Prevention strategies are the most important whether or not you already have swelling. Following these strategies will help prevent lymphedema altogether, delay its onset, or slow its progression. The strategies are designed to prevent injury or overuse of the involved extremity. The precautions apply to the involved extremity and include:
- Applying lotion/moisturizer to prevent dry skin and cracking
- Good nail care – to include trimming of calluses and avoidance of cutting cuticles
- Use of gloves while gardening, landscaping, or using chemicals to prevent cuts, scrapes, and burns
- Protection of the skin via sunscreen and bug repellant
- Use of an electric razor to prevent nicks and scrapes
- Thorough cleansing of scratches/punctures with soap and water followed by application of an antibiotic/first aid ointment to prevent infections
- Slowly increase the length of time and intensity of daily activities, including gym routines
*Avoid long periods of repetitive activity if you have not been doing that activity much before (i.e. painting your house all day)
*Take breaks during periods of intense activity
*There are no limits to what you can do; you just need to get there slowly!
- Avoid blood pressure or blood draws (In the case of emergencies, do not limit access to this extremity)
- Wear loose fitting clothing and jewelry
- Participate in aerobic activities (something that gets your heart pounding and makes you sweat) if cleared by your physician
- Inform you physician immediately if you develop signs/symptoms of infection, which include fever, chills, fatigue, nausea/vomiting and/or a red, swollen extremity, which may be painful and warm/hot to touch. Treatment should be sought within 12 hours of onset of these symptoms.
If swelling has already started
In the early stages, when swelling comes and goes, the best treatment typically includes use of a compression sleeve, and potentially the use of a self-massage and an exercise program. The sleeve is worn during activities that induce swelling and the self-massage can be used to help reduce swelling or prepare the body for activity. Compression sleeves are not recommended for nighttime use.
When swelling becomes constant, treatment is geared towards reducing the limb down to its smallest size prior to being placed in a compression garment. Treatment of this kind is called complete decongestive therapy, or CDT. It includes compressive bandaging, manual lymphatic drainage (massage), skin care, patient education, and therapeutic exercise. Treatments vary between patients, but are typically performed 3-4x/week for 60-90 minutes. Treatment may take as little as 2 weeks, but may last more than 2 months depending on the severity of the swelling. These treatments propel the trapped fluid into the working portions of the lymphatic system, where it will be put into the blood, leaving the body as urine. After size reduction is complete, a compression sleeve is used for long-term maintenance.