Advice from a lymphoedema specialist

I asked my patients the question, “What advice do you feel I should give that would enhance your quality of life?” It was very interesting, as they all gave the same three responses: how to self-manage lymphoedema, how to gain more strength and mobility in their arm, shoulder and breast area, and how to choose a bra and prosthesis to wear after a mastectomy. So my advice is as follows…

10 ways to manage your lymph system by kick-starting it:

• Deep diaphragmatic/tummy breathing.

• Drinking eight glasses of water a day.

• Ensuring your tummy works, at least daily.

• Exercising the affected limb.

• Swimming.

• Yoga.

• Dry brushing/self-manual massage.

• Rebounding (bouncing on a mini trampoline).

• Walking.

• Following a sodium-free diet.

10 ways to strengthen your arm, shoulder and breast area (Note – do as many as you’re comfortable doing):

• Lie flat on your back with your hands behind your head, elbows out. Bend your knees with your feet flat on the ground. Rotate your knees alternately to opposite sides. You should feel your arm, underarm and trunk stretch.

• Sit with your hands behind your head and your elbows to the side. Keeping your elbows back, side flex to alternate sides.

• Sit as above, keeping your elbows back. Rotate your trunk from side to side.

• Stand with your back against the wall. Clasp your hands together. Raise your arms to touch the wall behind you. Do not arch your back.

• Stand and stretch your arms up and back as far as you can reach, keeping your elbows straight. Flex your wrists backwards. You should feel a sensation up into your hands.

• Sit and clasp your hands together behind your back. Straighten your elbows and sweep your hands far down and backwards, without arching your back. You will feel it in the pectoral area into your arms.

• Starting with a 500g dumbbell, stand against the wall with your arms on your sides and thumbs facing upwards. Lift your arms up to the sides at a 45-degree angle between your front and side and gently lower them. Tuck your shoulder blades down and in, during the exercise.

• Stand against the wall, holding 500g dumbbells in your hands. With your palms facing frontwards perform a biceps curl. When you lower your arms twist your palms to face the wall to work your triceps.

• Sitting with the weight in your hands, keep your elbows at your waist bent to 90-degrees. Slowly rotate your forearms out to the side and bring them back to the front again.

• Hold a TheraBand resistance band in both hands and perform marching arm movements.

10 things to consider when purchasing a good fitting bra and/or prosthesis:

• Only consult with and purchase from a fully qualified, accredited supplier of bras and prostheses.

• Only purchase a bra that is manufactured for patients who have undergone treatment for breast cancer.

• If you wear a prosthesis, ensure that the bra cup has a pocket into which it can be placed.

• Ensure that the cup size fits the larger of the two breasts. The smaller breast cup may be filled with a silicone prosthesis.

• If you have large breasts, ensure the shoulder strap is wider as not to dig into your shoulders.

• Ensure that the cup size is not too small, digging into your breast resulting in pain and oedema.

• Ensure that the bra, on the side of your body, fits high under the armpit.

• Purchase a lighter prosthesis, if you have had a bilateral mastectomy or if it is a large size.

• Do not wear an underwire bra.

• Do not wear your prosthesis for six weeks after surgery or post radiation therapy.

Written by Sue Serebro.

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