Monthly Archives: February 2021

Getting Lymphedema Under Control

Getting Lymphedema Under Control

By James Perry

(Picture of lymphedema, 2018)

Lymphedema can be a very destressing and disabling disorder which can impact so many different areas of your life. Unfortunately, many people diagnosed with lymphedema, often do not recognize they have the disorder until it is too late. This CDC video by (Lymphatic Education Research Network, 2019) staring Kathy Bates goes into detail on the causes and symptoms of the disorder.

The excess swelling, caused by lymphedema, can make the affected limb more painful, or harder to move. The swelling can also prevent you from wearing your favorite clothing, or make you feel embarrassed about the appearance of the affected limb.  These consequences of the symptoms make many of those diagnosed with the disorder feel trapped. This often leads to decreased participation in your favorite activities. Others diagnosed with lymphedema share these same experiences, and it is important to recognize that you are not alone. 

Increased research has begun over the past years into the topic of lymphedema management, and the good news is the symptoms are manageable. There is no cure for it, but simple lifestyle changes can have a major impact on the swelling. Getting your symptoms back under control is the first step in getting rid of that trapped feeling you may be experiencing. Changes you can make such as diet adjustments, performing daily exercises, and improved skin care can help you get these symptoms back under control.

Dietary Changes

Your diet has a major role to play when it comes to the swelling you experience. Simple changes supported by a study conducted by (Cavezzi et al., 2019) you can make to your diet can help you reduce the swelling from your lymphedema. They found that your diet should contain:

  • More fruits, vegetables, fermented foods, garlic, extra virgin olive oil, nuts, and fish.
  • you should eat foods rich with nutraceuticals, coumarin, and curcumin, such a turmeric.
  • Intermittent fasting, which occurs for a twenty-four-hour period once or twice a week.
  • You should decrease the amount of fat, and calories in your diet.

They found you should avoid:

  • Avoid highly processed carbs,
  • excess sugar and salt consumption,
  • and diets high in omega 6 or 9 fatty acids.

Making these changes can help reduce the swelling in your effected limb.

Exercise Routines

Remember: it is important for you to consult a physician first before attempting to exercise, as all exercises need to be completed with a compression sleeve on your effected limb. Your physician will help provide you with the one that works best for your limb.  

Exercise plays an important role in the management of your swelling. The contractions of your muscles help to push the lymph fluid out of the extremity and can help decrease the swelling in your limb. The movement of the limb is the most important piece when managing your swelling. A study conducted by (Comrie et al., 2016) assessed if the intensity of a workout had any effect on decreasing the swelling in the affected limb. They found that there was no difference in reduction in the swelling between those who had a light work out or a vigorous workout. So, if you keep your affected limb active you should expect to see the swelling decrease. Check out this video from (Fox 2 St.Louis, 2019) demonstrating the benefits of exercises on lymphedema management.

  • Please note lymphedema will not kill you. But it is very important to perform proper skin care for the reasons listed below.

Skin Care

Taking care of your skin is crucial to your health and wellbeing with lymphedema. The increased swelling causes the skin to thicken and can cause your skin to develop folds. If left unchecked these folds can breed bacteria which can lead to infections. Jones (et al, 2019) conducted a study assessing the importance of skin care with lymphedema management. They found that it is important for those diagnosed with lymphedema to perform daily skin checks to ensure their skin is not worsening. They suggest finding a doctor and remaining in close contact with them is key to manage symptoms. Explaining your situation to your doctor provides them the personal information they need to best serve you. It may be difficult at first but try to be as open with your doctor to help get the best treatment for your swelling as possible. Below is a video from (Atlas Therapy Group, 2019) going into further detail on the importance of skin care. 

In conclusion, remember that Lymphedema is a challenging disorder experienced by many. You will go through of a rollercoaster of emotions while managing the symptoms and this is perfectly normal. If you keep in mind these methods for managing your symptoms, your journey through managing your symptom should be a little easier.

