Pathways Summer 2015 (Volume 4, Issue 3)

Page 14

Clinical Perspectives

Top 10 Self-Care Tips for Lymphedema

By Lori Radke

As a physical therapist and certified lymphedema therapist, the hardest words I have to say to someone is, “Yes, you have lymphedema. Yes, it is a chronic condition and will not go away.” But I always follow that with, “but, we can manage this together.” While it may take a while to fully accept that living with lymphedema is your ‘new normal’, there are things you can do each day that will help to keep your limb healthy and your lymphedema under control.

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RISK REDUCTION is the Best Medicine If you can avoid some of the main triggers for lymphedema, hopefully you can avoid progression of the condition. This means maintaining a healthy weight, avoiding infection and injury to the limb, in order to reduce your chances of developing and worsening your lymphedema. As well, timely and regular treatment of your lymphedema is important. At our clinic, we include education in almost every session

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SOFT and Smooth A key goal of skin care for lymphedema is to prevent the more injurious outcome of a cellulitis (infection) in the affected limb or body part. Cellulitis can make you very ill, cause the lymphedema to get worse, and make you more susceptible to further infections. Application of a good moisturizer with a low pH to the skin on the affected body part at least twice a day reduces the risk of skin breakdown and subsequent infection. (A list of recommended skin care products can

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COMPRESSION May be Your Best Friend Compression bandaging therapy will provide you with the most volume reduction and the best maintenance of this reduction. McNeely and colleagues1, in a 2011 systematic review, reported reductions of 17-60% from compression therapy treatment. Multilayer compression bandaging has been used successfully for many years. Now, there is another option for you, the lighter 2-layer Coban bandaging system. Having more than one option for compression bandaging allows us to customize your lymphedema treatments to suit your needs! Mastering the skill of applying multi-layer bandages yourself can help you to successfully self-manage your lymphedema. A retrospective study on a self-bandaging programme in Quebec found

with our patients, to give them the necessary tools to keep their lymphedema under control. It is important that your lymphedema therapist directs you to reliable websites, books, and resources. The National Lymphedema Network (NLN) publishes an excellent resource about risk reduction (www.lymphnet.org) and there is good information plus hints and tips on the new Canadian Lymphedema Framework website (www.canadalymph.ca).

be found in the Spring 2014 issue of Pathways). If the skin has been radiated, then extra care is needed to protect the fragile skin in this area. If you get a cut or abrasion in the limb or region of the swelling, you need to clean the area immediately and apply an antibiotic ointment. At the first signs of infection, (rash on the limb, feeling unwell, fever) you should seek medical attention immediately as the infection can spread very quickly and you may require intravenous antibiotics.

the majority of participants were able to reduce their limbs to a level equal to the outcome achieved by trained therapists. As well, when provided with adequate training and follow-up, these patients expressed an increased feeling of control over their lymphedema and appreciation for the effectiveness of bandaging2. Night-time compression therapy may be useful in the maintenance phase when we are trying to maintain the volume reductions achieved from intensive CDT treatment. Vignes and colleagues3 found that women with breast cancer related lymphedema who applied compression bandaging at least four nights a week had better control of their lymphedema than women who were wearing only day-time compression.

Lori Radke, BSc, PT is a Certified Lymphedema Therapist (Norton School of Lymphatic Therapy), and has worked across the province since 1988. Lori has been the Rehabilitation Coordinator at the Tom Baker Cancer Center since 2008 where she initiated oncology rehabilitation services focused on lymphedema management.

14 L y m p h e d e m a p a t h w a y s . c a

Summer 2015


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