instruction on how to wrap your hand and arm
Comments
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I have the instruction in color( how to wrap your arm and hand) step by step as i saved it in my document
when it was on our website.
The link on the INTERNET won't work.
Just for the heck of it i send it to my e-mail and i got it okay.
I don't know how to post it here from my documents.....maybe someone can tell me.
If you really want it i can send it to you. If we get it on here you should print it out as i don't know if the other link will ever work again. You could save it on your computer to.
Maybe (Binney may know) if we can have it at the top of our page for everyone to use.
bc and le hugs jinky (carol) you can pm me if you want to
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Jinky emailed me the instruction. (Thank you Jinky!)
It couldn't be posted because it was saved in the format that wasn't compatible with this forum. Now I've re-written it and am posting the link for Jinky and other fellow sisters who have got this stinky LE.
http://tkt.hostned.ws/luv/le_wrapping/index.htm
xo
Fumi with minor LE in her bad arm
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Thank you so very much Timtam..... We could never have got this
without you .Everyone should save this to your computer and also print it of.
Also Binney mentioned we may be allowed to put this up at the top of our for form.
wow i am happy .....thanks Timtam....le hugs jinky xxxxxoooo
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Thank you, Fumi! You're such an incredible problem solver!
Jinky, the only way I know to get it put at the top of the forum is to ask the moderators to do it, which I'll go do right now. Probably it'd help if several of us asked, so they'd know it's a felt need. If you look at the top post on the LE board you'll see it was posted by them: Click on "Moderators Tami-Melissa" and you'll get their home page, where you can click on "Send a message." Let's see what we can do.
Thanks to both of you for making this available again!
Binney
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Binney it was you who suggested Timtam.....Binney i sent a note to the moderators.....Binney i had a really hard time to find where to e-mail them.
Just tried to find it again but got lost. If anyone else can't find Binney it,
(I am volunteering Binney lol) to help them.
My hubby said "you can make the most easiest thing difficult. lol No supper for him. lol
We have to keep this up at the top as when you are wrapping you can follow it....
After chemo and femara my brain is mush.
bc and le hugs jinky
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Thanks so much Timtam, jinky, Binney. It's so true, a picture is worth a thousand words!! Hugs.
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Hi --
Just out of curiosity, where did these instructions come from? Were they written/photos taken by your physical therapist or some other medical institution? I've seen different methods and wrapping materials depending on the therapist, so I was just confused. (I haven't used the materials shown iny your photos) Is any supervision required the first time a person tries this, etc.? Or is it okay to just try it on your own and take your best guess? Thanks for any info!
Chloe
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Hi, Chloe,
Those are really good questions. You're right, there are other products that can be used for wrapping, and other wrapping patterns as well. And different individuals need special padding, wound dressings or other considerations besides. But the pictures illustrate the standard order and "look". There's an initial layer (stockinette) to protect the skin, the gauze for the fingers (if the lower arm is involved), then the padding layer which can be thin foam as illustrated or another soft product. This layer is important to help even the compression and protect sensitive areas (elbows, for instance). Then the layered short-stretch bandages, which must be applied with gradient pressure. There may be many more than illustrated, depending on the size of the arm (both length and diameter) or other special needs of each individual woman. These layers can be wrapped in other patterns too, such as the herringbone pattern.
So basically the pictures just help remind us of the order and expectations of our wrapping. Some of us need the prompting because we're new at it, others because we don't do it every day so we need a "refresher course" when we have to do it again after a gap of time. But equally important is for new women to be able to visualize the procedure and the look before they begin therapy. It's a shock otherwise, and it's really difficult to describe in words, so pictures can help protect them from the trauma of that initial therapy session.
As for supervision the first time around -- Chloe, how about the first half-a-dozen times! This is definitely a skill that needs to be taught in person by a well-trained LE therapist, and practiced with his/her supervision until it can be done safely and effectively every time -- even in an airport lobby with an audience of gawking fellow-passengers!
Thanks for clarifying, and welcome to the boards!
