What makes Lymphoedema worse

• We have no control over these factors such as:
  
  
  • Age, radiotherapy, the number of lymph vessels and nodes removed


• We can control
  
  
  • Overweight (means there may be a greater load of fluid waiting to be removed) Being overweight can be realted to diet and activity levels but there is a condition called lipoedema, which has a genetic component, in which fatty deposits in the surface tissues can reduce the ability of the lymphatic system to work properly. Sometimes the load can be so great that even a normal lymphatic system fails. So if the lymphatics have been damaged or destroyed being too heavy for your body frame can mean a worsening of any swelling.
  
  
  • Skin care (importance of good quality skin care) as the ultimate barrier to bacteria/fungus
  
  
  • Wear a medic alert bracelet “caution lymphoedema leg/arm” to alert heath care workers to not needle that arm or use BP arm sleeve etc…
  
  
  • Wear loose fitting clothes do not constrict your limb
  
  
  • All these little things can make a difference either through reducing the lymph load (the amount of fluid waiting to be removed) or through increasing the lymphatic transport capacity (fluid load carrying capacity)

• The skin is a very important barrier. It separates your internal body contents from the outside environment. If you have had any operation or any situation which has damaged or interfered with your lymphatic system, then for the rest of your life you must take greater care to maintain the quality and the integrity of your skin. The main reason is to prevent bacteria from entering your body. Take particular care of your feet and toes. Moisturise and keep your skin and tissue soft constantly.


• Take care especially if shaving your legs. It is best not to use a blade type razor since these may damage the skin. An electric one is preferred.


• The whole system is in a rather delicate balance, ideally you do not disturb it since then you might get a swollen limb, or the swelling can get worse.


• When you get a cut or scratch or when you develop a dermatitis rash, the area becomes redden and sometimes warmer. This means that more fluid and proteins than normal will be leaking out of the blood capillaries into the tissue spaces, this will increase lymph load and if bacteria gets through a break in the skin will result in an infection and further inflammation.

• Mild Exercise – is good for the circulation and the variation in pressure that the muscles surrounding the deeper lymph vessels create helps move the lymph out of the limb.


• E.g. swimming (good for external compression and cooling effect) or hydrotherapy very beneficial


• Walking, gentle bike riding, Yoga, Tai Chi and Qi Gong


• Deep breathing is important to pump the lymph vessles


• Do take care of your diet and thus your weight. Being overweight will aggravate the lymphoedema.


• Manage your stress! stress has been found to make lymphoedema worse due to it’s effect on the blood pressure


• Wear a light compression garment and do mild exercise with deep breathing when flying. Often in large planes the cabin pressure is reduced below that of the atmosphere at sea level. This combined with immobility of the limb can often lead to swelling when flying. The steps taken will encourage the lymph to leave the tissue spaces and get into the larger remaining lymph vessels to be transported away. However, in using any support garment ensure that it is not exerting a tourniquet effect on the ankle, knee or in the groin since it may exacerbate your condition.


• Avoid strenuous exercise unless you are fit. Warm up and down carefully. This increase your heart rate and blood pressure, causing more fluid to leak from your blood vessels into tissue spaces. Means that there is more fluid awaiting removal and thus the lymphatic system must work harder. A good gentle exericse program helps to pump out some of the excess fluid from the limbs.


• Do not get sunburnt – wear a sun-screen or protective clothing


• Avoid hot spas or sauna or steam rooms due to increase of blood flow to superficial tissue and put an unnecessary load on the lymphatic system.


• Avoid sleeping on the affected side – over compression


• Avoid any event which could disrupt the skin, cuts, scratches, bruises etc, always wear gloves when doing house hold chores


• Avoid injections on the affected limb or Acupuncture treatments


• Elevate your limb when and where possible


• Avoid long periods of total inactivity (it is really important to help the pumping of lymph by variation in pressure that the muscles exert on the tissues and the fluid within them.


• Wear an insect repellent when outdoors if mosquitoes are common


• Tell us about your problem, if you notice any change at all e.g. darkening of colour of skin, change in texture, hardening of skin, pitting of tissue, whether a change in how it feels or looks, contact your doctor or your lymphoedema therapist as soon as possible.