In response to our recent article “Debunking the Myths and Fears around Lymphedema,” Tribe members wrote in with follow up questions:
I’ve heard that using hot tubs and saunas can be dangerous if you are at risk for developing lymphedema. Should I stay away from saunas/hot tubs?
Hot Tubbin’ in Helskinki
Dear Hot Tubbin’,
This is a great question! In order to answer it thoroughly, let’s first review the 4 Factors that research has proven increase your risk of developing lymphedema:
- Number of lymph nodes removed (for perspective, we have on average between 20-40 nodes per armpit)
- Whether or not you had radiation
- Developing an infection in the arm, trunk or breast
- A BMI (body mass index) > 25*
*Not sure your BMI? Use this calculator.
If your question is not related to one of the four factors, the answer is always, “maybe that will increase your risk?”
Our lymph systems are unique and unfortunately do not respond identically to similar situations. With that (admittedly annoying) bit of info, we can only talk about “risk reduction,” vs “how to prevent lymphedema,” or in this case, “how risky is it to use a sauna or hot tub?”
The reason saunas/hot tubs are traditionally on the “no-no” list, is because heat opens up our blood vessels, and increases the amount of blood flow to the heated area. Increased blood flow increases the amount of lymph that the lymphatic system then has to deal with, potentially creating a back up. Therefore, the conservative answer is, “avoid saunas/hot tubs.”
Ok, great, but that doesn’t answer the better question of “how risky is it?”
Here is a list of questions to ask yourself when deciding how risky it is for YOU:
- how many of the 4 factors do I have? (ie, am I at high risk of developing lymphedema in general?)
- how clean is this sauna/hot tub? Am I also at risk for developing an infection from it?
- how scary is the idea of lymphedema to me/ vs how important is this sauna/hot tub? Is it something I’m willing to possibly risk developing lymphedema for?
If you are someone who meets 3 of the 4 Factors, I personally WOULD NOT get in a sauna/hot tub.
Say you are a contestant on “the Bachelor” where it is basically required you get in a hot tub. There are ways to minimize risk and still partake:
- for sauna, sit on your own clean towel, and stay for no more than 5 min
- for hot tub, sit with your chest and arms out of water, and again limit time to no more than 10 min straight. After you leave hot tub, do not reenter until your body has completely cooled back off (at least 30 min).
Take home message:
The world of lymphedema is a gray one, often lacking definitive guidelines. With some knowledge, you can make informed decisions for what works best for you. If that responsibility stresses you out, simply avoid saunas/hot tubs altogether.
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