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Lymphedema is a build up of fluid and protein causing swelling in the body. This may occur in women who have had lymph nodes removed and/or radiation to the axilla (armpit). Swelling may be found in the arm, chest and back on the side where the surgery was done. Lymphedema may occur shortly after surgery or radiation or it may occur many months or even years later.

You may feel numbness, tingling or pain in your chest, shoulder or arm. Some women experience swelling in the chest, arm or hand if lymph fluid is not draining properly through the lymphatic channels. This swelling, called lymphedema, should be checked by a doctor.

If lymphedema is not treated, you may get:

• An enlarged arm
• Pain and numbness in the area
• The skin and tissues under the skin will get hard
• A loss of movement in the arm
• Possible infection in the swollen arm

How Can I Take Care of My Hand and Arm?

Here are some things to do to care for your arm on the side of your surgery to lessen the chance of getting lymphedema:

• Use your other arm for injections, blood tests and to check your blood pressure when possible
• Clean cuts and burns and apply an antibiotic cream
• Protect your hands with gloves when gardening or doing heavy housework
• Take care of your nails - don't cut the cuticles
• Shave your underarms with an electric razor
• Use your other arm to carry heavy items
• Avoid tightly fitting jewellery and cuffs
• Wear sunscreen
• Check with your doctor before using hormones or hormone creams 

This is general information developed by the Canadian Cancer Society. It is not intended to replace the advice of a qualified health care provider. This information has been taken from the exercise guide "Exercise After Breast Surgery - What you need to know". 

Managing Lymphedema

Managing lymphedema involves the use of special garments called ‘compression’ garments, exercise and skin care. Some physiotherapists and massage therapists have special training in Manual Lymph Drainage. Manual Lymph Drainage is a type of hands-on massage that moves this fluid and protein build-up. This is done by working the smooth muscles in the small lymph channels to pump more fluid away from the affected area.

Gentle Self-Massage helps to drain the lymph fluid during and after exercise, during long periods of sitting, after a warm shower, or any time when signs of lymphedema occur. The goal is to move the lymph fluid from the affected side (arm, chest and back) into lymph nodes that have not been affected by surgery or radiation. Do it often.
 

Apply enough pressure to cause the skin to move slightly. If you glide over the surface of the skin, your touch is too soft. If your skin becomes red, you are pressing too hard. Do not use creams or lotions for this.
 
Step 1.

• Raise your affected arm up. Begin from the armpit .
 

• Use your other hand to gently stroke the lymph fluid

a) across your chest wall, and/or back, going around any scar tissue, to the unaffected lymph nodes in the armpit area on the other side, and
 

b) down along the affected side of your body to just below your hip bone to the lymph nodes in your groin area.
  
 
 

Step 2.

• Raise your affected arm up. Begin from the palm side of your hand and gently stroke your affected arm toward the back of your armpit.
 

• Continue the stroke sweeping down along the side of your body to just below your hipbone into the groin area.
 
 
 
 

Step 3.

• Raise your affected arm up. Begin from the back of your hand.
 

• Gently stroke your affected side toward the back of your shoulder, down the side of your body moving the lymph fluid to just below your hipbone into the groin area.
 

• Do Step 1 again to end.
  Do each massage 3-5 times each time. 
  Do these exercises 3 – 5 times a day.
 
 
 

This text was copied in part from a handout called "Lymphedema, Secondary to Breast Cancer", produced by Breast Cancer Action in Ottawa. To obtain a full copy of the text including a Lymphedema Alert bracelet, contact their office at info@bcaott.ca or call 613-736-5921. You may also want to visit their website www.bcaott.ca.