Lymphedema-MW: The Body
Medicine WheelSpritualPhysicalEmotionalMental
The Medicine Wheel and Lymphedema's Impact on the Body


Medicine WheelSpritualPhysicalEmotionalMental
What are the symptoms of lymphedema?
  • Swollen arm(s) or leg(s) that may become up to twice the size as normal or have large folds of tissues, bumps or creases
  • A feeling of heaviness or fullness in the arm or leg
  • A tight feeling in a hand or foot
  • Changes in skin (rough, dry, hardening)
  • Difficulty moving the arm(s) or leg(s) (less flexible than normal)
  • Infections or sores that do not heal
  • Skin that "pits" or remains indented for 5 seconds or longer when you gently push your finger on the swollen arm, hand, leg or foot
What are ways to help protect my body from getting lymphedema?

NOTE: These are general guidelines. You need to work with your providers to find out how each of these guidelines relates to you, or can be modified for you and your daily activities. For example, if you have never had a problem with lymphedema or if you are very strong, you may be able to lift more than 3 pounds with the arm that had lymph nodes removed. Please ask your provider.
  • You must avoid pressure, infection or any injury to your swollen arm(s) or leg(s)
  • If you use "constriction" garments or bandages they need to be fitted to you by a trained provider. They only last for about 6 months and you usually will need more than two sets.
  • Even when the arm(s) or leg(s) that had lymph nodes removed are NOT swollen, you should:
    • Not have blood pressure taken in that arm or leg.
      • Your provider can take blood pressure from another body part.
      • Remind the provider that you have had lymphedema so that s/he understands your concern.

    • Not get any shots or injections in the arm(s) or leg(s) that had lymph nodes removed or damaged.
    • Not have blood taken from the arm(s) or leg(s). There is some debate about how safe it is for someone who has never had lymphedema to have blood drawn from the arm(s) or leg(s) that had lymph nodes removed. Ask your provider.
    • Not wear tight-fitting jewelry, including rings, wristwatches, bracelets or cuff links.
    • Not wear elastic cuffs or tight sleeves or pants (like sweat pants with elastic cuffs that are tight enough to leave indentations in your ankles).
    • Not carry anything heavier than 3 pounds (fish, game, groceries, purse, backpacks, suitcases)
      • Obviously this is a general recommendation. If you are very strong, you may not have trouble carrying more weight. But if you have any problems talk with your provider about how much weight is "safe" for you to carry.

    • Not carry a purse or backpack of any weight that straps and hangs around your arms. Same caution note as in the previous item.
    • Not carry heavy lances, staffs or other traditional items with the arm that has had any lymphedema in the past or present
    • Be careful of how you move or use your arm(s) or leg(s)
      • The physical therapist can tell you what you can and cannot do

    "While attending a wellness gathering for Native Survivors, the participants did a fly fishing exercise that moved their arms so that one of their elbows was above their shoulders and then moved their arms forward like they were casting the fishing line. The exercise caused an elder's lymphedema to immediately swell. She had to go home and it took three weeks to get the swelling down in her arm. Fall 2004"

    • When you take a plane to fly somewhere, you may want to wear your compression sleeve or bandages. The air pressure in some planes changes enough to make some people more likely to get lymphedema. Get up and walk around for about 10 minutes every hour (obviously do this more frequently if you feel it is helpful to you).
    • Personal daily cleanliness and behaviors may need to vary
      • If you shave your underarms (a lot of us don't have much underarm hair):
        • Use an electric shaver rather than a shaver with a razor blade.
        • Ask your provider when it is safe for you to shave.
        • Do not shave until your lymph node surgery wounds are completely healed.
        • Clean and change the shaver heads of the electric razor often.

      • If you have breast prosthesis, get a type that does not weigh much.
      • You may need to wear soft pads under your bra straps. Do not wear bras with under-wire support. Do not wear bras with thin straps.
      • Wear loose fitting but secure rubber gloves when washing dishes, cleaning fish or game and washing gardening or other tools.
      • Wear long oven mitts to protect your hands and forearms from burns when cooking (both indoors with the oven and stove, and outdoors over the open fire or smoking fire).
      • Wear warm sweaters, coats, gloves and boots when in cold weather
      • Keep the arm(s) or leg(s) covered when outside to avoid accidental cuts or punctures.
      • Use sun screen to avoid sunburn (you are more likely to burn after your cancer treatments: Even if you never used to get sunburned).
      • Use insect spray to help prevent insects from biting or stinging your arm(s) or leg(s).
      • Use a thimble when sewing to avoid punctures.
      • When flying or riding in a car for more than an hour:
        • Wear a compression sleeve or wrap your arm
        • Drink lots of water
        • Avoid salty foods (like cheese, chips, sodas)
        • Get up and out of your seat to walk around for at least 10 minutes every hour.

      • Wear a lymphedema alert bracelet or necklace in case you have a problem or accident and are not conscious
      • Have your provider give you an antibiotic prescription in case an infection begins when you are far from the clinic. Talk with your provider about how to decide if you should begin to take this medication, how much to take and for how long. Schedule an appointment with your provider to discuss this infection to make certain it is cured or if it was something other than an infection.

    • For lower body (leg(s) and feet) lymphedema, avoid crossing your legs, sitting or standing for long periods of time and wear well-fitted shoes (you may need to have two different sizes of the same shoe to not make the swollen foot too tight).
What are other prevention behaviors I can do to avoid lymphedema?
(http://www.lymphnet.org and Cure: Spring 2003, pp. 58-61; http://www.curetoday.com)
  • Get to your healthy weight (Avoid obesity or extreme thinness)
  • Keep skin clean and well moisturized
  • Do a daily "skin check"
    • See if you have any cuts, burns, bits or other injuries.
    • Treat the injuries as directed by your provider. This usually includes using an antibiotic cream.
    • See if you have any redness, red streaks, tenderness of swelling
    • Keep your arm and underarm clean and dry.
    • Pat your arm dry rather than rubbing it with a towel.

  • Look for hangnails or cracked or torn cuticles. Keep your cuticles moist with cream. Push them back. Do not cut the cuticles.
  • Wear comfortable, loose-fitting clothing and jewelry
  • Protect your arm(s) or leg(s) from injury (see physical protections within the leaf on the medicine wheel)
  • Keep the swollen arm or leg raised on a pillow or something soft so that it is higher than your heart
    • While sitting, sleeping, or traveling if possible

  • Wear a compression garment (support sleeves or compression stockings); The National Lymphedema Network can help you find garments that work well (http://lymphnet.org)
How to manage lymphedema

Christine Mangiati
Italian Non-Native
Inflammatory Breast
Stage 3.5

They removed my left breast and 12 lymph nodes, 8 of which were cancerous. I went through 6 weeks of physical therapy and it was horribly painful, and I no longer have the swelling in my arm. I went in 2 times a week and my insurance covered it. I also have my lymph nodes flushed once a week.

... I do Shiatsu massage to help my side effects ... I'm so far, so good in the healing. There doesn't seem to be any signs of cancer. I'm also able to use my arm as well.

Lymphedema is managed based on guidance from your provider that is specific to you.

Why does it matter how quickly I get help for my lymphedema?
  • Lymphedema can cause the arm or leg to be permanently swollen
  • Early treatment may prevent the problem from becoming permanent
  • If you notice even 1/2" swelling, redness, harness, or warmth in your arm, underarm or affected breast area, call your provider.
  • Starting therapy before the arm or leg swells very much can help shorten the episode



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