Foot care for Lower Extremity Lymphedema
The National lymphedema network NLN has been flooded with questions regarding foot and ankle care for patients with lower extremity lymphedema. Dr. Joseph Hewitson, a San Francisco Podiatrist, who has worked with many lymphedema patients, provided NLN a list of guidelines and suggestions for proper foot care for people suffering from lower extremity lymphedema. These guidlelines are excerpted from The July NLN newsletter.
Be sure to trim your toenails, but not necessarily straight across. If the corners have grown into the skin, trim the offending border.
If you get an infection, you should remove that side of the nail to resolve the infection. Antibiotics often will not work because an abscess (walled off infection) has occurred. Soaking may only provide temporary relief.
A lymphedema patient should never undergo a chemical matrisectomy (destroying root growth matrix with a chemical to permanently remove nail).
Fungal nails are common in lymphedema patients and should be soaked in 1:1 vinegar/water solution for 20 minutes, with antifungal solution applied afterwards.
Routine foot care every three months with a podiatrist if possible or your physician.
Meticulous nail care decreases the chance for inflammation and infection.
Taking Care of Your Toes
The inner spaces between your toes need to be kept clean and dry.
Soaking in a 1:1 vinegar/water solution for 20 minutes at least once a week and running a piece of gauze between your toes to remove any debris will help keep your web spaces clean.
Using a drying agent/antifungal solution like Castelani's Paint decrease chances of irritation and infection.
Applying lambs wool (see your pharmacist) between the toes allows the web greater breathability.
Open toed compression garments will also allow greater breathability, as will breathable footwear that is fitted correctly.
Dr. Hewitson says that proper footwear is very important. He says always buy your shoes at the time of day when your foot is most swollen (usually the end of the day). If you wear a compression garment, make sure you fit your shoes to accommodate this. Good athletic shoes are excellent to wear because they are more supportive, and more breathable. For very large feet, a Velcro strap shoe is usually more accommodating.
If you have painful corns and calluses, they should be routinely trimmed by a podiatrist or practitioner. Never use any callous removal pads, because they can cause burns and infections.
Dr. Hewitson also says to always work with reputable practitioners who are willing to further educate themselves on lymphedema. He adds, you may be their best and only teacher.