As a community Pharmacist I regularly come across patients suffering from lymphoedema.
Lymphoedema is swelling that occurs in the body due to the accumulation of protein rich fluid (lymph). It is most commonly caused by the removal of or damage to the lymph nodes as a result of cancer treatment but can also be as a result of, among other things, surgery or blockage of a lymph node or vessel.
For many patients it can inhibit their ability to perform general tasks at work and at home. Where I can help you is in the correct measurement of the limb and supply of ready-made compression garments.
Compression garments work by applying pressure to the area keeping lymph moving in the correct direction and therefore reducing the accumulation of fluid in the affected limb.
Before being measured for a compression garment it is recommended that a patient undergoes proper Lymphoedema Physiotherapy to reduce the size of the limb. This can consists of manual lymphatic drainage, multilayer bandaging, pressotherapy and/or specific exercises. The patient should also confirm with their medical team that they are a suitable candidate to wear a compression garment.
Before a patient is measured in my pharmacy, it is advisable to phone ahead to ensure that a person qualified to measure is available. Measurement should always occur first thing in the morning. It is not an invasive procedure and measurement occurs in the private consultation area of the pharmacy. The affected limb(s) is measured at specific points and these measurements are used to determine the correct size of garment for the patient.The garment is ordered and is generally available for pick up within 24-48 hours.
These garments can be washed and often once a patient is confident that the garment is comfortable they will purchase a second garment. When putting on the compression garment it should be pulled out and up along the limb. If the garment is dragged or pulled up over the limb compression will not be even.
The garment should be changed every six months as the compression will be lost over time due to wearing the garment and regular washing. Each time a garment is replaced the affected limb should be re-measured. Never presume that the size has remained the same.
If a patient is wearing the incorrect size garment compression will not be effective, too small will cause further swelling at either end of the garment and possible blood flow restriction to the area, too large will mean that there is not adequate compression and the limb will continue to enlarge due to accumulation of lymph. Wearing the correct size garment will allow a patient to improve the symptoms of their lymphoedema.
Regina Quinn MPSI
Regina is the owner of Cunningham’s Pharmacy in Bray. She successfully completed our 4 week Physiotherapy-Pilates course in 2009 to reduce back pain and improve her posture. Since then, Regina continues to attend Physiofit Woman Physiotherapy and Massage as part of her maintenance plan. Regina is a regular contributor to our Women Expert’s Corner.
3 Killarney Park ,Bray , Co Wicklow.