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Risk Factors and Triggers

Risk Factors and Triggers
 
Lymphoedema can occur spontaneously in someone susceptible or may be triggered by an event.

Lymphoedema can develop within months of surgery /radiation or arise decades later.  Events that are known to trigger the beginning of lymphoedema include:
  • air travel, due to the changes in air pressure
  • injury to the limb /area e.g. sprains, fractures, wounds or skin punctures, e.g. mosquito bites, injections, blood tests in the susceptible limb should be avoided
  • infections in the skin on the susceptible limb/ area
  • exposure to excessive heat including sunburn
  • burdening the limb by carrying heavy bags on the susceptible hand/arm or standing on susceptible leg for long periods
  • constriction on the limb /area from blood pressure tests, tight clothes, and jewellery
    • be careful and get well fitting back packs
Some people wonder whether excessive use of the limb and exercise in the first 18 months after surgery can trigger lymphoedema.
 
What can I do to reduce my chance of getting lymphoedema? 
Air travel
Wear a well fitting compression garment/s during air travel.  Your surgeon or lymphoedema therapist can advise you on how to get one.  Move around on the aircraft and move your head, neck and limbs.  Leave the garment on for at least 4 hours after the flight or until you go to bed.  No matter how tired you are, go for a walk or swim after landing, whatever you can manage. 

Injury, infections, burns, constriction and changes in temperature
Protect yourself from injury.  Wear gloves/shoes and long sleeves/trousers when gardening.  Protect yourself from sunburn.  If your arm is susceptible take extra care not to cut or burn yourself.  Wear rubber gloves when washing up and protect your hands when doing things like cooking, fishing, sewing or cutting up things. .  Avoid blood tests, injections, IV drips and blood pressure tests on the susceptible side.  Use an electric razor on the susceptible limb and area.   If your leg is susceptible take care at the beach, protect your feet from cuts and grazes and treat fungal infections promptly.  Wear protective clothing when mowing lawns etc 

Minor injuries
Treat even minor burns with cold running water.  Keep an antiseptic or antibiotic in the house.  Treat minor cuts.  Run the cut under cold water to wash germs out.  Dry the cut carefully and cover with fabric plaster.  Keep the cut clean, dry and covered for a few days.  Change the plaster at least daily.   If the cut gets wet change the plaster.  If the cut looks a bit red, gets warm or more painful then put on some antibiotic cream.  See a doctor immediately if your skin is painful, hot, or red or looks infected.  This can be serious.  

If your leg is at risk, ask the doctor for an anti fungal cream.  Treat athlete’s foot.

Chafing – if the skin is dry some people have found cornflour is useful to prevent chafing.
 
Keep a healthy weight 
The bigger you are the more lymph you produce but your lymph vessels aren’t any bigger.  Try to maintain your weight in the healthy range. 
 
What may make lymphoedema worse? 
All the things listed above can make your lymphoedema worse.
The academic literature and research studies do not really discuss stress or diet.  For information on activities visit the Exercise and Lymphoedema page.
 
Some people think that lymphoedema can be made worse by certain activities, food and stress.  If your lymphoedema flares up it may be worth thinking about what you did the day before.  Think about stress levels, activity and what you ate.  Internet web sites list foods that some people have found made their lymphoedema worse.  For example fatty or salty foods, caffeine, alcohol, hot spices, mono sodium glutamate or smoking.
 
You may want to try stopping certain foods for a few days and then restart the foods one by one, every 3 or 4 days to see if food affects your lymphoedema.
 
Get a survival kit 
The book Coping with lymphedema by Joan Swirsky and Diane Sackett Nannery lists things to keep on hand including:

  • a filled prescription for antibiotics with instructions from your doctor
  • antiseptic or antibiotic cream - keep two tubes on hand and carry with you when you travel
  • fabric plasters, especially for hands and feet that get wet.  Fabric plaster dry out, plastic plaster holds water
  • insect repellant
  • for those with lymphoedema of the leg:
    • anti-fungal powder, ointment or cream, to place in your socks or stockings or shoes to prevent fungal infections; sandals for the beach or rocks, protective shin guards for mowing lawns
  • for those with lymphoedema of the arm:
    • several well insulated wrist high oven mitts; pairs of rubber gloves; cotton gloves (useful when doing the housework); fisherman’s fillet glove (flexible, metal mesh, available from sports / fishing shops), useful for cooks who cut themselves.

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