 

References

Atlas Therapy Group. (2019). Skin Checks for Lymphedema [YouTube Video]. In YouTube. https://www.youtube.com/watch?v=z8Lsxgf73NA&ab_channel=AtlasTherapyGroup

Cavezzi, A., Urso, S. U., Ambrosini, L., Croci, S., Campana, F., & Mosti, G. (2019). Lymphedema and nutrition: A review. Veins and Lymphatics, 8(1).             https://doi.org/10.4081/vl.2019.8220

Cormie, P., Singh, B., Hayes, S., Peake, J. M., Galvão, D. A., Taaffe, D. R., Spry, N., Nosaka, K., Cornish, B., Schmitz, K. H., & Newton, R. U. (2016). Acute inflammatory response to low-, moderate-, and high-load resistance exercise in women with breast cancer– related lymphedema. Integrative Cancer Therapies, 15(3), 308–317.          https://doi.org/10.1177/1534735415617283

Fox 2 St.Louis. (2019). Woman with lymphedema goes from beauty queen to hiding from the public [YouTube Video]. In YouTube. https://www.youtube.com/watch?v=_UwQbS2gOLA&ab_channel=FOX2St.Louis

Jones, A., Woods, M., & Malhotra, K. (2019). Critical examination of skin care self-management in lymphoedema. British Journal of Community Nursing, 24(Sup10), S6–S10.           https://doi.org/10.12968/bjcn.2019.24.sup10.s6

Lymphatic Education Research Network. (2019). CDC – Kathy Bates and Lymphedema [YouTube Video]. In YouTube. https://www.youtube.com/watch?v=auK7IcOI_v8&ab_channel=LymphaticEducation%26ResearchNetwork%28LE%26RN%29

Picture of lymphedema. (2018). Lymphedema: how to care and manage? https://dattmedi.com/blog/lymphedema-how-to-care-and-manage/

Let’s Make Your Bathroom Safer!

Getting older in life is a process and this process can come with obstacles that can affect the way we live our life.  The bathroom is a place we use daily and sometimes we may take for granted that something bad could potentially happen.  Falls are the most common way for someone to injure themselves in the bathroom and by performing a safety assessment, it is possible to find ways to modify this environment for a safer experience.

As a practicing Occupational Therapy Assistant, I have seen first hand the benefit that a raised commode and grab bars provide with reducing a fall.  Grab bars can easily be installed into the walls and a commode can be placed safely over most toilets.  This gives the person more support and stability when getting on and off the toilet. The Center for Disease Control also advocates that modifying the bathroom with grab bars and non skid mats can help to reduce your fall risk (CDC, 2020).  The links to the CDC website and Home Fall Checklist can be accessed below.  Once completing the home check list ask yourself, what can I do to make my bathroom environment safer?

Keep on Your Feet—Preventing Older Adult Falls | CDC

Check For Safety A Home Fall Prevention Checklist For Older Adults (cdc.gov)

It’s also important to assess the shower for safety since we have all heard the term “falling in the shower”.  Grab bars can easily be added and the use of a shower chair or tub bench can greatly reduce the risk of a fall.  Depending on the person having a place to sit during the shower has also been shown to decrease the risks of a fall.  Non skid mats can also be incorporated where appropriate to provided an even greater safety experience.

The following media clip below is a YouTube video demonstrating some of the features that bathroom safety equipment can provide as well as various ways to organize the bathroom to maximize the safety potential.  The second video is a simulated conversation between a mother and daughter explaining the products and explaining their safety benefits.

http://http://https//www.youtube.com/watch?v=gTWv6hOmRak&feature=emb_logo

 Bathroom Safety for Elderly: Protect A Loved One Before A Bathroom Fall Occurs – YouTube

By the end of reading this post I hope you have gained an understanding into the benefits of a simple bathroom safety assessment.  It could be the smallest change that can produce the greatest reward, living a healthy and functional lifestyle.

