Lymphedema Alternative Medicine
Ideally, ask the patient to avoid smoking or drinking caffeinated beverages for 30 minutes before the blood pressure is taken and to rest for at least 5 minutes. Check to make sure the examining room is quiet and comfortably warm. Make sure the arm selected is free of clothing. There should be no arteriovenous fistulas for dialysis, scarring from prior brachial artery cutdowns, or signs of lymphedema (seen after axillary node dissection or radiation therapy). Palpate the brachial artery to confirm that it has a viable pulse. Position the arm so that the brachial artery, at the antecubital crease, is at heart level roughly level with the 4th interspace at its junction with the sternum. If the patient is seated, rest the arm on a table a little above the patient's waist if standing, try to support the patient's arm at the midchest level.
1 The lymphatics may become blocked by infection and fibrosis due to the Microfilaria bancrofti. This usually results in lymphoedema of the legs and scrotum but occasional involvement of the main channels of the trunk and thorax is followed by chylous ascites, chyluria and chylous pleural effusion.
The health care professional managing the detainee should clean and dress open wounds as soon as possible to prevent the spread of infection. It may also be appropriate to start a course of antibiotics if there is abscess formation or signs of cellulites and or the detainee is systemically unwell. However, infections can often be low grade because the skin, venous, and lymphatic systems have been damaged by repeated penetration of the skin. In these cases, signs include lymphedema, swollen lymph glands, and darkly pigmented skin over the area. Fever may or may not be present, but septicemia is uncommon unless the individual is immunocompromised (e.g., HIV positive). Co-Amoxiclav is the preferred treatment of choice because it covers the majority of staphylococci, streptococci, and anerobes (the dose depends on the degree of infection).
Although lymphatic metastases are commonly found in patients assessed for radical treatment, they do not invariably give rise to clinical problems. When they do, patients usually suffer from the effects of lymphatic obstruction, resulting in swollen legs. It is relatively unusual for para-aortic, or mediastinal lymph node metastases to be of clinical significance, although, presumably, they are frequently involved pathologically (16).