Summary of Optimal Care
(for details refer to Managing Your Lymphoedema)

• Take particular care of the skin of your feet, toes and heels
  
• Generally keep your skin moist with moisturing cream
  
• Wear a light support garment if flying and do gentle exercises
  
• Maintain your weight within reasonable limits
  
• Undertake a regular, gentle exercise program, including swimming
  
• Have a diet which is low in fat and salt but high in fiber
  
• Drink reasonable amounts of water/juice or herbal tea
  
• Wear an insect repellent when outdoors if mosquitoes or insects are common
  
• Elevate your limb as often as possible – especially during inactivity
  
• Use a SPF 30+ sunscreen
  
• Wear socks and underwear which do not exert great pressure on the claves or groin.

Do Not

• Pick at hangnail or your cuticles
  
• Dig in the garden without shoes or thongs
  
• Allow your leg or foot to be sunburnt
  
• Wear tight fitting socks
  
• Wear tight fitting underwear or jeans
  
• Wear support garments that have an obvious constrictive effect

The Aims of Treatment and Management

• There are 2 main target areas. The first is to deal with any underlying obesity by a review of dietary composition and calorific intake.
  
• The second is to attempt to optimize the functioning (uptake and removal of accumulated fluids) of the lymphatic system so that cellular and tissue health can be optimized
  

3 Important aspects of Diet

• Calories and metabolic rates
  
  
  • As far as the dietary aspect is concerned the attempts revolve around ensuring that there is no calorie excess which might be deposited as additional fat either subcutaneously or in the abdominal areas. In fact often a diet which is in total calorie deficit may be appropriate but this must be taken up after discussion with your dietician. Another strategy is to increase your basal metabolic rate through variation in your calorie intake over the day – often with smaller and more spread out meals. Since most of the body fats are regularly metabolized and replaced changes in either calorie intake and in metabolic rate may have a strong beneficial impact on any underlying obesity.
    

• The type of fats
  
  
  • The second dietary aspect involves one which is reduced in long chain fatty acids (often called triglycerides). Diets of this nature are often called MCT diets after the predominance of mid chain length fatty acids. All of the long chain fats have to be absorbed from the intestine by the lymphatic system, thus often putting an unnecessary load on it, Mid chain and short chain fats can be absorbed from the intestine by the blood vessels and so do not pose an additional load on your lymphatic system. There are some significant issues for those on longer term MCT diets so before embarking on one check with your dietician.

• The amount of fats
  
  
  • Obviously a high fat diet, no matter what the distribution of the fats within it is not a wise option for any person with lipoedema or even lymphoedema or a combination of the two. Again this is due to their dependence on the lymphatic system for their removal from the intestine and the additional load they may place on it.