What is Lymphoedema
Lymphoedema is a chronic and permanent swelling which can affect any area of the body, most commonly affecting the limbs. It results from poor drainage of the body's lymphatic system. It affects over 100,000 people in the UK of all ages and genders. It can impact on your body image, self esteem and cause not only physical, but emotional distress as well. If an unexplained swelling is noticed the patient's GP should be consulted and, if necessary, a referral into the lymphoedema service should be made.
The Gloucestershire Macmillan Lymphoedema Service are able to see patients with Primary or Secondary lymphoedema regardless of cause.
The BMJ have developed a short learning module on Chronic Oedema/Lymphoedema which any healthcare professional involved in the care of patients with these conditions may find helpful please see link below.
5 THINGS EVERY GP SHOULD KNOW ABOUT LYMPHOEDEMA
- Primary – hereditary, congenital
- Secondary – Many cancers and their treatments, venous disease, immobility, injury, Filariasis
- Skin care – daily inspection, washing and moisturising of skin
- Exercise and maintenance of mobility
- Compression garments/multilayer lymphoedema bandage
- Simple/Manual Lymphatic Drainage
- Referral to specialist clinic
- Lymphorrhoea (leaking legs)
- Skin changes
- Skin folds
- Social/Psychological impact – lowered self-esteem, difficulties at work, finding clothes etc
4. RISK FACTORS
- Any previous cancer anywhere – even if many years ago
- Lymph node removal: irradiation increases the risk
- Venepuncture or blood pressure on at risk or oedematous limb
- Infection – cellulitis and fungal infections
- NONE – condition requires self management and specialist support
- Diuretics only if patient has cardiac history
- Antibiotics as per Consensus Document for Cellulitis (www.thebls.com/concensus.php)
- Pain control – need to identify cause of pain
5 THINGS EVERY PERSON WITH SWELLING SHOULD KNOW ABOUT LYMPHOEDEMA
- Primary – ie: a person is born with a lymphatic problem and swelling occurs for no apparent reason. This can happen at any point in life and can run in families.
- Secondary – ie: cancer treatment which involved removing of lymph nodes and radiotherapy can make a person more prone to developing lymphoedema; if a person has a long term condition and cannot walk very they may develop swelling in the legs.
2. SKIN CARE
- Wash daily and moisturise the skin.
- Avoid cuts, scratches and burns to your skin which may get infected.
- Avoid injections, blood tests and blood pressure measurements to the swollen limb, unless essential for treatment of other conditions.
- See your GP if you have any signs of infection: area of redness, hot to touch, fever.
- Gentle exercise and sensible positioning will help move fluid which is causing the swelling from the limb.
- NB: It is important not to sleep with you feet down. Sleep in bed and not in a chair.
- Garments such as stockings or armsleeves, if prescribed need to be worn every day as directed by your medical practitioner and removed at night.
- Multi-layer lymphoedema bandaging may be applied in more severe cases.
- Simple Lymph Drainage (SLD) can be taught for you or your carer to do daily to assist in drainage of the limb.
- Manual Lymph Drainage (MLD) should only be done by a trained therapist if your medical practitioner recommends it.