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Lymphatic Health after Breast Cancer


       Melissa Etheridge                                 


 Lymphedema is  an unfortunate side effect of breast cancer. If your lymphatic system is struggling to do its job effectively, the result may be a swollen arm or hand. In the case of breast cancer it is most commonly because of removal or damage to lymph vessels or pathways from surgery or radiation.  Sometimes lymphedema can show up well after cancer is gone or years after lymph node removal.  It is so important to be aware of the signs of lymphedema and also some ways to keep your lymphatic system working its best.

The signs of lymphedema are: 

  A feeling of fullness or heaviness

  Tight feeling skin

  Less flexibility in a hand, wrist, foot or ankle 

  Clothes that feel tighter in one specific area

  A  ring, watch, bracelet or shoe that feel tighter



Caring for your Lymphatic System after breast cancer

  1. Watch for the signs of lymphedema listed above and seek help from a certified lymphedema therapist if you see these signs.
  2. Wear compression when flying: the lower atmospheric pressure can cause swelling
  3. Regularly clear your lymphatic pathways through dry brushing, manual lymphatic drainage and gentle exercise.
  4. Maintain a healthy weight and healthy lifestyle.

Learn More:  https://www.breastcancer.org/treatment/lymphedema/reduce_risk/do





The month before everyone wears pink (Ovarian Cancer Awareness Month)

September is ovarian cancer awareness month. I am mostly aware of this because my mom died of ovarian cancer when she was 67. I remember getting the life changing call in January.  I wanted to vomit. My questions came… what? When? How? Where?  I remember hoping it was breast cancer. But it came back as ovarian cancer and I then learned things about Ovarian cancer in 1997. It is difficult to detect. It is a silent killer, the symptoms are vague….. When she was diagnosed, she was at stage IV.
I taught myself the warning signs: bloated, feeling of fullness, frequent urination, fatigue. I KNEW the signs and 18 years later, I HAS  those signs. I was diagnosed with ovarian cancer 4 years ago. Here is what I realized, that list of symptoms was not what I felt. Yes, I felt tired a lot. I made a lot of trips to the bathroom, my back hurt, I felt full.  I had felt all those feelings before and each one of them I could discount.  Don’t discount those symptoms. They are sneaky. If you are peeing all the time or it hurts when you poop or If you have to lay down during the day cause you are so tired or if your back has a slow dull ache that is there all the time… dont think it is aging or stress. Don’t think you can just take some Tylenol and you will be ok. Be proactive. Get checked out. 


Unfortunately, a possible side effect of ovarian and other gynecological cancers is lower body lymphedema. Diagnostics, treatment and side effects can disrupt the normal route of lymphatic fluid from the legs and/or abdomen and result in  swelling of these areas that does not go away. Those with lymphedema benefit greatly from a therapy technique called complete decongestive therapy (CDT). CDT addresses skin care, manual lymphatic drainage, compression and exercise to  reduce swelling and minimize symptoms. If you think you  may have lymphedema, speak to your doctor and use this as a resource if your doctor is unfamiliar with lymphedema. 
As always, I am here to help. If you live in the Chicagoland area, please take advantage of my 1:1 treatment options. If you live outside of this area, you can still take advantage of my phone consultation or find a Certified Lymphedema Therapist in your area.

Swelling after Plastic Surgery

A blocked lymphatic system can result in swelling, pain, and discomfort.  Surgical procedures like a tummy tuck, breast augmentation or liposuction can disrupt the natural pathways of the lymphatic system causing it to be injured or blocked and not performing is functions as well as it should. In your research before your plastic surgery, you might have come across the terms lymphatic massage or manual lymphatic drainage. This can be a useful tool in your recovery to help  with swelling and achieving your best result.


The lymphatic system has several roles in the human body. One of these jobs is removing excess fluid and waste products found in and around tissues. The lymphatic system gathers unwanted material and moves it through  the body until it is ultimately is removed from the body. A good video on how the lymphatic system works is found on my website.

