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Frequently Asked Questions about Lymphedema

Frequently Asked Questions about Lymphedema

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Frequently Asked Questions about Lymphedema

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  1. The following are frequently asked questions about managing lymphedema and lymphatic system disorders. They are by no means complete answers to what are always very complex questions but are meant as a guide. Each individual's situation is unique and each person should consult with their treatment team for their specific recommendations for their particular case.

  2. Answer: Appropriate exercise stimulates the flow of lymph. Muscle contraction and changes in pressure in the chest from deep breathing cause changes in pressure on the lymphatic vessels. When the muscles contract against the compression of the compression bandages or compression garments worn on the affected limb this creates changes in tissue pressures that help the lymph to flow. Question #1:"Why do I have to exercise?"

  3. Answer: When an individual has lymphedema, the pressure of the edema stretches out the skin so that it no longer provides a firm surface for the muscles to contract against. Exercise causes increased blood flow which caused an increase in lymph load in an already compromised limb. The compression of the garment/bandage provides a "new firm skin" for the muscles to contract against so that the pressure will be exerted on the lymph vessels and the fluid will move. Without the garment/bandage, the skin will just stretch and the force of the muscle contraction will not be translated to the lymph vessels. The involved limb could swell more if you exercise without compression. Question #2:"Why do I have to wear my compression garment/bandages when I exercise?"

  4. Answer: Compression garments are made of elastic materials that stretch out after wearing for about 12 hours. The areas where a limb bends (knee, elbow) stretch out more than the rest of the garment and then those areas do not receive the correct amount of compression which can allow pooling of edema fluid that can cause constriction at those areas. Some individuals can wear compression garments day and night and do not need to bandage their involved limb at night. These individuals should change their garments in the morning and again in the evening. Others may need to apply compression bandages for nighttime wear or use an alternative device such as a Reid sleeve, Tribute, or Jovi. Consult with your treatment team to discuss which option is right for you. Question #3:"Why do I need to change my compression garment twice a day?"

  5. Answer: Compression garments are made of elastic materials that stretch out after wearing. Washing them daily helps them to retain their elasticity as well as removes perspiration, bacteria and dead skin that accumulate inside the garment from normal wear. Question #4:"Why do I have to wash my compression garment every time I change it?"

  6. Answer: Moisturizing the skin helps to retain the elasticity of the skin which helps to avoid cracks/breaks in the skin. This is important because any break in the skin allows bacteria to enter the limb which is at risk for infection because of the lymphedema. Question #5""Why do I have to use moisturizer on my affected limb?"

  7. Answer: Our tissues are supplied with oxygen and nutrients by the blood. This blood is pumped around the body by the heart. With every beat of the heart, blood is filtering into our tissues. 90% of the blood volume in the tissues is picked up by the veins and brought back to the central circulation. 10% of the fluid volume in the tissues can only be brought back to the central circulation by the lymphatics. So, even when you are sleeping, even if your arm is elevated, blood is getting to your tissues (thank goodness!). Remember that in an impaired lymphatic system, the muscles need something to contract against to assist the flow of lymph fluid. Otherwise, the fluid will just pool under the skin and the limb will swell overnight. Then you may not be able to fit properly into your compression garment the next morning. Question#6:"Why do I have to wear compression on my affected limb 24 hours a day?"

  8. That 10% of fluid volume, the lymph fluid, amounts to 2 liters a day in the whole body. Remember that a compression garment is not engineered to "reduce" a limb. It is engineered to "hold" a limb that has already been reduced. However, you should always discuss your individual case with your treatment team, as there are no absolutes and each person is different. 24 hour compression may not be right for you.

  9. Sources for this presentation: http://lymphedemastore.com http://www.lymphedema-therapy.com/FAQ.htm

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