Flying with lymphedema: what the guidance recommends

This page is for people with lymphedema of the arm, swelling caused by lymph fluid that cannot drain properly, who are planning to fly. It covers what MedlinePlus advises for flights and for the rest of the trip.

If you are prescribed a compression sleeve, MedlinePlus self-care guidance gives two specific pieces of advice for flying.

Wear the sleeve when traveling by air. And, if possible, keep your arm above the level of your heart during long flights.

That is the whole of the flight-specific advice on that page. It is short, but it is unambiguous, and it can be acted on.

The common explanation people hear is that lower cabin pressure at high altitude lets fluid move into the tissues. That, the story goes, makes swelling worse.

This source does not say that. It gives the instructions without giving a mechanism.

That is worth being upfront about. Advice can be sound without a published explanation attached. A reason that sounds right and gets repeated online is not the same as a documented one. Follow the instruction, but treat the reasoning as uncertain.

Act on the advice, and hold the explanation loosely.

The compression advice on the same page is broader than flying alone.

• Wear the sleeve during the day
• Remove it at night
• Make sure you get the right size
• Wear it when traveling by air

MedlinePlus says to make sure you get the right size. The same guidance separately warns against tight clothing or wrapping anything tight on the limb with lymphedema. NCI says some people wear compression garments at night as advised by their lymphedema therapist. Ask your care team to check your sleeve and your routine before you travel.

MedlinePlus says to keep your arm above the level of your heart during long flights if possible. It does not say how. Ask your care team what is realistic for your flight.

Travel involves more than the flight itself, and the general self-care advice still applies while you are away.

• Clean the skin of the affected limb daily and use lotion to keep it moist
• Use an electric razor for shaving
• Wear gardening and cooking gloves for those tasks
• Avoid tight clothing on that limb

MedlinePlus also advises sunscreen with an SPF of 30 or higher, insect repellent, and carrying a handbag with the unaffected arm. A cut on vacation is harder to get looked at than a cut at home.

MedlinePlus lists the signs of infection to watch for: rash, red blotches, swelling, heat, pain or fever. Its instruction is to contact a health care provider right away. NCI says cellulitis, a skin infection that is common with lymphedema, can be life-threatening. It says to call your doctor right away for a fever or other signs.

Before your trip, find out how you would get medical advice at your destination and what your insurance covers. That is a fifteen-minute job at home and a stressful one abroad.

The most useful conversation is the one that happens before the tickets are bought. Your team knows your limb, your history and whether anything about your situation makes travel more complicated.

Take the flight length and the destination with you to that appointment. Specific questions get more useful answers than general ones.

• Call your care team right away if the limb with lymphedema develops a rash, red blotches, swelling, heat or pain, or you run a fever of 100.4°F (38°C) or higher, whether you are still travelling or already home. If you cannot reach your team, go to an urgent care center or emergency department.
• Call your care team within a day or two if the swelling that started with the flight has not settled after one to two weeks, or a ring, shoe or sleeve that fitted before the trip now feels tight.

• MedlinePlus — Lymphedema: Self-care
• NCI — Lymphedema (PDQ), patient version