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Frequently Asked Questions Regarding Wearing Compression Bandages

Frequently Asked Questions Regarding Wearing Compression Bandages Many Lymphedema patients have lots of questions regarding going about their daily activities while wearing compression bandages.— While wearing compression bandages is an adjustment, you will still be able to perform most of your daily activities, such as walking, driving, etc. Some Frequently Asked Questions— How can I shower with compression bandages on? Everybody has their own method, but we recommend using cast covers or well secured trash bags to cover the bandages while showering, so they do not get wet. We also recommend using a shower chair to avoid slipping or falling in the shower. What should I do if my bandages are falling between treatments? Occasionally towards the beginning of a patient’s course of treatment, bandages may start to fall due to rapid reduction in swelling. If this does happen, first assess whether your circulation is being restricted at any point. If any part of the bandage is cutting off circulation, remove the bandages. If the bandages are not affecting your circulation, attempt to remove the section where the bandage is falling. If it is possible to keep any of the bandages on until your next treatment, it is advisable to do so. What should I do if my bandages are too tight? Some patients complain of their bandages feeling too tight towards the beginning of treatment. While this may just be part of the patient adjusting to wearing compression bandages, if it is too bothersome, we recommend removing 1 bandage at a time to alleviate the feeling of tightness. If it is possible to keep any of the bandages on until your next treatment, it is advisable to do so. Do you have any questions about compression bandaging?? Post your questions below!

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Sleep Apnea and Lymphedema

Obstructive Sleep Apnea and Lymphedema Did You Know… In a study conducted by Roux, Villemur & et al., 74% of their subjects (whom all had Lymphedema) also presented with Obstructive Sleep Apnea. Obstructive Sleep Apnea is a common condition in which one experiences abnormal breathing patterns and actually stops breathing multiple times while they are asleep. This happens due to soft tissue collapsing in the back of the throat. This causes a lot of stress on the heart and when left untreated can lead to many serious complications. Signs and Symptoms People with Obstructive Sleep Apnea commonly present with the following signs– gasping for air and snoring. The most common symptoms of Obstructive Sleep Apnea include– fatigue, dry mouth, decreased attention, irritability and more. It has been shown that in Lymphedema patients, fluid accumulates at night– sometimes in areas which can obstruct their airway. This pattern occurs most frequently in lower extremity Lymphedema patients. Testing and Treatment If you or someone you know is presenting signs of Obstructive Sleep Apnea or is at risk of developing Obstructive Sleep Apnea, there are sleep studies which can be done to diagnose Obstructive Sleep Apnea and other sleep disorders. Treatment for Obstructive Sleep Apnea is a combination of lifestyle changes and a therapy called Positive Airway Pressure in which a machine delivers air pressure through your nose and sometimes the mouth. The most common type of Positive Airway Pressure device is a CPAP (Continuous Positive Airway Pressure) which provides continuous air pressure– helping the airway passages to stay open. Please contact us if you have any questions. We are here to help!

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Lymphedema Friendly Travel

Lymphedema Friendly Travel As we head into the season full of holidays and travel, it’s important for all Lymphedema patients and at risk patients plan Lymphedema friendly trips. If you are at risk or have Lymphedema, please be aware and careful to avoid physical stresses that could trigger an increase in swelling. Stay Compressed During Your Travel The most important tip for a Lymphedema patient to follow during travel is to stay compressed as much as possible. (Wear your compression wear!) Often times travel involves long periods of sitting (without being able to elevate extremities), which is not good for swelling. Wearing your compression wear during the travel will help you combat this potential risk for swelling. The changes in pressure and altitude in plane flights can cause anyone to experience swelling, so it is particularly important to stay compressed as possible during plane flights. Ask for Help Sometimes traveling can be tricky– heavy suitcases, carry-ons, elevators and more. Lugging around heavy bags and jumping on shuttles can cause some stress on your system and trigger swelling. Be cautious and don’t be afraid to ask for help! Keep Up Your Routine Keep up your Lymphedema routine as much as possible throughout your vacation. While it is an extra thing to carry, it will benefit you to bring your compression device and continue pumping. If you have an exercise routine, keep it up! While it is a time to enjoy family, food and beverages, be conscious of what you consume. Keeping up your routine will help you a LOT if you are having a few extra calories! If you have questions or concerns about traveling with Lymphedema, feel free to reach out to one of our specialists.

