Understanding Lymphedema Treatment
Now what about weight lifting? Very controversial, but I do truly believe that lifting light to moderate weights will activate the muscle pumps within your affected arm and this will help the movement of lymph fluid. What I should caution you with is over exercising your arm because then you will end up stressing your lymph system and increasing the volume of lymph fluid in your arm. So please exercise in moderation, but enjoy yourself. I will just remind those of you who have, who were not on my previous talk, that there are four symptoms that you can potentially feel if you are over exercising or overstressing your arm during exercise and these four symptoms are: a feeling of fatigue, achiness, heaviness, or tingling and you might get any one of those or all four of them. You may feel them while you’re exercising or you may only feel them after you’ve finished exercising. But in either case, certainly if you feel them during the exercise, you should stop immediately and rest; and if you feel them after you’ve done the exercises, then you may want to consider reducing the weight of the weight that you’re lifting and the number of repetitions that you are performing.
The treatment and management of lymphedema is very much a challenging task, both for the therapist providing the therapy, but also for you. But I really encourage you to stick with it for as long as you can because eventually the lymph system will maintain some sense of equilibrium and the results of your efforts will be greatly rewarded. Lymphedema should never stop you from living your life fully and actively. So I wish you all very well and thank you very much for listening to me this evening. I’m now ready to answer your questions.
Ilana from Illinois is on line; please go ahead.
Ilana: You mentioned doing kind of workout in the pool. What about just swimming?
Julia Osborne: Plain swimming is also very, very good.
Ilana: You mentioned lifting light to moderate weights you thought was okay. What weight, in terms of pounds, what do you think is reasonable?
Julia Osborne: Well everybody’s a little different, but I would say anything from two to five pounds is what I usually advise my patients to do. But some people who’ve been lifting for years, can do just fine with five to seven or even seven to ten. So it really does depend on the individual person; and the best guideline that you can use is that if you are lifting weights that are too heavy, you will feel that fatigue, achiness, tingling, and puffiness coming on and then you’ll know you’ll need to back off. But mostly I start at two to five.
Operator: Heather from Illinois is on line; please go ahead.
Heather: My question is: I have bilateral both arms lymphedema and one of my challenges is, and I just wanted to check with you, is like insisting not to have my blood pressure taken in the arms or blood drawn or injections or whatever should be done in the foot. Is that… I mean I really have to advocate for myself. It seems like people don’t know this and insist.
Julia Osborne: I know they don’t.
Heather: But I don’t let them.
Julia Osborne: Good, don’t because it will make your lymphedema worse. Just advocate really strongly. They should have a blood pressure cuff that can go around your foot or even around…
Heather: The thigh.
Julia Osborne …the thigh. If they don’t, then they either need to get one or you may have to find another place that does. But the risk of putting a blood pressure cuff on one of your affected arms will result in trauma to your arm and your lymph system will not cope very well and you will actually exacerbate your symptoms; and I would hate for you to have to do that.
Heather: Also that implies shots, injections, blood drawn?
Julia Osborne: Here’s my theory on shots and injections. All the textbooks say, “No shots, no blood draws on the affected side.” Well here you have both sides affected. Truly if it’s a sterile procedure, in other words if they clean with you alcohol first and put a sterile needle in and then you cover that little puncture wound immediately, which they mostly do, and keep a Band-Aid on it for a few days while it heals, you probably will be okay. But you will have to be meticulous in how you look after it. I don’t know how severe your lymphedema is but…
Heather: I have hard to find veins, so my concern is that they would stab me a few times.
Julia Osborne: That would not be good. If it’s clean shot, then it’s okay, as long as it’s kept clean and you cover the puncture wound. But you know I would be cautious about doing it if they may have to take a few shots. The worse thing and the absolute no-no is hanging any IVs on an affected arm because then they’re adding fluid to your arm and that could make the lymphedema worse. So the absolute no-no is IV bags. The second no-no is blood pressure and a third is shots for blood or blood removal.
Heather: Okay, because I’ve had to advocate for that in my foot too.
Julia Osborne: Yes, I’m so sorry, but keep going. Keep advocating.
Operator: Carol is on line with a question; please go ahead
Carol: I would like your thoughts on wearing a sleeve while on a plane.
Julia Osborne: If you have lymphedema, I definitely think you should wear a sleeve on a plane. If you don’t have lymphedema and you don’t want to get lymphedema, I would certainly recommend wearing a sleeve on the plane. The problem with the airplane, and this is another very controversial area and some physicians agree and some still disagree, but when you fly on an airplane, even though they regulate the cabin pressure, there is still a significant change of pressure and that pressure actually works on our entire fluid equilibrium in our bodies and that’s why some people get thrombosis, some people get swollen fingers, some people get swollen ankles when they fly and it could be a two-hour or three-hour flight, it’s because of the pressure change that we subject our body to when we fly. Well in your affected arm, even if you don’t have lymphedema, your lymph system in your affected arm has to work extra hard to compensate for that pressure change for the duration of the flight. If it fatigues, which is difficult for us to tell if that would happen or not, but if it did fatigue, then it would become overstressed and you would end up with lymphedema. So my suggestion is to wear a compression sleeve preventatively to help support the lymph system in your affected arm if you don’t have lymphedema and to help support the lymphatic system in your arm if you do. Does that make sense to you?
