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DID YOU KNOW

Our LymphYoga study 67% reported a reduction in swelling to their limb

DID YOU KNOW

Exercise will enhance the effects of your compression hosiery

DID YOU KNOW

100% of our patients who underwent intensive treatment packages reported a benefit and positive outcome

At LymphCare UK we offer a range of comprehensive treatments to help you manage your condition whether you are in  an intensive phase of specialist treatment in the clinic or supporting you with self-management of your condition.

Initial Consultation and Care

What is a Lymphoedema Nurse Specialist?

A Lymphoedema Nurse Specialist is a registered nurse who has undertaken specialist training in lymphoedema, lipoedema and chronic oedema management. He or she offers expert assessment, diagnosis and specialist treatments for all these conditions. Our team of nurses at LymphCare UK are passionate about this speciality and have expert knowledge in these areas. They are skilled and experienced in evidence-based practice. LymphCare UK provides training for pre-registration nursing students, as well as general awareness and specialist training and education to community and primary care teams.

What can I expect at my first appointment?

LymphCare UK accepts referrals from a wide range of health care professionals, for example this may be your GP, District Nurse, hospital consultant or specialist nurse. Following your referral to LymphCare UK you will receive an appointment to attend one of our clinics, or a home visit, and a leaflet about LymphCare UK and the services we provide. We will see you as soon as we can after receiving this referral, but please contact us if you have any issues or concerns whilst you’re waiting for your first appointment. We may be able to offer some advice over the phone. We will ask you to contact us to confirm that you are able to attend. You are welcome to bring a relative or friend along with you. Let us know in advance if you want a chaperon or need an interpreter. We aim to offer you an appointment in the clinic most local or convenient to you. If you are housebound we can arrange to see you at home. You will be seen by one of our experienced Lymphoedema Nurse Specialists. At Lymphcare UK we are proud to work in partnership with Birmingham City University and provide pre- registration nursing student training. If there is a student in clinic on the day of your appointment we will ask your permission for him or her to join us. Assessing your needs Your first appointment can take up to 1½ hours. During the first part of your appointment, we will ask you about your medical history. It is helpful if you can bring with you a list of medications and bring any dressings or creams you use. We will then ask you about your swelling, how long it has been there and how it is affecting you physically and emotionally. This will enable us to offer you the best support and advice. We will then carry out an examination of your swelling. We may take measurements and, with your consent, we may take photographs. These are both helpful as a measure to judge how well your treatment is progressing. If it is your legs that are affected an arterial assessment may be carried out using a painless non-invasive procedure. You may need to come back into the clinic for this. We may suggest to your GP a referral as appropriate to other healthcare provider or specialist service. Planning your Care Before the end of your appointment, we will discuss the different types of treatments you may require and, together with you make a care plan. We will provide you with a copy of the care plan and any other relevant leaflets or information to enable you to improve and manage and your condition. We will then with your permission, write to your doctor and any other relevant health care professional. We will inform them of your plan of care, order any prescriptions which you may require, and possibly ask for any other information/investigations that may be helpful for your diagnosis and treatment. It may be appropriate in some cases to go straight into a maintenance programme of care, this relies on you self-managing your lymphoedema following a care plan that we will develop together. If you need one of our intensive treatment options, sometimes known as Decongestive Lymphoedema Treatment (DLT), such as compression bandaging , Intermittent Pneumatic Compression Therapy and Medical Lymphatic Drainage we will arrange for you to come back into the clinic. If you are housebound, we will carry out DLT at home. These intensive treatments are undertaken over a 2 to 4 week period depending on your individual care plan. If you have any questions or concerns about what to expect at your first appointment or any of your appointments then don’t hesitate to ring us to discuss further.

What is my care plan?