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Head and Neck Lymphedema

Head and Neck Lymphedema While Lymphedema most commonly occurs in the extremities, it can occur in other regions such as the head and neck region, the breast and chest region or the genital region. There are 2 types of Lymphedema- primary and secondary. Primary lymphedema is hereditary and occurs due to a problem when forming the lymphatic system. Secondary Lymphedema develops if the lymphatic system is damaged due to a surgery, accident or pre-existing condition. Prevalence of Head and Neck Lymphedema This article will focus on head and neck lymphedema.– As mentioned above, Lymphedema can be hereditary in any part of the body. More commonly head and neck Lymphedema develops after some form of cancer treatment. Radiation and biopsies in this region can both lead to the development of Lymphedema. The head and neck region are full of lymph nodes making it very difficult to avoid during radiation or cancer biopsies. While head and neck cancer patients make up a very low percentage of cancer patients, the prevalence of developing Lymphedema amongst these head and neck cancer patients is extremely high– sitting at about 50%. Early detection and intervention of Lymphedema in the head and neck region is critical. If left untreated, the patient may begin to experience difficulty breathing, speaking and swallowing. The swelling begins in the internal structures such as the larynx and pharynx and gradually comes to the surface and becomes more visible. Prevention of Head and Neck Lymphedema As with all types of Lymphedema, it is important to be educated on practices that can help to avoid developing Lymphedema. It is important to avoid injuries, cuts, bruises and bites in the affected area, as these things can trigger the onset of Lymphedema or trigger a flare up in someone who already has Lymphedema. Other important prevention practices are– Maintain a healthy body weight Exercise regularly Sleep with upper body slightly raised Treatment of Head and Neck Lymphedema Treatment of head and neck Lymphedema is based on Complete Decongestive Physiotherapy. The most important components of Decongestive Physiotherapy for head and neck Lymphedema patients is Manual Lymph Drainage and Compression Wear. Manual Lymph Drainage is a light, manual therapy which assists the flow of Lymph fluid from the affected area back into the lymphatic system. Another important component of Decongestive Physiotherapy is Compression Wear. There are plenty of options of Compression Wear to suit the patient’s needs including custom sizing and fitting for the patient. Compression Wear is extremely important for head and neck patients to maintain the reduced swelling achieved through Manual Lymph Drainage. If you or someone you know is experiencing swelling that sounds similar to this, please contact us right away to work towards a plan of care.

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Chronic Venous Insufficiency and Lymphedema

Chronic Venous Insufficiency and Lymphedema Chronic Venous Insufficiency is a disease in which the veins stop functioning properly resulting in blood ‘pooling’ in the veins. This is due to blood clots in the lower extremities due to Deep Vein Thrombosis (DVT) in which the valves in the veins become insufficient. If Chronic Vein Insufficiency is left untreated, it can lead to many serious problems, one being– Lymphedema. Lymphedema is a serious condition which needs to be addressed immediately to avoid further complications. If you are experiencing– Swelling in your ankles New varicose veins Weeping wounds Skin becoming hard or changing texture Contact a Lymphedema specialist right away!

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Managing Your Lymphedema After Treatment

Managing Your Lymphedema After Treatment It is very important to understand the fundamentals of managing your Lymphedema after treatment to maintain your progress. There are a few key components to successfully manage your Lymphedema at home– Daily Use of Compression Wear Daily Use of Pneumatic Compression Device Maintain a healthy weight with proper diet and activity level Follow skin and nail care tips to prevent flare ups and infections Compression Garments Compression garments are an essential component of Lymphedema management. The lymphatic fluid removed from the are throughout treatment will be maintained through the daily use of compression wear. Compression Sleeve Pneumatic Compression Device For many patients, daily use of a pneumatic compression device is also recommended for lymphedema management post treatment. This practice will work together with the compression administered through the compression garments to maintain reduced swelling. Skin & Nail Care Tips The condition of your skin is very much associated with your Lymphedema. Avoid Lymphedema flare ups by protecting your skin from extreme temperatures, avoiding injury, cuts, burns and bites in the affected area. Be careful with nail care to not cut your cuticles too short as this is a common reason for a flare up in swelling. To learn more, schedule your consultation today!

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Lymphedema vs Lipedema

Lymphedema vs. Lipedema Image source: https://www.swfhealthandwellness.com/lipedema-vs-lymphedema/ Lymphedema and lipedema, also known as lipoedema, are two distinctly different conditions with similar names. Lymphedema is a condition that occurs due to damage to the lymphatic system, while lipedema is a condition which involves a deposition of fat typically in the legs and arms. Lymphedema Lymphedema occurs in stages– Stage 0 (The Latency Stage) In this stage, symptoms are not yet obvious and can only be detected by professionals. This is a very delicate stage in which a patient is at risk or pre disposed to developing Lymphedema. Patient education is very important in this stage as there are many things one can do to avoid progressing to stage 1. If someone in Stage 0 experiences a stressful event to the pre-disposed area, such as an injury, burn, bite, etc., this could trigger the patient to develop into Stage 1. Stage 1 (Mild) In this stage, a mild swelling occurs due to an accumulation of lymph fluid in the affected area. Pitting may begin to occur in this stage. Pitting is when a ‘mark is left in the skin by applying pressure from a finger, hand or object’ (www.onclink.com) In this stage, the swelling can be ‘reversible’ with compression and elevation. Stage 2 In this stage the affected area becomes increasingly swollen. It is common to experience inflammation, hardening or thickening of the skin tissue. Swelling can not be alleviated with elevation in this stage. Stage 3 This stage is the most severe stage of Lymphedema. This stage entails even more advanced swelling often causing the affected area to become misshapen or develop Lymphedema lobes. The skin often loses integrity and becomes leathery or wrinkled. Lipedema Lipedema also follows stages– these stages follow a succession of increased subcutaneous fat. It is possible in later stages of Lipedema for lymphedema to occur– this is called Lipolymphedema.

