Monday, February 13, 2017

Chapter 16 - Bandaging and Other Particulars

Bandaging and Other Particulars


The initial management of my swollen limb involved compression in the form of bandaging.  This was to decrease the amount of swelling at a time when it is treatable.  Compression bandaging is often the first mode of active treatment.

Bandaging is significantly more complicated than a garment.  Layers of gauze, foam and overlapping lengths of stretch bandages are arranged to ‘push’ the fluids of the limb’s lymphatic system in an upward fashion to the lymph nodes.  The tightness has to be graduated – so that there is no restrictions and fluid gathering.  The smoothness matters as well, because any deviance can create pressure pain.  

My bandaging period lasted four months during which time I was actively losing weight, getting my blood pressure under control and adjusting to my modified life.  My spouse learnt the methods of bandaging and so we were able to treat my arm in a consistent and effective manner.  Once a day, every day we unwrapped and reapplied the treatment bandages, following the pages of instructions to do so.  Then I wore that for the next 23.5 hours.  We got good at it, but I was grateful beyond belief when I didn’t need to bandage any longer.  (I do keep all supplies on hand, as quick response treatment, and have used the full kit during a flare up caused by air travel.)

Without someone to be my bandager, my other alternative would have been to endure five hour round trips to the physio department.  That much travel time with the factors of heat, seat belt restrictions and general immobility would have been problematic for my lymphedema.  Or I could have learnt to bandage myself, but that certainly isn’t factoring in my pain level and mobility issues at the time. 

I know people who bandage for sleeping, then use a custom sized and heavier tension garment for day wear.  That is normal for them.  There are air-assisted lymphatic pressure units that are a vital tool to help some lymphedema patients manage their condition.  And some people have to receive lymphatic massage treatments regularly. 

I’ve talked about being a newly diagnosed lymphedema patient with a one in a thousand level of pain.  I believed that would be my normal status, but it was not.  However, I thought I should share what my lymphedema feels like now.  First off, there is always something going on with my arm.  A tingle, or an ache or a ripple sensation or something.  Where?  You might ask.  This is totally random as well; first it will be located in my hand or my armpit or almost all of my upper arm and into my shoulder and neck region.  It’s quite interesting, if I care to look at it that way, but it can disturb my sleep and tires me emotionally as well. 

Pain is designed to make your mind pay attention to your body’s needs.  It’s a real challenge to know what my body is saying.  Have I strained muscles or is this the lymphedema?  Am I retaining more fluid or do I need to stretch more?    

I have learned that my lymphatic self-massage will fire up the sensations, so now I do that first thing in the morning, rather than just before bed.  I need to do my stretches daily, or my sleep will be disturbed by tension in the armpit and shoulder region.  This is a moving target, but I aim to do my best.  The sensations are what they are, but they definitely remind me to keep my routine.





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