Lymphatic drainage massage of the hand after mastectomy. Gymnastics, massage and folk remedies for hand lymphostasis after mastectomy

According to statistics, lymphostasis of the upper extremities is diagnosed in more than 10% of the world's population, and the reason for this is a sedentary lifestyle, stress, surgery or injury, and an unhealthy lifestyle. Massage with lymphostasis of the hand helps to get rid of the disease and prevent further defects in the limbs. During the disease, there is swelling of the upper layers of the skin, the formation of ulcers. Healing procedures during lymphostasis include drug therapy, ongoing care, as well as gymnastics and massage.

Fundamental rules

The treatment process is aimed at getting rid of puffiness and returning the hand to its usual state. The speed and effectiveness of therapy depend on the time of seeking help and diagnosing lymphostasis, as well as on the stage of the disease. To get rid of the disease in a short time, use all the doctor's recommendations and the following tips:

• after diagnosis, give up fatty foods, resume proper nutrition, do physical exercises every day, start to sleep fully;
• to consolidate the theory, watch a video of massage for hand lymphostasis, which is performed by a specialist;
• before the massage, turn on light music, use special oils and creams, which will allow you to relax and make the procedure more productive;
• starting position during the massage - sitting, with straightened shoulders;
• do not put pressure on your hand and do not rub it during the massage procedure - the affected tissues during lymphostasis do not tolerate rough and intense actions;
• do not do difficult physical work the affected limb.

During illness, avoid all kinds of injuries, burns - you need to minimize infection and prevent lymphedema.

Technique

Gymnastics and massage exercises for hand lymphostasis can be performed by the patient himself or a family member at home. Before starting the procedure, be sure to consult with your doctor, carefully listen to all his recommendations. The duration of the session is 5-10 minutes. It is recommended to perform the procedure every 3-4 hours. Use in massage the following methods:

1. Prepare for a massage - stroke the affected arm over the entire surface.
2. Raise your affected arm up. Place it on a vertical surface. Continue to make stroking movements, gently massage your hand using rubbing movements. Do this on your fingers, gradually moving to the shoulder, then from the elbow to the shoulder.
3. Pay attention to all sides of the hand. Perform massage on the inside and outside of the limb. The movements should be gentle, soft, lightly press on the skin.
4. Lower your hand down, finish the procedure by stroking the whole hand.

During the procedure, the patient should not feel severe pain or discomfort. If they occur, stop and postpone the massage session.

Lymphostasis after mastectomy

Mastectomy is an operation to remove the breast. Distinguish between dense and soft shape illness. In the first case, edema is treatable and occurs in the first 12 months after surgery, dense lymphostasis is characterized by the presence of scars in the lymph nodes due to the appointment of a course radiotherapy. If you do not treat mild lymphostasis, it will smoothly flow into a dense form of disease development.

the main task when getting rid of the disease - restoration of the outflow of lymph. Treatment includes hand massage for lymphostasis after mastectomy, as well as therapeutic exercises - you can use all the exercises described above. Sessions should be started 7 days after the operation, it is necessary to perform massage at all stages of lymphostasis. It is quite difficult to do gymnastics for the first time after the operation: the body hurts, and the hands do not obey their master. But the sooner you start the procedure, the higher the likelihood of avoiding possible complications.

The main treatment after surgery is massage and physiotherapy. Drug treatment is used in case of ineffectiveness of the first methods. Physical exercises improve the outflow of lymph, increase tissue elasticity, and help get rid of muscle spasms. As an additional therapy, experts recommend visiting the pool and using a special compression sleeve.

Excessive physical activity for women who have undergone a mastectomy is prohibited. Be sure to distribute the load.

If you ignore the symptoms of the disease, swelling of damaged tissues and deformity of the fingers will occur. The hand will lose its shape, its movement will be disturbed. With each subsequent stage of the disease, lymphostasis becomes more and more dangerous, therefore, at the first detection of signs of the disease, you should immediately consult a doctor. The specialist will diagnose the disease, prescribe the correct drug treatment, as well as gymnastics and massage procedures for hand lymphostasis.

Self-massage for hand lymphostasis - video

Currently, the level of cancer is quite high. This can be explained various conditions: bad ecology, unhealthy lifestyle, a large number of chemical additives in food. Among all cancers, one of the leading places is occupied by women.

Unfortunately, it often happens that we seek help quite late, so we have to remove the breast, and this entails other problems, for example, lymphostasis of the hand after a mastectomy. It is with this disease that we will try to deal with our article.

What is lymphedema?

The operation to remove the mammary gland is carried out already in extreme cases, when doctors are sure that other methods of treatment will not give the desired effect. The most common complication after surgery is swelling. upper limb, which develops due to the appearance of lymphostasis.