A certified lymphedema therapist uses a technique called manual lymphatic drainage (MLD) to move fluid in a specific path to reuduce swelling and subsequent pain. MLD is very gentle. There is no deep tissue work it should not hurt. A large portion of the work is done well away from the point of incision. The technique encourages the movement of fluid away from swollen areas, to healthy vessels who then eliminate it  from the body. 

Persistent swelling sometimes occurs after surgery.  This swelling may result in fibrotic tissue. Fibrotic tissue looks and feels thick and somewhat leathery.  It is important to reduce the chance of developing fibrotic tissue. In addition to assisting the movement of fluid through manual lymphatic drainage, a therapist can recommend various compression pieces to reduce the fibrotic tissue or stubborn swelling. 

Scar management is also important for successful results. An untreated scar can become thick and even painful just like unchecked swelling. Techniques such as myofascial release and cross friction massage can help to minimize the appearance of a scar.  More information can be found here.

I usually recommend 3-5 sessions of manual lymphatic drainage after a procedure as a starting place. During these sessions, you will be taught self manual lymphatic drainage and given recommendations for additional compression items and/or exercise so that your recovery will continue after your treatment. 

You have taken a big step in feeling like the best version of yourself. Life is about taking risks and in my opinion, you can never be your best self without taking them.

Schedule a Complimentary Phone Consult 

Want to read more about the research behind MLD and cosmetic procedures? Click here

New Resources Discovered!!

I am excited to share a few resources I have recently discovered…

These will be added to the resource page of my website: click here to see all the info.

  1. The Lymphedema Podcast

Betty Westbrook is a CLT based in Texas who began a podcast all about lymphedema. Some of the topics include: What is Lymphedema?, Pregnancy and Lymphedema and Fashion for Lymphedema. She  is easy to listen to and explains information clearlyIt  is an excellent resource for those who want to learn more about lymphedema but wish to listen to information rather than read it. To access podcasts, use the podcast app on  apple devices or an alternative podcast player such as Stitcher.


Fluid Running®  

A few months ago, I started noticing Fluid Running popping up on some of the lymphatic instagram accounts I follow.  Coincidentally, I knew of fluid running from my local pool. It is a local business and Jennifer Conroyd, the founder lives in the same town as I  do. She was kind enough to connect with me since it seemed that we were reaching the same kind of people. I learned how Fluid Running can be an excellent exercise option for those with lymphedema It gives a great cardiovascular workout while also providing the compression so beneficial to a compromised lymphatic  system. It involves stationary running in a pool using a flotation belt. An app guides you through the workout. Check out the Fluid Running website for more details.

Swollen, Bloated and Puffy
by Kathleen Lisson CMT, CLT

Kathleen sent me this book about a year ago and I have finally gotten to reading it from cover to cover. It is an excellent resource for those who are looking for helpful tips “from proven to CRAZY to reduce swelling and boost the lymphatic system”  The topics include: What to put on and in your face and body to reduce swelling; how to have a happy lymphatic system and how to improve your immune system. There are ideas to help with inflammation that you may not get from your traditional medical provider. Her book is available for purchase on amazon. To stay updated with author Kathleen Lisson, follow her on Facebook, and YouTube.


Remember to check out the resource page here for a list of more lymphatic system resources. And don’t forget to connect with me if you have any questions or comments.

Building Your Team

Lymphedema is a chronic condition and. it takes commitment to keep it in check. Even then, there are bound to be set backs.  One of the most important things to do after a diagnosis of ANY condition is to 

Build Your Team. It takes a lot of time and maybe even some wrong choices to eventually get a good team together to help you in your journey with lymphedema. Here’s a list of who you should recruit.


