Lymphedema is the swelling of the arm due to pooling of fluid in the tissues because of the altered lymphatic drainage system. Lymphedema can develop shortly after an axillary node dissection and/or radiation therapy to the axilla, or appear many years later. The main risk factors for developing lymphedema are increased pressure in or on the arm and infection of the affected arm.
If you have had breast cancer and your treatment has included an axillary lymphnode dissection and/or radiation to the axillary lymphnodes, you are at risk of developing lymphedema in the affected arm. This information sheet is given to you with the goal of helping you learn many ways in which you may be able to reduce this risk using easy-to-follow lifestyle changes.
Following you can find a list of What to do and What to avoid to incorporate into your daily routine to reduce your risk of developing an infection or increasing the pressure on the affected arm.
What to do
What to avoid
Watches, armbands, rings or sleeves should fit loosely
Avoid constricting clothing and jewelry on the affected arm
Carry grocery bags and heavy objects with both arms/hands
Avoid carrying your purse or heavy objects on the side at risk
Alert everybody to take your blood pressure on your other arm
Avoid increased pressure on arm
Exercises that will strengthen your arm and increase its range of motion include: swimming, active range of motion exercises, walking, isometric exercises and bicycling
Avoid excessive exercise which puts greater strain on the affected extremity. Golf or tennis may be played at a recreational level only, if accompanied by daily stretching exercises
Limit weights to 1-2 lbs. for dumbbells or lowest weight possible on exercise machines. Keep repetitions low
Continue range of motion exercises throughout your radiation and until healing is complete, to promote circulation
Weight lifting should be avoided or limited with the extremity at risk. If you are an experienced weight lifter, get special instructions on how to proceed
Lubricate skin well and often to avoid cracked and dry skin
Avoid breaks in the skin of the affected arm, which will allow infection to enter
Wear gloves and long sleeves when gardening
Avoid thorn scratches, bug bites and scrapes
What to do
What to avoid
Alert all health care professionals that you need all IVs, injections, blood draws and TB skin tests on the other arm
Avoid trauma to the arm at risk
Use gloves when cutting meats, washing dishes with detergents, wear thimble when sewing
Avoid cuts and pricks
Be careful around the oven and iron
Avoid burns
Push cuticles back and keep cuticles and nail beds well-lubricated with lotion
Avoid cutting cuticles
Use sunscreen with SPF 15 or greater
Avoid sunburns
Use insect repellent when outside camping, barbecuing, hiking, etc.
Avoid bug bites
Stay away from hot or ice packs on arm at risk
Avoid temperature extremes
Elevate arm at risk when doing sedentary activities, such as watching TV or reading
Avoid prolonged dependency (allowing arm to hang down)
Eat plenty of fresh fruits and vegetables
Avoid foods high in salt and fat, which may promote fluid retention and weight gain
Eliminate or decrease use of spices, alcohol, tobacco and caffeine
In case of injury, promptly
Everybody is bound to get an injury at some point. Do not panic … follow the steps below
Clean area well with water and soap
Apply antiseptic solution, such as Bactine
Apply antibiotic ointment, such as Neosporin or Bacitracin
Clean and check at least daily, observing for normal healing
See your internist or surgeon immediately if you observe any redness, swelling or warmth
Seek emergency treatment if injury is too large for you to handle in the above manner
If you observe any swelling in your hand, wrist or arm, notify your radiation oncologist or radiation oncology nurse immediately. They will instruct you on further management of this condition, if it is determined you have lymphedema . The sooner lymphedema is treated, the easier it is to manage and control.