Be well,
Binney
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Chloe you are right that wrapping methods and materials will vary depending on the therapist's training and the patient's compression needs. I believe the site that Jinky posted is one from a LE patient's blog from several years ago. It has good basic instruction but there are many ways to wrap with some "fine tuning" of the basics.
If you have never wrapped before or been evaluated by a LE therapist, you should not be attempting this on your own. Generally, the process is to go to a specially trained LE therapist first, be evaluated, let her take baseline measurements of both arms, let her teach you how to do MLD and wrapping as she also performs these functions for you over a period of several days until you feel comfortable with it. Depending on the severity and type of LE you have, it may or may not be necessary to use heavy foams or "chip bags" in the wrapping process.
Also, wrapping takes some time and patience to get it "just right" so that the wraps are not so tight they cutoff your circulation, or so loose that they won''t stay up and are ineffective. You need to learn how to apply wraps in such a way that they provide firm, graduated pressure without causing pain or numbness. You can learn this with a therapist's guidance and lots of practice.
Hope this helps!
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Thank you for your responses. I had never heard of a stockinette and especially foam. My PT had me wrap my arm a few years ago when I was having some trouble but I don't need to now unless I have a flare. She taught me using short stretch plus the white gauze/bandage on the inside. She also lent me a video for a few weeks on how to do it. Since how I was taught wasn't anything like the photos here, I felt a little bewildered! Also I have friends who are treated at other institutions who were trained slightly differently than I was, but they still never used foam, so the context of the photos was a little confusing. Thanks for clearing that up.
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I agree, when wrapping it is an individual thing and not a one size fits all per say. Our lymphedema is as individual as we each are. The best place to start out is your trained PT.
Jennifer
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Hi Girls,
This is the way i was taught to wrap by my therapist and it worked for me.
I don't need to wrap anymore unless i get a flare up.
The foam is because my le is stubborn and it took the padding to bring
it down.
Also the tape i believe from North America Seminars on
"upper extremity & bandaging & self massage" is the same.
We all do it a little different because different therapists do it their way and it is important to check with your therapist first.
Hope whatever way you do it that it works for you.
bc and le hugs jinky
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Binney, when you said applied with gradient pressure, do you mean alittle tighter at the wrist and gradually less tight toward top of arm?
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Yep, that's exactly right. It's an art.
I did some suffering for my art, too -- or at least some angry tears and tossed bandages. But when you finally get it right, aaaah! It's a thing of pride and beauty!Well, maybe not beauty...
But you should definitely be proud of yourself! -
Can anyone tell me how long to wear the wrappings? I don't like sleeping with my arm wrapped, so I need to know what would be an effective length of time when I'm awake. Thanks!
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Hi, Patty,
I sure hear you on not liking to sleep with the rotten bandages on. It's a tough thing to have to swallow.
But I'm not quite understanding your question. Are you doing a Therapy Intensive with a lymphedema therapist? That'd mean four or five days a week of therapeutic massage and wrapping for a couple of weeks or longer. If that's what you're doing, then the therapist will be expecting you to wear the wrapping until you shower right before your next appointment. That's the quickest and most effective way to reduce the swelling and get some alternative lymph routes opened up and functioning. After the therapy reduces the swelling as far as it will go, you can be fitted for daytime compression garments and, if you like, with a different kind of night garment to wear instead of the bandages. It's lots more comfortable and convenient.
(But the swelling has to be down first before you can be fitted for it).It's perfectly understandable that you wouldn't want to wear the bandages that long, and I can sure identify with that feeling. But if you're not going to do it, then your best bet would be to talk it over with your therapist. Maybe she'd have some ideas on a compromise, like more self-massage, or sleeping with your arm elevated on pillows, or rewrapping twice during the day and only removing the wrapping while you sleep. After all we've been through already it's really hard to take this on too. We sometimes just need some time to get our bearings and make the decisions that are best for US.
