About wounds with lymphedema

Lymphedema is long-term swelling that builds when the lymphatic system cannot carry fluid out of an arm or leg as fast as it collects. The lymphatic system is a network of thin vessels and nodes that returns fluid to the bloodstream and helps the body fight infection. When it falls behind, fluid that is rich in protein settles in the tissue under the skin.

A lymphedema wound is any open area on a limb swollen this way. It may be a shallow raw patch, a blister that has burst, a split at the bottom of a skin fold or a deeper ulcer. Most are on the lower legs, ankles and feet. What they share is the setting: skin that is stretched, damp and slow to repair itself.

How the care plan is built

The care plan for a lymphedema wound has to fit the person who will live with it. The treating clinician weighs practical questions alongside the clinical ones:

  • Can you reach your own feet, and do you have the hand strength to manage wraps or garments?
  • Who is available to help, and at what times of day?
  • Where do you rest, and can the limb be raised there?
  • What will you wear on your feet over the wraps?

The answers shape the orders. A plan built on a garment that nobody in the house can put on will not last. Gateway then coordinates the supplies, any home health involvement and the follow-up schedule the clinician sets.

Wound care with lymphedema in Edwardsville

For people in Edwardsville, lymphedema care often spans two states. Cancer treatment or vascular care may have happened at a St. Louis hospital, while primary care, home health and the health plan are based in Illinois. Records sit on both sides of the river. Gateway gathers them and confirms first which partner clinician can see you in Illinois. Illinois Medicaid and Missouri plans follow different rules, and benefits for compression garments, wraps and dressings vary, so coverage questions are raised before visits begin.

Housing in Edwardsville covers a wide range: brick homes on the older streets near downtown, mid-century ranches, large newer subdivisions, and apartments and condominiums for students, working families and older adults. Assisted living, memory care, skilled nursing and rehabilitation settings are part of the mix. Gateway arranges visits with partner clinicians across all of them. The steps are the same wherever the patient lives: we confirm the setting, agree on a time with the patient, the caregiver or the facility staff, and make sure the treating clinician receives the records and current orders before the visit.

When care happens at home

Supplies run out quickly when a lymphedema wound is draining. Absorbent dressings, padding and wrap materials may be changed several times a week, and going without them for even a day or two can set the limb back. Gateway coordinates supply orders with the treating clinician’s orders and follows up with the supplier on delivery to your home.

Tell us when you are getting low, well before the last box is opened. It also helps to mention practical problems, such as fluid soaking through to bedding or furniture, or dressings that will not stay in place overnight. The clinician can often change the dressing or the plan to deal with them.

In a facility

A resident with lymphedema usually has other conditions that the attending physician is managing, and several of them influence swelling. The treating wound clinician and the attending physician need the same information: what the wound looks like, what compression is in place, and whether fluid, weight or medicines have changed.

Gateway handles the paperwork side of that exchange. Visit findings and recommended orders go to the attending physician and the director of nursing, and relevant labs or notes from the facility come back to the wound clinician. Each clinician keeps authority over their own decisions, and the facility keeps one clear record.

Signs to tell the clinician about

Compression should feel snug and supportive. It should not hurt. Report these problems to the treating clinician, and ask ahead of time what to do if one of them shows up at night or on a weekend:

  • Numbness, tingling or a pins-and-needles feeling below the wrap
  • Toes or fingers that look pale, blue or dusky, or feel cold
  • Pain that builds under the wrap instead of easing
  • A wrap that has slid down, bunched up or formed a tight band
  • Fluid soaking through the outer layer

Call 911 for chest pain, sudden shortness of breath, or a foot or hand that turns cold, white and severely painful.

Why primary care matters here

Because lymphedema lasts longer than any single wound, someone needs to hold the long view. A primary care clinician can track how often skin infections return, check the feet and toenails for the fungal problems that let bacteria in, and serve as the point of contact for the other specialists you see.

Gateway arranges wound care and primary care together for this reason. When the wound visits wind down, there is already a clinician who knows the history, the garments in use and what an early flare looks like for you. Questions such as who reorders garments, and how often the limb should be rechecked, have a place to go.

Primary care at home in Edwardsville →

Arranging wound care with lymphedema in Edwardsville

You may already have a surgeon, a wound clinic or a home health nurse and still want help with wound care with lymphedema closer to home in Edwardsville. That is a fine reason to call 314-325-0126. Tell us who is treating the wound now and what is not working, whether that is the travel, the gaps between appointments or unclear instructions. Gateway does not replace your current clinicians. We can arrange for a partner clinician to see the wound where you live and, with your permission, share notes with the offices already involved so the plans agree.

Anderson Hospital in Maryville, a few miles south on Route 159, is the closest hospital to Edwardsville, and some residents are treated at hospitals in St. Louis as well. Gateway is not affiliated with Anderson Hospital. Families can call us before or after a discharge to ask about follow-up at home. Discharge planners and case managers can refer by phone or by fax at 314-786-7966. Either way, we collect the discharge summary and orders, confirm the address or facility the patient is returning to, and arrange the visit with a partner clinician.

More wound care in Edwardsville

Read the full guide to wounds with lymphedema, or see everything Gateway arranges on the mobile wound care in Edwardsville page.

Common questions

Will Medicare or my health plan pay for lymphedema wound care in Edwardsville?

It depends. You can ask us about Medicare, Medicare Advantage, Medicaid and commercial plans. Whether a provider participates, and what your benefits are, depends on the treating provider, your plan and the care the clinician orders. Visits, dressings, compression garments and pumps are often handled under different rules. We go over these questions with you before care starts.

Should I rest with my leg raised or try to keep moving?

Usually both have a place. Raising the limb while resting lets gravity help fluid drain, and walking or moving the ankles works the muscles that push lymph along. Long hours sitting still with the feet on the floor tend to make swelling worse. The right balance depends on your heart, your steadiness on your feet and your wound, so ask the treating clinician what is safe for you.

My arm is swollen after breast cancer treatment and the skin has opened. Can Gateway help?

You can ask us about any lymphedema wound, including one on an arm or hand. Arm lymphedema after lymph node surgery or radiation carries the same infection risk as leg lymphedema, and a new opening in the skin should be reported promptly. Let your oncology team know as well. Gateway can arrange an assessment with a partner clinician and share the findings with the clinicians who managed your cancer care.

My parents live in Edwardsville and I live in another state. Can I arrange care for them?

Yes. Family members can call 314-325-0126 from anywhere. Have your parents’ address, a local phone number and the name of their regular doctor ready, and let them know to expect a call. With their agreement, we can keep you informed about scheduling and follow-up as the family contact. The treating clinician will want to talk with your parents directly about their health and their wishes.

General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.