Updated: Feb 21, 2022
Diabetes, obesity, heart disease and arthritis are all chronic diseases. A chronic disease is defined as being persistent, progressive in nature, non-curable, but treatable. Therefore, Lymphedema can be classified as a chronic disease. Many chronic diseases are preventable and some cases of lymphedema may be as well, there is not enough research to say that lymphedema is preventable. However, those people with a genetic tendency or who have had lymphatic damage, lymphedema cannot be prevented.
Management of diabetes, heart disease and obesity involves medication, exercise and healthy dietary choices. Lymphedema management involves exercise, weight management, compression and self-care that includes self lymphatic drainage, skin care, self-bandaging and self-monitoring.
You must be your own healthcare advocate.
To do this, you need to learn all you can about lymphedema, but also know that no two people are the same, so a one size fits all management plan will not be effective.
I am starting my very first blog post with something that I feel is the key to lymphedema management. I have found that not many people who have lymphedema really know about the compression garment they are wearing. I feel so strongly about the importance of compression that I have come up with THE 4 RIGHTS OF COMPRESSION. I hope you enjoy this post and can take away at least one new learning point from it!
COMPRESSION: MEDICINE FOR YOUR LYMPHEDEMA AND THE FOUR RIGHTS OF COMPRESSION
Over the years, I have found that many people wearing compression do not know just how important it is in their maintenance routine. Many are unaware of the vital role their garment is playing in maintaining their lymphedema.
Lymphedema is considered a chronic condition. There are many chronic conditions that are helped by medications. Medications for diabetes, hypertension, heart disease and many more do not cure the disease, but help to manage it, prevent complications and improve quality of life. At present, there is no medication that has been proven to help lymphedema, but compression has been proven to be effective at managing swelling, improving lymphatic and venous circulation, preventing complications and thus, improving overall quality of life. Therefore, compression can be considered a medication for lymphedema.
In nursing, it was driven into us that medicine administration involved giving the right medication to the right person by the right route at the right time. Translating that into what you should know as your own health advocate where compression is involved, keep the following in mind:
THE FOUR RIGHTS OF COMPRESSION
The right medication: What is the compression level of my garment? Is the garment the correct compression for me? Does the compression garment do its job?
The right person: This takes into consideration the physical qualities of your lymphedema and your physical abilities to put on and take off your garment. There are a wide variety of compression garments available, but you need one specific to you. Ask, is this garment the right fabric for my lymphedema? Is this the right garment for my ability to put it on and take it off? Is this the right garment for me? Have a discussion with your fitter and lymphedema therapist while choosing a garment.
The right route: Is a different garment required (thigh high as opposed to knee high if swelling goes above the knee or glove or gauntlet, which is appropriate)?
The right time: Compression in the reduction phase of treatment (the intensive phase) is worn 24 hours a day 7 days a week. It is removed for personal hygiene and reapplied within an hour, optimally. If it becomes loose later in the day, it will then need to be reapplied or adjusted again. Tried and true reduction phase compression involves a combination of short stretch bandages in layers over a protective layer of stockinette and foam. Other methods include adjustable wraps that can be cut and made smaller as you reduce in size. Compression in the maintenance phase is not worn overnight, however some people require a night compression garment. Maintenance garments can include knee high or thigh high stockings, arm sleeves, gloves, gauntlets, toe compression garments, compression bras, camisoles or shorts and short stretch Velcro wraps as well.
Taking control of your lymphedema involves knowing about your compression and being able to understand how it is working for you. Changes do occur over time and what you start out with may not be what you need in the future. You may need to switch from a maintenance phase to an intensive phase in times of increased swelling. Follow this guideline to help you determine if your compression is right for you. Ask your fitter or lymphedema therapist if you have any questions.
Watch for the other posts in this series related to being your own lymphedema health advocate (Exercise, Skin care, Manual lymph drainage and the cost burden of lymphedema).
Take good care and have a beautiful day
Catharine Burt RN, BScN, RMT, CDT