INOVA HEALTH SYSTEM : SERVICES : Rehabilitation Center

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Rehabilitation Center

703-504-3535

We treat a variety of neurologic and orthopedic disorders and have certified lymphedema and hand therapy specialists. Each patient is given a customized treatment regimen.

Lymphedema

What is lymphedema?

The lymphatic system absorbs the fluid that normally collects in the tissues throughout the body and returns the fluid back into the blood. Changes in the lymphatic system may cause a back-up of fluid in the system, leading to fluid collection in the tissues. This type of fluid collection is swelling or lymphedema.

Who can develop lymphedema?

Lymphedema occurs in a small number of women following treatment for breast cancer. It can occur anywhere in the body where there has been a chance in the normal lymphatic flow, including the hand, arm, chest wall, breast or back.

Related to breast cancer treatment, lymphedema may be caused by cutting tiny lymphatic vessels. This occurs during surgery or scarring of the lymphatic channels that may occur during healing or radiation.

When does lymphedema occur?

Lymphedema may occur soon after therapy for breast cancer treatment or not for many years after treatment. Sometimes swelling of the arm occurs immediately after axillary node dissection. If swelling remains longer than you and your surgeon feel is normal, further workup for lymphedema can be done.

How can I reduce my risk of developing lymphedema?

The chance of developing lymphedema after surgery is small, but there are some simple guidelines to follow that may reduce the risk of developing lymphedema:

Activity - If an exercise or activity causes the arm to swell, or creates a burning ache or heavy feeling, lie down and elevate the arm when you are able. Inform your doctor or therapist.
Infection Control - Do not allow blood to be drawn or have any injections in your arm on the side of your breast surgery if possible. You may need to remind your health care professional about this. Keep your hand and arm clean.
First Aid - Check the area at least twice a day. If the arm on the operated side is cut or scratched, wash the area well with an antibacterial soap. Use an antibacterial ointment and cover the area. Report any signs of increasing redness, swelling, heat, fever, pain, drainage or an area that doesn?t seem to heal, to your doctor.

Precautions for the Arm on the Side of Your Surgery

Gradually return to your usual activity.
Carry heavy objects, such as your purse, on the opposite arm or shoulder.
Gradually return full movement to your shoulder.
Do not use harsh soap, detergent or hard abrasives on hands.
Avoid exposure to temperatures that are too hot or too cold for you. If you have numbness or tingling in your hands, test temperatures with another area of your body where you can feel things normally.
Wear a well-fitting bra ? not too tight or too loose.
If you wear a breast prosthesis, have it checked to make sure it is the right weight for you.
Use an electric razor when shaving your underarms. Regularly replace the shaving head to keep it sharp and prevent pulling. Replace the screen as needed.
Avoid puncture wounds.
Wear insect repellent to minimize the chances of insect bites.
Wear gloves when gardening or washing dishes.
Be careful when playing with pets.
Wear a sunscreen with SPF 15 or higher? do not get sunburned.
Do not cut your cuticles when manicuring nails.
Have your blood pressure checks, blood samples and injections (shots) on the other arm, not the side of your surgery, if possible.
Watch for signs of infection (redness, swelling, increased warmth, pain).
Wear compression sleeve/bandages on the arm when performing strenuous activities or exercises if swelling is present.

What treatment is available?

If you have lymphedema, consider seeing a therapist trained in treating lymphedema. There are effective, time-efficient treatments available to help you. The best treatment programs use exercise, manual lymphatic drainage (a special massage technique), skin care and compression bandages as part of the treatment plan to reduce swelling. Compression bandages look like "Ace" bandages, but don?t stretch as much. The compression bandages provide therapeutic pressure to decrease and treat the lymphedema. The compression bandages are worn mostly at night and during exercise.