Following on from your first appointment an individual care plan will be discussed and this will help you to self-manage your condition. Self-management is a vital part of your ongoing treatment and maintenance. This may include skin care, exercise, nutrition, Self-Lymphatic Drainage (SLD) and compression garments. Your care plan may involve more intensive treatment (Decongestive Lymphoedema Treatment) carried out by our specialist nursing team. This may include compression bandaging intermittent pneumatic compression therapy, medical lymphatic drainage. LymphCare UK provides a comprehensive range of treatments options in the clinic and at home. Whether you have lymphoedema, lipoedema or chronic oedema some or all of the treatments, which are available at LymphCare UK, may be applicable to you and this will be discussed during your consultation.

Compression Therapy

Compression therapy helps patients with venous disease. Especially, those with chronic venous insufficiency (CVI) which may result in changes to the skin and oedema. Lymphcare UK provides treatments using compression therapy and they include the following.

Compression Bandaging

Following your assessment, at the clinic, you may have been advised you need a course of lymphoedema compression bandaging.

This may be because the shape or the size of your limb is not yet suitable for a compression garment, or your skin may not be in a good enough condition.

You may have a wound or leg ulcer that would heal faster with bandaging treatment. It may be you are having a top up of previous intensive treatment. Before commencing any bandaging we will have carried out a simple investigation of your arterial assessment, on your legs. This is to check it is safe to apply compression to your limb.

Also, we may need to write (with your permission) to your GP and/or hospital consultant. This is to ensure there are no contra-indications to treatment related to your medical history.

At LymphCare UK we use two different types of bandage systems and on assessment, your Lymphoedema Nurse Specialist will advise which is most appropriate for you.

What to Expect during Bandaging

The usual length of treatment is 2 to 4 weeks, however, if your situation is complex it may take longer.

You will be required to attend clinic between 2 and 5 times a week according to which bandage system we are using.

This will be done in your own home if you are housebound. You should keep your bandages on over the weekend. We take into consideration your personal circumstances and try as much as possible to meet your individual needs.

We also work with District Nurses and Practice Nurses to carry out treatment in the most appropriate place for you.

We may measure your limb before and after your course of treatment in order to monitor your progress. At each session we will discuss anything you have been experiencing during your treatment and then remove your bandages and examine your limb, we can review how well your bandages are working and make any adjustments required. Your arm or leg will be washed and dried well.

If you are also having other intensive treatments at the same time as your bandaging such as Medical Lymphatic Drainage, or intermittent pneumatic compression therapy, these treatments will be carried out at this point. We will then moisturise your limb, apply any dressings if necessary and reapply your bandages.

During your treatment, we will be discussing and planning what compression garment you will require following your bandaging. This will then need to be worn on a daily basis. We may also advise you to wear this at night for a period of 4 to 6 weeks after your bandaging, this will be advised on an individual basis.

When to Remove your Bandages

Your bandage should feel firm but not uncomfortable or painful. Therefore, if you experience any of the following remove your bandages immediately.

  • Pain
  • Shortness of Breath
  • Chest pain
  • Discolouration of toes
  • Numbness of toes

Inform us of this as soon as possible during clinic hours. If required, and if you are housebound, we will make sure you have access to emergency District Nurses to assist you with removing the bandaging. Top Tips

  • Driving: this can be an issue if you are having compression bandage therapy as part of your plan of care. Compression bandaging can be bulky and can affect what footwear or clothing you wear and may restrict your movement. Always check with your car insurance company that you are still covered to drive whilst in bandaging. It may be advisable to make alternative arrangements for a relative to take you to the clinic. Be responsible and safe.
  • Clothing -With several layers of padding and compression bandage you may find this quite bulky and difficult to wear your normal clothing. You will need stretchy wider trousers or skirts for leg bandaging and vest tops, wider sleeved tops for arm bandaging.
  • Footwear -your Lymphoedema Nurse Specialist may ask your GP to prescribe a special bandage shoe or you could try to apply your own shoes if they are large enough.
  • Remember to bring any soap substitutes and moisturisers with you to the clinic.
  • Remain as active as possible and carry out any specific exercises that your Lymphoedema Nurse Specialist has advised – your bandaging works much better due to the muscle movement.
  • Elevate your bandaged limb when resting
  • If you are having your arm bandaged plan ahead re meals and washing up-enrol help of friends and family
  • Don’t forget to bring your usual footwear on the last day of treatment, it’s amazing how many people forget!

