Lymphoedema Self-Care Tips

If you have been diagnosed with lymphoedema or are at risk (read more on risk factors), There a few things you should be doing and a few you should avoid. Here are a few tips on the do’s and don’ts and the reasons behind them.

DO:

  • Perform daily self-Manual Lymphatic Drainage (SLD) Daily

    Drainage will keep your lymphatic system active and prevent pooling of the lymph fluid. Even if you wear compression, you should still perform (SLD)

  • Keep your body moving throughout the day

    lymph nodes are located in areas of movement (e.g. in your armpit, elbow, groin and behind your knee). If you keep active, the movement created will help to empty the lymph nodes.

  • Perform exercise & take it slowly to start

    As with the above statement, the lymphatics are emptied through movement, so exercise is a must. If you are new to exercises it is recommended that you start off with low impact, low intensity exercise (such as walking, swimming and basic yoga), so that you do not fatigue your body which will result in decreased lymphatic flow. You can always work up to more intense exercises as you get fitter. Maintaining a healthy weight helps to reduce excess strain on your body and thus your lymphatics. You only have a limited amount of lymphatics to supply your entire body, if you have more tissue (i.e. by being overweight), the lymphatics become less effective.

  • Wear prescribed compression hosiery as advised

    Well fitted and appropriate compression hosiery (such as a stocking or sleeve) helps to “contain” the volume of the limb. Your lymphoedema therapist together with your orthotist will advise on how and when you should wear compression. The compression you wear during the day will be different to what you wear at night. In some instances it is recommended that you use compression for travelling if you are at risk of developing lymphoedema, but do not yet have any swelling.

  • Drink plenty of water

    People often think that reducing their water consumption will assist with their lymphoedema. This is not true, as lymphoedema is a condition where fluid is trapped into the tissues due to poor transportation by the lymphatics. Reducing your water intake will not have a positive effect on the oedema; in fact it can make it worse, by increasing the ration of proteins left behind in the tissues. This does not mean that you should drink more than the recommended amount of fluids per day either. The recommended water intake for an adult is about 8 glasses per day, unless you have some other medical condition that you have been advised to reduce your water intake (e.g. a heart condition or renal problems)

  • Eat a balanced diet

    Again, lymphoedema patient’s sometimes have some misconceptions about what will help their swelling. I have had patient’s asking if they should reduce their protein intake as lymphoedema is a “protein rich” swelling. Whilst there are excess proteins found in the tissues of people suffering from lymphoedema, the problem is that the lymphatics are not transporting the proteins efficiently and not that you have too much protein. Eating a balanced diet and maintaining a healthy weight will help your system to be as effective as it can. There is some evidence that a diet high in salt and sugar contributes to oedema, so avoid too much salt and sugar.

DON’T:

  • Wear overly tight clothing, or jewellery

    Tightness around the limbs can constrict the lymphatic vessels and result in decrease lymphatic flow, so avoid anything that’s too tight (i.e. if it causes marks on your skin after wearing, rather avoid it)

  • Perform strenuous exercise that your body is not used to

    Exercise is an important part of managing lymphoedema, but if you overstress your body in an exercise session, your muscles will be too tired to assist with blood flow, putting strain on your lymphatic system. So be mindful when exercising that you don’t exhaust yourself and if you are starting exercise for the first time, start off light and gradually increase the intensity and duration of your exercise.

  • Ignore any increase or changes in your symptoms, even if they are slight

    Flare-ups of lymphoedema can happen, where your symptoms get worse or change. It may be caused by trauma, infection, or just that your current maintenance regimen needs a bit of tweaking. If it is due to an infection, early treatment with oral antibiotics may keep you from needing to be admitted to hospital for IV antibiotics due to a more serious infection. Also if you allow a flare of lymphoedema to continue, you may end up with a more severe form of lymphoedema which is more difficult to manage.

  • Do deep massage without consulting with your therapist (to the affected limb)

    Theoretically deep tissue massage on the affected limb / area can cause damage to the lymphatic system and cause local inflammation, which can exacerbate lymphoedema. There is no definitive evidence to prove this, if is done by a trained professional. In some instances, e.g. if you have hurt a muscle in your affected limb, it may be necessary to have deep tissue massage done, but consult with your lymphoedema therapist, so they can monitor for any adverse reactions and manage them early.

  • Forget to replace your compression hosiery

    Most compression hosiery has a lifespan of 6 months. After this period it loses its ability to compress the limb effectively. A worn garment will thus not contain your limb volume and you may start to have accumulation of fluid in the tissues. Also replace any garments that have tears or holes in them. If you have two garments that you alternate wearing you will be able to replace them annually as they are only being worn half the time.

  • Overload the affected limb with heavy activities/weight

    As with overdoing it on the exercise, mentioned above, overstraining a limb with very repetitive activities or with too heavy objects (that you are not used to) causes the muscles to be fatigued, decreasing their effectiveness in assisting with blood flow and therefore staining the lymphatics. So avoid the heavy lifting with the affected limb where you can.

  • Allow injections, blood pressure to be taken on the affected limb if it can be avoided

    This more a theory, then a fact. The theory is that injections and blood pressure cuffs cause trauma to the tissue and can cause a flare-up of lymphoedema. Whilst it is more likely that an injection will be done in a clean environment and a blood pressure cuff will not be placed on your arm for a prolonged period, rather err on the safer side and offer your unaffected side.

  • Keep the limb in the same position for extended periods

    Exercise and movement is your body’s natural way of emptying out the lymphatics, so by keeping your limb in the same position for extended periods you are not encouraging lymphatic drainage. Also if you are, for example, keeping your elbow in a bent position, you are actually constricting the natural lymphatic flow from you hand and forearm. You need to be practical about it too though, so just try moving the limbs position from time to time as you go about your day-to-day business. Related to this is how do I sleep if I shouldn’t keep my affected limb in the same position? Use pillows to position the limb in a slightly elevated and more straightened position (e.g. rest your arm on a pillow and/or put a cushion between your knees). If you wake up and your limb is in an overly flexed position, do not panic. Move the limb in to amore straighten position, and it will allow the lymphatics to flow again.

  • Give up on yourself. Many healthcare professionals don’t know treatment exists

    Many patients undergo various tests in an attempt to find a “diagnosis” for their swelling, but results often come back as “normal” or “inconclusive,” and it can be a very frustrating process getting the treatment you need. Lymphoedema is diagnosed by a knowledgeable health care professional doing a clinical examination and noting your history. Tests rarely show anything. That is not to say you should refuse testing, as it is important to rule out any other conditions that may cause swelling. Lymphoedema is a chronic condition and requires ongoing and daily self-maintenance. As with any chronic condition, it is going to have its ups and downs. It is both physically and mentally draining and at times you will feel alone in your condition. Don’t give up! Reach out to lymphoedema support groups; others are having similar struggles. Get yourself a healthcare team who will work with you. Whilst education regarding lymphoedema in South Africa is growing; many health care professionals are not familiar with the condition and if they are, they do not know how or who treats it. You’ll sometimes have to do a little of your own research to get to the right people to help. (Find a therapist at LAOSA).

You can read more about lymphoedema and its treatments on our services page or browse through through our resources page for more info on lymphoedema.

If you are concerned about changes in your lymphoedema or have newly developed swelling, it is advised that you book an assessment with a qualified lymphoedema therapist.

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