Bandages for Lymphedema

Bandaging is a mainstay of treatment for stage 2 and stage 3 lymphedema (moderate to severe lymphedema). Bandaging involves creating a soft cast on the arm or upper body by wrapping with multiple layers. This is a main component of the larger treatment regimen called complete decongestive therapy, or CDT, and many research studies have demonstrated the effectiveness of CDT. While there aren't many studies that focus just on bandaging, the small amount of research available suggests that bandaging can reduce arm volume.

At first, your lymphedema therapist should do the bandaging for you while teaching you the right technique. Some therapists provide an instructional DVD or written directions to guide you. The process starts with an inner liner made of stocking-like fabric or gauze, also known as a stockinette. The liner would be placed over the arm and hand after moisturizing the skin with a gentle lotion such as Eucerin or Curel. Try to avoid lotions with anything that could irritate the skin, such as perfumes or dyes.

In most cases, padding made of polyester, cotton, or foam would be placed over the stockinette, followed by multiple overlapping layers of short-stretch bandages. Short-stretch bandages look like the Ace bandages you might get at the drugstore, but they're much less stretchy. Generally, there would be more layers further down on the limb and fewer layers higher up, creating graded pressure that helps fluid move up and out of the arm. The bandages should feel snug but not tight.

Bandaging is also an option for lymphedema of the chest or trunk, as short-stretch bandages come in all sizes. Bandaging is a reductive therapy, meaning it makes the limb smaller. When your arm is bandaged, your muscles are "held in" by the multi-layer soft cast every time you use your arm. This is known as working pressure. When you do any prescribed exercises with the bandages on, or simply use your arm as for normal activities, this working pressure creates an internal pumping action that moves fluid out of the tissues and into vessels of the lymphatic system. The bandage cast helps prevent fluid from flowing back into the limb, and it also softens the tissue under the skin. This is why bandages are an important treatment for lymphedema that is causing moderate to severe swelling and/or soft tissue changes.

It is recommended to work with a certified lymphedema specialist to create a tailored plan to treat and manage your lymphedema. We have several certified lymphedema specialists on our Ricky Knowles Hair & Wellness team. Our therapists will work with you to address any problem areas and our certified compression garment fitter, Kristen, can create custom compression wear to help you improve your condition and mobility.

To schedule a free consultation, call a RNHW team member at 713-623-4247 today!

Tips For Lymphedema Skin Care

The treatment of lymphedema often focuses on controlling the swelling and on avoiding further injury to lymph vessels. This is why many patients with lymphedema know about lymphedema pumps and about the need to avoid tight clothing and compression, such as blood pressure cuffs. But excellent skin care is also an important part of lymphedema treatment. The central reason skin care is important in lymphedema is to avoid infection.

The following are several useful tips that can help lymphedema patients take better care of their skin: Use a moisturizer – Daily use of a moisturizing lotion is very important in keeping the skin elastic and healthy. We usually recommend that lymphedema patients use lotion twice a day all around the affected limb. Avoid using lotion between the toes because that could promote a fungal infection (“athlete’s foot”). Examples of moisturizing creams are Amlactin and Eucerin.

Avoid injury – The main hazard with lymphedema is skin infection. Skin injury is a way for infection to enter the body. Avoiding injury means avoiding infection. Sources of injury are all around. A common example is shaving your legs with a razor. Patients with lymphedema should use an electric mechanism.

Think about toenail hygiene – As can be seen in the picture patients with leg lymphedema may have nail changes. The toenails may thicken. Having a podiatrist take care of your toes can help you avoid much grief from accidental injury. Remember – avoid injury!

Examine your feet every day – Most people do not look at their feet. At least not every day. But foot examination can be critical in lymphedema patients. By examining your feet or having someone examine your feet every day you will find problems very early as they come and avoid severe problems from developing.

If you have questions about skin care for your lymphedema, call the Ricky Knowles Hair and Wellness team at 713-623-4247, and speak with our BOC/ABC certified custom garment fitter, or one of our certified lymphedema massage therapists. We would be happy to help you find answers to your important questions!

Lymphedema Best Managed Through Exercise and Complete Decongestive Therapy

From Oncology Nurse Advisor

Self-care is an essential part of treating patients with lymphedema, with full-body exercise and complete decongestive therapy being the best ways to minimize symptoms and maintain quality of life.

Nearly 40% of breast cancer survivors suffer from lymphedema, which is a chronic condition that causes body limbs to swell from fluid buildup. It is a result of lymph node removal and radiation therapy. No cure exists, so patients with the condition must find ways to manage the symptoms throughout their lifetimes.