Compression Garments

Compression garments are the most important treatment in the long term management of your lymphoedema, lipoedema or chronic oedema.

Whatever the cause of your swelling, once it has been established that compression is appropriate for you, wearing your garment on a daily basis is the most effective way of improving or maintaining your condition.

How do Compression Garments work?

Compression garments work in several different ways.

First, the pressure of the material helps to prevent retention of fluid in the tissues. It also provides resistance for the muscles to work against, which encourages the flow of blood and lymph fluid within the lymphatic and venous systems.

Compression garments are graduated – higher strength at the foot or hand which reduces through the garment.

This helps to move fluid towards the root of your limb where it can be drained away more effectively. There are many different levels of compression, materials and style of garments.

Our Lymphoedema Nurse Specialists are experts in assessing and advising you on the most appropriate garment for you. Sometimes we may need to take some more specific measurements to then supply you with a made-to-measure garment. As much as possible your garments will be prescribed either by a Nurse Prescriber, or a prescription will be requested from your GP.

Occasionally, your garment may not be available on prescription and your garment will be provided at the clinic. It may be that your swelling is located in a part of your body other than your arm or leg, for example, your face, chest, abdomen, or genital area.

We are also able to assess and measure you for suitable garments or supports in these situations. It is usual to wear your garments during the day and remove it at night. Your

Garments last approximately 4 to 6 months depending on materials and manufacturers guarantee, always make sure your garments are in a good condition as they will be less effective when well washed and worn.

REMOVE YOUR GARMENTS IMMEDIATELY IF YOU EXPERIENCE ANY OF THE FOLLOWING

  • Your fingers/toes become painful, numb or discoloured
  • Your garment is too tight or painful
  • Your limb has become red, hot, or more swollen than usual you may have cellulitis

Top Tips for Compression Garments

Wear your compression garment every day

  • Put your garment on as early as possible in the morning
  • Wear your garments during exercise and travel
  • Always tell your Lymphoedema Nurse Specialist if you have any problems with your garments-we want to help solve any issues to make your daily wearing of garments as comfortable and effective as possible
  • Always follow manufacturer’s washing instructions, your garments will last longer, you should have two garments one to wash, one to wear.
  • Ask about application and removal aids, it can make all the difference
  • Ask about grip tops and skin glues if you are having problems with your garment rolling down

Compression Velcro® Wrapping Systems

In some situations, Velcro® wrapping system can be a very useful as an alternative to compression bandaging or compression garments.

The wraps work in the same way as bandaging and works best when you are moving, using your muscle pump action.

The wrapping systems consist of a protective liner, over which the wrap is then applied. Velcro® stretch bands are secured around the limb and you are able to alter compression according to how much you stretch the wrap as you apply it.

Wraps consist of a foot piece, a lower leg piece, and in some systems a thigh wrap option.

Your Lymphoedema Nurse Specialist can advise you if wraps are a possible addition to your treatment. Some wrapping systems are available on prescription via one of our Nurse Prescribers or your GP.

Intermittent Pneumatic Compression Therapy

Intermittent Pneumatic Compression Therapy (IPC) is the use of mechanical air driven pumps via inflatable garments that are used over your swollen limbs.

IPC has been available for many years in the management of chronic oedema.

IPC should only be used under the supervision of a Lymphoedema Nurse Specialist who can assess your suitability for IPC as it is not suitable for everyone.

IPC can be used as part of a combination of treatment in clinic or a standalone course of treatment.

LymphCare UK is proud to have a lending library of IPC pumps at our branches. This enables patients, after their trial treatment in clinic, to borrow a machine for a six week period. The device can then be used regularly in the comfort of your own home.

Please ask your therapist if you would like to know more about IPC.

