Bandaging 101

There's no easy fix for lymphedema, which is frustrating.  Whenever my kids have gotten sick, I've taken them to the doctor, they got medicine, and got better in a few days.  Lymphedema has totally thrown that pattern of behavior out of whack!  The most effective treatment for lymphedema is a multi-pronged approach, Complete Decongestive Therapy (CDT), consisting of nighttime bandaging, wearing daytime compression garments, a special type of massage called Manual Lymph Drainage (MLD), meticulous skincare, and exercises.  Sounds easy, right?  There are actually certified lymphedema therapists who manage this and help patients learn to live with lymphedema.  We are fortunate to have such a person at our local hospital and she has been super supportive!  MA has been seeing the therapist 3 times a week for the past month or so, and during that time I've learned to do the bandaging at home.  It's taken a few times to get it right however!  Here are a few pictures I took of the wrapping process so I had a reference when I tried it at home.

 

The first step is to apply low Ph lotion (Eucerin) to the entire leg, then put on the stockinette.  Next comes the toe wrapping and padding of the ankle joint with cotton.

Next comes padding the knee with cotton.

The leg is encased in custom-cut foam, which is held in place with a "fixing bandage", a stretchy thing with velcro on the end to hold it in place.

This is a wrap called the Roman Sandal, aka the "Most Difficult Bandaging Thing You'll Ever Have to Do If You're Not a Medical Professional".  Notice more foam pieces on the top of the foot and on either side of the ankle.  The idea with all this bandaging is to have the most compression around the foot and ankle, and progressively less compression as you go up the leg, forcing the lymph fluid up and out.  This is a 6 cm bandage and it's wrapped around her foot several times, applying lots of pressure.

Here's the HAS (Heel, Ankle, Sole) bandage.  It's 8 cm, and starts at the ankle, then around the sole of the foot, around the heel, around the ankle, and repeat until the bandage is used up.

Now we're using 10 cm bandages and going up the leg 3 times.  The first layer just spirals up the leg.

The second layer goes in a herringbone pattern.  Up at an angle, around, down at an angle.  I'm pretty good at this one - guess that's all my crafting experience coming out!

The third layer is another straight spiral.

Now to the upper leg: more foam and a 12 cm bandage starting below the knee, brought up and around, and then coming back to the knee level.

More 12 cm bandages, finishing with one long spiral from the ankle to the upper thigh.

Explaining it now, it seems fairly easy, but the first time I tried this at home it took forever.  Even with these pictures and reference notes, I had a hard time remembering the ins and outs of each wrap.  If this is you, hang it there - it will get easier!