Physician:   The primary doctor on your team may change over time. It is important that you always have a doctor who is able to oversee care, treat infections, and provide scripts for therapy .   Someone may initially have a wound doctor diagnoses and recommend lymphedema treatment but may not continue to them once the wound has healed. In the same way, an oncologist may initially give a script for therapy and other treatment but over time  an Internist or GP may be needed to call in the case of an infection. If you are having trouble finding an appropriate doctor, ask some of your other team members for recommendations. CLICK HERE for information on how to talk to your doctor about lymphedema..



THERAPIST:  You need a certified lymphedema therapist (CLT)  you can see regularly. It is important that this person has completed a  135 hour certification course in Complete Decongestive Therapy. The therapist should have the initials CLT after their name.  This stands for Certified Lymphedema Therapist. The initials LANA stand for Lymphology Association of America. A therapist who has these initials has passed a comprehensive examination demonstrating knowledge of the lymphatic system and lymphedema management. There are weekend classes that can be taken and even lymphatic massage classes that give an introduction to lymphedema therapy however you want a CLT to be on your team to help manage your lymphedema. After you identify someone who is a CLT, it is important that this person is someone who is easy to learn from and  communicate with.Ideally, this relationship will be a long one so finding a person who is both good at what they do and also easy to communicate with is important. I recommend having a therapist who fits into the regular insurance world (in the US) and also someone who you can go to every once in a while to help you with maintenance of your lymphedema.

Click here for a pdf to help find a lymphedema therapist  

Click Here to schedule a phone consult with me



A Certified Fitter. This may also be your therapist or it can be someone different. Everyone has their areas of interest and it may be that your therapist is not as interested and therefore not as up to date on all the latest in terms of compression and garments that are out there.  Compression is one of the main treatments of lymphedema management so again, having someone who you can get a hold of and communicate well with is very important. A poorly fitting garment may be worse than none at all. Check your local DME shop as many of them have a fitter or  Click Here to find a fitter

 An advocate: As humans, we are meant to live in community. We are meant to help each other out when we need it and rejoice in the good times. I strongly encourage you to find a person or many people who can be there for you. They can be an extra set of ears during appointments, help you wrap yourself when it is difficult, encourage you and provide accountability. They can lift your spirits when you are discouraged and celebrate your victories.  Find that person and talk to them about what you may need.  Need help figuring out what to say? Click Here  

or Here

A support group: It is important to find people further along in your journey and over time also be that person to someone else. With lymphedema, there are so many practical questions like shoes and clothes, opinions on pumps, lotion  and garments as well as if things like success of alternative medicine. It is great to have a place to learn about things as well as share your life knowledge. Additionally, no one knows exactly what you are going through but people who share a lymphedema diagnosis are more likely to have gone through the same thing as you and are easier to vent to .  There are online facebook groups and in person support groups. Local hospitals may have a support group or you may be able to find one on the MEETUP app. The important thing is to find the support.

Fitness Accountability Partner: Fitness is a very important component to managing your lymphedema. Your lymphatic system works best at a normal weight. Keeping as close to a normal BMI as possible will help to keep your lymphedema symptoms under control. Additionally, muscle contraction which happens in exercise is necessary to help move your lymphatic fluid. Your fitness routine may involve group classes, an online program, a fitness buddy or a personal trainer. One thing is for sure…. Having accountability helps consistancy. 

The importance of building your team is so important. Having the people you can count on set up and ready to go when you need them reduces stress and allows you to live your best life. Your team may grow over time. Nutritionist,  Chiropractor, Podiatrist, Acupuncturist among others may be additional members you add along the way. Through it all, remember that being able to easily communicate with these people is key to them working well with you on your journey.