Self Managment

Whether you have lymphoedema, lipoedema or chronic oedema it can affect you as an individual in different ways, on different levels and may pose challenges physically and emotionally to aspects of your daily life. Our aim is to help you manage your condition and to improve your quality of life. In the following sections, we have tried to offer some practical advice and tips to help support you in managing your condition effectively. We welcome any feedback and suggestions on any topic or issues that you feel need to be included – it could help you or someone else with similar concerns.

General tips on managing your condition

Please try to avoid things that may cause inflammation or increase the risks of infection to the affected area.

  • Do not apply heat to the affected area.
  • Keep your skin and nails clean to avoid infection.
  • Do not restrict or hinder lymph flow – avoid crossing your legs, or carrying a heavy shoulder bag. Avoid having wearing tight clothing or jewellery, e.g. tight socks or waistbands.
  • If you have arm or breast lymphoedema it’s important that you are fitted with a correctly fitted bra – we advise wide shoulder should straps and side panels on the bra. Underwired bras can sometimes cause restriction and make the lymphoedema
  • If you have an arm swelling, then do not have your blood pressure taken on the affected arm, let the person taking your blood pressure know you have lymphoedema. The same applies with having blood taken or injections – avoid the affected limb being used. (If you are going into hospital we can provide you with a lymphoedema armband giving the hospital staff information about avoiding blood pressures and needles in the affected arm).
  • Protect yourself: wear gloves when washing up dishes, oven gloves when removing hot items from the cooker, and garden gloves for working in the garden etc.
  • If you do injure yourself e.g. a bite, scratch or cut, then clean the area and apply an antiseptic cream or lotion. Observe the area – look out for any signs of infection in the tissues (cellulitis) – such as it becoming more swollen, red, hot to touch and painful, or you may develop flu like symptoms, these are all signs of cellulitis and you will need antibiotic as soon as possible. If in doubt seek medical advice.
  • Avoid tattoos: there is a risk that having a tattoo may cause trauma, sensitivity and infection of the skin or tissues.
  • Exfoliating: avoid waxing or wet shaving. Use an electric shaver or hair removal cream. Always check first though, on a part of your skin with no swelling, to ensure you that you are not allergic or sensitive to the cream.
  • Avoid extremes of heat or cold, i.e. hot baths/showers or cold compresses.
  • If you are having complementary therapy then always let the practitioner know that you have lymphoedema. It is advised to avoid massage over, or near, swelling unless the therapist/practitioner is trained and qualified in Medical Lymphatic Drainage (MLD). Sometimes acupuncture may be recommended to help with pain – please discuss this with your Lymphoedema Nurse Specialist and your acupuncturist. It’s important that your acupuncturist is aware that you have lymphoedema, and you have an increased risk of infection if inserting needles to the affected swollen area. It doesn’t always mean that you cannot have the therapy, but it is about having an informed choice and weighing up the risks against the benefits of treatment for your pain.
  • Driving: this can be an issue if you are having lymphoedema compression bandage therapy as part of your plan of care. Compression bandaging can be bulky and can affect what footwear or clothing you wear and may restrict your movement. Always check with your car insurance company that you are still covered to drive whilst in bandaging. It may be advisable to make alternative arrangements for a relative to take you to clinic. Be responsible and safe.
  • When resting, if you have leg swelling, it is important to elevate your legs as this will help with circulation.
  • Some patients may find they prefer to sleep in a chair rather than going to bed, this can make swelling worse, it’s important to try elevate your legs at rest.

