lymph nodes in the underarm, groin, pelvis, or neck

  • Radiation to lymph nodes in the underarm, groin, pelvis, or neck

  • Surgery to the chest, head, neck, or pelvis

  • Being overweight or obese

  • A history of venous insufficiency

  • Infection or injury

  • A history of diseases that affect the lymphatic system such as Milroy disease

What are the signs and symptoms of lymphedema? Signs and symptoms may happen where lymph nodes were removed, or in the arm, leg, chest, or underarm.

  • Swelling or itching

  • Pain, burning, or aching

  • Tight, hard, or red skin

  • Hair loss

  • Heaviness or fullness

  • Numbness or tingling

  • Stiffness

How is lymphedema diagnosed? Your healthcare provider will examine areas of swelling and ask about your symptoms. Tell him if you have ever had cancer, radiation treatment, or surgery. You may need an ultrasound, MRI, CT, or nuclear scan. These tests take pictures of the lymphatic system. They may show areas of fluid buildup. You may be given dye to help the lymphatic system show up better in pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body. You may need other tests to check for other causes of swelling.

How is lymphedema treated? There is no cure for lymphedema. Treatment can relieve symptoms and prevent lymphedema from getting worse. You may need any of the following:

  • Therapeutic massage helps move lymphatic fluid through your body. It is done by a specialist, who may also teach you how to perform the massage yourself.

  • Compression devices are sleeves, gloves, boots, or bandages. These devices use pressure to help move lymphatic fluid and prevent fluid buildup.

  • Physical therapy may help decrease swelling and pain. It may also help improve strength.

  • Surgery may be needed if other treatments do not work. Surgery may be done to remove tissue, drain fluid, or create a path for lymphatic fluid to flow.

How can I manage my symptoms?

  • Elevate your arm or leg above the level of your heart as often as you can. This will help decrease swelling and pain. Prop your arm or leg on pillows or blankets to keep it elevated comfortably.

  • Wear compression socks, sleeves, or bandages as directed. Compression devices must be fitted by a healthcare provider. Compression devices may need to be replaced every 3 to 6 months.

  • Exercise can help you maintain or regain function of your arm or leg. Ask your healthcare provider what type of exercise to do and how often to do it. Start slow, take breaks, and gradually do more each day. Do not do vigorous, repeated exercises. Watch for changes in your arm or leg during exercise. Stop and rest if you have swelling, increased pain, or heaviness. Elevate your arm or leg above the level of your heart.

  • Change your position often to help move lymphatic fluid through your body. Do not sit or stand in one position for more than 30 minutes. Do not cross your legs when you sit. These actions can cause lymphatic fluid to buildup.

  • Maintain a healthy weight. Ask your healthcare provider what you should weigh. Weight loss may improve your symptoms. If you need to lose weight, your healthcare provider can help you create a weight loss program.

How do I care for my skin and help prevent infection? A skin infection can make lymphedema worse. Do the following to decrease your risk for a skin infection in your arm or leg with lymphedema:

  • Wash your skin gently and dry it well. Use a mild soap to wash your skin. Gently pat your skin dry after you bathe. Apply a mild cream or lotion to moisturize your skin and prevent dryness or cracking. Keep your feet clean and dry.

  • Protect your skin from injury. Wear gloves when you garden and wash dishes. Cut your nails straight across to prevent injury to your fingers and toes. Use sunscreen and insect repellant to avoid burns and punctures. Wear slippers in the house. Wear shoes when you go outside.

  • Check your skin every day for signs of infection. Signs of infection include redness, swelling, increased heat, or pus. You may also have a fever or chills.

  • Care for cuts, scratches or burns. Apply antibiotic ointment to cuts and other small breaks in the skin. Apply a cold pack or cold water to a burn for 15 minutes. Then wash it with soap and water. Cover scratches, cuts, or burns with a clean, dry gauze or bandage as directed. Keep the area clean and dry.

  • Tell healthcare providers that you have lymphedema. Tell them not to do, IVs, blood draws, and blood pressure readings in the arm or leg with lymphedema. If there is lymphedema in both arms, ask them to take your blood pressure on your leg. Do not allow flu shots or vaccinations in your arm with lymphedema.

When should I contact my healthcare provider?

  • You have a fever or chills.

  • You have an open area of skin that looks red or swollen, or drains pus.

  • Your symptoms, such as swelling or pain, get worse.

  • Your arms or legs feel heavy, or you cannot move them.

  • Your skin becomes hard, thick, or rough.

  • You have a skin wound that will not heal.

  • Your shoes, clothes, or jewelry feel tighter.

  • You have questions or concerns about your condition or care.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.