Lymphoedema Pupuhitanga nā te raru pūnaha waitinana

Sometimes your body produces more lymph than normal, such as when:

• you have an infection
• you have an injury
• your muscle cells work hard during strenuous exercise
• you have a disease such as venous disease.

Normally, your lymphatic system and blood vessels can cope with this extra fluid, but if either is damaged, the fluid builds up in your tissues. This causes swelling.

Your risk of developing lymphoedema is increased by:

• trauma to your lymphatic system due to things like surgery, radiotherapy, chemotherapy, an infection or an accident
• advanced cancer
• reduced mobility
• being overweight
• venous disease.

You can inherit lymphoedema from your parents, but this is rare. If you inherit lymphoedema, it can start at birth or soon after. It may also not be noticed until puberty or later in life. This type of lymphoedema most often affects your legs.

It is more common for an injury or damage to your lymphatic system to cause lymphoedema.

Lymphoedema can affect any part of your body, but it most commonly affects your arms or legs.

If you have lymphoedema, you are likely to notice:

• swelling or a feeling of fullness in your arm or leg
• your arm or leg feels heavy, achy or painful
• your clothing or jewellery might feel tighter.

These symptoms are common in the early stages of lymphoedema. You should get it checked out by your healthcare provider, even if the swelling comes and goes.

Your healthcare provider will diagnose lymphoedema by:

• examining you
• asking about your symptoms and medical history.

They may measure your affected limbs.

They may also arrange for you to have a scan or to see a specialist if they are unsure whether the swelling is caused by lymphoedema or something else.

Early diagnosis and treatment can help prevent your condition from getting worse.

If you have been told by a doctor that you are at risk of lymphoedema, there are ways you can reduce your risk. You should:

• keep your skin clean and well moisturised
• treat cuts, skin infections (including athlete's foot) and insect bites quickly
• avoid getting sunburnt
• wear gloves and long clothing when gardening
• wear gloves when doing dishes and be careful with extremes of temperature such as using ice or heat packs and hot spas or saunas
• avoid having blood pressure checks, injections and blood tests on arms or legs that might be at risk
• take care when using hot water bottles, ice and heat packs
• avoid tight, restrictive clothes on arms or legs that might be at risk
• maintain a healthy weight — being overweight may slow your lymphatic flow
• keep active with regular activity such as walking, swimming, Pilates, tai chi and yoga
• if you want to remove hair on arms or legs that might be at risk, use an electric shaver
• get early treatment from a physiotherapist for any injury to your arms or legs, such as sprained ankles.

While lymphoedema cannot be cured, there are treatments that can improve and control your symptoms.

There are no medicines for lymphoedema. Diuretics (substances that make you produce more urine) are not helpful in reducing the swelling in lymphoedema. 

If you have lymphoedema, you should follow the advice above about reducing your risk.

Managing symptoms

There are ways to help manage your lymphoedema symptoms:

• Raise your affected arm or leg whenever you can.
• Avoid getting overheated from hot baths, spas or saunas. This may increase your swelling.
• Learn how to do lymphatic massage and do it daily. A lymphoedema therapist can teach you how to do this. It helps move the lymph out of your swollen arm or leg.
  Lymphoedema therapists
• Get fitted for compression garments by a lymphoedema therapist and wear them every day from morning till night. These garments will need replacing when they lose elasticity.
• Be careful with strenuous activity such as sport and gardening in hot weather. Physical activity is good for your wellbeing, but you may need to take it slowly and see how it affects your body. If your arm or leg swells, you should wear a compression garment when doing these activities.

There are some types of surgery for lymphoedema, but these are not commonly done in Aotearoa New Zealand. There is no surgery that removes the need to wear a compression garment.

Get advice from a lymphoedema therapist or your healthcare provider if you are going to be travelling for longer than 4 hours.

Take care at work

Think about your work activities and if they affect your lymphoedema. Heavy lifting and repetitive movements are not good for lymphoedema. Pay attention to your posture and how you sit at work. It is a good idea to wear your compression sleeve or stockings at work. 

Lymphoedema therapists are usually nurses, physiotherapists, occupational therapists or massage therapists who are specially trained to manage lymphoedema.

They can provide several types of treatment including:

• bandaging
• massage
• exercises
• taping.

They can also measure and fit you for compression garments and tell you what you can do to manage your condition.

Talk to your healthcare provider about seeing a lymphoedema therapist. You may be able to get funded care or you can see a therapist privately.

Lymphoedema therapists — Lymphoedema NZ