Skincare

Why you need to look after your skin When you have lymphoedema, lipoedema or chronic oedema or you have been identified as being at risk of developing lymphoedema, looking after your skin is the single most important thing you can do. In lymphoedema, the superficial lymphatics in the skin are less able to clear substances such as proteins, which may increase the risk of developing an infection such as cellulitis. Cellulitis can lead to an increase in swelling and then further infection. Having lymphoedema may lead the skin becoming thicker and less supple. Any skin breaks or cracks can make you more likely to get an infection. Keeping your skin healthy, intact and well moisturised helps to prevent this. How to look after your skin You can do a number of things to help protect your skin:

  • Keep your skin clean and dry by washing and drying well (patting the skin dry – don’t rub) on a daily basis. It is important to pay particular attention to the skin between your fingers or toes, and any skin folds, to prevent fungal infection.
  • Even if your skin is in a good condition moisturising your skin at least once a day is essential, more frequently if you have been advised by your Lymphoedema Nurse Specialist, GP or consultant to do so. This will prevent your skin becoming dry and cracked.
  • Wash any cuts or grazes straight away with clean water, then put on antiseptic cream, cover the area if necessary looking out for the signs of cellulitis
  • Protect your skin from the sun by wearing a high factor sun cream or cover up with clothes
  • Avoid extremes of temperature that can dry your skin – including hot, cold or windy weather
  • Look out for any blisters or leakage of lymph fluid through the skin (lymphorrhea). Report, to us, any changes which you are concerned about and your Lymphoedema Nurse Specialist will advise the best course of action.

Moisturising To keep your skin in the best condition it is important to moisturise the affected areas daily. You will find a time that suits you best maybe after showering, but it is important to let the moisturising cream absorb into the skin for 10 minutes prior to applying your garment. Some people consider the best time to put on your moisturiser is before you go to bed at night so that it has time to absorb well into the skin. Then in the morning, you can directly put on your compression garment after your normal personal hygiene routine. Emollients which help rehydrate the skin come in the following forms:

  • Bath oils
  • Soap substitutes
  • Moisturisers-these can be either ointments, creams or lotions

During your assessment, we will examine your skin in detail. Depending on the condition of your skin your Lymphoedema Nurse Specialist will advise the most appropriate skin care plan. It is important that you discuss any allergies or sensitivities at your first appointment. Avoid perfumed body lotions because they can dry the skin. Apply moisturisers gently in a sideways (not upwards) motion to avoid blocking your hair follicles which may lead to an infection known as folliculitis. Fungal Infections Fungal infections are common in patients with swelling, between the toes and fingers and in any skin fold where the environment is warm and moist. If left untreated, fungal infections may lead to other more serious infections such as cellulitis, therefore prompt treatment is advised. If you develop a fungal infection it is important to see your GP/nurse or pharmacist for advice on appropriate creams/powders and fungal nail treatments. If you are interested in an alternative and preventative treatment, tea tree oil is known to have anti-fungal properties. It may be helpful to use a tea tree cream, or tea tree oil, diluted in water. It is important to remember to treat footwear, as fungal infections can live in footwear leading to constant re-infection.

Health eating

A healthy, nutritious diet can help us all look and feel our best. Excess weight can lead to a variety of health conditions such as heart disease, stroke, diabetes, and certain cancers but it can also put a strain on our lymphatic system, how our bodies deal with fluid and may cause increased inflammation. NHS Choices gives guidance and tips on healthy eating such as cutting down on saturated fats, sugar, salt and alcohol, eating more fish, fruit and vegetables as well as the importance of not skipping breakfast and drinking plenty of good fluids.

The Eatwell Plate

The eatwell plate highlights the different types of food that make up our diet, and shows the different types of food and the proportions required for a healthy, balanced diet which provides us with essential nutrients. Eatwell plateThe percentages for the eatwell plate are as follows:

  • Fruit and vegetables: 33%
  • Bread, rice, potatoes pasta and other starchy foods: 33%
  • Milk and other dairy products : 15%
  • Meat, fish, egg, beans and other non-diary sources of protein: 12%
  • Foods and drinks high in fat or sugar: 7%

