Jun
27
Written by:
Eric Mason
6/27/2009 12:37 PM
Premier Physical Therapy is honored to provide lymphedema management services to the greater Jacksonville area. We offer Complete Decongestive Therapy (CDT) which includes Manual Lymphatic Drainage (MLD), Compression Garment fitting, and Lymphedema Exercises. We are committed to the early detection and treatment of lymphedema through patient, caregiver, and healthcare provider education.
Statistics
• 2-3 million people in the U.S. have secondary lymphedema
• Over 5 million people in the U.S. have lymphedema
• 25%-33% of breast cancer patients will develop lymphedema
• Annual incidence of new breast cancer patients is 213,000
• Potential new cases of lymphedema each year is up to 70,000
• 80% of people who undergo inguinal lymph node dissection will develop lymphedema
Pre-Op or Immediate Post-Op Measurements are Critical!
• All lymphedemas begin as Grade I
• All patients with a Grade I or pre-clinical lymphedema should be referred for physical therapy evaluation and treatment
• Health care professionals must listen to the patient and look for the signs and symptoms of lymphedema
• Early diagnosis, early referral, and early intervention prevents the lymphedema from progressing from Grade I to Grade II or Grade III
• Grade I lymphedema is the easiest to treat!
Prevention of Lymphedema
A. Diet
There is no specific diet known to help prevent or cure lymphedema. In general, however, a well balanced diet consisting of high fiber, variety of fruits and vegetables, very low salt and low fat (i.e. less than 20% is recommended). It is important to maintain ideal weight. Patients must avoid obesity.
B. Skin Care
Meticulous skin care is needed for the lymphedema patient. Creams and lotions such as Eucerin and Curel are recommended. Lotion should be at a relatively low pH balance.
C. Precautions
1. Do not have injections, vaccinations, flu shots, blood draws, and IV placement on the affected upper extremity.
2. Avoid having your blood pressure taken in the affected limb.
3. Keep the skin clean, dry and well moisturized.
4. Utilize antibacterial and hypoallergenic soap to wash extremities.
5. Inspect the involved limb for blisters, cuts, scratches and fungal infections.
6. Keep the cuticles pushed back but do not cut them.
7. Keep the cuticles moist with cream or lotion.
8. Wear rubber gloves while doing housework that includes cleaning with harsh detergents, steel, wool etc.
9. Wear protective gloves with other work that may result even in minor injuries such as when cleaning out the garage.
10. Wear proper fitted shoes. Avoid tight fitting shoes (high heels) and/or constricting laces and boots.
11. Avoid walking outside barefooted.
12. Wear swim shoes around the pool and locker room.
13. Do not shave the affected extremity or arm pit. It is recommended to use an electric or battery operated shaver with a narrow head rather than a straight razor. Under no circumstance should one use depilatory creams.
14. Use a thimble when sewing by hand avoid needle and pin pricks.
15. Be careful of skin injuries when making arts and crafts i.e. burns from glue guns.
16. Do not wear clothes that are constrictive.
17. Avoid getting sunburned especially anywhere in the radiated field of the lymphedemetous limb. Wear sunscreen.
18. Avoid saunas and hot tubs. An increase in temperature can cause an increase in the lymphedema.
19. Be knowledgeable of how the lymphedemetous limb responds to various levels of exercise intensity and frequency.
20. Any exercise that causes the limb to increase in size which does not return to pre exercise size within 24 hours should be avoided.
21. Use insect repellent when outdoors (i.e. to avoid infections from insect bites.)