About wounds with lymphedema
People whose swelling has been present for a long time are the ones most likely to develop a lymphedema wound. That includes people who had lymph nodes removed or treated with radiation for cancer, people with long-standing vein disease in the legs, and people who have had skin infections in the same limb more than once. Severe obesity can overload the lymphatic system. So can spending most of the day seated with the legs down, which is common after a stroke, with advanced arthritis, or with heart and lung conditions that limit walking.
A smaller group is born with lymph vessels that did not form normally, and their swelling may begin in childhood or early adulthood. Older adults often have several of these causes at once.
What the treating clinician looks at
A first assessment usually starts with the story of the swelling. The treating clinician asks when it began, whether it affects one limb or both, and whether it goes down overnight. A history of cancer treatment, leg surgery, injuries, blood clots or repeated skin infections matters, and so does the list of current medicines.
This history points to the cause, or more often the mix of causes, and that shapes the care plan. Swelling driven mostly by the lymphatic system is handled differently from swelling driven by the heart, the kidneys or the veins. The clinician may want records or test results from other offices, and Gateway gathers those ahead of the visit when it can.
Wound care with lymphedema in St. Peters
In many households in St. Peters, the family member who helps with wraps leaves early for work and gets home late. That leaves a long stretch when a wrap that slips or a dressing that soaks through has no one to fix it. Tell the treating clinician about the household schedule. Orders can sometimes be built around it, and home health nursing during the day may be an option. If your relative lives in one of the newer senior living communities, Gateway coordinates with the staff there as well.
Most people in St. Peters live in single-family subdivisions, and many of those houses are split-level or two-story, with the bedrooms up a flight of stairs. There are also apartment complexes, condominiums, villas for older adults, assisted living, memory care and skilled nursing facilities. Gateway arranges visits with partner clinicians in any of these settings. For a home visit we confirm the address and who will be there. For a facility visit we work with the nursing staff on timing, records and orders so the visit fits the resident’s day.
When care happens at home
Most of the work on a lymphedema wound happens between visits. The treating clinician leaves instructions for the days in between, and they usually cover washing and thoroughly drying the skin, using a moisturizer if one is ordered, keeping wraps or garments on as directed and resting with the limb raised.
Wraps slip, dressings soak through and questions come up. Ask at the visit whom to call when that happens and what to do in the meantime, so no one is left guessing on a weekend. If part of the routine is not working, say so. A plan can be adjusted, but only if the clinician hears about the problem.
Care in skilled nursing and assisted living
Rehabilitation stays are hard on swollen legs. Long sessions in a wheelchair with the feet down let fluid pool, and wraps can loosen or slide during therapy. The treating clinician works with physical and occupational therapists on timing and positioning, such as when wraps are checked, how leg rests are used and how much ankle movement and walking can be built into the day.
Discharge needs planning too. Before the resident goes home, someone has to know who will apply compression, where supplies will come from and who follows the wound. Gateway can arrange for visits to continue at home, with availability confirmed by location.
What to report and when to call 911
Changes in the swelling itself can point to something beyond the wound. Tell the treating clinician about:
- Swelling that increases quickly over a day or two
- Swelling that moves higher, into the thigh, groin or belly
- Rapid weight gain, or shoes and garments that suddenly do not fit
- Needing extra pillows to breathe comfortably at night
Sudden swelling and pain in one leg, often with warmth in the calf, needs urgent medical evaluation because it may be a blood clot. Call 911 for chest pain, trouble breathing, coughing up blood, fainting, or a racing heartbeat with lightheadedness.
Why primary care matters here
Medicines are part of the swelling picture. Some commonly prescribed drugs, including certain blood pressure, diabetes, pain and hormone medicines, can cause the legs to hold fluid. Water pills reduce some kinds of swelling and do little for others, and they can affect the kidneys and blood pressure along the way.
Sorting this out is a job for the prescriber. Do not stop or change a medicine on your own because of swelling. A primary care visit that includes a full medication review gives the prescriber and the wound clinician a shared, current list, and Gateway coordinates the records so both are working from it.
How to get started in St. Peters
To arrange wound care with lymphedema in St. Peters, call Gateway at 314-325-0126. Patients, family members and caregivers can call directly, and a referral is not required. We will ask where the patient lives, what has been done for the wound so far and which clinicians are involved. Gateway then confirms whether a partner clinician is available for that address and care setting, requests the relevant records and schedules the visit. At that visit the treating clinician examines the wound and decides on the plan. Our job from then on is the coordination: orders, supplies, follow-up visits and keeping the care team informed.
Barnes-Jewish St. Peters Hospital sits within the city, and many residents also receive care at SSM Health St. Joseph Hospital in St. Charles or Progress West Hospital in O’Fallon. Gateway is not affiliated with any of them. If you or a relative is coming home from one of these hospitals with a wound or a new care need, you can call us before or after discharge. Discharge planners and case managers can refer by phone or fax, and we coordinate records, the clinician’s orders and the first visit with a partner clinician.
- County: St. Charles County, Missouri
- ZIP codes: 63376
- Nearby hospitals: Barnes-Jewish St. Peters Hospital; SSM Health St. Joseph Hospital in St. Charles; Progress West Hospital in O'Fallon (not affiliated with Gateway)
- Nearby communities: St. Charles, O'Fallon, Missouri, Cottleville, Weldon Spring, St. Charles County
- Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation
More wound care in St. Peters
Read the full guide to wounds with lymphedema, or see everything Gateway arranges on the mobile wound care in St. Peters page.
- Diabetic foot ulcers
- Venous leg ulcers
- Pressure injuries and bed sores
- Arterial and mixed wounds
- Non-healing wounds
- Post-surgical wounds
- Reopened (dehisced) surgical wounds
- Surgical site infections
- Skin tears and traumatic wounds
- Skin graft aftercare
- Wound VAC (NPWT) follow-up
- Wound care with lymphedema in St. Charles
- Wound care with lymphedema in O'Fallon
- Wound care with lymphedema in St. Charles County
Common questions
Do I need a referral to request lymphedema wound care in St. Peters?
No. Patients, family members and caregivers can call Gateway directly at 314-325-0126 or send a callback request, with or without a referral. Some health plans have their own referral or authorization rules, and we ask about those when we confirm the treating provider. The web form asks only for a name and phone number, so please save medical details for the phone call.
Can a wound care clinician come to a home in St. Peters for a lymphedema wound?
Gateway arranges home visits with partner clinicians across Greater St. Louis and the Metro East, and availability in St. Peters is confirmed by address and care setting. Call 314-325-0126 to ask. It helps to have a list of your medicines, the names of the clinicians you see and any wraps or garments you have tried. The treating clinician decides what care is needed after seeing the limb.
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.
Can Gateway arrange a visit at an assisted living community in St. Peters?
Yes. Assisted living, memory care and skilled nursing residents in St. Peters can receive visits where they live. A family member or a staff member can make the request. Gateway works with the staff on timing, shares the treating clinician’s orders with them and keeps the family informed, so everyone caring for the resident follows the same plan.
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.