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Focus on Lymphedema Presented by Jeannette Zucker, DPT, CLT-LANA, CSCS |
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Lymphedema is an abnormal swelling of the arm that may occur as a result of removal of some or all of the axillary (armpit) lymph nodes or of radiation treatments directly to those nodes. It occurs when lymphatic channels of the arm are no longer able to remove all the lymphatic fluid that is normally filtered from the blood vessels and skin. Lymphedema can occur immediately after surgery, or months or even years later. Sometimes lymphedema is triggered by an injury, infection, burn, or other trauma to the arm.
Signs of lymphedema may include visible swelling in the arm or part of the arm, a sensation of heaviness, achiness, or tightness in the arm, easy fatigability of the arm, or pain in the arm. It may be treated by an occupational therapist using a variety of techniques, including compression garments, exercise, and/or gentle massage.
If you do notice arm swelling, redness, or pain, it is very important to consult your doctor so that infection, if present, can be treated. Additional testing such as a Doppler ultrasound of the veins of the arm (to look for blood clots) and an MRI of the armpit region (to make sure there is no recurrent cancer) may be necessary.
While there is no proof that avoidance of certain activities will prevent the development of lymphedema in patients who undergo axillary lymph node surgery, there are some general guidelines that patients can follow to reduce the chance of getting an infection that might lead to lymphedema:
- Avoid getting breaks in the skin that can lead to infection of the affected arm. If you do get a cut, clean the area well and apply antibacterial ointment and a bandage. Watch the area for signs of infection until it heals.
- Use a moisturizer daily to help protect the skin of your arm and hand.
- Manicure your nails carefully. Do not cut the cuticles.
- Wear gloves when gardening, cleaning, or washing dishes.
- Use care when removing hair under your arm. Do not use a straight razor or hair removal (depilatory) cream, as they can cause skin breaks.
- Use insect repellent to avoid stings.
- Avoid tight jewelry, clothing, or anything that can cause a tourniquet effect (such as blood drawing or the taking of blood pressures) on the affected arm. If both arms are involved, ask your doctor how to proceed.
- Take care not to get sunburned. Use sunscreen with an SPF of at least 15.
- Avoid the use of local heating and hot packs on the affected arm and shoulder
