lymphedema and surgery/casts

Stronglady, my fracture didn't require surgery, but I was in a spica cast for 6 weeks, and the trauma of the fracture caused a lot of swelling.

I saw my LE therapist on a regular basis, and she compared notes with her former partner in NYC who had a patient with a more severe frecture at the very same time. 

I finger wrapped at night, elevated a lot, and did MLD above, and it never swelled above the cast, except one cast that was too tight: I found it that a good cast tech was imperative--there was a great one, and he "bivalved" my cast--cut through the fiberglass down to the padding so it could expand, and he padded the heck out of my hand and pressure points on wrist. He did my first one when I was really swollen, and then another tech put on a really tight one two weeks later--and it hurt almost immediately, and I went in, and another not so good cast tech just cut out a window over the tightest spot on my wrist, and I spent a painful weekend and got some swelling at the elbow above it, and went in on the Monday, and demanded the great tech, and that's when he did the super cast.

When the cast came off: my hand was swollen and disgusting. And it took time to get my hand back to "normal"--but it has pretty much gotten there. My swelling is primarily in my hand, and I don't usually need much day time compression, and I'm back to that point. I do wrap at night.

So, in my experience, the cast tech needs to understand your dual need for protection and not to over constrict.

After the cast came off, I did OT with a woman trained for LE: and she still didn't get that I couldn't do 40 reps with a 1 lb weight, but she learned, but overall, she was a very good OT. I went to her because she also treats LE. She's not my primary LE therapist who is a LMT.

Good luck. It's doable, IMO.

Kira