“You’ve saved my life.”

 Sue Cox doesn’t know how many times patients have said that to her, but she never gets tired of hearing it. The certified lymphatic therapist, who is president of Cancer Rehabilitation Specialists Lymphatic and Venous Disorders, Inc., said lymphedema is both manageable and preventable.

Lymphedema is an obstruction of the lymph nodes, blocking drainage so fluids cannot move freely through the body. The risk for breast cancer patients developing lymphedema is between 20-40%, depending on whether they have had radiation and how many lymph nodes were removed.

“As many as half of breast cancer patients are unaware of this,” said Cox. “That’s why education is so important. This is a chronic, lifelong risk for some breast cancer patients. Once we have educated a patient, I can’t think of one that has come back here for treatment. Education is truly prevention.”

Many patients are afraid to move their arms after surgery, and Cox said that is a mistake.  

“I am a huge advocate of physical activity,” she said. “I’ve had patients walk around for years, holding their arm up to their shoulder, because they were afraid movement will result in lymphedema. It’s just the opposite.”

If you’ve ever attended a ball game in the hot summer sun, you can understand lymphedema. Have your feet been swollen when you stood up for the seventh inning stretch? That’s because your bodily fluids were not circulating properly. Getting up and moving around helps.

The main symptom of lymphedema is persistent, painful swelling, usually of the arm. Treatments include exercises, compression and manual lymph drainage in the form of massage.

“We re-direct the fluid and send it toward the armpit on the opposite side,” Cox said. “The body is really smart, so it quickly understands this alternate way to drain. Repetitive massage changes the flow. This is nice for patients, because it’s about the only massage insurance companies will pay for.”

Often, Cox and her staff are the first people to actually touch a patient’s chest after surgery. It’s an emotional time, but even patients who arrive near tears leave with a huge sense of relief- and smiles on their faces.

 Comprehensive decongestive therapy, or compression, involves stiff bandages that force fluid back into the lymphatic vessels. Patients are taught to apply these bandages daily, and the swelling begins to go down almost immediately. Relief can be felt as soon as the bandages are applied.

Exercise is important, especially while bandages are in place.

“That muscle pumping against the bandage propels the fluid out of the arm,” said Cox. “But watch out for repetitive activity, like raking the yard or painting a room.”

Cox suggests switching it up. If you’re vacuuming, go through one room and then, rather than vacuuming the whole house, stop and dust. Then bring the vacuum to another room and clean there. If swelling develops, modify your exercise so it’s not so intense. Learn to listen to your body.

“Lymphedema is nothing more than a fluid transport problem,” said Cox. “It’s not something to be afraid of, it’s something to be aware of. Education can prevent it altogether.”