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Breast Cancer and Lymphedema

Breast Cancer and Lymphedema Lymphedema is commonly experienced in breast cancer patients who have undergone a mastectomy, lumpectomy or radiation. Often times, lymph nodes are removed or damaged during surgery or treatment. This damage to the lymphatic system can cause blockages in the lymph vessels resulting in swelling (Lymphedema). According to multiple studies cited in the Susan G. Komen website, “10-20% of women who had axillary dissection develop Lymphedema”. In breast cancer patients, the Lymphedema typically develops around 1 to 3 years after surgery and will require treatment to reach a more manageable level of swelling. With treatment, patient education and continued use of compression wear and a pneumatic compression device, most patients are able to easily manage their swelling on their own. If you or someone you know has or has had breast cancer, it helps to be informed on the possibility of developing Lymphedema. Please reach out to us with any questions you may have!

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Lymphedema and Cellulitis

Cellulitis and Lymphedema One common complication that Lymphedema patients experience is a condition called Cellulitis. Cellulitis is a skin infection that can enter the body through a break in the skin, a scratch, an open wound or other pre-existing skin conditions. What is cellulitis ? Cellulitis occurs when bacteria, most commonly streptococcus and staphylococcus, enter through a crack or break in your skin. Any minor case of cellulitis can lead to a more advanced systemic infection called sepsis, which can be life threatening– which is why it is critical to be able to identify, prevent, and treat cellulitis quickly and effectively. Why are Lymphedema patients predisposed to getting cellulitis more often than other people? The dense fibrotic tissue associated with lymphedema increases risk for skin breakdown, slows wound healing and impedes immune response to infection. The body’s response to healing frequent infections in turn creates more fibrosis with each subsequent infection or injury, creating a cycle of worsening symptoms over time. How to recognize Cellulitis? The most obvious symptom of Cellulitis is a red, swollen area that feels hot and painful/tender. Other common symptoms of Cellulitis are fever, chills, disorientation, wounds, blisters if it progresses. What to do if you suspect you have Cellulitis– If you are experiencing symptoms that sound like Cellulitis, you should call your doctor immediately or go to your nearest emergency room. Tips to Prevent Cellulitis– Be careful to avoid injury to the skin, maintain good hygiene, manage skin conditions as directed by a physician, use lotion, and wear at least 30 mmhg compression on the affected limb to reduce the development of fibrosis. References- https://www.mayoclinic.org/diseases-conditions/cellulitis/symptoms-causes/syc-20370762

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Compression Wear for Lymphedema

Compression Wear for Lymphedema Compression garments or compression wear play a huge role in Lymphedema management. Compression wear provides an easy way to keep pressure on the affected area to manage swelling. For someone with significant Lymphedema, compression wear is recommended towards the end of a course of Lymphedema treatment to help patients have options for managing their swelling at home. The compression garments typically recommended by professionals for a Lymphedema patient are not the compression garments that you may find at your local sports store. It is important for a Lymphedema specialist to prescribe the compression wear based on the patient’s level and area of swelling. Lymphedema grade compression wear is measured in millimetre of Mercury (mmHg) which is simply a manometric unit of pressure. Some Lymphedema compression wear is what is referred to as ‘gradient compression’ which means more pressure is applied to the distal part of an extremity (such as near the hand or foot) and gradually lessens in pressure as it travels up the arm or leg. This method is very efficient in avoiding swelling and encouraging fluid to circulate. Some patients may require or benefit most from a custom compression garment. A therapist will measure the patient and send off the measurements to a top Compression manufacturer such as Sigvaris or Juzo, who will then design the compression wear specifically for the patient. In conclusion, compression wear for Lymphedema management is critical and most beneficial when used towards the end of Complete Decongestive Physiotherapy treatment which includes Manual Lymphatic Drainage, Multi-layer Compression Bandaging and Pneumatic Compression Pump Therapy. If you or someone you know would benefit from Lymphedema treatment, feel free to contact us!

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