If after the operation there is a violation of the outflow of lymphatic fluid, then they say that lymphostasis of the hand has developed after removal. In this case, an increase in the affected organ occurs. If such a problem is not eliminated, then the process spreads to neighboring tissues, microcirculation of blood and lymph is disturbed there. From such a state is not far from fibrosis and trophic ulcers.

If we add to this, and then sepsis is within easy reach. When, as a result of the operation, large lymph nodes are removed, the drainage function, which leads to swelling of the hand.

Reasons for the development of the disease

With lymphostasis, persistent edema is observed, which occurs due to a violation of the outflow of tissue fluid. If you have been diagnosed with lymphostasis of the hand, the reasons may be the following:

1. Operations with the removal of lymph nodes, which just include a mastectomy.
2. Erysipelas.
3. Chronic problems with the lymphatic and venous system.

Regardless of the cause, this disease requires immediate treatment to prevent serious complications from developing. There are times when it is completely removed The lymph nodes and muscle tissue, and lymphostasis does not develop, and in some, even with the slightest intervention, a severe complication begins.

Varieties of lymphostasis

Doctors distinguish several stages in the development of lymphostasis:

1. Early swelling.
2. Late.

The first variety usually develops immediately after the removal of the breast, as damage to the lymph nodes and leakage of lymph occurs. This swelling is also called soft.

Late lymphostasis of the hand after removal of the mammary gland can develop even after quite long time after operation. Most often, such complications affect women who were exposed to radiation before or after surgery. They can also be provoked by scarring processes, which prevents the restoration of normal lymphatic drainage.

You should not take measures to eliminate this problem on your own, you need to consult a doctor, because often late edema can signal a recurrence of an oncological disease. If this is not confirmed, then it is possible to begin treatment of lymphostasis of the hand after a mastectomy.

Diagnosis of the disease

Usually, after the operation, the woman will be in the hospital for about three more weeks under the supervision of doctors, so during the examination, the doctor can detect problems with the lymphatic system in time.

If the edema begins to develop at later stages, then you will also need to consult a gynecologist, who will definitely ask:

• What operation was carried out and how many there were.
• Were there any complications in early stages after breast removal.
• The time when lymphostasis of the hand appeared after the removal of the mammary gland.
• How the disease proceeds.
• What medications have you already taken.
• The presence of others chronic diseases such as hypertension, diabetes, heart disease.

Since it is not a gynecologist who should treat lymphostasis, he will recommend that you contact a specialist for an adequate solution to this problem.

Lymphostasis of the hand: symptoms

If the disease occurs in mild form, then we can note the appearance of swelling of the hand, which usually increases during the day, and disappears after a night's rest. May lead to an increase in edema exercise stress or, conversely, a long immobile position.

At this stage, irreversible changes in the connective tissue are completely absent, therefore, if you turn to a lymphologist in time, the prescribed treatment will allow you to get rid of this problem.

The average degree of the disease is characterized by edema that does not disappear after rest. In this case, the growth of connective tissue occurs, the skin is stretched and thickened, and pain can be felt. With persistent lymphostasis, fatigue and convulsions are observed.

If lymphostasis enters the last stage, which is considered severe, irreversible changes in the lymphatic system are already observed. Fibrocystic formations and elephantiasis can be observed. These changes lead to the fact that the contours of the hand change and its functioning is disrupted.

The most terrible is a serious complication of this period - sepsis, which can lead to death.

Treatment of lymphostasis

Therapy this disease includes two stages:

1. Ambulatory treatment. Assigned by a lymphologist. At this stage, the treatment of hand lymphostasis after mastectomy is reduced to the following procedures:

• Wearing special compression stockings.
• Hand massage.
• magnetic therapy.
• Medical treatment.
• laser therapy.
• Compliance with a certain diet.
• Physiotherapy.

2. Treatment surgically if hand lymphostasis in breast cancer could not be overcome conservative methods. Operation is also indicated in cases where the disease progresses rapidly.

Medical therapy

If lymphostasis of the hand develops, only a doctor should prescribe treatment. Along with all physiotherapeutic methods, drug therapy, at which they are prescribed:

• Angioprotectors.
• Phlebotics.
• Immunostimulants.
• Enzymes.
• Antibiotics, if attached erysipelas.

All of these groups of drugs in conjunction with the procedures make it possible to restore the normal outflow of lymph and strengthen the walls of blood vessels.

Therapeutic exercise for lymphostasis

Not only massage for hand lymphostasis will be effective, but also a complex exercise that your doctor recommends. All complexes are aimed at improving the outflow of lymph. You can start classes from 7-10 days after the operation.

After the woman feels some stiffness in her arm and shoulder girdle, from this she begins to stoop, press her hand to her body. This leads to additional problems in the form of headaches, spasms that disrupt the movement of lymphatic fluid.

