Tue, Dec 3rd, 2013

Miriam Stoppard: When sore a swollen limb is an emergency

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Lymphoedema is the swelling of one or more limbs when the lymphatic system is unable to transport lymph back to the circulating blood.

Just before the summer holidays I was having lunch with a friend who’s had a mastectomy and chemo for breast cancer.

She is cured but she still has swelling of her right arm, an uncomfortable condition which is called lymphoedema.

As we ate she started to complain of soreness in her swollen arm. I took a look at it and it was red and hot. I frogmarched her to the nearest hospital for instant treatment.

An infection in a limb with lymphoedema (with ovarian cancer it can be a leg) is an emergency because it takes hold quickly and can rampage through the whole arm.

Lymphoedema is the swelling of one or more limbs when the lymphatic system is unable to transport lymph back to the circulating blood.

Lymphoedema of the arm most often results from damage to the lymphatic vessels and removal of glands during surgery for breast cancer and can be a problem after cancer treatment.

One in five women with breast cancer will get lymphoedema.

The frequency is four times higher in those women who have glands removed from the armpit, something surgeons do to check for spread and to prevent spread.

Lymphoedema is at the least unsightly and at the worst painful. Care must be taken of the skin which can become thickened and any skin infection, no matter how minor, treated immediately.

It’s important that patients like my friend are treated holistically and that the treatment includes all four aspects of lymphoedema therapy.

These are manual lymphatic drainage, compression therapy, skin therapy and exercise – and collectively they are known as “combined decongestive therapy”.

Specialist nursing staff and breast care nurses are essential to the treatments.

Manual lymphatic drainage is a specific massage technique which can only be done by a lymphoedema-qualified therapist.

It involves the manual stimulation of the lymphatic pathways, in a specific order, to encourage lymphatic drainage up out of the arm.

Multi-layer compression bandaging applies pressure to the arm, which encourages excess fluids to flow back into the lymph and blood circulation.

Compression bandaging may involve multi-layer bandaging or the recently introduced two layer system.

This two layer method is more popular with patients because it is less bulky and also because it allows for more movement.

The type of bandaging used depends on the activity and mobility of the patient.

My friend was admitted to hospital for intensive antibiotic treatment, lymphoedema massage and compression bandaging.

She is back to normal now, doing her regular morning swim to keep fit.

source: www.mirror.co.uk

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