NHS Choices states that the eatwell plate applies to most of us – whether we’re a healthy weight or overweight and whether we eat meat or are vegetarian. The eatwell plate doesn’t apply to children under the age of two, because they have different nutritional needs. Anyone with special dietary requirements or medical needs might want to check with their GP whether the eatwell plate applies to them. If you have been advised by a health practitioner that you need to lose weight then this is best achieved by following a healthy eating plan, rather than by using fad crash diets. Restricting certain food groups may mean that you are missing out on important nutrients, while complicated dieting plans can be confusing and off-putting. Try keeping a food diary, following the eatwell plate. At LymphCare UK, we are always here to offer support via one of our in-house healthy eating programmes or by referral to one of the public health initiatives such as to Slimming World or Weight Watchers. For more specific dietary advice we may refer you to a dietician. NHS Choices has lots of useful advice including tips on healthy eating.

Are You getting Enough Fluid?

It’s important to ensure that you are getting enough fluid throughout the day, maybe keep a diary to check. It is important to drink about 1.6 to 2 litres of fluid every day to prevent us becoming dehydrated unless in some cases you have been advised to restrict fluids due to a specific medical condition. This is in addition to the fluid we get from the food we eat. Water is always the healthier choice, avoid sugary drinks and drinks high in calories. Researchers have found that having too many drinks which contain caffeine such as tea, coffee and energy drinks or drinking alcohol has been found to worsen lymphoedema in the long term* and may also have an effect on any other oedema. *Dawson R, Pillar N, Diet and BCRL: The facts and fallacies on the web. Clinical Review, The Journal of Lymphoedema 2011, Vol 6, 36- 42)

Exercise

Exercise can have a positive impact on lymphoedema, lipoedema and chronic oedema and generally will benefit our overall well-being. It can help with controlling your swelling, improve your muscle tone, your range of movement and aches and pains as well as keeping joints flexible and more. NHS Choices states that ‘’People who do regular activity have a lower risk of many chronic diseases, such as heart disease, type 2 diabetes, stroke, and some cancers. Research shows that physical activity can also boost self-esteem, mood, sleep quality and energy, as well as reducing your risk of stress, depression, dementia and Alzheimer’s disease.’’ Exercise can be beneficial, however, it is important that you build up any activities slowly and sensibly, do not overdo it. Co-existing medical conditions may need to be considered (e.g. heart disease, diabetes, arthritis, osteoporosis etc). Seek advice on this from your GP if in any doubt. Try doing something you enjoy – it could be walking, swimming, Tai-chi or Yoga. At LymphCare UK’s Dudley Branch, we currently provide LymphYoga classes which are a bespoke yoga therapy specifically for lymphoedema lipoedema patients and a recent audit showed many benefits for patients. There are different types of exercises such as stretching, cardiovascular and resistance. Lymphoedema exercises, used with compression, help the body’s natural muscle pump to increase venous and lymphatic fluid return to the circulatory system and out of the swollen areas. If you are not so mobile then there are still some simple gentle limb exercises that can be done while sitting in the chair, such as ankle turns and calf pumps and specific arm exercises. Take notice of how your swelling/condition responds to the activity or exercise – if you have any worsening of swelling and pain or reduced range of movement etc then you may need to adapt the exercise accordingly and always let your Lymphoedema Nurse Specialist know when you next come into the clinic. Remember, if you have any queries about your condition, don’t wait – ring and ask for a call back from one of LymphCare UK’s Lymphoedema Nurse Specialists.

LymphYoga

LymphCare UK has developed LymphYoga classes through an agreement with Public Health Dudley. When we studied a group of LymphCare UK patients who had attended our classes over a 12-week period, we found that LymphYoga was really beneficial, improving the patient’s range of movement, reducing limb swelling, helped with weight loss and generally improved the patient’s quality of life. The team produced a poster of the LymphYoga project and it was accepted for an abstract at the British Lymphology Society conference 2015. You can download the information leaflet using this link: LymphYoga.

Sun, Travelling and Holidays

You need to take extra care, if you are travelling, getting exposed to the sun and going on holiday.