Massage and physiotherapy exercises will help to avoid such consequences or get rid of them, if any. The effect will depend on the time when classes begin - the sooner the better.

You can perform the proposed exercises while sitting on the bed, straightening your shoulders. Repeat each exercise 4 to 10 times. Do not bring yourself to exhaustion, when unpleasant or pain need to rest.

1. Straighten your arms and put them on your knees, palms down. It is necessary to turn the brushes over, but without straining at the same time.
2. The position is the same, fingers alternately clenched into a fist and unclenched.
3. The arms should be bent at the elbows, while the palms lie on the shoulders. Slowly raise and lower your arms.
4. Lean in the direction where the operation was performed, lower your hand and make small movements back and forth with it.
5. It is necessary to raise the arm from the operated side up and hold it in this position for several seconds.
6. Inhale - raise your hand in front of you, hold your breath and take your hand to the side. Exhale - lower your hand.
7. Perform in the shoulder joint.
8. Interlace your fingers behind your back and straighten your arms. Try to raise your arms in this position.
9. Connect your hands behind your back in a “lock” and press them to your lower back.

Perform all exercises slowly, do not rush. In this case, it is not the speed of execution that matters, but the regularity.

Healing massage

Before a woman is discharged from the hospital, the doctor will definitely talk to her about the daily routine, the sets of exercises that need to be done, and also show and tell about the massage technique.

Folk healers against lymphostasis

Don't panic if you've been diagnosed with hand lymphedema after a mastectomy. Treatment with folk remedies in conjunction with other methods of therapy will give good results.

Primarily ethnoscience advises taking diuretic infusions and decoctions that will not contribute to fluid retention in the body. good effect gives a diuretic tea, here is the recipe for its preparation:

1. Collect, dry and chop blackcurrant leaves.
2. Combine them with the same amount of rose hips.
3. Brew 1 teaspoon of the mixture with 200 ml of boiling water.
4. Take before meals 4 times a day, 100 ml after the tea is infused.

If you ask from traditional healers about how to treat lymphostasis of the hand, they will give you a lot of recipes. Here are some of them:

If you combine folk recipes with physiotherapy, drug treatment, then you will be able to get rid of lymphostasis.

Diet for lymphedema

You should always monitor your weight, since extra pounds do not add health to us, and even more so if there are problems with the lymphatic system. Nutrition for hand lymphostasis should be rational and within reasonable limits, after all, we eat to live, and do not live to eat.

Any food can become a medicine, ancient philosophers spoke about this. You can give the following recommendations on the diet during lymphostasis:

• Reduce the amount of foods containing animal fats.
• Remove smoked meats, sausages from the diet.
• Increase consumption of fresh vegetables and fruits.
• Do not give up whole grains in the form of cereals.
• The diet should include dairy products.
• Butter is not recommended to be completely excluded, but replace most of it with vegetable oil.
• Food should be boiled, stewed, not fried.
• In addition, you can add a multivitamin.

It is necessary to get up from the table with a slight feeling of hunger. This will not only have a good effect on your health, but will also give you more strength.

Particular attention should be paid to the amount of liquid that you consume during the day. It should not exceed 1.5 liters per day. It is advisable to drink this amount before 16-17 hours. Before going to bed, it is better not to drink liquid, if you want, you can afford a glass of kefir or fruit.

when ill

After any operation, a person needs to be restored, but there is no need to talk about breast removal. This is not only a physical injury, but also a great psychological stress for any woman.

First of all, in order to recover faster after the operation, and even more so if you have lymphostasis of the arm after removal of the mammary gland, a special role is given to the daily routine. The body needs rest to recover, so night sleep should be at least 7-8 hours. Do not sit up in front of the TV until midnight, it is advisable to go to bed at 22.00 or 22.30.

To sleep soundly and healthy, you need to take a warm shower, Special attention giving water massage to sore spots. Many doctors do not recommend taking a bath. For a sore arm, you can prepare a second, higher pillow if you have lymphostasis of the arm. The photo just shows that this position is more convenient.

While there are problems with the lymphatic system, it is not recommended to sleep on the affected side, especially putting your hand under your head. After waking up in the morning, you need to pay attention to the morning toilet, a little exercise and take a light breakfast.

If you do not need to rush to work, then you can take a walk in the park. At home, you can remove the bra with a prosthesis so that the body rests. Recommended during the day daytime sleep, it will help to quickly restore your strength after the operation.

Many women almost immediately after returning from the hospital rush into battle and begin to put things in order, wash, clean. This is strictly forbidden, your household must take this into account, and they will have to take on most of the worries if they want to see their mother and wife healthy.

