Brandy Mckeown, CEO of the International Lymphedema and Wound Training Institute, is a Certified Lymphedema Therapist and Training Instructor. She is nationally recognized as an expert in the field of lymphedema. She shares her expertise with us this month by outlining how to manage and reduce fibrosis.
Lymphedema is the accumulation of protein rich fluid in the tissues. As this protein rich fluid in the tissues become more concentrated, it can cause varying degrees of fibrosis (thickening of the tissues). The longer the lymphedema goes unmanaged the more fibrotic the tissues become. Excess diuretics (water pills) can also increase fibrosis. Diuretics pull some of the fluid from the tissues but leave the proteins behind thus causing increased fibrosis.
How do we manage and reduce fibrosis?
If you have not already had a full course of lymphedema treatment with Complete Decongestive Therapy (CDT), then your first step in reducing fibrosis is to find a certified therapist. After that, consider the following:
- Talk with your physician to limit or eliminate diuretics. Some diuretics are necessary for controlling other medical issues, so be sure to discuss with your physician prior to decreasing or discontinuing.
- Be sure to stay hydrated. Water naturally helps to flush this thick fluid out of our bodies.
- Limit excessive salt intake to help reduce swelling. Salt holds onto excess fluid in the tissues and can cause an increase in swelling and fibrosis.
- You do not need to limit protein, as this does not affect the protein in the tissues.
- Elevate your arm or leg when sitting and in bed (for leg elevation in bed, place a comforter or pillow between your mattress and box spring at the very foot of your bed, creating an approximate 6-inch elevation. This way you can flip, flop and turn in bed, without having to reposition pillows all night).
- Fibrotic tissue has a high tendency for significant skin changes, therefore be sure to use a properly pH balanced soap (such as Dove) and moisturizer (such as Lubriderm or Eucerin) to help prevent infections.
- Wear your compression garments daily. If your garments are older than six months, they likely need replacing. Flat knit compression garments help contain and reduce fibrosis formation much better than circular knit garments.
- Nighttime garments with channeling and foam work well to soften and break up fibrosis.
- Use a compression pump daily will help to soften fibrotic tissue. If you do not have a pump, be sure to complete self-manual lymphatic drainage daily. You also can “knead” the more fibrotic tissues to help soften them.
If you’re experiencing fibrosis, look into Juzo’s selection of flat knit garments, along with Juzo Night, our new lightweight garment that helps prevent edema from rebounding during sleep.