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Lymphedema

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What is lymphedema?

Lymph nodes are present in many parts of our bodies as small bodies . Lymph vessels collect lymph fluid from nodes in various areas throughout the body. The lymph fluid contains proteins, salt, water, and white blood cells. They function to filter out injurious substances and act to protect us from infections.

When surgery is performed for a patient with breast cancer, sometimes one or more lymph nodes are removed from the area under the armpit to see if the cancer has spread to the lymph nodes from the breast tissue. By removing these lymph nodes, the way in which lymph fluid flows out of that area of the body is affected. This can cause excess fluid to build up which can subsequently lead to swelling, or lymphedema. Radiation therapy, in addition to surgery, can also affect the flow of lymph fluid and can potentially lead to lymphedema. This build-up of lymph fluid often occurs slowly over time, appearing months to even many years after treatment.

What are the signs of lymphedema?

 

  • Swelling in the breast, chest, shoulder, arm, hand
  • Skin changes in texture, becomes tight or hard, or appears red
  • Discomfort or aching in affected area
  • Less range of motion in nearby joints
  • Difficulty fitting your arm into clothing with sleeves
  • Bra does not fit the same

 

 

Prevention and Control of Lymphedema

Many women will experience short-term lymphedema in the weeks following surgery or radiation treatment, but it usually resolves within 6-12 weeks. In order to decrease swelling, you can do some of the following:

  • Elevate the affected arm above the level of the heart 2-3 times a day for 45 minutes at a time
  • Exercise the affected arm while it is elevated by opening and closing your hand 15-25 times. Do this 3-4 times a day.
  • Continue to do your daily activities with the affected arm like write, dress, eat.

To further prevent and control any lymphedema, you need to take precautions for the rest of your life following surgery or radiation treatment.

  • To begin with, make an effort to avoid infection. This means maintaining good hygiene and taking care of the skin in the affected area.
  • Avoid burns by taking precautions .
  • Avoid any constriction by wearing loose clothing ,avoid  having your blood pressure taken on the affected arm, and not using shoulder straps when carrying briefcases and purses when possible.
  • Also try to avoid muscle strain and gaining weight because this extra strain on the affected area can worsen lymphedema.
  • Try to stay away from extreme temperature changes while bathing or washing dishes. Keep away from hot tubs, steam baths, and spending a lot of time in hot climates.
  • Limiting foods high in fat and salt, drinking lots of water, decreasing your alcohol consumption, and avoiding processed meats but eating more vegetables and fruits can also be helpful in reducing lymphedema.

 

When should I call a doctor or nurse?

 

  • If swelling persists for more than 1-2 weeks
  • If the affected area suddenly becomes hot, appears red, or swells. This could indicate an underlying infection
  • If you have a temperature greater than 100.5F that is unrelated to a cold or flu
  • If you have any new pain in the affected area that is due to an unknown cause

 

 

Treatment for Lymphedema

Unfortunately there is no cure for lymphedema. However there are several different types of treatments available to reduce the swelling, prevent it from getting worse, and decrease the risk of infection.

You should seek treatment from a licensed health care professional. They can provide you skin care, massage, special bandaging, exercises, fitting for a compression sleeve to encourage lymph fluid flow through the affected area, as well as complex decongestive therapy (CDT) or manual lymphatic drainage.

Most insurance companies will cover treatment costs for lymphedema, but make sure to check with your insurance company to see what kind of coverage is available for your therapies.

It often helps to talk with others for support who are going through the same things as you are. You can contact the National Lymphedem Network to find support groups in your area at 1-800-541-3259 or http://www.lymphnet.org.

Priya Kalapurayil

References

[1.]http://www.cancer.org/Treatment/TreatmentsandSideEffects/PhysicalSideEffects/Lymphedema/WhatEveryWomanwithBreastCancerShouldKnow/index

[2.] http://www.webmd.com/breast-cancer/guide/side-effects-lymphedema?page=3

[3.] http://www.uptodate.com/patients/content/topic.do?topicKey=~uuz.l9jrtmrR