After a mastectomy, the body will take a long time to restore its lymphatic system. How successful this is can be judged by the presence of edema on the arm. A ring on the finger can be a good indicator: if it is put on as easily as it was before the operation, then everything is going well.

For those who have a personal plot or their own house with a plot of land, the amount of work there should also be significantly reduced. If this cannot be avoided, then prepare a bench for work. As soon as you feel a little tired, you need to rest.

Do not forget not only about the area of ​​operation, but also about healthy breasts. Try to avoid injuries, shocks, especially in crowded vehicles.

How to prevent the development of lymphostasis

If you could not avoid such a diagnosis as hand lymphostasis, treatment will still be needed to prevent more serious complications. But you can take some measures to minimize the risk of such a disease or prevent it altogether:

• Things with tight elastic bands and cuffs should be removed from your wardrobe in order to prevent squeezing of the lymphatic and blood vessels.
• Use your healthy hand for physical labor, carrying bags, and so on.
• To measure blood pressure necessary on a healthy hand.
• Try to exercise every day.
• As soon as you notice some changes in the hand, whether it be redness, swelling, pain, you should immediately consult a doctor.
• In the first year after the operation, you can lift no more than 1 kg with your hand from the side of the removed breast.
• Do not allow work that requires you to stand for a long time with your torso bent forward and your arms down.
• The hand must be protected from all injuries and damage, even injections should not be done into it.
• Sleep on your back or healthy side.

Lymphostasis is pathological condition characterized by stubborn swelling. It appears with stagnation of the outflow of lymph (tissue fluid). One of the most common causes pathologies are surgical operations. There are several stages of the disease, all of which have certain characteristics.

Lymphostasis may appear after irradiation with cancerous tumors mammary gland, after surgery, when damage occurred lymphatic system, in the presence of benign and malignant tumors of the lymphatic system.

Lymphostasis of the hand, which arose after the removal of the mammary gland

This operation is called a mastectomy. Execute it if available. malignant tumor in the breast (breast cancer).

During surgical intervention can remove the lymph nodes under the arm, which will lead to lymphostasis. A similar situation appears during irradiation.

Persistent and strong swelling of the limb occurs as a result of violations of the outflow of lymph (damage to the drainage and the lymph nodes themselves).

When the edema subsides a few months after the operation, it means that post-mastectomy lymphostasis has taken place. Otherwise, they talk about lymphedema.

This pathology does not appear in the distance in all women who have undergone breast removal, but if it occurs, it can remain for life.

The danger of this violation lies in the fact that deformation of the hand can occur. In addition, this condition is often accompanied inflammatory processes. Lymphosis causes both physical and psychological discomfort.

If lymphostasis appeared in the first year after the operation, then it is perfectly treatable. As usual, the swelling is mild, but causes aching, bursting pain. Timely treatment of lymphostasis will allow you to quickly get rid of discomfort.

Why does lymphostasis occur after breast removal?

Mastectomy involves the removal of not only the gland, but also the lymphatic vessels that fed it. This process provokes a malfunction in the functioning of the body. Removal of lymph nodes is a necessary measure, because there is a possibility of the presence of cancer cells in the lymphatic system. If they are removed, then it is possible to avoid the recurrence of the disease in the future. It is worth noting that the presence of oncocells in such cells can be verified only after their removal by means of histological examination.

After the removal of the lymph nodes, the lymphatic system continues to direct the lymph to this part of the body, the lymph, which gradually accumulates in the shoulder and arm. It is impossible to determine the outcome of surgery in advance. There are cases when the disease does not appear, but it also happens, when the slightest engagement leads to its occurrence.

Symptoms of lymphostasis

First stage: mild swelling arises in the evening, passes until the morning; puffiness is monitored continuously; connective tissue growths are not yet available, it's time to see a doctor.

Second stage: swelling does not go away; skin hardens, connective tissues grow; the skin is tense, swollen, which provokes pain syndrome. Treatment of lymphostasis of the hand after mastectomy in this case is still acceptable, but it is quite laborious.

Third stage: irreversible metamorphoses; the signs of the first and 2nd stages are intensified; cysts and wounds appear; deformation of the fingers occurs; the limb becomes inactive; eczema, erysipelas, or ulcers may occur.

Diagnostics

The doctor first conducts an examination, comprehends the anamnesis and signs. After that, it is necessary to pass a biochemical and general review of blood / urine. You need to consult a vascular surgeon, full examination pelvic, thoracic and abdominal cavity, limbs and veins. To confirm the diagnosis, lymphography is performed without fail - a procedure for examining the lymph nodes and blood vessels.

A woman who has had her breast removed must be prepared for the occurrence of such complications. You should immediately consult a doctor at the first warning signs. A vascular surgeon, lymphologist or phlebologist can help. The expert will prescribe a set of reviews and ultrasound. During the diagnosis, x-ray lymphography is used in order to determine the places of blockage of blood vessels.