  • You may notice that your swelling becomes worse in extremes of heat or cold.
  • If you are flying you should follow these tips and it’s important to plan any journey well.
  • Let your Lymphoedema Nurse Specialist know that you are planning to go on holiday or travelling (especially when flying) – he or she can offer individual practical advice.
  • Always wear your compression garments when flying.
  • Try and request a particular seat with more leg-room, or an aisle seat so that you can move your limbs more easily and do your leg exercises. This is particularly important on a long haul flight.
  • Wear loose underwear and clothing.
  • Avoid wearing your seat belt too tightly.
  • Make sure that watches, bracelets and jewellery are not too tight – that they are not leaving indentations or red marks on your skin. Remove if necessary.
  • If you have leg swelling, wear well-fitting shoes with good support.
  • If you are travelling to hot climates you may find your swelling increases. It’s important that you continue to wear your compression garment and protect your skin from burning in the sun by applying a high factor sun-screen at least SPF 30 (even under your garment).
  • Using a refreshing and cooling body spritzer or spray, can help to cool you down and can be used on your garment.
  • Keep your spare garment in a plastic bag in the fridge – it will be lovely and cool when you apply it.
  • If you are wearing your compression garment in the pool then wear an older one. Remember, the water itself acts as a form of compression. Remember to apply your sunscreen while you are swimming. Always wash your skin after swimming to remove chemicals or salt and ensure that you dry your skin carefully.
  • Be careful of walking barefoot on the beach etc. – in case you injure yourself – especially if you have swelling in your feet or legs.
  • Insect repellent can prevent or minimise the risks of being bitten and it’s always recommended to apply a small amount to an area of skin, where you do not have swelling, to test that you do not have an allergy or sensitivity.
  • Lymphoedema increases your risk of developing an infection – especially in the skin and tissues. This is known as cellulitis. The symptoms include the affected area may become red, hot and painful or you may develop flu like symptoms. It’s really important that you seek medical advice as soon as possible if this occurs. Sometimes your GP may prescribe a course of antibiotics that you can take with you just in case you need them. This is particularly important if you have had episodes of cellulitis in the past. Ask your Lymphoedema Nurse Specialist about this before you go on holiday.
  • Take a first aid kit containing antiseptic cream, dressings and antihistamines to help with irritation from bites or stings can be useful too.
  • Always try to continue with your usual personalised lymphoedema treatment plan i.e. skincare, exercises, simple lymphatic drainage and compression therapy whichever has been recommended for you by your Lymphoedema Nurse Specialist.
  • Be kind to yourself, don’t over-do it! Enjoy your holiday/break.
  • Make sure that you drink plenty of water and remember that alcohol is dehydrating.
  • If you have leg swelling then, then take plenty of exercise and elevate them when resting.

General Wellbeing – Emotional Aspects

For some lymphoedema, lipoedema and chronic oedema patients life can sometimes be challenging, especially if it has not being managed or well controlled. Ill-fitting shoes and garments, heavy limbs and discomfort may cause individuals to have low self-esteem, anxiety and may lead to depression. If you are worried about your condition or are feeling down, about managing it, then it is important that you talk to your GP or a Lymphoedema Nurse Specialist. There are a lot of effective interventions that can help, even talking things through with someone can be helpful. Why not come along to one of our regular coffee mornings, join your local support group, or join our patient forum. By following your treatment plan and managing your condition will always help to improve, and then maintain your swelling.

Support

The team at LymphCare UK is here to support you in managing your lymphoedema, lipoedema and chronic oedema, offering assessment and diagnosis, a personal care plan, a range of comprehensive treatment, as well as advice and guidance on managing your condition. LymphCare UK’s patient forum preferred coffee mornings rather than a formal support group. Our popular coffee mornings are a good way to get out and meet the team and other patients who also have lymphoedema, lipoedema or chronic oedema and their carers. Refreshments and an interesting speaker or topic are highlighted at each event. We are always looking for suggestions for topics or speakers so let us know what you’d like to know more about.

