My name's Rianne Davis and I'm a Macmillan university teacher at the University of Glasgow.
Lymphoedema is best managed by a combination of four main aspects and that's good skincare,
massage, exercise and some sort of containing it so that it can't swell anymore. The compression
garments are things that you need to be measured up for, so again, the specialist nurse or
specialist physiotherapist will measure your limb, or whichever part of your body and prescribe
a particular garment for you. Once you're happy that this is comfortable and that it's
feeling right for you then they'll supply you with more than one.
The most important thing of all is to prevent infections, because that really does make it worse,
so avoiding scratches and bites from kittens and puppies, thorn scratches
in the garden. Wearing gardening gloves or wearing rubber gloves when doing washing up,
things that avoid trauma to your skin. Similarly, on a summer's evening, making sure that you
wear long sleeves or long trousers so that the skin doesn't get bitten by a small fly.
Skincare for lymphoedema is good cleaning with a neutral soap, so not one that's too
acidic or heavily perfumed. And then moisturising the skin, keeping the skin supple so that
it doesn't become dry or flaky, so that it doesn't tear, because the one thing that we're
trying to avoid is any germs going into the skin and causing an infection,
this would really make the lymphoedema worse.
The exercises are very simple exercises and
it's just a case of trying to keep the circulation going in that limb regularly through the day,
so if it was an arm we would just recommend fist-clenching, arm, elbow-flexing and some
movements of the shoulders. Massage is also useful, but this is something
that you learn in a specialist clinic or from the specialist nurse and there are also helpful
diagrams in the Macmillan leaflet on lymphoedema. A few people will need more intensive treatment
and this will be done in a lymphoedema specialist clinic. Again it's the same four components
but this time the lymphoedema specialist will do a prolonged, very specialist massage for
the lymphoedema, if it's necessary. Bandaging may be necessary, and this is to reshape the
limb and to improve the condition of the skin and then it may be that specialised garments
may need to be made, very specifically made to measure. There are some specialist clinics
that will offer other treatments, these may include laser to soften up the tissues, they
may involve a special form of taping such as athletes use but this is to drain fluid
away from the swollen area to a healthier part of the body.
And then for a very small percentage of people, it may be appropriate that they're referred
to a surgeon who may offer some of the very newest techniques or even liposuction but
this isn't the sort of liposuction that's used in beauty clinics but a very particular
form of liposuction for lymphoedema. There are a lot of new treatments coming along through
the research for lymphoedema now and these include things like hyperbaric oxygen, which
is very promising but not yet readily available and even acupuncture but there's a bit more
research needs doing on these before they become generally available.
Coping with how lymphoedema makes you feel is sometimes the worst part of lymphoedema,
in that it's something other people can see, where perhaps you were able to hide that fact
that you had the cancer in the first place. And it can also cause functional problems
like just the difficulty of brushing your hair, or washing yourself and getting dressed
and those things can get you down when it's day after day. These are things that it's
worth speaking to somebody about and getting the support that you need early on.
If you find the lymphoedema is affecting your ability to do your work or everyday life then it may
be worth contacting the Macmillan helpline, there's a whole host of information and advice
there that may help you. It doesn't have to have a major impact on your life, you can
feel normal again, just seek the advice that you need early on
and learn how to manage it for yourself.
For information, help, or if you just want to chat,
call the Macmillan support line on 0808 808 00 00 or visit macmillan.org.uk.