What should patients with lymphedema pay attention to? Diet, sleep, bathing, and dancing all have their own rules!

Author: Wang Tingting, head nurse at Beijing Century Altar Hospital, Capital Medical University

Reviewer: Xu Lili, Chief Physician, Beijing Zhongguancun Hospital

As the saying goes, 30% treatment and 70% care. In daily life, the care of lymphedema needs to be reflected in all aspects, including diet, sleep, and even bathing and dancing!

diet:

A proper diet is one of the preventive measures for lymphedema.

Patients should eat easily digestible, low-salt, low-fat, high-fiber foods; prohibit overeating, smoking and drinking; avoid eating spicy and pickled foods, because spicy and overly salty foods can cause thirst and increase water intake.

Figure 1 Original copyright image, no permission to reprint

There are no strict requirements for the amount of water that lymphedema patients should drink, but a high-salt diet will cause water and sodium retention, increasing the burden on the affected limb. For obese people, they should also eat a light and reasonable diet, because for lymphedema, a high BMI (body mass index) is one of the predisposing factors of lymphedema, and weight control can reduce the burden on the affected limb. The normal BMI calculation is weight ÷ height squared. If it is higher than 23.9kg/㎡, it is considered overweight or obese. It is recommended to control weight in life by adjusting diet and exercising appropriately.

Sleep:

There are certain requirements for the body position of patients with lymphedema when sleeping to avoid prolonged pressure on the affected limb.

For example, if you have lymphedema on the left upper limb, you should try to avoid lying on your left side. When you sleep, you can raise the affected limb appropriately, 20-30 degrees above the heart level. It is important to remind you that you don’t need to raise the affected limb too high. In clinical practice, some patients raise their limbs to 60 degrees, which may affect their sleep and is uncomfortable. So raising it to 20-30 degrees is enough.

Another point is that ordinary patients can take off their compression stockings when they go to bed at night, but patients who have undergone liposuction surgery are required to wear compression stockings 24 hours a day, unless they feel uncomfortable, in which case they must take them off for inspection to avoid pressure injuries.

bath:

First of all, the room temperature must be comfortable. People will feel comfortable at a room temperature of 20℃-26℃. Once the temperature is too low, the capillaries of the skin will contract, and some collateral circulation will also contract, which will affect the return. If the temperature is too high, the sweating system will be turned on, the blood circulation of the skin will increase, the patient's skin blood vessel capacity will increase, and the return volume of lymph will also increase, which is not conducive to the return of lymph. Therefore, patients with lymphedema should not use overheated water to take a bath or go to a sauna. The water temperature should not exceed 40℃.

Figure 2 Original copyright image, no permission to reprint

Secondly, do not rub the skin hard during the bath to avoid damage. Because some damage is invisible to the naked eye, the pores will expand when exposed to hot water, and bacteria will easily invade. Skin care is the most easily overlooked by patients. It is very important to maintain the integrity of the skin, otherwise it will lead to the occurrence of erysipelas, which is what we call infection, and there will be fever, redness and swelling of the affected limb, increased skin temperature, and pain. After the occurrence of erysipelas, lymphedema will be aggravated, and lymphedema will increase the frequency of erysipelas, and the two will form a vicious circle.

In addition, be careful to avoid using alkaline soap, because the pH value of alkaline soap is 10-11. Frequent use will damage the skin's protective barrier and make the skin drier.

It is recommended to use neutral skin care products, non-irritating, fragrance-free, and preservative-free skin care products for skin care. In terms of selection, ointments have less water content and are better than creams in preventing skin dryness, and creams are better than lotions. For patients with intact skin, it is required to apply these skin care products every day to keep the skin moist; for patients with extremely dry skin, it is required to apply skin care products at least twice a day.

Dance:

If patients with lymphedema want to dance, they should choose music with a slow rhythm, not music with an intense rhythm. Because patients with lymphedema abroad will join some dance clubs, and they can also maintain a positive attitude when dancing. However, it should be noted that they should wear elastic stockings and elastic bandages before dancing.

In clinic, some patients are able to get out of bed and move around, but they don’t dare to do so. This is a misunderstanding. They think that if they get out of bed and get tired, or move for a little longer, or participate in some activities, it will cause further harm to lymphedema. This is actually a misunderstanding.

Some patients think that they cannot move or do anything after suffering from lymphedema, and they are useless, which leads to a negative mentality. For these patients, we should guide them to increase their knowledge in this area, and their family members and medical staff should encourage them to participate in some sports, including some daily labor. We advocate that the best exercise and sports for patients with lymphedema are slow non-competitive sports, such as Ba Duan Jin, Tai Chi, and swimming. In fact, these are very good sports for patients with lymphedema, but it is necessary to pay attention to the protection and cleaning of the skin.