Edema & Lymphedema

Another word to add to my cancer glossary: Lymphedema

Lymphedema concerns me because I had fluid build up under my arm and scar. Last Monday, after a very difficult and painful weekend, I had to see my doctor. He drained the seromas.

The medical term for swelling is edema. A certain amount of swelling always accompanies injury or surgery. It’s part of the normal inflammatory process by which our immune systems bring white blood cells to the area to help repair it. However, because it’s literally hot, as in inflammation, it’s also a nice little laboratory for the formation of problems like cellulitis or other infections, blood clots, seromas, and tissue necrosis. When our circulatory vessels get clogged up and overwhelmed by dealing with all this, the fluid can get backed up in the armpit or arm or even the torso next to the surgical site, signaling the onset of lymphedema.

An excellent website that provides thorough information about the diagnosis, prevention and management of lymphedema is StepUp-SpeakOut.org

The more lymph nodes you have removed or more trauma the higher the likelihood of developing lymphedema.

So grateful I only had two lymph nodes removed. At times, the area under my arm hurts more than the area where my actual breast was removed.

Can lymphedema be prevented? Unfortunately, no. But the good news is that you can do many things to reduce your personal risk.

The following six areas are highlighted in a position statement of the National Lymphedema Network:

1) Skin care – avoid trauma/injury to reduce infection risk: keep extremity clean and dry, apply moisturizer daily to avoid chapping/chafing of skin; attend to nail care and DO NOT cut cuticles; protect exposed skin with sunscreen and bug repellent; use care with razors to avoid nicks and cuts; wear gloves, especially while performing activities like gardening or using tools or chemicals; if scratches or punctures occur, wash with soap and water, apply antibiotics and watch for infection (redness); if a rash, itching, redness, pain, increased skin temperature, fever or flu-like symptoms occur, contact your physician immediately for early treatment of possible infection.

2) Activity/lifestyle – gradually build up intensity and duration of an activity; take frequent rests to allow for limb recovery; monitor the extremity during and after activity for any changes in size, shape, heaviness etc.; maintain your optimal weight.

3) Avoid limb constriction – wear  loose fitting jewelry and clothing; avoid having blood pressure or any punctures (shots included) on the at-risk extremity.

4) Compression garments – if your medical professional has recommended you wear compression garments, they should be well-fitting, should support the at-risk limb during strenuous activity and worn during air travel.

5) Extremes of temperature – avoid exposure to extreme cold, which can be associated with rebound swelling or chapping of skin; avoid prolonged exposure (15 or more minutes) exposure to heat, particularly hot tubs and saunas; avoid placing limb in water temperature above 102 degrees Fahrenheit.

6) Additional practices – support the at-risk limb with a compression garnet for strenuous activity, except in patients with open wounds or with poor circulation in the at-risk limb.