Management of Lower Extremity Lymphedema
You are at risk for lymphedema in your legs if you have a family history of leg swelling, trauma insulting the lymphatic system, had gynecological cancer, melanoma, prostate or kidney cancer in combination with inguinal node dissection and/or radiation treatments. Lymphedema can occur when you are young, middle aged or older, immediately after surgery, months, or even years later. With education and care, lymphedema can sometimes be avoided and if it does occur, can be kept under control.
- Do not ignore an increase of swelling in the toes, foot, ankle, leg, abdomen or genitals. Occasionally measure the circumference of your leg. If you notice your clothing is fitting tighter around that area or you have a feeling of heaviness you should consult with your doctor immediately.
- Never allow an injection or a blood drawing in the affected leg (s). Consider wearing a lymphedema alert bracelet.
- Keep the at risk leg meticulously clean. Be sure you gently but thoroughly dry between each toe and in creases. Use a quality lotion with a low-pH, free of perfumes and alcohol free. Two examples are Eucerin or Nivea.
- If hair is to be removed from legs use an electric razor instead of a razor blade. Be sure irritation is kept to a minimum.
- Be careful when trimming your toenails to avoid cutting the cuticles. Always cut toenails in a straight line to avoid ingrown toenails.
- Avoid walking barefoot in public areas; as doing so may lead to contact with fungus. Aquatic shoes while swimming would be a good precaution.
- Always wear clean, dry socks. If excessive sweating occurs, wash and dry feet and change socks. Avoid wearing sandals or open toe shoes due to the possibility of injuring your toes. Closed toe shoes or boots worn with clean cotton socks are best.
- Do not wear socks or undergarments with tight elastic bands.
- Avoid extreme temperature changes when bathing or sunbathing such as following up with a cold shower or using a sauna or hot tub.
- Keep the legs protected from sunburn. Use sunscreen that is labeled “SPF 15” or higher and try to stay out of the sun during the hottest part of the day.
- Your lymphedema could become worse due to various occurrences. These include but are not limited to: fractures, sprains, surgery, generalized infection, cuts or scrapes.
- Avoid traumas such as insect bites, cat or dog scratches, burns, cuts or scrapes and sports injuries. Wear insect repellent when outdoors. Clean the area if you do acquire a cut or scrape and use an over the counter antibacterial cream.
- Exercise is recommended, but must be done in moderation without overtiring your leg. Athletic activities such as marathon running, basketball and other high level sports may be participated in but only with special considerations. If you were active before, slowly progress back to the activities you enjoy. Suggested exercises include walking, swimming, light aerobics, bike riding and yoga. Avoid vigorous, repetitive movements against resistance (working out in the gym using heavy weights) with the affected leg(s).
- When traveling by air, patients with lymphedema or those at risk for lymphedema should wear a compression stocking. Long flights may require full bandaging. With any travel, short frequent exercise breaks should be taken.
- When traveling by car, take frequent breaks and perform exercises to prevent increased swelling.
- If you have lymphedema, be sure to wear a well-fitting compression stocking during the day. Replace the stocking every 4-6 months or when it becomes loose on your leg—either the stocking has lost its’ elasticity or your leg may have become smaller.
- Weight control is important. You should eat a well-balanced diet, low in sodium and high in fiber. If you are diabetic watching your sugar is very important. You should not smoke or drink alcoholic beverages. Eating easily digested proteins such as chicken, fish or tofu will benefit you the most.
- Contact you physician immediately if you notice a rash, blistering, or redness and heat in your leg in conjunction with a fever. This could be an infection called cellulitis that must be treated with an antibiotic.
- See a podiatrist once a year as prophylaxis (to check for and treat fungi, ingrown toenails, calluses, pressure areas).
The above information was adapted from recommendations by the National Lymphedema Network.