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Living with lymphedema
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About three months after undergoing surgery and radiation for breast cancer, Nancy noticed an uncomfortable tightness and fullness around her left wrist—the same side on which the cancer had occurred. She was having difficulty buttoning cuffs and wearing a watch, and within days her arm had swollen to three times its normal size. Alarmed, she saw her doctor, who told her it was lymphedema.

Lymphedema is a painless swelling of an arm or leg that occurs when lymph, a natural body fluid, is unable to drain properly. Most of the 2.5 million lymphedema cases in the U.S. are the result of cancer treatments, especially those involving the breast, the reproductive organs, the prostate and melanomas of the arms or legs.

The reason: Surgical removal of lymph nodes or radiation therapy that damages lymph vessels can disrupt lymph flow, causing it to back up into the arms or legs. That’s when the swelling occurs.

Treatment

Lymphedema can’t be cured, but it can be treated. The most effective approach is known as complete, or complex, decongestive physiotherapy. It has four steps:

  1. Massage. This goal of this gentle massage is to clear blocked lymph vessels in the trunk so fluid in the swollen limb has somewhere to go. The massage is done twice daily until the limb becomes normal–size again.
  2. Bandages. Cotton bandages are wrapped around the limb immediately after the massage to keep the lymph fluid that has been forced out from reentering. The bandages are worn overnight or until the next massage session. It’s a good idea to keep the limb elevated or above heart level while the bandages are on.
  3. Exercises. Moving the affected limb while the bandages are on forces out even more fluid.
  4. Skin and nail care. A special skin cream is applied to the affected limb about twice a day to help keep the area well lubricated. In addition, the skin and nails of the affected limb must be kept clean to prevent infection.

After the limb reaches normal size, most patients will have to continue wrapping the limb overnight and wearing elastic support sleeves during the day.

Self–help

Experts also recommend taking steps to prevent infection, such as wearing gloves while gardening and cooking, using thimbles when sewing, wearing water shoes when swimming and avoiding extreme hot or cold. In addition, some researchers say that eating a low–fat, low–sodium diet and maintaining a healthy weight can help keep lymphedema under control.