Patty, this is about YOU, and you are worth a whole lot of effort and inconvenience to make sure you're as well and as safe as you can be. Wrapping is the pits because lymphedema is the pits, but the best way to get your life back in your own hands is to do the therapy as quickly and effectively as you can. And that means wrapping at night.
So, grim as this is, Patty, if you've got a good therapist, work with her. The therapy ends, even if it seems like it never will
, and you end up with far more convenient and comfortable ways to control the lymphedema and move on with your life. Hang tough! Binney
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I have some naive questions about wrapping.
Background: This past Monday, my onco surgeon gave me a referral to see a PT/LE therapist because of the cording, pain, limited ROM, etc., in my mast/SNB arm. The clinic has confirmed the referral but the scheduler hasn't called yet. I'm pretty sure this will turn out to be LE, 'cause I'm getting some swelling with pitting edema in my forearm that wasn't there a few days ago. I was evaluated by the therapist in April but did not have any signs of LE or other problems then.
Anyway, I already know I need to go to a med supply place to be fitted for, and to purchase, a sleeve and gauntlet. My surgeon gave me a script for that on Monday, when I told her the therapist had said in April it would be good to have one "just in case." The therapist doesn't do the fittings for sleeves and gloves.
But, what about the bandaging material for wrapping? Does the PT/LE therapist provide those, when she shows me how to wrap (if I need to wrap)? Or, will I have to get another script from my surgeon (2 hours away) and go to the med supply place for those, too? How many sets do you need to buy? Can they be washed and re-used, or must they be thrown away?
This is so confusing and scary! I was soooo hoping I would not get LE, especially this soon after finishing my surgery & chemo. My surgeon estimated that I had only a "5% chance" of developing LE, since she only removed 3 sentinel nodes and they were negative. But, I had less than a 5% chance of developing BC in the first place... so I guess I must be the lucky type.
otter
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Otter, my LE therapist gave me the stockinette, foam, a lighter type cotton wrap, finger gauze bandages, and the three sizes of short stretch bandages for wrapping when she taught me how to wrap.
I ordered a second set of the exact same thing from Bandages Plus. I did not need a prescription to order them, but just ordered the exact same thing my therapist gave me.
I throw away the stockinette, but wash the other stuff on gentle, cold water in Dreft, and hang them to dry.
Not sure what others do, but this was suggested by my therapist.
And I think each therapist has certain "tricks of the trade" as far as wrapping styles go--indeed, you should not try this on your own until you have done it several times with your therapist watching and approving of the way you do it.
My first therapist measured and fitted the sleeve and glove and showed me how to put it on--what a waste--second therapist sent me to the medical supply fitter--she was great--insisted I use the donning glove, had me put it on and take it off, showed me how to put my hand againt the wall and use the glove to totally smooth the entire sleeve--made sure it went right up to the axilla and no turns, bends, wrinkles, etc. And that fitting was for free!!! When she saw the sleeve and glove my first therapist had given me, she showed me how poorly it fit, how it was much too short for my arm, how the glove was much too loose and was not helping at all--
While it might take a bit to learn both the wrapping and the proper putting on of the sleeve it is well worth it!
You will do fine.
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Aw, phooey, otter!
Okay, if I remember correctly you went and saw a really crackerjack therapist, right? Is this the one you'll see again? Hope so! You are gonna be in good hands.
DON'T go get the sleeve and glove now, because IF you do a massage and wrapping therapy intensive, you'll want to wait and be fitted when that's over. Getting them now, if there's some swelling present, will only get you the wrong size.
As for bandages, when you make the appointment ask if you need to bring any supplies with you. Some therapists supply you with the first set, which will last throughout the therapy intensive and a bit beyond. By then you'll be an old hand at it and know how to order on-line and not have to run to the medical supply place.
If your fingers are wrapped, the finger gauze doesn't last as long as the arm and hand bandages, but you'll still have enough time to order them on-line before you need to replace them. Most insurance doesn't cover bandages, but it doesn't hurt to check. Everything's washable, but you need a lingerie bag so they don't wrap themselves around the washer thingy. (Does that sound like the voice of experience speaking? Does that sound like "duh!"? Well, yes, on both counts.
