Sunday, September 9, 2007

Swelling Feet or Hands? This Might Be More Than You Think.

UPDATE: We are holding vein testing sessions September 28 and 29 11am-1pm as part of our Second Anniversary celebrations. No appointment necessary and it only takes a few minutes. This test can help determine whether you are at risk for potential circulation problems. Troy Briddle from Juzo, manufacturer of high quality compression garments, conducts the testing and answers your questions. Free, of course.

Once we reach a certain age, all kinds of things start showing up. If you are around that certain age, you know what I’m talking about. One of the surprises that might appear on the scene is unexplained swelling. Usually, it’s the result of overwork, a strain on certain parts of the body and with a little TLC, things go back to normal pretty quickly. However, there is a condition called lymphedema that is worth taking a close look at. If you have lymphedema, you will want to know how to care for it.

Lymphedema is a common cause of leg or arm swelling due to the collection of too much lymph fluid in a particular part of the body. Nearly 1,000,000 Americans are affected by this condition. In fact, worldwide figures are approaching 100 million. This condition might cause pain; it almost always causes limitations in a person’s ability to use arms or legs and increases the risk of certain infections. Most people who suffer with lymphedema have some kind of emotional distress as well.

The lymphatic system plays a significant role in our immune function and circulation. There are lymph vessels just under the skin which meet up with lymph nodes located in our necks, armpits, and groin. The job of lymph vessels is to move fluid out of the tissues. Since we are made up primarily of water and other fluids, it is not unusual that sometimes too much fluid will collect in a certain part of the body. Lymph vessels help drain the extra fluid, which often contains waste products, bacteria, dead cells and large protein molecules. These waste products are carried to the lymph nodes where they are broken down and eliminated along with other toxins in our bodies. The protein rich fluid is transported back to the heart to rejoin circulation. If these tubes become plugged or broken, these extra fluids build up and cause the part of the body that is not draining to swell.

There are two essential types of lymphedema: primary and secondary. Primary is caused by malformation of the lymphatic system. They are most common in women and be present at birth or develop later, during puberty or pregnancy. Primary lymphedema is most common in the legs, but might occur in the arms or torso.

Secondary lymphedema is a result of damage to the lymphatic system from cancer, infections, surgery, certain injuries, radiation therapy, insect bites. You will see secondary lymphedema most commonly in the arms, especially after mastectomies or lumpectomies with radiation. Removal of the lymph nodes almost always leads to lymphedema.

You will notice the first symptoms of lymphedema when swelling occurs, swelling characterized by “pitting.” You will recognize this when the skin is depressed for a few seconds and the indentation does not immediately disappear. Other symptoms may include a tightness or heaviness in the affected area or changes in the texture of the skin. Jewelry and clothing might feel tighter. Your body will start working harder to circulate this build up of fluid. When it no longer can handle it, swelling continues.

It is rarely possible to “cure” lymphedema, but it can usually be treated with success. Simple procedures, such as elevating the swollen limb whenever possible will help drain the excess fluid back into the blood. Sometimes the use of pumps to squeeze the swollen body part or massage to push fluid out of the swollen areas are techniques used by some. Wearing compression garments, tight fitting wraps around the affected part of the body, is the common approach to treating lymphedema. Graduated compression garments replace bandages that were applied in earlier times.

Some individuals wear compression garments for the rest of their lives to manage swelling. Others use compression garments when they are engaged in repetitive motion activities, cleaning, working in the garden, exercising. Many individuals, even those who do not have chronic lymphedema, like wearing low level compression when they fly or have to stand on their feet all day. These garments help keep the swelling down, improve circulation and prevent lymph fluid from re-accumulating in the affected area. With serious lymphedema, there are also special compression garments to wear at night, designed for non-ambulatory states.

Living with lymphedema, as with any condition, requires attention and consciousness. Here are common tips to follow:
  • Take care of your skin. Keep it clean and dry, but be gentle.
  • Wash hands frequently and apply lotion afterwards. Avoid over-drying skin.
  • Avoid injury or overexertion of the affected area.
  • Wear compression support garments as prescribed during waking hours, removing when you sleep. Repeat skin care tips before and after wearing the garments.
  • Avoid blood pressure cuffs, needle sticks, injections or procedures on the affected limb.
  • Wear a “lymphedema” alert bracelet or necklace.
  • Avoid wearing tight clothing or jewelry
  • Don’t carry heavy purses, shoulder bags or luggage.
  • Avoid excess heat, such as hot showers, direct sun, hot tubs and saunas. Do not get sunburned.
  • Use an electric razor.
  • Avoid cutting into the cuticles when trimming fingernails or toenails.
  • Maintain normal body weight.
  • Exercise daily as your ability allows.
  • Drink plenty of water
As I mentioned earlier, wearing graduated compression stockings when traveling is a good idea for everyone. You might notice more swelling when you drive or fly for long hours. Light compression socks will help with circulation while you are sedentary. If you have lymphedema, your physician will prescribe compression garments. You will need to be fitted for these garments so you will have the appropriate fit. We are certified fitters at Capabilities. Be sure to contact us if you have lymphedema and have questions or concerns about fitting or purchasing compression garments.

Caring for compression garments is fairly easy. Wash them daily in mild detergent. Depending on the brand you purchase, you might be able to machine wash and dry. Do not use fabric softeners, chlorine or bleach which might damage the garments. At Capabilities, we will give you complete information concerning the care of your garments. We carry several brands so you have the choice you prefer as with all purchases.

Putting on compression garments requires some practice, especially garments with high levels of compression. Wearing rubber gloves usually helps with grip and slide. They also protect the garments from fingernails, rings and other jewelry snags. There are numerous tools that help putting on and taking off garments easy and comfortable. As you may know by now, we focus on your comfort at Capabilities. We have several sock aids and stocking donners for you to try while you are purchasing your compression garments. One of our suppliers, Juzo, makes an incredible assistive device, Slippee Gator, that helps with donning and doffing socks and stockings. Come by for a demonstration if you are in the Denver metro area.

Let us know your thoughts or what kinds of treatments have worked for you if you have lymphedema. Email us or post your comment.

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