If you are under the lymphoedema team at the UHNM, there may be times during 2020 that the team are unable to review you in a timely manner due to the lymphoedema nurses being redeployed to help with the coronavirus crisis.
We have written this leaflet to help you self-care during this time. If you do have problems we hope to be able to offer telephone consultations if required and we can be contacted on 01782 676688. The response time may be slower than usual.
Definition of lymphoedema: Failure of the lymphatic system which gives rise to swelling, skin and tissue changes and a predisposition to infection. It most commonly affects the lower or upper limbs, but may also affect midline structures such as the head and neck, trunk, breasts or genitalia.
Please follow these core principles:
Compression:
It is possible that your nurse will not be able to see you to re measure for your garments in a timely manner during the crisis period, we therefore request that you take extra care of your garments to ensure they last as long as possible. We recommend that you wash your garments according to the manufacturer’s instructions. If you have older garments please hold onto these to see you over this crisis period.
It may be possible to request a repeat of the last prescription from your GP or Patient Choice (0800 862 0686) without seeing the lymphoedema team. This would only be appropriate if you feel your limb(s) has not changed considerably in size/shape.
Skin Care:
Please keep your skin and tissues in good condition and to prevent/reduce the risk of infection (Cellulitis). Please continue to reduce the risk of skin breakdown (such as athletes foot) this can trigger Cellulitis. Please continue to use the cream you usually use or a bland emollient.
Cellulitis is an infection of the skin, look out for redness, swelling and heat, with associated pain and tenderness in ONE arm or leg, which may be accompanied by fever, nausea/vomiting and a feeling of generally being unwell. People with lymphoedema are particularly susceptible to cellulitis.
What should I do if I develop Cellulitis?
Contact your doctor immediately as you will need antibiotic treatment. This is very important and should be considered an emergency and should not be delayed even in view of the current health care crisis. If you are seriously ill you may require admission to hospital for intra-venous antibiotics.
If you have previously had cellulitis you may have probably been advised to keep oral antibiotics at home. If you suspect cellulitis please start taking the antibiotics but please also seek medical advice.
If you suspect cellulitis please follow the following advice:
- Continue to wear compression garments unless the pain is too severe, if this is the case return to wearing hose as soon as it can be tolerated again.
- Discontinue Simple Lymphatic Drainage (massage) and exercise until the infection is improving.
- Rest your leg/arm in a comfortable position.
- Keep hydrated.
- Paracetamol may be taken.
Exercise:
Please keep up with your regular exercise routine. If you have compression garments that are worn out or poorly fitting the extra focus on exercise can be even more beneficial. If you increase your exercise this may compensate for your garments. Even if you are self-isolating or social distancing you can exercise indoors or take a walk as able/indicated.
If you want more ideas about what exercise helps lymphoedema please visit https://www.thebls.com/pages/everybodycan
Manual Lymphatic Drainage/ Simple Lymphatic Drainage (massage):
Please continue to carry out the simple lymphatic drainage if you have been taught this by your lymphoedema nurse.
Elevation:
Some patients find that elevation helps with increased swelling, this is variable. But if you swelling does increase try resting on the bed in the afternoon if possible to help drain the legs, or elevating the arm on a pillow when resting.