As it happens, during my journey with arm Lymphedema, and due to travel and geography, I consulted with three different physical therapists (PT) specialized in lymphatic drainage. Although all three applied what is commonly referred to as the Gold Standard which includes Manual Lymphatic Drainage (MLD) and multilayer compression bandaging, I found that while one was more proficient at explaining the bandaging technique to me, the other provided essential pre-wrapping exercises and skin care, and the third educated me on the different kinds of bandages and how to care for them. Along with some proactive research of my own, I have managed to put together a reliable strategy and some foolproof tips to keep any swelling in check.
Essential Lymphedema Management Strategy:
- Find a physical therapist (PT) who is well-trained in Manual Lymphatic Drainage (MLD). No amount of self-management will suffice without an expert’s guide and professional treatment.
- Ask your PT to show you how to perform the MLD massage on yourself. Incorporate this into your daily routine. Soon you will find it becoming a natural acquired behavior like brushing your teeth. You will still need to regularly visit your PT for more thorough drainage massage.
- Ask your PT to show you how multilayer compression bandaging is done. Learning to wrap your arm yourself is very empowering and essential in the maintenance stage, AFTER your PT has worked on you to reduce your limb volume. It may feel difficult or intimidating at first, but you will soon get the hang of it and wrap yourself almost blindfolded.
- Wear compression garments (sleeve & glove) during the day especially when exercising.
Maintenance Lymphatic Drainage Self-Management Tips:
Thefollowing are some effective practices that help me control sudden flare ups. Please note, however, that these tips and practices are only useful in the maintenance phase, AFTER the volume of your arm has been reduced.
SKIN CARE
- Always keep your hand and arm properly moisturized to avoid skin dryness or chaffing to reduce the risk of infection.
SELF-MANUAL LYMPHATIC DRAINAGE MASSAGE
- Before you give yourself your MLD massage,
- use a dry brush on your arm, sweeping upwards. Dry brushing increases lymph activity and elimination.
- apply some soothing essential oil. Essential oils can help detoxify, boost blood circulation and improve lymphatic flow.
COMPRESSION BANDAGING
- After your MLD massage, raise your arm for a few minutes before you wrap it with your compression bandages.
- Maintain compression bandaging for 20+ hours a day. It is the most effective tool to reduce swelling in the limbs.
MOVEMENT & EXERSICING:
- EXERSICE! EXERCISE! EXERCISE! Consult with your PT, but boosted walking, Pilates, swimming and yoga have been very helpful in controlling the swelling in my arm. I also lift light weights which help to strengthen my arm. Make sure you move as much as you can during days when you are not exercising. This helps to keep your lymphatic system stimulated.
- Avoid wearing tight clothing as this can increase the pressure in nearby blood and lymph vessels which may lead to increased fluid and swelling.
- Practice deep breathing. This encourages lymph to flow back into the blood as well as help you to relax.
- Cross your arm over your chest onto the opposite shoulder whenever you can.
- Raise your arm over a pillow while you sleep or sit to prevent fluid from building up. Be careful not to raise your arm higher than your shoulder. Make sure you don’t leave it in the same position for too long.
NUTRITION
- Cut down on salt in your diet. Large amounts of salt often causeyour body to retain fluid which worsens your lymphedema symptoms.
- Drink plenty of water! This reduces both water retention and dehydration which in turn reduces lymphatic congestion.
- Start your day with a fusion of warm water and 1-2 tablespoons of apple cider vinegar. You could also add a little organic honey. Alternately you could add 1-2 table spoons of ginger juice and / or a generous squeeze of half a lemon into your warm water. The acid in these mixtures will speed up the detoxification process, reduce swelling and improve circulation.
Along with maintaining regular follow-up with my PT, I found that keeping myself educated on lymphedema self-management practices and maintaining compression bandaging have been the most useful strategies for helping me manage my lymphedema over time. It is important to accept that this is a lifetime condition, and that us patients have to proactively self-manage it as a part of our daily routine.
