Dear OncoLink "Ask The Experts,"
I developed lymphedema after a hysterectomy, with lymph node dissection 1 year ago. What are the precautions I should be taking in caring for my swollen leg?
Linda McGrath Boyle PT, DPT CLT-LANA, Cancer Rehab Specialist and OncoLink Lymphedema Team Editor, responds:
Lymphedema education consists of daily attention to excellent skin care and an understanding of the disease of lymphedema. Persons with lymphedema are more apt to develop infection in the area of their body that has lymphedema, because the lymph system is damaged and cannot filter germs effectively. Skin needs to be protected from injury and sun using sunscreens and protective clothing. For example, persons with leg edema should not go barefoot and need to wear socks to prevent blisters on their feet. Skin must be cleansed daily, with special attention to washing between each toe. This is followed by application of a low pH, fragrance-free lotion such as Eucerin. This will help prevent cracks in the skin that can result in germ entry and infection (cellulitis).
Cuts, burns, or insect bites need to be cleansed immediately, an antibiotic cream needs to be applied, and a non-latex bandage used to cover the area. Care must be taken to avoid injury while cutting the toenails. Tight clothing or pants/socks with elastic bands must be avoided. Shoes need to fit well and breathe to avoid injury or athlete's foot. Leather or canvas shoes are preferable to those made of plastic materials. Avoiding hot tubs or very hot weather helps to avoid sudden increases in the lymph load.
Regular exercise is important, with gradually increasing activity. A 5-minute warm-up and cool down during the exercise session is important to avoid sudden changes in lymphatic load.
Recognizing the signs of infection and obtaining immediate care with antibiotics is emphasized. The signs of infection include redness, pain, increased swelling, fever of 100.5 degrees F or higher, and possibly a rash. Excellent care and treatment will help to avoid the progression of lymphedema.