cuts

[wendy]

hi, this is marissa mom. I have a question about cuts. The other day marissa got a scrape on her foot (where she has lymphedema) her foot did not swell as it usaually would but, she would not walk on it the whole day. The scrape was on the top of her foot. she didnt say it hurt but , she just went and sat down. unless marissa's foot swelles up bad she is running around. I would like some input on what to do if anything.
thanks wendy

[cpthomas]

Hi Wendy,

I am a lymphedema therapist, and here is my opinion on what to do with Marissa's cut.

First, keep it very clean and as long as she is not allergic, you should put Neosporin on the cut. You can call her physician if you are unsure if you should use it on her. The goal is to prevent infection. Keep it covered with a clean bandage to prevent dirt from getting into it and also to prevent rubbing on the skin from her socks/shoes.

Next, you should keep compression on the foot, to maintain/decrease any swelling. Whatever Marissa normally uses for daytime compression should be fine, unless it is painful. If her shoe is painful, you may want to bandage the foot if you are familiar with that. Also, if you are familiar with Manual Lymph Drainage it is important to perform that 1-2 x daily on the entire leg, and the affected site, to move fluid out of that area.

Finally, keep an eye on the cut. Change the bandage 1-2 x daily, rewash, and put on more Neosporin. As you are changing the bandage, look at the cut. If it looks reddened, irritated, sore, or feels hot, call her doctor immediately, as these are signs of infection. Even if the cut does become infected, if you catch it early it can be easily managed with oral antibiotics.

Christine

[wendy]

hi
wendy again thanks for your help but i still have a question do i do mld on marissa's leg if it doesn't swell? Marissa is almost 3 and her swelling is not bad so i do mld as needed (when her foot agains to swell) I know about cleaning and care for cuts,does a cut hurt more or feel any different in a lymphedema leg? if so can you tell me so i can expain what is happening to her.
I am sorry ask this question but Marissa is young and can not tell how it feels i just want to help her understand.

thanks
wendy

[cpthomas]

Hi Wendy,

Boy, that is a great question...does a cut or any "boo boo" hurt more on a body part that has lymphedema? I honestly do not know. I do know that an area that has lymphedema will swell more if it is damaged than an area that does not have lymphedema. It seems only logical that it might therefore hurt more, too. When explaining it to Marissa, I don't think you need to emphasize to her that the foot hurts because of her lymphedema, you can just explain that it hurts because it got scraped, it was an accident and it will go away soon.

To answer your question about doing MLD if the area is not swollen...I think it is a good thing to do as it can actually prevent swelling from developing after a cut or bruise, but on the other hand if Marissa seems to be back to her usual routine and is not avoiding being on that foot, I wouldn't interrupt her normal activities just to do the MLD. Maybe you could do a little bit as you're putting her down to bed at night. Even if you just do the MLD on her neck, belly, and upper leg, it will get the whole lymphatic system moving and will help to move fluid out of her leg. You do not have to do the MLD directly on the bruised area if it seems too sore. If it seems to be really upsetting her that you want to do the MLD, then I think you can just skip it.

I would simply keep the area clean and covered with a bandaid until it is completely closed...you can just explain that you're helping her boo boo to get better fast. Is Marissa now back to her normal routine or is she still favoring that leg?

Christine

[wendy]

Hi Christine,
Thanks for all of your help. The scrape that Marissa got was about a month ago and, she started walking and playing noramally after about 2 days. I just wanted to know: if it happened again. Every 3 year gets scrapes and cut; The older they get the more they do......
so thanks again I enjoyed talking with you. Marissa is getting ready to start preschool so I'm sure that I will have more questions. I hope you can help me when I do..
Wendy

[cpthomas]

Hi Wendy!

I am so glad to hear that Marissa's foot is "all better!" It was my pleasure to answer your questions and I hope you won't hesitate to post in the future with anything else that's on your mind.

Hope you and your family have a great Thanksgiving!

Christine

[wendy]

Hi,Christine,
Marissa, a few days ago Sunday I think it was: put her hand in her pocket and kept it there all day. At first we thought she was just trying something new. but after about a hour I thought some thing was wrong with it. she didn't want me to look at it. and she wouldn't take it out of her pocket until Sunday night but balled her fist up and would not use it untill today. it did not swell and not cut or bruces; I looked at it when she was asleep. I need to know if this is normal for a 3 year old to or is it Lymphedma. the hand that this happened to is her right hand(the side with lymphedma) As I told you before Marissa is starting preschool in January . She is right handed. I know that the school needs to know about her lymphedema but should I tell them this also? I need some answer please.....
Thanks
Wendy

[cpthomas]

Hi Wendy,

I am not quite sure what to make of Marissa's behavior with her hand. Has she ever experienced any lymphedema in that hand/arm? Am I correct in thinking that Marissa has Turners' Syndrome?

Christine

[wendy]

Hi
It's me again yes Marissa has had lymphedema in this hand her hand was very big until she was about 6 months old you can still see some difference in her right and left (the right is a little bigger)
Yes Marissa also has Turners.
wendy

[cpthomas]

Hi Wendy,

I am not quite sure what to tell you with regards to Marissa's hand. It is possible that it feels uncomfortable to her if the edema is increasing, and it may feel more comfortable for her to keep it in a fist. But if she is keeping it in one position and not moving it around at all, this could make any swelling worse, because edema needs muscular contractions to help move it out of the hand.

Is Marissa still keeping the hand in her pocket? I think my best advice would be to have Marissa seen by the physician who primarily manages her Turners' Syndrome. Also, if you already have a lymphedema therapist, he/she may be able to help assess if there is more swelling in the hand and what can be done to manage it.

I'm sorry I don't have more to offer on this topic. Do you have a lymphedema therapist?

Christine

[wendy]

Hi
Christine,
Yes Marissa has a lymphedema therapis, I am also going to call Dr. Davenport tommorow. and I may Call Lymflo. Thanks for your help.
thanks wendy