The research team reviewed published literature about lymphedema self-management to determine which practices were most effective in managing the condition. Full-body exercise, such as weight lifting and stretching, was found likely to be effective in minimizing lymphedema symptoms. Additionally, complete decongestive therapy, which is a comprehensive treatment that incorporates skin care, exercise, manual lymphatic drainage and bandaging of swollen limbs, also helps patients to effectively manage the condition.

“There's a sense of empowerment—of autonomy—that comes from meeting the challenge of living with lymphedema,” said Jane Armer, PhD, RN, RAAN, nursing professor at University of Missouri and an author of the studies. “Some breast cancer survivors say that they've become a new person after cancer because they met a challenge, and they like the stronger person they've become. The challenge of lymphedema is similar. It's something that is pervasive in every part of life. It takes problem solving and persistence to manage the condition without letting it interfere with their goals.”

Dr. Armer added, “Previous research suggests that, the earlier the interventions, the better the outcomes. If patients can learn how to successfully manage the condition early on, then they can continue those processes throughout their lives, and their outcomes will be better than those of [persons] who resist participating in self-care.”

Our team at Ricky Knowles Hair and Wellness is ready to assist you in managing your lymphedema.  We have a certified compression garment fitter who will trouble shoot and create a custom tailored plan to best treat and manage your lymphedema.  We also have certified massage therapists and treatment specialists who can assist you with MLD and limb bandaging.  Call us today at 713-623-4247 and set up a free consultation!

Blood Test May Allow for Early Diagnosis of Lymphedema

From Oncology Nurse Advisor

Levels of a set of proteins circulating in the blood may accurately flag the presence of lymphedema, which currently is difficult to diagnose before the onset of physical symptoms.

At present, the only known way to diagnose lymphedema, an often painful inflammatory condition caused by radiation therapy for cancer, is by means of physical inspection. But by the time the main symptom of swelling of one or more limbs is detectable, the condition may be difficult or impossible to reverse with available treatment options, explained Stanley G. Rockson, MD, senior author of the study describing the new blood test, in a statement from Stanford University Medical Center in Stanford, California. Rockson is a professor of cardiovascular medicine at Stanford University School of Medicine.

Noting that the biological events underlying lymphedema may be present for 5 years or more before physical symptoms indicate the presence of the disease, Rockson's group studied skin-biopsy samples from 63 persons with lymphedema and 27 healthy subjects in an attempt to discover protein analytes that could distinguish diseased tissue from healthy tissue. The researchers focused on genes that were more actively engaged in the generation of their respective protein products in lymphedema vs healthy tissue, eventually narrowing the field to six overproduced proteins through statistical modeling.

Each of the six proteins is associated with at least one of the hallmark features of chronic lymphedema: accumulation of fibrous deposits, stimulation of fat-cell activity, inflammation, and lymphatic-vessel formation. Although none of the six proteins alone was predictive of lymphedema, in aggregate their presence at certain levels and in certain ratios appeared to serve as a biomarker for the condition.

Because levels of these proteins rise early in the course of lymphedema, the biomarker panel could lead to earlier identification of lymphedema risk or onset and earlier treatment that might ease the effects of the condition or even reverse its course.

When Rockson's team evaluated the validity of the biomarker panel using blood samples from an additional cohort of 36 adults with lymphedema and 15 healthy adults, the test was nearly 90% accurate in distinguishing persons with lymphedema from healthy subjects.

If you are a cancer survivor, or are currently undergoing cancer treatment and need help with lymphedema treatment, custom compression garments or lymphedema support groups, contact our team at Ricky Knowles Hair & Wellness at 713-623-4247 and schedule a free consultation.

I have lymphedema and wear compression hose during the day. Is there an alternative to bandaging at night-time?

Let's face it, managing lymphedema can be a lot of work! Luckily with the awareness of the condition, there has been a lot of advancement in the availability of alternative compression garments.

Night garments, such as JoviPak or Tribute can be described as alternative non-elastic compression garments that are made to replace bandaging in order to improve quality of life by making the process of compressing the limb at night easier and faster to apply. So for clients who are in the management phase of lymphedema therapy, rather than having to set aside the time and energy to self bandage at nighttime, you can simply don a nighttime garment, allowing you to be more compliant in your treatment.

Of course each client is different, but on average a nighttime garment should be worn for around 12 hours. It is important however to be properly fitted by a certified lymphedema therapist and to receive specific guidance on how long or often to wear the garment. 

Our goal at Ricky Knowles Hair & Wellness is to help you succeed in your self-care management. If you have questions about what types of compression garments might give you more quality of life, please call us for a free consultation with our BOC/ABC certified compression fitter at 713-623-4247.  

