What can I do for my patient
What can I do for my patient
Once an assessment has been carried out and a diagnosis of chronic oedema or lymphoedema has been made, the patient should be referred for specialist treatment or advice to prevent further complications, such as skin damage, leakage and infection. Whilst lymphoedema is not a medical emergency, the earlier treatment is commenced the easier it is to minimise its severity and associated complications.
To find out where your local specialist is please view the BLS directory and click on your region. Additionally you can email or telephone the Lymphoedema Support Network (LSN). If there is no service in your area please go to the section ‘There is no specialist service in my area – what can I do to help?’
All patients with chronic swelling should expect:
An explanation about the most likely cause of their chronic swelling
Prompt referral to a lymphoedema practitioner
A treatment programme incorporating the four cornerstones of lymphoedema treatment as appropriate
Ongoing care according to accepted standards
The option of additional treatment at intervals as needed
Whilst ultimately you may not be the health care professional providing ongoing care for those with lymphoedema in your practice, there is some helpful general advice which you can offer your patients once an assessment and diagnosis of lymphoedema/chronic oedema has been made.
Try to use the affected limb as normally as possible without over using it, as muscle activity will encourage lymph drainage
Try to keep their weight within normal limits
Drink plenty of fluids and avoid taking diuretics unless they have another medical condition that requires them to do so. Diuretics are not recommended for routine use in simple lymphoedema.
Keep their skin clean, moisturised and in the best possible condition, avoiding injections/needles, blood tests and blood pressure readings on the affected limb, whenever possible
Everyone who lives with lymphoedema is different and their experience of the condition is unique but there are four specific areas of treatment that may be used to create an individual plan for your patients.
Skin Care – to keep the skin in good condition and reduce the risk of infection (cellulitis).
Exercise – is essential to maximise lymph drainage, keep the body supple and weight within normal limits.
External Compression – this supports the area, assists in reducing the overall swelling, improves shape and helps prevent further build-up of fluid. This may involve the use of bandages initially followed by compression hosiery in the long term management of the condition.
Lymphatic Drainage – this is a special, gentle massage technique aimed at moving fluid out of the affected area. Manual Lymphatic Drainage (MLD) should only be carried out by qualified practitioners. At present, the registered charity MLD UK Ltd holds a register of trained practitioners who have an MLD qualification. A simplified form (SLD) can be taught to patients and/or their partners/carers. The LSN has produced a self-management DVD which features this technique.
Encourage patients to join the LSN
Living with any long-term medical condition is challenging and successful management is vital in lymphoedema. The LSN has a website and produces patient information fact sheets about lymphoedema and how best to manage the condition.