Lymphedema

The lymphatic system is made up of lymph vessels and lymph nodes, which carry a fluid called lymph. Lymph consists of waste from the cells. This fluid drains through lymph vessels under the skin to nearby lymph nodes. Lymph nodes filter waste products from the cells. They kill any bacteria present before returning the lymph fluid to your blood circulation.

When the lymph vessels are damaged, lymph fluid can't drain from tissues. This causes the lymph fluid to back up, causing swelling. This most often affects the arms or legs. Signs of lymphedema include heaviness, stiffness, or aching in an arm or leg. The limb may swell. The skin might look red. Shoes and rings may feel tight. Ankles and wrists might become less flexible.

The most common cause of damage to the lymph system is surgery or radiation for breast or testicular cancer. Other causes include repeated skin infections (cellulitis), burns, or injury to the arms or legs. It can take many years for symptoms of lymphedema to appear. Once present, lymphedema can become an ongoing (chronic) condition. This means the problem can be managed but not cured.

Treatment often includes using compression garments, getting massage, and doing special exercises. Talk with your doctor about these treatments and the best treatment plan for you. Ask your doctor about a referral to a certified lymphedema therapist. This is a provider who specializes in lymphedema teaching and management.

You can help keep the condition from getting worse. Follow all instructions you have been given. Do your exercises and wear your compression garments as recommended. Also, care for yourself as advised by your doctor.

• Be careful with your skin. Small skin injuries like a cut, burn, or insect bite are more likely to cause a skin infection. Take special care to not get injured. If you have any signs of infection, contact your doctor right away.
• Take care of your skin and nails. Use a moisturizer on dry skin. Wear protective gloves when doing chores, such as gardening.
• Don't wear tight clothing or jewelry on the affected arm or leg. Don't carry bags or other weight with the affected arm.
• Shave with an electric razor instead of a razor blade.
• If at all possible, don't have blood pressure taken, get shots, or have blood drawn in the affected arm.
• If a leg is involved, don't cross your legs when sitting. Don't go barefoot.
• Don't use hot tubs, steam rooms, or saunas.

If you are at risk for lymphedema but have not developed it, these tips can help also help prevent it. Follow your doctor's instructions.

Follow up with your doctor as advised.

Lymphedema can change the appearance of your body. This can be emotionally difficult to adjust to. You may benefit from a support group where practical advice and emotional support are offered. Also consider getting one-on-one counseling.

Contact your doctor right away if any of the following occur:

• Swelling gets worse
• Rash, blistering, or other skin changes on the affected limb
• Area of skin becomes red, painful, or warm to the touch
• A wound increases in pain, becomes warm, drains pus, or sends out red streaks
• Fever of 100.4°F (38°C) or higher, or as directed by your doctor