Treatment of various stages of hand lymphostasis

With the support medications allowed to overcome the disease on early stages his formation. The therapy is aimed at stopping swelling and correcting the typical proportion of a body part, preventing complications.

The course of treatment includes a whole range of activities:

• taking medications;
• manual lymphatic drainage, the use of ointments and creams;
• sock bandage and compression underwear;
• physiotherapy;
• massage.

Laser therapy may be involved electromagnetic stimulation. On the final stages diseases use osteopathic visceral methodologies.

Lymphostasis of the hand, which occurred in breast cancer, is associated with a course of radiation therapy. The origin of dense edema indicates that cancer cells not eliminated and there is a risk of recurrence of cancer. It is recommended to start gymnastics and massage for prevention purposes immediately after the end of radiation therapy. Swimming and wearing a compression sleeve proved to be excellent. It is worth noting that the therapy is based on massage, gymnastics, and drug treatment is only an addition.

Hand massage with lymphostasis, the one that arose after a mastectomy

The procedure can be performed by both the patient himself and his family members.

However, you need to read the instructions for its implementation in advance.

The duration of one session is 5 minutes. It is recommended to repeat the procedure every 2-3 hours.

Gymnastics with lymphostasis of the hand, which arose after mastectomy

Therapeutic exercise is an indispensable component of therapy. Each exercise is done in 5 sets of 10 repetitions.

Lymphostasis after mastectomy: therapy with folk remedies

plantain recipe

Pour 2 tbsp. l crushed dried leaves of the plant with 2 cups of burning water and leave to infuse overnight. In the morning, the resulting remedy is filtered. Drink it 30 minutes before a meal, adding a spoonful of honey in advance. The course of treatment is 2 months.

Recipe with tar

head of unpeeled onion baked in the oven. After cooling, it is cleaned and mixed with tar (1 tablespoon). The resulting mixture is smeared with a gauze bandage (thick layer), which is applied all night. In the morning, the compress is removed, the hand is washed warm water and get a massage right away. It is recommended to repeat this procedure for 1-2 months.

Recipe with garlic

Mix in a small container 250 g of fresh chopped garlic and 350 g of honey. The mixture stand for a week, and then take 15 ml before a meal. Course - 2 months. Therapy with folk remedies is also based on taking tinctures, applying compresses from plants rich in vitamins P and C. The latter thin the lymph, which contributes to its outflow. It is recommended to drink more than pomegranate juice, rosehip broth, cranberries and currants; fruits and vegetables of red color (beets, currants, mountain ash, grapes).

For more detailed advice, please contact your doctor!

Lymphostasis of the upper limb is one of the most frequent complications after surgical interventions for (ICD-10 code -I89.9)

Causes of lymphostasis

In the human body, all organs and systems are interconnected. In addition, various biological fluids of the body also perform a vital function. Such fluids include blood, lymph, bile, various secrets, etc.

• One of the most important functions of the lymph is to regulate the amount of interstitial fluid, or in other words, the drainage function.
• Lymph contains a large amount of protein, lymphocytes, hormones, etc.
• Equally important is immune function lymph, as various infectious agents, toxins, slags and salts that the body is trying to get rid of.

Lymphatic vessels always pass close to the blood vessels. At the same time, the cardinal difference between the lymphatic system and the circulatory system is that on the path of the lymphatic vessels there are lymph nodes in which “unnecessary” cells settle.

For example, when infectious diseases lymph nodes increase, as bacteria, viruses or fungi with lymph flow stay in them for a long time.

During oncoprocesses, atypical cells also enter the tissues of the lymph node with the lymph flow. Sometimes there are so many cells that the entire tissue of the node is replaced by a metastasis. Of course, in this condition, the filtration function of the lymph node is lost.

Patients who have undergone radical surgery about breast cancer, often face such a complication as lymphostasis of the upper limb on the side of the lesion.

The cause of lymphostasis is the surgical intervention itself. During radical operation(mastectomy) not only the mammary gland with a tumor is removed, but also possible ways for the spread of atypical cells throughout the body.

In breast cancer, the main route of metastasis is considered to be lymphogenous - i.e. with lymph flow. Therefore, a mammary gland with a tumor and several groups of lymph nodes are removed as a single block.

After removal, the lymphatic vessels from these lymph nodes are ligated. As a result, the processes of violation of the outflow of lymph are launched.

Measures for the prevention of lymphostasis begin to be carried out already in the early postoperative period.

Sometimes lymphostasis can develop without surgery. So, with a widespread tumor process, when several groups of lymph nodes are replaced by metastases, the outflow of lymph from the upper limb is also disturbed.