Specialised Treatments

There are a number of specialist treatments that can help with lymphoedema, lipoedema and chronic oedema. These include the following.

Medical Lymphatic Drainage

Medical Lymphatic Drainage (MLD) is a specific type of skin stretching/massage technique that is used to redirect lymphatic flow towards functioning lymphatics, encouraging fluid to drain efficiently.

MLD was first used in the 1930s and there are a number of recognised schools of lymphatic drainage such as Vodder, Foldi, Casley Smith and Leduc. All nurses at LymphCare UK are trained in MLD techniques, including the new innovative Fluoroscopy Guided MLD.

This technique builds on existing knowledge using the most recent findings of anatomy, pathology and physiology in lymphoedema. We may carry out MLD for you as part of an intensive package, or as a standalone course of treatment.

The most common reason for using MLD is to treat areas that are hard to manage with other treatments, for example, the chest/breast/back/genital area (truncal oedema).It is also very effective in improving and maintaining head and neck lymphoedema.

Before commencing any MLD we may need to write (with your permission) to your GP and/or your hospital consultant. This is to ensure there are no contraindications to treatment related to your medical history, especially if you are undergoing any chemotherapy or radiotherapy.

Courses of MLD treatment vary between 2 and 4 weeks depending on the area and severity of the swelling. Following this you may then require some maintenance sessions, this will be assessed towards the end of your course of treatment.

Individual MLD sessions take between 30 to 60 minutes. You may be asked to remove some clothing so your therapist can treat your affected areas correctly. In some circumstances, you may not require MLD in clinic and your Lymphoedema Nurse Specialist will teach you how to undertake Self Lymphatic Drainage (SLD) at home. This can also be used to maintain the improvement after MLD.

Useful websites

www.mlduk.org.uk

www.lymphoedema.org

Kinesio Taping

Kinesio tape is an elastic adhesive tape that was originally developed in Japan to help treat muscle and joint problems.

It is also now used in the treatment of lymphoedema, lipoedema and chronic oedema.

When applied to the skin in a specific way it encourages lymphatic fluid to travel from a congested swollen area to an uncongested area, where it can drain naturally back into the circulation

Laser

Laser is a relatively new and innovative treatment for lymphoedema in the UK, however, it is well established in other countries.

Recent studies in the UK have found that patients with lymphoedema have reported increased softening and reduced tightness in tissues and improved range of movement.

When delivered as an additional therapy, it has been found to enhance the effect of manual lymphatic drainage and compression therapy.

The Lymphoedema Nurse Specialist holds the handheld laser to the affected area during treatment.

It is not painful and treatment sessions will take 20 to 30 minutes and are scheduled over a number of weeks according to your needs.

Liposuction

Tumescent liposuction is a surgical technique in which fluid is infused into the tissues and a vibrating microcannula is inserted through small incisions to remove fat.

It can be used to remove excess fat from an affected limb to help reduce its size. It is important to be aware liposuction does not correct poorly functioning drainage systems. It should only be undertaken by an expert surgeon with knowledge of lymphoedema, lipoedema and the lymphatic system.

Access to liposuction for lymphoedema and lipoedema is not generally available in the NHS, although individual funding requests can be made for NHS treatment.

Patients who may be considering private treatment should discuss this with their Lymphoedema Nurse Specialist.

Micro-Surgical Procedures

There are other relatively pioneering microsurgical treatments such as Lympho-venous anastomosis. This is where a lymphatic vessel is joined to a venule (small vein) in order to improve drainage.

Another surgical procedure is lymph node transplantation this is where healthy lymph nodes are harvested along with tissue and transplanted into the non-functioning area.

In some cases, these procedures are used in conjunction with each other.

Access to micro-surgical procedures for lymphoedema and lipoedema are not generally available in the NHS, although individual funding requests can be made for NHS treatment.

Please talk to your Lymphoedema Nurse Specialist for further information on any of these surgical procedures.

Useful Websites

National Institute for Health and Care Excellence (NICE)

LipoedemaUK