)otter, I was so hoping you wouldn't get LE too! Not ever! I wish we lived close and I could hug you for real, but short of that I really do want to reassure you that once you have things back in control, and the skills you need to keep it that way, it'll be even easier than having to worry that you might get it. The massage is wonderful, so do relax and enjoy it. Learn to do it yourself and do it right, with soft lighting, your favorite music and a peaceful mind and heart. The wrapping is bizarre, but doggone if it doesn't work like a charm. And the precautions really do become second nature. You can do this, otter. It'll be good!
Hugs, prayers,
Binney -
Jane, you throw away the stockinette every time?! Doesn't that get EXPENSIVE!! For me that's the easiest part to wash -- toss it in with my other clothes and dry it in the dryer. Snaps right back into shape. The finger gauze is another thing, have to smooth it all out inch by inch to get it to lie flat again. Only time I ever heard of replacing the stockinette every time was when there was open infection.
There is ALWAYS something new to learn on this board!
Blows my mind... Binney
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Binney--they had a sale on the stockinette--25 meters for I think it was $5.00 so I got two--also, if you keep your eyes open, Bandages Plus often has either sales, or you will get a "free" short stretch, or a "free" roll of foam or cotten padding with certain things--but thanks for the tip--I thought it was so flimsy it would be out of shape from the washing. I will start washing it and see what happens. $5.00 is still $5.00!
Opps--Thank you Binney--I had forgotten to mention the mesh lingerie bag for washing--he he he--another "duh!" and voice of experience here--that was no fun unwrapping from around the "washer thingy."
Binney--have you ever put the bandages in the dryer in a mesh bag? My therapist said to hang the to dry, and also to not put the sleeve/gauntlet in the dryer either and they will last longer--any opinion?
Otter, I too was hoping you would not be joining our swell club, but if you are, it certainly seems like you are getting it right at the get-go, which is great. The therapist you first consulted with will have all of your initial measurements, and that is great, you will see just where you stand.
And the intensive stage does end--drum roll please--I am having my last intensive this morning with my therapist and will "graduate" to self care, only seeing her if things get out of control and I need her.
And Binney is so right about making the MLD a pleasant, relazing time. I took Binney's advice and learned to enjoy it, and made a special play list of music for my I-Pod, sprinkle lavender oil around the room (I love that smell!) and my cocker gets on the bed with me--I start by giving her tummy rubs until she makes happy sounds, then tell her--my turn, sweetie--and she lies next to me--I take a couple breaks in between for deep breathing and give her some tummy rubs till I hear happy sounds, and then back to me.
Then we do the Lebed Tape--I also incorporated the dog into this--she has her special squeaky toy for this, she loves the music and I tell her "shake your booty" and she shakes and squeaks her toy in her mouth and runs around the house and back into the bedroom and brings it to me--I throw it, tell her to shake her booty and she runs around the house squeaking and comes back. (We had taken doggie free style dancing lessons, and when "Dancing Queen" comes on, we divert into one of our old dance routines)
Afterwards, I feel like we both had a relaxing massage and a work out, and what a great way to start the day. Of course it means getting up earlier, but it is worth it.
Instead of feeling like the MLD is a pain in the a$$, we have made it fun. Thanks for that suggestion, Binney.
Keep us updated, Otter. You will do fine.
Just a little disclaimer here--I am a newbie at this, and please always take Binney's advice over mine--I just throw in what I found helpful, and do not want to ever give bad advice to anyone due to my inexperience.
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Thanks for all the great advice, everybody! I felt much better after reading your helpful and encouraging replies. It's funny how some kind words, sage advice, and a good night's sleep, can make a scary situation seem much more manageable.
The PT/LE clinic called today to set up my appt. They are really, really busy (lots of referrals for LE lately), so the soonest I can get in is Sept. 8th. She said she'd call right away if there was a cancellation.