Symptoms and signs of lymphostasis of the upper extremities

There are several degrees of lymphostasis:

• At the first degree, the swelling is soft, the upper limb does not lose its function.
• At the second degree, the edema becomes more dense, it can join pruritus, the size of the upper limb (in comparison with a healthy hand) is much larger, which is accompanied by a decrease in hand function.
• And the third stage is when the edematous tissues of the upper limb are dense. It's accompanied pronounced violation upper limb function and severe pain.

In people with such conditions, you can often hear the term "elephantiasis." This is due to the fact that the hand on the side of the lesion looks several times larger (in comparison with a healthy hand).

Thus, it is possible to formulate the main symptoms of lymphostasis:

• Change in the size of the upper limb on the side; radical surgical intervention;
• Edema of the upper limb varying degrees expressiveness;
• Color change skin On the hand;
• Change in skin elasticity on the side of the lesion;
• Pain of varying intensity;
• Skin itching;
• Change in the vascular pattern of the skin of the hand;
• Decreased function of the upper limb.

People with lymphostasis are forced to wear clothes several sizes larger than necessary in order to cover their defect as much as possible.

Hello. My name is Christina, I am 45 years old. In July 2017, I underwent a left Madden radical mastectomy. Discharged with all recommendations for the prevention of lymphostasis. A week ago there was pain in the left arm, the arm was slightly swollen, the temperature rose to 37.5. Which doctor should I see now?

Hello Christina. You can contact a general oncologist at the polyclinic at the place of residence with the obligatory provision of all documentation from the hospital where you received treatment (extract). A general oncologist can recommend a consultation with a surgeon and a rehabilitation doctor

Prevention of hand lymphostasis after mastectomy

Preventive measures of lymphostasis are the most important task: since the lymph contains a large amount of protein, the risk of developing septic (purulent) complications increases (because protein is a nutrient medium for a large number microbes).

Septic complications can develop both in the early and late postoperative period. An example of a purulent complication after surgery for breast cancer complicated by lymphostasis is erysipelas. Also, the risk of septic complications in lymphostasis of the hand increases against the background of diabetes mellitus.

Lymphostasis is a complication that needs to be dealt with as early as possible!

Often, after surgery, patients try to avoid traumatic conditions and try to cover, protect the place where the operation was. In most cases, this is accompanied by a forced position of the hand. Many tie up the arm in a bent state so that it is almost completely immobilized (as in a fracture).

Contracture of the shoulder joint is a serious complication that leads to disability of the patient.

Contracture is a pathological condition in which the motor function joint. Contractures are flexion and extensor. After a mastectomy, patients most often deal with flexion contractures.

This condition is dangerous because, in patients, the shoulder joint ceases to unbend. And this affects the patient's standard of living: many lose the ability to take care of themselves, cannot dress themselves, perform various manipulations, etc.

AT modern medicine great emphasis is placed on improving the patient's quality of life, which is why it is vital to fight lymphostasis.

These measures include:

• Explanatory conversation with the patient. Each patient should be informed in detail about what this or that complication threatens.
• The complex of measures for the prevention of lymphostasis of the upper limb includes massage, physiotherapy exercises, apparatus methods, certain physiotherapeutic methods and diet.

Massage and exercise therapy often begin to be carried out even in the patient's room. The attending physician, together with a rehabilitation doctor, selects a rehabilitation program for a particular patient.

This takes into account indicators such as:

• Age
• Complaints
• volume of surgery
• timing of surgery
• body type
• comorbidities (chronic diseases)
• severity of lymphostasis
• Ultrasound with dopplerography of the upper limb

Massage and physiotherapy for hand lymphostasis after mastectomy

There are several types therapeutic massage for the prevention of lymphostasis of the upper limb:

• simple medical massage
• pressure therapy (a kind of medical massage, using special devices that can compress and unclench the muscles of the upper limb)

• pneumotherapy (air massage)
• hydrotherapy (fluid massage)
• lymphatic drainage (both manual and with the use of medical equipment)
• self-massage

Some methods of physiotherapy are also used:

• Magnetotherapy
• Laser therapy
• Taping (teip-tape, which, when glued to the arm, forms a local zone under it) reduced pressure, thereby starting the processes of accelerating the flow of lymph).

Therapeutic exercises for lymphostasis

For therapeutic gymnastics exercises with passive and active flexion and extension, abduction and adduction of the arm, as well as rotations of the torso and neck are used.

All patients after radical mastectomy with preventive purpose appoint wearing special underwear in the form of a compression sleeve. In order to choose the right size and compression class, take into account such indicators as:

• the widest point of the upper limb (or elbow area)
• distance from wrist to shoulder
• circumference of the wrist
• circumference of the middle of the forearm.