Cellulitis FAQ

Cellulitis can land you in the hospital with IV antibiotics fast! In my (many) years as a therapist, cellulitis is something people  seem to be routinely uneducated about.  Recovering from cellulitis can be a long and difficult journey. Those with lymphedema are at higher risk for cellulitis and having cellulitis can cause damage to the lymphatic system. Knowing the signs of cellulitis and how to reduce your risk of getting it are important.
Cellulitis is a bacterial skin infection usually caused when bacteria enter a wound or area where the skin is open such as a scrape, sore or incision. The most common bacteria that cause cellulitis include Group A ß – hemolytic streptococcus (Strep), Streptococcus pneumoniae (Strep), Staphylococcus aureus (Staph). Staph and strep bacteria are commonly found on the skin and mucous membranes of the mouth and nose in healthy people. The infection happens when there is a break in the skin that allows the bacteria to enter.

The symptoms of cellulitis are skin that is red, swollen, warm  or tender. You may also experience fever, chills or fatigue. At times people also have leaking of  clear fluid or pus in the swollen area. If any of these symptoms occur, call your doctor to develop a plan of attack. 

Anyone can develop cellulitis, but some people have a higher risk than others. If you fall into one of the higher risk categories, you should watch any injuries to the skin carefully:

Lymphedema: Lymphedema is swelling  due to a damaged lymphatic system. The swollen and stretched skin can crack and the protein rich fluid allows for bacterial growth.

Impaired immune system: People who have an impaired immune system are more vulnerable to contracting infections in general. These include people who are undergoing chemotherapy or who take corticosteroids.

Chronic illnesses: Illnesses like diabetes can increase your risk of developing infections. People with diabetes are particularly susceptible to getting sores on their feet and lower legs, which can become infected.

Skin conditions or disorders: Skin conditions and disorders can cause breaks in the skin. These include eczema, shingles, even so-called childhood illnesses like chicken pox.

 Obesity: People who are obese have a higher risk of having cellulitis and of getting it again.

History of cellulitis: If you’ve had cellulitis before, you do have a higher risk of getting it again.

Here’s how can you reduce your risk of cellulitis:

Keep feet clean and dry, including regular washing of feet and changing socks.

Keep feet moisturized to avoid cracking

Examine skin of feet and legs for any open sores, cuts or scrapes and monitor them for signs of infection.

Use antibiotic cream on open skin and keep injuries covered with bandaid if possible.

Keep your nails well-manicured.  When cutting your fingernails and toenails, you want to take care not to injure the surrounding skin

When getting blood drawn, take from a body part that has not had cellulitis

Treat infections promptly.

Avoid injuring your skin.

Treat lymphedema  Of all the medical conditions that increase your risk of getting cellulitis again, lymphedema ranks highest. Lose weight. Research shows that if you are overweight or obese and lose weight, you reduce your risk of getting cellulitis again.

Stop smoking. While more research is needed to know whether smoking increases your risk of getting cellulitis again, research suggests it might.

What’s the big deal?  First of all, Cellulitis can be very painful. It can, if left untreated lead to sepsis which is life threatening.

Cellulitis causes swelling and swelling in itself can cause problems…

Shoes do not fit.  Not having proper footwear can lead to a multitude of issues such as inability to  exercise, slips and falls, and risk for additional skin injuries.

Also, skin is vulnerable to more cracks and scrapes when it is swollen. This is  due to the lack of flexibility of the skin. When there are open areas on the skin, the chance for bacteria to enter the body increases and the chance for cellulitis increases.

Swelling can make moving difficult.  If the swelling in the lower leg, it can become nearly impossible to pull your feet underneath your knees far enough to allow the body to stand. Swelling can make walking difficult due to the weight of the limb 

Ultimately, and maybe most importantly cellulitis like many illnesses has a mental aspect to it.  Things like no shoes that fit, trouble standing up, leaking fluid all make it hard to lead an active lifestyle. Anytime, you have to give up things because of an illness, you can feel down and depressed. That is why it is so important to recognize cellulitis and fight hard to keep it from returning. LIfe is worth it.

What more info?

If you have or had swelling especially in your legs that has persisted, you may have a condition that can be helped through lymphatic treatment.

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