Self-management

An individual learning process

Primary lymphedema and chronic secondary lymphedema are life long conditions that can be managed successfully. Management involves learning about lymphedema (from a trained lymphedema therapist, where possible), treatment as necessary, and commitment to self-care practices.

Learning to manage your lymphedema is an individual and gradual process. The encouragement and support of friends, family and medical professionals can help. The LAQ encourages developing self-management practices where possible, because of the benefits of feeling more in control, maintaining reduced swelling, and leading an active life.

Compression garments

Compression is the most essential component of self-care. Check with a therapist or a trained fitter. Compression garments are worn during the day. Garments must:

	Be prescribed by a physician.
	Fit properly.
	Be fitted by trained personnel.
	Be cared for and washed regularly.
	Be replaced approximately every six months.

Compression bandaging

The swelling of lymphedema can vary with changes in climate, activity and weight gain. During times of increased swelling, it may be necessary again to apply compression bandaging, or other compressive devices at night. Lymphedema therapists can teach proper bandaging techniques to their patients, and family members or other supportive caregivers.

Self manual lymph drainage (MLD)

Lymphedema therapists can help their patients to understand the rationale of lymphatic drainage and can teach the techniques of MLD that are best for each individual.

	Find a quiet time each day to make MLD as pleasant as possible.
	Correct pressure and direction of strokes are important in applying self-drainage techniques.
	If in doubt or if reduction is not maintained, contact a certified therapist for review of proper techniques in bandaging and self-MLD.

Self measurement

	Monitor the affected area regularly for sudden or persistent increases in swelling.
	Check adjacent areas for feelings of heaviness or swelling.
	Consider regularly monitoring your lymphedema by measuring the circumference of the limb at various intervals using a measuring tape. Ask your therapist for guidelines.

Dr. Lette's home arm volumeter

	Dr. Jean Lette, one of our medical advisors, has designed an arm volumeter specifically for home use based on the water displacement method.
	Dr. Lette’s Home Arm Volumeter.

Individual exercises

	CDT therapists can demonstrate decongestive exercises appropriate to each individual.
	Stretching, aerobic exercise and moderate strength training may also help.
	As everyone has different physical ability and needs, and as severity of lymphedema varies from individual to individual, it is best to consult your physician, lymphedema therapist and\or a trained exercise therapist to determine frequency, duration and level of activity that may be appropriate.
	It is important to wear compression bandages or garments during exercise.

Group exercises

	Exercising in a group can be fun and offer support.
	Aquatic exercises, integral tai chi, and dance exercise groups are offered in some regions of Quebec. Consult Exercises.
	When starting a new exercise program, take care to progress gradually and to monitor the response of your body.
	Remember to wear your compression garment during exercise.
	Warm up before and cool down after strenuous exercise.
If swelling increases, reduce the amount of exercise, and check with your therapist.

Skin care

	Regularly check the colour and texture of your skin in the affected areas.
	Be alert for signs of infection.
	Keep skin clean and adequately moisturized.
	Prevent fungal infections in lymphedema of the lower limbs by keeping skin dry.

Regular check ups

A check up every so often with a lymphedema therapist is a good idea for re-assessment and review of self-care measures. A short course of treatment may be necessary from time to time to maintain gains already achieved or to prevent additional swelling from increasing.

Activities of daily living

Coping with the body changes of lymphedema may mean that for some people, some activities will need to be modified. Learning to manage lymphedema and its impact is a gradual, day-by-day process, and may vary from individual to individual.

Commitment to self-management involves not only physical care, but self-understanding and self-acceptance. Recognizing emotions, communicating with others, and following through with treatment require active participation. Support of family, friends, the medical profession, and the community can all make a difference.

Air travel

	Wear your compression garment.
	Do any of the exercises that can be undertaken in the space available to you.
	Try to arrange to have a seat where you have more space and may be able to raise your affected limb.

Support groups

Anyone living with lymphedema and especially families of children with lymphedema may find support in the wider community through internet connections. There are a number of lymphedema support groups that may be accessed on-line. These can provide valuable personal connections and emotional support.

When considering comments by non-experts or information obtained from for-profit sites, however, be aware of commercial interests, or untested claims. Information from other patients may be factually correct, but may not apply to everyone because of different medical conditions. If in doubt, consult your physician.

On-line lymphedema support groups:
email LISTSERV@ACOR.ORG Type in the body of the email: SUBSCRIBE LYMPHEDEMA, your first name, your last name.

http://www.lymphnet.org/patients/PLAN.htm

For information about lymphedema, risk reduction, and management in PDF format, download the LAQ patient pamphlet "Living with Lymphedema" from the LAQ Home Page

Other useful links:

http://www.lbbc.org/newsletters-complete.asp?id=28
http://www.lymphnet.org/pdfDocs/nlnairtravel.pdf
http://www.lymphnotes.com/
http://www.pitt.edu/AFShome/g/e/genetics/public/html/lymph/
http://www.lymphnet.org/
http://www.lymphovenous-canada.ca/
http://www.lymphedemapeople.com/
http://www.lymphedemacircleofhope.org/
http://health.groups.yahoo.com/group/childrenwithlymphedema/
http://www.vascularweb.org/_CONTRIBUTION_PAGES/Patient_Information/NorthPoint/
Lymphedema.html

DISCLAIMER: This site is for information and community support only, and should not be used as a substitute for professional medical care. Always seek the advice of your physician with any question about a health problem or medical condition. This site also includes links to websites providing information about lymphedema, but the LAQ cannot be responsible for the content of those sites.