Measurements are made with an ordinary centimeter tape. These banding indicators are also necessary for dynamic monitoring of the patient. The compression class and the size of the product are determined by the doctor.

Drug treatment of lymphostasis of the upper limb

For medicinal solutions to the problems of lymphostasis, apply:

• diuretics (diuretics-lasix)
• antiplatelet agents (trental)
• anti-inflammatory drugs (Wobemzyme)
• agents that improve microcirculation in tissues (traxevasin)
• antihistamines (to combat itching of the skin - tavegil)
• multivitamin complexes (milgamma)
• balanced proper nutrition

Also, drugs such as detralex and phlebodia 600 have proven themselves well. Both drugs are aimed at strengthening the vascular wall of the veins of the upper limb, reducing the risk of its microruptures. There were no significant differences in efficacy.

Treatment with folk remedies

Treatment of lymphostasis with folk remedies is extremely doubtful, as it is significantly inferior to traditional methods of treating this complication.

For example, the use of dietary supplements containing succinic acid, hirudotherapy, as well as the use of various salt compresses is permissible only with the permission of the doctor and as an addition to the main traditional treatment.

Hello. My name is Vera, I am 60 years old. Since 2016, I have been registered with a mammologist for cancer of the right breast. I had surgery in February 2017. The breast could not be saved. During the first month after surgery right hand greatly increased in size, began to bend worse, itched. Having got an appointment with the doctor who performed the operation on me, I received a course special treatment lymphostasis (massage, exercise therapy, physiotherapy). In addition, received different drugs. Feeling much better. As soon as I was discharged from the department, I canceled all the drugs myself, because I think that folk remedies it is better. A neighbor gave an infusion for compresses. What is lymphostasis in general, and why should it be treated in a hospital? From what treatment the result is better?

Hello Vera. Lymphostasis is a complication in the form of a violation of the outflow of lymph in the arm on the side where the operation was performed. A serious enough complication to experiment with infusions from a neighbor. It is unlikely that your neighbor is a doctor and will be able to help you. All types of treatment are reduced to a complex traditional methods. And only in rare cases can be supplemented with folk remedies. Be sure to see a doctor as soon as possible for further examination and treatment. Make the Right Choice

You can ask your question to our author:

Lymphostasis is the accumulation of protein-rich fluid in the interstitial space, which occurs due to impaired lymph transport and is accompanied by an increase in the volume of the affected organ. May be the result of a congenital or acquired violation of the transport of lymph through the lymphatic vessels. Lymph transport can be impaired due to a malformation of the lymphatic system or damage to a normally functioning lymphatic system during a person's lifetime.

Causes

Lymphostasis is otherwise called lymphedema, elephantiasis. It is characterized by the accumulation of fluid in the interstitial space due to impaired lymph transport, which is accompanied by an increase in the affected organ. This disease can be either congenital or acquired. The causes are:

• Developmental disorders of the lymphatic system. These include: aplasia, hypoplasia, hyperplasia of the lymphatic vessels.
• After undergoing surgery related to oncological diseases. The most common is breast cancer.
• Oncology.
• abnormal obesity.
• Klippel-Trenaunay-Weber syndrome.

Thus, women who have undergone surgery for breast cancer very often face such a complication as lymphostasis of the upper extremities.

The reason lies in surgical intervention. When the mammary gland is removed, the possible routes of passage of atypical cells are also removed. Some lymph nodes are also removed - this is the cause of a violation of the outflow of lymph.

With breast cancer, lymphostasis can also develop without surgery, since cancer can affect the lymph nodes, which also leads to impaired lymph outflow.

Symptoms and signs of lymphostasis of the upper extremities

One symptom is severe swelling. Tissue lymph has the property of accumulation in tissues, which leads to squeezing of blood vessels and veins.

Common symptoms of lymphedema:

• an increase in the volume of the limb (mainly on the side of the surgical intervention);
• severe swelling;
• changes in skin color;
• skin elasticity is lost;
• pain;
• changes in the vascular pattern;
• decreased motor activity;
• the appearance of wounds and ulcers on the arm.

At the onset of the disease, periodic edema is noted, which is very noticeable in evening time and in the morning. There is also tingling all over the arm.

With the onset of the development of the disease, there is a constant swelling of the hand (or both hands).

When the disease begins to progress, it is noted:

• the hand is very hard to the touch;
• itching may be observed;
• the skin of the hands begins to peel off, resembling scales;
• there is severe swelling throughout the arm that does not subside.

At the advanced stage, it is noted:

• the skin of the hand is covered with wounds, hematomas;
• there is tissue necrosis;
• pain;
• impaired motor function;
• blood poisoning begins - sepsis.

The last stage is already irreversible and cannot be treated.

