18 Steps to Prevention of Lymphedema for Upper Extremities
For the patient who is at risk of developing lymphedema, and for the patient who has developed lymphedema. (National Lymphedema Network Recommendations)
1. Absolutely do not ignore any slight increase of swelling in the arm, hand, fingers, neck or chest wall (consult your doctor immediately).
2. Never allow any injection, IV, or a blood drawing in the affected arm(s).
3. Have blood pressure checked in the unaffected arm.
4. Keep the edemic arm or at-risk arm spotlessly clean. Use lotion (Eucerin) after bathing. When drying, be gentle, but thorough. Make sure it is dry in any creases and between the fingers.
5. Avoid vigorous, repetitive movements against resistance with the affected arm (scrubbing, pushing, pulling).
6. Avoid heavy lifting with the affected arm. Never carry heavy handbags or bags with over-the-shoulder straps.
7. Do not wear tight jewelry or elastic bands around affected fingers or arm(s).
8. Avoid extreme temperature changes when bathing or washing dishes (no sauna or hot tub). Keep the arm protected from the sun.
9. Avoid any type of trauma (bruising, cuts, sunburn, or other burns, sports injuries, insect bites, cat scratches).
10. Wear gloves and long sleeves while doing housework, gardening, or work that could cause even minor injuries.
11. When manicuring your nails, avoid cutting your cuticles (inform your manicurist).
12. Exercise is important, but consult with your therapist. Do not overtire an arm at risk: if it starts to ache, lie down and elevate it. Recommended exercises: walking, swimming, light aerobics, bike riding, and specially designed ballet or yoga. (Do not lift more than 15 lbs.).
13. When traveling by air, patients with lymphedema (or at risk) must wear a compression sleeve. Additional bandages may be required on a long flight. Increase fluid intake while in the air.
14. Patients with large breasts should wear light breast prosthesis (heavy prosthesis may put too much pressure on the collarbone/shoulder area). Soft pads may have to be worn under narrow bra straps. Wear a well-fitted, supportive bra; not too tight; no wire support.
15. Use an electric razor to remove hair from axilla. Maintain electric razor properly, replacing heads as needed.
16. Patients with lymphedema should wear a well-fitted compression sleeve during all waking hours. At least every 4-6 months, see your therapist for a follow-up. If the sleeve is too loose, most likely the arm circumference has reduced or the sleeve is worn. Unfortunately, prevention is not a cure. But, as a cancer and/or lymphedema patient, you are in control of your ongoing cancer checkups and the continued maintenance of your lymphedema.
17. Warning: If you notice a rash, blistering, redness, increase of temperature or fever, see your physician immediately. An inflammation or infection (lymphangitis) in the affected arm could be the beginning or a worsening of lymphedema.
18. Maintain your ideal weight with a well-balanced, low-sodium, high-fiber diet. Avoid smoking and alcoholic beverages. Lymphedema is a high protein edema, but eating too little protein will not reduce the protein element in the lymph fluid – rather, this will weaken the connective tissue and worsen the condition. The diet should contain protein that is easily digested, such as chicken fish, or tofu.
