“I don’t want my arm to blow up,” says one breast cancer survivor, talking frankly about her struggle to manage post–breast cancer lymphedema. She’s quoted this month in Part 2 of AJN‘s two-part article on the condition, which is characterized by an abnormal accumulation of lymph in the arm, shoulder, breast, or chest. In Part 1 (July), authors Mei Fu and colleagues described its pathophysiology and diagnosis. This month they discuss current approaches to risk reduction, treatment and management, as well as the nursing implications.
Effective risk reduction and management involve several strategies. For example, the authors emphasize the need to
- prevent infection by performing daily skin care and treating punctures, cuts, abrasions, and insect bites with a topical antibiotic.
- prevent injury by avoiding injections in the affected area and using caution when cooking.
- prevent muscle strain by avoiding overuse of the affected arm and wearing a compression garment during strenuous activities.
- avoid restriction of the affected area by avoiding having blood pressure measured on the affected arm and wearing loose-fitting clothing and jewelry.
- avoid excessive heat by avoiding prolonged exposure (as in a sauna or hot tub).
- promote lymph drainage by elevating the affected arm above the level of the heart for short intervals daily and by engaging in regular, light aerobic exercise.
— Sylvia Foley, AJN senior editor