Prevention of hand lymphostasis after mastectomy

Preventive work is one of the main tasks, since the lymph contains a huge amount of protein, which can lead to the development of complications. The risk of complications increases if a woman suffers from diabetes.

Many women, unfortunately, do not have information on how to behave after surgery. What can and can't be done.

So, for example, women, in order to relieve pain after surgery and to protect the suture, begin to tie up their arm (from the side of the suture) as in a fracture, in a bent position. This is strictly prohibited. With this position of the hand, such a complication as contracture of the shoulder joint often develops.

Contracture is understood as a pathological condition resulting in impaired motor function of the joint. Contracture is of flexion and extensor nature. As a result, this leads to disability. At the same time, a woman cannot serve herself (it is impossible to dress, put on shoes, and much more).

Preventive measures after surgery are prescribed immediately. Basically, 2.3 days after surgery:

• First of all, explanatory work is carried out. The doctor must explain everything possible complications: how to behave after the operation, what you can do, what you can not.
• Appoint massage of the top extremities.
• Exercise therapy is prescribed - physiotherapy exercises.
• Physiotherapeutic procedures are prescribed.
• special diet.

The doctor who manages your disease and the rehabilitation doctor jointly select rehabilitation measures.

For each patient strictly individually. The rehabilitation program depends on:

• age;
• complaints;
• the operation itself (the amount of material removed);
• timing of the operation;
• the structure of the patient's body;
• existing chronic diseases;
• the risk of complications.

• healthy lifestyle;
• active lifestyle;
• to the best of sports (with the advice of the attending physician);
• quitting smoking and alcohol;
• avoid infection;
• avoid injury and burns;
• use constantly moisturizing creams;
• the use of disinfectants (ointment, cream);
• psychological peace.

Massage, physiotherapy and therapeutic exercises for hand lymphostasis after breast removal

There are several types of massage:

• Regular medical.
• Massage with the help of special devices. This type massage is able to more deeply affect the muscles of the limbs.
• Air massage - pneumotherapy.
• Water massage - hydrotherapy.
• Lymphatic drainage massage (special devices may be used).
• Self-massage.

Self massage

Of course, it is best to entrust the massage technique to a specialist. But you can also master massage techniques. To do this, you need to raise your hand (from the side of the operation) up and resting it on a hard surface (the wall can serve as a surface) with the fingers of the other hand, stroke the surface of the outstretched arm, starting from the elbow and going towards the shoulder. After completing the massage, you repeat the procedure only from the fingers to the shoulder. Thus, you must work out the entire surface of the hand. At the same time, the movements are gentle, smooth, with little pressure on subcutaneous tissue. But remember, you don't have to feel pain.

The duration of the massage is on average 5-8 minutes. You can repeat the massage 2 times a day.

Physiotherapy

With this disease, three types of procedures are mainly prescribed:

• laser therapy;
• magnetotherapy;
• taping (using a special teip tape).

Physiotherapy

Almost all patients are prescribed the field of surgery to wear a special compression sleeve. For right choice you need to know and rely on:

• measurements of the widest place of the arm (mainly the area of ​​\u200b\u200bthe elbow bend);
• distance from shoulder to wrist;
• wrist size;
• the size of the circumference of the forearm (middle).

In therapeutic gymnastics, the emphasis is mainly on exercises with passive and active extension and flexion of the arms, abductions and adductions of the arms. Also turns the torso and neck.

Exercise 1

On your knees, hands palms down (while the elbows are straight), do flips of the hand from the palm to the back surface, while not straining the fingers.

Exercise 2

Kneeling, hands palms down (while elbows are straight), you need to tightly clench your fingers into a fist and unclench.

Exercise 3

Standing, bend your arms, put your palms on your shoulders. Slowly raise bent arms at the elbows in front of you and lower.

Exercise 4

Standing, lean slightly to the operated side. Relax and lower your hand, while swaying in different directions.

Exercise 5

Standing, raise your hand and lower (alternately) and hold in this position for 10 seconds, lower. Valid support good hand over the shoulder.

Exercise 6

Standing, make slow circular motions in shoulder joints- back and forth.

Exercise 7

Standing, take your hands back so that your fingers are connected (elbows should be straight). You need to raise your hands behind your back, bringing your shoulder blades together.

Drug treatment of lymphostasis of the upper limb

Treatment includes a complex to eliminate lymph stagnation and prevent complications and relapses.

Mainly prescribed:

• diuretics,
• antiaggregants,
• anti-inflammatory drugs,
• antihistamines,
• multivitamins,
• phlebotics.

These drugs include: Paroven, Detralex, Phlebodia and others.

If there are ulcers on the hand, then they are treated with Iodoriron or Lavasept solution.

Also, do not forget about the diet. Which should be sparing, salt-free. Salt, spices, fatty foods, smoked foods should be completely excluded from the diet.