SO WHAT IS LYMPHEDEMA?
I guess the simplest way to explain it is that lymphedema is an abnormal swelling of the arm, hand, fingers, or chest where a protein-rich fluid accumulates with inadequate drainage. And, yes, it can be just a little swelling.
However, the amount of swelling can vary greatly. From just a minimal amount of swelling to "elephantitis." In the latter case, the limb grows very large, and the damage is irreversible. My physical therapist told me that she had a client whose affected arm was 120% larger than the other. So, NO.....not always just a little swelling!
The photo below is actually a milder case of lymphedema, similar to mine. My underarm and shoulder are affected as well.
Lymphedema can be a side effect of breast cancer surgery. During surgery, whether a mastectomy or lumpectomy, some of the lymph nodes in the underarm (axillary lymph nodes) may have been removed to see if they contain cancer cells. During the removal, the lymph vessels can become blocked, preventing the lymph fluid from leaving the area, resulting in lymphedema. I had 11 removed along with my right breast, and all 11 contained cancer cells. My surgeon warned me that I was at considerable risk for developing lymphedema.
IN ADDITION TO SURGERY, THESE BREAST CANCER TREATMENTS CAN ALSO CAUSE LYMPHEDEMA:
- Radiation therapy to the lymph node area. The scar tissue that forms from radiation can cause blockages in the lymph flow, making it harder for the body to build new lymphatic paths.
- Steroids used during chemo regimens. Steroids can sometimes cause fluid retention, which can affect the arm and trunk.
- Hormone blocking drugs. Hormone blockers can cause edema.
INFECTIONInfection is a real concern after having lymph nodes removed. If you no longer have all of your nodes, a cut that wouldn't have been serious before has the potential to turn into an infection that can spread throughout the body. The more lymph nodes that have been removed or damaged, the harder it is for your lymphatic system to deal with any injuries or cuts, even the ones that are barely visible to the naked eye.
TIPS TO REDUCE RISK OF INFECTION:
- Try to avoid injuries, scratches, and bruises.
- Wear gloves when doing house or yard work.
- Keep skin clean and well moisturized.
- Use insect repellent when outdoors.
- Use the arm that is not at-risk when having blood drawn, having blood pressure taken, or getting injections.
- Avoid sunburn, excess heat from saunas, hot baths, and other sources.
- Do not cut nail cuticles.
Treat suspected infections of the at-risk arm and hand right away. Wash the area and apply an antibiotic ointment.
It is essential to watch for a spreading rash, especially if the skin feels warm or tender. This can indicate cellulitis.
Cellulitis requires immediate medical attention. If not treated with antibiotics, cellulitis can spread rapidly and become life-threatening.
Lymphedema is irreversible. But it is manageable.
SOME THINGS TO HELP MANAGE LYMPHEDEMA
- Exercise and move the arm. Find some exercises specifically for lymphedema.
- Get fitted for a compression garment.
- Avoid sleeping on the affected arm.
- Elevate the affected arm or hand and prop it on pillows to help reduce swelling.
- Don't carry heavy bags on the affected arm.
- Have a lymphatic massage by a trained specialist.
- Reach or maintain a healthy weight.
WEIGHT AND LYMPHEDEMA RISK
People who are overweight or obese are more likely to develop lymphedema after breast cancer treatment. When your body stores extra fat, that fat tissue requires more blood vessels to bring it oxygen and nutrients. Any areas of the body with excess fat have more fluid to get rid of. If your lymphatic system can't handle the amount of fluid coming from your arms or upper body, lymphedema can result.
I recently read that overweight is defined as having a body mass index (BMI) of 25-29.9, obese as a BMI of 30 or greater! For example, a 5'5 woman weighing 150 pounds or more is considered overweight and obese at 180 pounds. There are many online tools you can find online to calculate your BMI. Um, yeah, I have some weight to lose!
THE IMPORTANCE OF EXERCISE IN THE MANAGEMENT OF LYMPHEDEMA
Exercise is crucial in the management of Lymphedema. I know that not only from reading many articles on the subject but from personal experience.
THE BENEFITS OF EXERCISE
- It works your muscles, which increases the flow of lymph fluid and helps move it away from the affected area
- It keeps your joints flexible and improves your range of movement
- It can help reach or maintain a healthy weight, which can reduce lymphedema swelling.
Walking and running are a fantastic way to get the lymph flowing, but I have a problem with the summertime Georgia heat! I prefer to be indoors with air-conditioning! A treadmill would be great, but I don't have one, and I really can't afford one!
Recently my friend, Debbie, asked if I had ever considered using a mini-trampoline/rebounder. Why hadn't I thought of that before?! After our conversation, Debbie and I both did a bit of research, and we discovered several articles about the benefits of using a rebounder to help stimulate lymph flow.
I started looking into purchasing one right away! I was a bit shocked by all of the different styles and sizes available and the cost to buy one! They definitely aren't cheap! I had planned to find the least expensive one I could, but Debbie surprised me by sending me money to purchase a really nice, sturdy one! Yes, I am truly blessed to have this woman in my life!
At first, I was a little afraid of the rebounder, since my balance has been off more than usual since being on Letrozole. My last bone density scan showed some bone loss since the previous scan, so the first few times I got on the rebounder, I was a little cautious! Now, I am very comfortable bouncing on it, though, and I really enjoy my workouts!
Brady wishes he could join me!
I'm also giving yoga another try! In addition to helping with my lymphedema, I know that yoga can be a great way to deal with stress for many people. I personally have always steered away from yoga for several reasons. One being that I am an impatient person! I have a problem with the whole, "be still-just breathe" thing!
I also happen to have an arthritic knee that doesn't bend very well. However, I have recently found a few videos online to adapt to my knee issues, and I am actually starting to enjoy yoga!
I hope this info is helpful to anyone who might just be curious about lymphedema. But I especially hope that anyone reading who is dealing with a breast cancer diagnosis might find it useful. Please feel free to contact me with any questions.
BTW, here's a guick overview of the Lymphatic System and how it works:
The lymphatic system is part of our immune system and it helps protect our bodies from infectious diseases. The system consists of a large network of lymph nodes and lymph vessels located throughout the body. Lymph nodes are small, bean-shaped organs that trap unwanted substances and fight infection. Lymph vessels are tubes that circulate lymph, which is a clear fluid that is pushed through our body's tissues to cleanse them and keep them firm. The contractions of our muscles push the lymph fluid through our lymphatic systems. The lymph nodes filter the lymph fluid, removing the bacteria, viruses, cancer cells, and other harmful substances. The filtered lymph fluid is then returned to the bloodstream, and the unwanted substances are eliminated from our body.