What is the importance of gradient?
Sequential pumps with calibrated gradient pressure have proven to be the best devices for reducing the amount of excess lymphatic fluid in a limb in a comfortable and efficient manner. These pumps function in much the same manner as the body does when it utilizes its own “muscle pump.” The body uses various muscle groups to move the lymphatic fluid through the channels.
How often and for how long should I use the pump?
Most patients will begin using the pump 3 times a day for 45-60 minutes. Their long-term goal is to get on a maintenance schedule of using the compression pump every other day. How long that takes varies from patient to patient and how severe and what their condition is. Do not stop using the pump altogether, as lymphedema is not curable and will never completely go away. Every patient is different and their long- term, daily treatment plan, which ensures pain and swelling stays controlled, is individual to them.. No major changes in therapy should be made without authorization from the patient’s physician.
What is the application of the pump for treating ulcers and open wounds?
The pump can be used on patients with venous ulcers and/or open wounds as long as there are no signs of an untreated infection/cellulitis. If you have cellulitis you can use the pump once antibiotics have been administered for at least 72 hours. Signs and symptoms for infection are an abnormal sensation of heat in extremity, a rash, red streaks, pain or fever. If one or more of these symptoms occur while you are under compression therapy treatment, discontinue your treatment and contact your physician. Wounds must be covered with the appropriate dressings and it is recommended that daily dressing changes be ordered. You should clean and change your dressing immediately following your treatment with the pump. Wounds will drain significantly during pump therapy; this is normal.
How important is awareness and hygiene for lymphedema patients?
The patient must be taught meticulous skin care, especially with the edematous limb. Because of the increased fluid levels under the skin, the skin is much more susceptible to rips and tears than is non-edematous skin. Any breakdown in the integrity of the skin results in susceptibility to bacteria, infection, and cellulitis, the most serious of complications facing the patient. Teach the patient to treat all cuts, burns and bruises, hangnails, ingrown toenails, ingrown hairs, razor rashes, blisters, scrapes, mosquito bites, etc., as potential sites for infection.
Should the patient notice any signs or symptoms of infection or cellulitis they should contact their doctor immediately. Delay in treatment will enable the infection to spread to other areas throughout the body.
Take care of your affected limb. Do your best to prevent complications in your arm or leg. Clean your skin daily, looking over every inch of your affected limb for signs of trouble, such as cracks and cuts. Apply lotion to prevent dry skin.
Take care of your whole body.Eat a diet rich in fruits and vegetables. Exercise daily, if you can. Reduce stress. Try to get enough sleep. Taking care of your body gives you more energy and encourages healing.
Can the pump be used by pregnant women?
Some pregnant women will develop lymphedema lasting the entire term of their pregnancy, but which disappears when the baby is born. However, others can continue to have a problem with edema even after delivery. The patient should wear compression pantyhose and elevate their limbs as often as possible. Using a pump during pregnancy presents no adverse effects. The pressures for the pump are set according to the protocols used for primary lymphedema.
What is manual lymphatic drainage?
Manual lymphatic drainage is designed to reroute the lymphatic system, switching drainage to the blood vessels rather than through the lymph nodes. It generally takes 21 days of daily treatment to establish successful drainage. Once the patient is discharged from manual lymphatic drainage therapy, pump therapy is used to encourage fluid to keep moving through the new channels developed through MLD.
Can a patient still receive a pump if they have CHF (congestive heart failure)?
Active CHF is a contraindication for a compression pump. However, some doctors will prescribe compression therapy for a patient with a history of CHF when the disease is not in an active state. The physician should be asked whether the patient’s CHF is well controlled. If the condition is well controlled, compression therapy is beneficial. Remember to have the patient in a sitting position while using the compression therapy pump. Teach the patient to monitor him- or herself for any problems, including shortness of breath or chest pain. Should they experience any of these symptoms they should immediately stop their therapy and contact their physician.
Can a patient with a DVT (deep vein thrombosis) receive a pump?
A patient with an active DVT is not an appropriate candidate for a compression pump. However, if the patient has had a DVT and it is resolved, they are a candidate for a compression pump. DVTs are often prevented with the use of compression therapy. It is always a good idea to make the physician aware that an active DVT is a contraindication. Request a copy of the last Doppler (within six months) for your records.
There has also been some question about using compression therapy with patients who have a history of DVTs and who have filters. These patients are also candidates for compression therapy, with the same conditions as stated above and with lower compression used during therapy. The only difference would be the physician will generally use less compression for treatment. Teach the patient the signs and symptoms of an active DVT. If it hurts, something is wrong. Stop and contact your physician.
Can a patient use a pump over a multi-layer bandage system?
Yes, a patient can use a pump over a multi-layer bandage system. but pressure must be set lower.
Can I reduce the risk of getting Lymphedema?
If you’ve recently had, or are going to have surgery, ask your doctor if your procedure will involve your lymph nodes/vessels so you’ll be aware of the possible lymphedema risks. To reduce those risks, do the following:
Protect your arm or leg. Avoid injury to your affected limb. Cuts, scrapes and burns can invite infection. Protect yourself from sharp objects. For example, shave with an electric razor, wear gloves when you garden or cook, and use a thimble when you sew. Wear sunscreen. If possible, avoid medical procedures, such as blood draws and vaccinations, in your affected limb.
Rest your arm or leg while recovering. After cancer treatment, exercise and stretching are encouraged. But avoid strenuous activity until you’ve recovered from surgery or radiation.
Avoid heat on your arm or leg. Don’t apply ice or heat, such as with a heating pad, to your affected limb. Also, protect your affected limb from extreme cold.
Elevate your arm/ leg. Whenever possible, elevate your affected limb above the level of your heart.
Don’t wear tight clothing. Avoid anything that could constrict your arm or leg, such as tight fitting clothing and, in the case of your arm, blood pressure cuffs. Ask that your blood pressure be taken in your other arm.
Keep your arm or leg clean. Make skin and nail care high priorities. Inspect the skin on your arm or leg daily, watching for changes or breaks in your skin that could lead to infection. Don’t go barefoot.