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  • Jeanine Mewburn

Covid-19 cautions for people with lymphoedema

When the pandemic started in 2019, many hospitals, physicians and patients were concerned about continuing treatments, including lymphoedema due to space availability and risk of virus spreading. Many patients suspended their follow-up treatments and rehabilitation for primary and secondary lymphoedema. Quality of life was affected. Some people suffered cellulitis, poorer state of mind due to fear and anxiety, and worsening of symptoms.

It is important to remember that lymphoedema alone does not make you more susceptible to having coronavirus. The lymphoedematous limb on the other hand is more prone to infection due to the lymphatic system being compromised in the local area, but not to Covid-19 particularly. Usually, it is due to bacteria invading the compromised area because of a cut, an insect bite, ulcer etc. The integrity of the skin is most important to avoid infection.


A few guidelines have emerged for safeguarding people with lymphoedema against infection and Covid-19.


Self-management

Since day one of a diagnosis, anyone with lymphoedema or the risk to develop it needs to take precautions such as:

  • Avoid lifting heavy weight or intense activity with the limb at risk

  • Slip, slop, slap to avoid sunburn

  • Wear insect repellent to avoid insect bites

  • Wear a protective compression garment

  • Have your blood pressure taken from the unaffected arm

  • Do your regular self-massage

  • Have good hygiene

  • Keep active

  • Avoid injection on the limb at risk


Covid-19 vaccination

A few things to know and remember:

  1. Use the unaffected upper arm for the injection.

  2. Ask to have the injection in the buttock or the thigh if lymphoedema is present in both arms.

  3. Lymph nodes can swell following Covid-19 injection. This situation, however, should resolve in a few days. In this instance, it is best to monitor the reaction and only contact your doctor or therapist if swelling persists.


Breast screening

Because swelling of the lymph nodes is a known effect of Covid-19 vaccines, it can cause undue concern for patients with a family history of breast cancer or the BRCA gene mutation. Swelling in one armpit is a sign that is considered in the diagnosis of breast cancer (differential diagnosis). Vaccination is therefore recommended before breast screening or four to six weeks after the second dose.


We need to base our decisions on facts and evidence, which is not easy when bombarded with so much information through the media. I hope this blog can help you navigate the Covid-19 gauntlet. Please continue your regular check-ups and treatment, and contact your doctor or lymphoedema therapist if you need more information or a lymphatic drainage massage. Happiness is when what you think and what you do are in harmony.




References

Australasian Lymphology Association. (2021, March). Retrieved February 9, 2022, from Information about coronavirus (COVID-19)*: https://www.lymphoedema.org.au/education-&-resources/covid-19/

British Lymphology Society. (2021, May 25). Retrieved February 9, 2022, from Consensus document on COVID-19 vaccination for patients with: file:///C:/Users/lymph/Downloads/document-42621622017262.pdf

Lane, S., & Shakir, S. (2021, February 26). Drug Safety Research Unit - DSRU. Retrieved February 9, 2022, from Pharmacovigilance Evidence Review: The effect of COVID-19 vaccines on breast screening: https://www.dsru.org/pharmacovigilance-evidence-review-the-effect-of-covid-19-vaccines-on-breast-screening/

Liebert, M. (2020, April 17). Mary Ann Liebert, Inc. Publishers. Retrieved February 9, 2022, from Lymphatic Research and Biology: https://www.liebertpub.com/doi/10.1089/lrb.2020.29084.cov

Mahase, E. (2021, March 3). thebmj. Retrieved February 9, 2022, from Covid-19: Schedule breast screening before vaccine or 4 to 6 weeks after to avoid false positives, says guidance: https://www.bmj.com/content/372/bmj.n617

Mehmet, F. (2020, October 8). NIH US National Library of Medicine. Retrieved February 9, 2022, from ClinicalTrials.gov: https://clinicaltrials.gov/ct2/show/NCT04568005

Pearce, J. (2021, May 2). thebmj. Retrieved February 9, 2022, from Response to Covid-19: Schedule breast screening before vaccine or 4 to 6 weeks after to avoid false positives, says guidance: https://www.bmj.com/content/372/bmj.n617/rr-1

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