What Treatments Are Available for Lymphedema?

Unfortunately, there is no cure for lymphedema. However, with early intervention and proper treatment, the condition can be controlled and minimized, allowing the individual to lead a full and normal life.

Treatment begins with a physicians referral to a lymphedema trained massage therapist. The therapist performs a thorough evaluation to determine a baseline of the individuals sensation, pain, range of motion, strength, skin integrity, and extent of swelling.

A treatment plan to decrease the swelling and improve the individuals ability to function may include:

• Lymphatic manual drainage, or MLD, is a specialized lymphatic "massage," to move the extra lymph fluid through intact lymphatics and create new pathways for the lymph fluid to flow.
  
• Compression bandaging to reduce swelling.
  
• Exercise to improve functioning of the lymphatic system, range of motion, and strength.
  
• Establishment of a good skin care program to decrease the chances of infection.
  
• Recommendation of a compression garment and instruction for wear and care.
  
• Thorough patient education regarding all of the above to promote independence with self-management of lymphedema.

Not all therapists have received special training to treat lymphedema, so it is important to select a therapist that is qualified to treat individuals suffering with the condition. At Ricky Knowles Hair & Wellness, we have several qualified therapists who have been trained and certified to treat lymphedema.  We have a BOC, ABC certified garment fitter, who is constantly troubleshooting to find clients the best solution in compression garments.  Our team would be happy to help you develop a customized plan to help you improve your mobility. Our insurance specialist will even submit your claims and serve as your patient advocate, ensuring that you receive your full insurance benefits.

For more information, or to schedule an appointment, please call 713-623-4247.

Is it OK to exercise with lymphedema?

Yes, exercise is safe and beneficial for individuals with lymphedema, as long as a few standard guidelines are followed.

1. Always wear your compression bandages or garments when exercising – Compression garments help to move your lymph fluid from your limbs, trunk or face.  Without the garments, lymph fluid will collect in the affected area and increase swelling.
   
2. Get clearance from your doctor – As always, it’s a good idea to discuss your exercise goals with your physician and to make sure that you are in good overall health before starting an exercise program.
   
3. Start slowly – Your exercise program should include stretching, strengthening and endurance.  Some good examples of exercise programs are: Yoga, walking, swimming or cycling.  It is NOT advised to engage in high-speed activities like tennis, water skiing or football.
   
4. Hydrate – Hydration is super important to maintaining a healthy body, and even more important for people with lymphedema, as it aids in your body’s ability to expel lymph fluid.
   
5. Pay attention to your body – It is important that you feel good after exercising!  If you notice increased swelling, then you will want to choose a different activity for that day (i.e. swim instead of walk).

We want to assist you in reaching your exercise goals.  With our dedicated staff on your team, we can ensure that your custom compression garments will support you in your exercise program.

Let us know if you have any questions or concerns about your treatment options.  Our certified lymphedema specialists will be happy to answer your questions about how we can help you or someone you know who have lymphedema.  Call today at 713-623-4247, or email us at Kristen@hairandwellness.com

Is MLD massage right for me?

We are often asked this question from our lymphedema and edema patients. In most cases the answer is YES!  

MLD, or Manual Lymphatic Drainage helps your body's lymphatic system to drain and aids in removing wastes, toxins, bacteria and fluid build-up from your body's tissues.

The lymphatic system is a natural detoxification system. Your lymph nodes, in your armpits and groin, are responsible for filtering out waste, which plays an extremely important role in your immune system. The lymph system produces lymphocytes to kill bacteria, which helps you prevent and fight off infection. If MLD is applied correctly, it can have profound effects on your body. Having an MLD massage can help with the following:

• Lymphedema

• Muscoloskeletal problems

• Increase effectiveness of detox following a dietary detoxification (usually recommended by a Naturopathic doctor)

• Reduce pain signals sent to the brain

• Help post-surgical recovery

• Reduce scar formation

• Decrease general fatigue and "sluggishness"

If your lymphatic system has been compromised, due to a trauma or surgery, you may be at risk or have lymphedema. MLD is a proven primary tool in the treatment of this condition. Combined with compression therapy, MLD will help your lymphedema so you can achieve better mobility and a better quality of life.

Of course, there are exceptions to every rule. Manual lymphatic drainage is not an appropriate treatment if you have the following:

• Active cancer

• Inflammation (infection)

• Congestive Heart Failure

• Thrombosis

If you have additional questions about Manual Lymphatic Drainage, please call us at 713-623-4247 and book a consultation with one of our certified massage therapist. We will help you understand how MLD can improve your mobility and well-being.