Hello
In last week’s post we looked at what lymphoedema is and why it can happen following treatment for ovarian cancer. Today we’ll start to look more closely at how lymphoedema is managed.
As we said in the last post, lymphoedema develops when the lymph fluid can’t move freely through the lymphatic vessels so it starts to leak into the surrounding tissues causing swelling. The aim of most lymphoedema management is to help the lymph to circulate.
One of the main ways of doing this is compressing the affected area using bandages or a special garment like a sleeve or a stocking. This applies even pressure and helps to reduce swelling. It also helps the lymph to move to an area that’s draining well and supports the muscles to move the lymph through the vessels.
As people with ovarian cancer most often experience lymphoedema in the leg, we will focus on compression stockings in this post.
Compression stockings will be fitted for you by your lymphoedema specialist to make sure that they’re the right size and apply the right amount of pressure. You will usually be given two stockings, so that you can wear one while the other is in the wash.
Depending on where you live, you may be given both at once or, for example, get one from your specialist and have the other prescribed by your GP. At first your specialist will measure you every few months, as the amount of swelling may change.
Once your leg has reached a stable size, you can get the stockings from your GP on repeat prescription. If your leg changes size because of swelling or weight loss or gain, you should be measured again to make sure your stocking is the right size for you.
The stockings should be replaced about every three to six months, as they lose their elasticity and don’t apply even pressure any more. You should aim to wear both stockings equally, so that one doesn’t wear out more quickly than the other.
You can wash them by hand or with mild laundry detergent at 40 degrees or lower and dry them flat and away from direct heat. Your garment will have washing instructions.
You should wear your stocking all day, especially when you’re moving around or exercising, and take it off at night. If you find it uncomfortable at first, you can start by wearing it for a few hours each day and build up the time over a few days. It’s best to put it on in the morning, when your leg is at its smallest. Wait until your skin is dry after washing or moisturising, as this will make the stocking easier to put on.
Your lymphoedema therapist will show you how to put on and take off your stocking. You can roll up the stocking or turn it inside out as far as the knee or ankle, pull it over your foot up to the ankle or knee and then unfold it up to the top of your leg.
You should unroll it a little at a time rather than pulling from the top of the stocking. Some people find it helpful to use some unperfumed talc or wear a rubber glove to help with putting on the stocking. You may also be able to get an applicator.
It’s important that the stocking doesn’t have any wrinkles or loose areas, so make sure that it’s fitted smoothly and don’t turn the top over. After removing the stocking at night, it’s a good idea to use some moisturiser to help keep your skin healthy.
The stocking should be comfortable to wear and not restrict your movement. If you develop pain, pins and needles, numbness or a change of colour in your toes, your garment may be too tight and you should remove it and contact your lymphoedema specialist straight away.
Compression garments must only be used on healthy skin. If your skin is fragile or damaged, if lymph fluid is leaking through the skin or if you have cellulitis (an infection of the skin), you should not wear your garment and contact your lymphoedema specialist for advice.
Compression garments may be uncomfortable to wear in hot weather. Some manufacturers make special garments designed for use in warmer weather. You can also put your garment in the fridge to cool down before you put it on and spray cool water on it during the day. Your lymphoedema specialist will be able to advise you on other options if you’re still finding hot weather uncomfortable.
If your lymphoedema is severe or has caused your leg to change shape, or if your skin is damaged or fragile, you may need treatment before you can have a stocking. In that case, your lymphoedema specialist may start by bandaging your leg in layers that put pressure where it’s needed to reduce the swelling. Bandaging is often combined with massage to drain the fluid and exercises that your specialist will teach you to do at home.
Usually this treatment is given every day or two by a specialist in clinic over a period of about three weeks. The specialist will remove the bandages, give the massage treatment then reapply the bandages. At the end of treatment, you may be able to have a compression stocking.
You can shower and bathe at home but will need to keep the bandages dry. You may also not be insured to drive with the bandages on, so it’s important to check with your car insurer if you’re planning to drive during your therapy.
You can find more information about compression garments and bandaging at:
macmillan.org.uk/cancer-inf...
royalmarsden.nhs.uk/your-ca...
about-cancer.cancerresearch...
If you would like to share your experiences of compression therapy or have any tips on it, please comment on this post. If you would like information or support, please contact our Support Line on 0800 008 7054 or email support@ovacome.org.uk.
Best wishes
Julia (Support Services Officer)
In hospice now
