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Maintaining Health > Lymphedema & The SOFTEE® |
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 Lymphedema Management
After surgery for breast cancer, there are areas of your health that you will need to monitor. You need to exercise your surgical arm to regain your range of motion, and you need to learn how to prevent or treat lymphedema.
Removal of the lymph nodes under your surgical arm or radiation therapy to the underarm area may cause a swelling called lymphedema. (Lymph, from lymphatic fluid; edema, swelling from fluid accumulation.) Having only sentinel nodes removed will greatly reduce this potential. However, radiation therapy may cause fibrosis in some women, increasing the potential for lymphedema.
Lymphatic fluid is high in protein. These proteins leak from vessels into surrounding tissues when vessels are obstructed. The protein then draws water into the tissues. This condition results in swelling from the slower flow and removal of lymph fluid and accumulation of protein and water in the tissues of your arm. Only a small percentage of women experience lymphedema after surgery, but all women need to know of the potential and treatment if it should occur. It can occur anytime, from shortly after surgery to years later. It is suggested that you measure or have someone measure your arm three inches above the elbow prior to surgery so you can monitor with more accuracy if you have any swelling.
Arm lymphedema can produce pain, restricted movement of the shoulder and arm, and increased susceptibility to infection. Medications and treatments are often limited in their effectiveness; therefore, the best strategy is to prevent the problem before it occurs.
Lymphedema may be related to:
- Surgical removal of lymph nodes
- Poor range of motion in your surgical arm
- Infection
- Obesity
- Radiation therapy to the breast and underarm area
- Constriction caused by clothing or jewelry
- Long periods of positioning the arm below the level of the heart
- Repetitious tasks using the surgical arm
The first line of defense against lymphedema is regaining the full range of motion of your arm by using the exercises suggested by your physician. While these exercises may seem dull and unnecessary, they serve to facilitate the flow of the lymphatic fluid from the arm area. Do not begin an exercise program until your physician gives you permission.
Steps to Help Prevent Arm Lymphedema
- For several weeks after surgery, when lying down, prop your arm up on a pillow above the level of your heart to help drain the fluid. Elevation of the arm helps reduce swelling and prevents additional accumulation of fluid.
- Keep your arm slightly away from your body, so as not to compress the underarm area. Using a small pillow or a small stuffed animal under your arm when sitting will keep the arm away from the body and keep swelling at a minimum. Some swelling under the arm is expected due to surgery and will improve with time.
- Avoid using your arm and hand in a dependent position (below the level of the heart) for long periods of time. If you need to perform a task of this sort, periodically hold your arms above your head to promote drainage.
- Make a fist or squeeze a small rubber ball in your hand repetitively for two to three minutes several times a day to assist the accumulated fluid in returning to general circulation.
Steps to Avoid Injury and Infection
- Do not allow the surgical arm to be used for blood pressure checks, blood samples or injections. Ask your nurse for a pink wristband or ribbon to be placed on the wrist of your surgical arm as a reminder to all your healthcare givers.
- Do not wear anything that is tight on the surgical arm or hand, such as rings, watches, bracelets or tight elastic in sleeves.
- Do not hold a cigarette in this hand.
- Do not cut your cuticles; keep hands soft by using hand lotion regularly. Avoid nail salons that use rotary files that could injure your cuticles.
- Do not carry heavy packages or purses on the side of your surgery.
- Wear protective gloves when working in the garden, washing dishes or using any irritating chemicals, such as hair dye or cleaning products.
- Avoid burns and cuts when cooking.
- Wash all cuts or injuries with antibacterial soap, apply an antibiotic medication, and cover the area with sterile gauze or a Band-Aid™ until the wound heals.
- Avoid sunburn. Wear long sleeves or a sunscreen at all times when in direct sunlight for a period of time.
- Use a thimble when sewing.
- Avoid insect bites by wearing insect repellant.
- Be careful with animals. Avoid scratches.
- Use an electric razor under your arm.
- Ask your healthcare provider about purchasing a custom elastic sleeve if you plan to travel by air.
When to Notify Your Physician
These precautions may help you to avoid injury and potential for infection in your arm. If you ever experience any redness, pain, infection or after injury you run a low-grade fever, contact your healthcare provider. When accumulated lymph fluid becomes infected with bacteria and inflames the surrounding tissue, it is a condition called cellulitis. Antibiotics will be necessary to treat the infection. Early intervention is necessary to prevent the spread of infection to other parts of your body. If you have any evidence of redness or inflammation in your arm, your healthcare provider needs to be notified as soon as possible. This is one problem that does not need to wait; if it occurs outside of office hours, call or page your healthcare provider.
Courtesy of: EduCare, Judy Kneece, RN, OCN, www.educareinc.com
Benefits of Wearing the SOFTEE® with Lymphedema
The Original SOFTEE® is frequently the first choice for lymphedema patients. Comfortable and non-binding, the stretch fabric and laces offer easy access for dressing and undressing. The armholes are cut deep to prevent chaffing and irritation, and the soft poly-fil breast form(s) will help to maintain a balanced and natural appearance whenever wearing a bra is not an option.
What Women Say About the SOFTEE®
--JH -- Montana"Three months after bilateral mastectomies I still have extensive swelling on the left side. The SOFTEE® camisole has been an answer to my prayers. I can now dress and look normal. The SOFTEE® also helps with the pain associated with the swelling [lymphedema]. For the first time I feel like I might be able to return to a normal life."
--SP -- TEXAS “What a great garment! Now that I've developed lymphedema, I'm using the SOFTEE® TWO again - supportive and comfortable. What a great garment."
--WW -- AZ
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