In the meantime, I'm staying cool, elevating my left arm, doing MLD (not so skilled at that yet), not eating salt, drinking lots of water, etc. I do have a script for a sleeve & gauntlet, but I'm hesitant to get fitted now, before I talk to the therapist and before the swelling (though mild & transient) goes down.
I'm happy to be surrounded (virtually) by such wonderful women!
otter
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otter, good for you! Keep us posted. Hugs, prayers!
Jane, I'm no pro either! Just a patient like you, though I've made enough mistakes to learn a lot.
With my LE gear, I don't put any of it in the dryer (except the stockinette and my night garments). My fitter, who works for Bio-Concepts, says I can put the sleeves and gloves in the dryer on a cool setting, but they're so easy to hang out I don't bother. The short-stretch bandages I roll up wet, just to get them smoothed out, then I unroll them over the shower bar and let them hang dry. The gauze is more trouble. I smooth it inch by inch over the rounded metal back bar of a kitchen stool then hang them nice and straight over the shower bar. I've heard of women ironing the gauze with a coolish iron, but that's way above and beyond for me!Otter, it'll be good!
Binney
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I want to ask a question: I've had 10 of 33 treatments of radiation on my left side and today I noticed that my left arm felt tight and sore like I had the circulation cut off. My watch and ring were also tight. I plan to talk to the nurse in the morning, but was looking for information. Does this sound like lymphedma?
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Good morning, Sharpie,
Sorry a response is late and hope by now you've gotten some help from the nurse. Sure does sound like you'll want to get an evaluation from a well-qualified lymphedema (LE) therapist. You'll need a referral from any of the docs on your medical team, and if you need help finding a therapist who's well-trained near you, here are a couple of links that will help:
www.mylymphedema.com Click on the Therapist Locator and follow all the links.
www.clt-lana.org There's a menu on the left-hand side with a link to locate therapists.
For reliable information about LE, you can't beat the National Lymphedema Network. Check out their Position Papers on Risk Reduction, Air Travel, Exercise, and Therapy here:
And do please let us know what you discover today!
Gentle hugs,
Binney -
Hi, everyone.
I talked to the dr. yesterday and they took measurements and again this morning. He said it was highly unlikely that I was developing lymphedema since the radiation wasn't going in the area of my lymph nodes, but they would keep measuring my arm. Last night, my left fingers were so swollen my ring had left an indention, yet my right side was fine.
Thanks Binney for the websites. I've been reading and I at least know what to watch for now.
Thank-you's to this board!
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Sharpie, it might be wise to remove your rings for now until this is well settled. I see from your signature line you had no nodes purposely removed, but any surgery to the chest area can result in lymphedema, so certainly LE is possible even without radiating the axilla. So...unlikely, yes (and I sure hope it's not LE
!), but still possible.You're 1/3 of the way there! Congrats, and hope the remaining rads time flies by!
Be well,
Binney -
I am reposting Kira's pictures of finger wrapping up here so we can all find it when needed:
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could you please e-mail me the instructions on how to wrap your and arm. I am going to thereapist and am still learing and could use written instructions and pictures. I just joined this site and love it. I have lymphedema in my right hand and arm and I am right handed. My e-mail is jcd91843@yahoo.com Thanks jumpingjoan
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Hi, Joan, and welcome!
Glad you found us.
Here's a webpage with some pictures and information about wrapping, but since every therapist will do it a bit differently, do make your own adjustments to the written instructions:http://www.stepup-speakout.org/wrapping_bandaging_for_lymphedema.htm
There's also a book called "Lymphedema, a Breast Cancer Patient's Guide to Prevention and Treatment" by Burt and White that's full of instructions for all the steps of therapy, plus interviews with other women about how they handle their self-care. It's a good reference to have on hand. You can order it from any bookstore, or on-line at Amazon.
Hope that helps! Learning to wrap and do the self-massage is a steep learning curve, especially left-handed. Some of us have even been known to do some raging and bandage tossing in the process.
Hang in there -- it gets better, honest!Hugs,
Binney
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