CDC, C. (2020, December 16). Keep on your feet-preventing older adult falls. Retrieved February 22, 2021, from https://www.cdc.gov/injury/features/older-adult-falls/index.htm

Elizz, E. (2021). Retrieved 2021, from https://www.youtube.com/watch?v=gTWv6hOmRak&feature=emb_logo

Turkey leading country in elderly CARE: Expert – Turkey news. (n.d.). Retrieved February 22, 2021, from https://www.hurriyetdailynews.com/turkey-leading-country-in-elderly-care-expert-147252

Wingler, W. (2017, August 24). Top 5 things to consider when designing an accessible bathroom for wheelchair users. Retrieved February 22, 2021, from https://www.eastersealstech.com/2014/06/11/top-5-things-consider-designing-accessible-bathroom-wheelchair-users/

Is the COVID vaccine safe, and should you get it?

Over the last couple of months many have stated their desire for vaccination, while still others condemn it and vilify it as poison. Yet as the debate rages on, many are still lining up and most of those are front-line workers.Ages 65 and older are now being added to those eligible to receive the vaccine. So what is fact and what is fiction in regards to the vaccine? And what can you do to help yourself through the immune response that comes with vaccination?

The Role of the Media

Much of the country watches the news on a daily basis. To this end, to keep up on the daily happenings, but also on daily infection rates and vaccine information. What is critical is that the media not sensationalize adverse events, and to report the facts versus opinions. Many people rely on the news for their information, and not picking apart the accuracy of the information being provided and whom may be providing it via these forums. Let’s take a look at some of the links to information on the safety of the COVID-19 vaccines currently available. 

https://www.youtube.com/watch?v=eK0C5tFHze8

 

https://www.youtube.com/watch?v=eZvsqBCvB00

 

https://www.youtube.com/watch?v=4479JRBmQtA

What is a normal immune response?

  • Arm soreness
  • Body aches
  • Fever
  • Flu-like symptoms

How long should this last?

  • A day or so
  • No longer than a handful of days

As a resident who is 65 or older receiving the vaccine, what should I expect?

Vaccines are especially important for older adults. As you get older, your immune system weakens and it can be more difficult to fight off infections. You’re more likely to get diseases like the flu, pneumonia, and shingles — and to have complications that can lead to long-term illness, hospitalization, and even death.

If you have an ongoing health condition — like diabetes or heart disease — getting vaccinated is especially important. Vaccines can protect you from serious diseases (and related complications) so you can stay healthy as you age.

What can you do to lessen your immune response? 

  • Tylenol
  • Ibuprofen
  • Ice packs for injection site
  • Fluids
  • Rest
  • Swim in the ocean (depending on your location)

How can you lessen the fear of media sensationalism?

  • Deep breathing
  • Meditation
  • Talk to your doctor
  • Consult valid medical websites such as CDC.gov, WHO.org
  • Safe vaccination from over the years
  • Keeping in mind the safety of your family and friends and yourself
  • Protecting yourself with any pre-existing conditions
  • Speak with your doctor about any possible medication interactions
  • Consult your physician if you are immunocompromised

Should we really be changing out IV lines?

 

                                                         

What have we always been taught? That IV catheters need to be replaced within a certain time frame to avoid catheter related infections? Has anyone ever thought about the idea of leaving them in longer than the normal 48-96 hour deadline? According to the patient safety network there is no found evidence that catheters that stay in for 72 hours compared to 96 hours pose any increase chance of infection. In my opinion I feel that intravenous catheters should be kept in until they no longer function. At my place of employment we have a 3 day rule for intravenous catheters, then they have to be removed.

However, if a patients’ IV is still functioning properly, free from signs of phlebitis and infiltration then why increase the potential risk of infection by sticking someone again when their IV works perfectly fine. I have seen IV’s left in patients for a week and function just as well as a one day old IV.

One may ask where is this coming from? Why is she asking this question? Well you see we as nurses can propose change, we as nurses can change policy with our voices. If we don’t propose these questions then no one will explore new ideas. Don’t believe me?  Explore the topic for yourself!

 

References

https://psnet.ahrq.gov/web-mm/peripheral-iv-too-long