Showing posts with label sore. Show all posts
Showing posts with label sore. Show all posts
Monday, March 4, 2013
exciting news :)
Hello everyone,
I have the most exciting news someone with Lymphedema could possibly have!! After a long & tedious 2 year battle with a pressure sore on my left heel I am pleased to announce that...
It has finally healed.
The nurses & Dr's kept telling me that I was going to loose my foot/leg. I was so distrort. So for them to actually be happy with my progress it's fantastic.
have a great day/night all.
Amanda <3
Friday, September 28, 2012
lymphedema.
Is a condition of localized fluid retention and tissue swelling caused by a compromised lymphatic system.
Tissues with lymphedema are at risk of infection.
Lymphedema affects approximately 140 million people worldwide
Lymphedema may be inherited (primary) or caused by injury to the lymphatic vessels (secondary). It is most frequently seen after lymph node dissection, surgery and/or radiation therapy, in which damage to the lymphatic system is caused during the treatment of cancer, most notably breast cancer.
associated with accidents or certain diseases or problems that may inhibit the lymphatic system from functioning properly.
The diagnosis or early detection of lymphedema is difficult. The first signs may be subjective observations such as "my arm feels heavy" or "I have difficulty these days getting rings on and off my fingers". These may be symptomatic of early stage of lymphoedema where accumulation of lymph is mild and not detectable by any difference in arm volume or circumference.
Stages
Stage 0 (latent): The lymphatic vessels have sustained some damage which is not yet apparent. Transport capacity is still sufficient for the amount of lymph being removed. Lymphedema is not present.
Stage 1 (spontaneously reversible): Tissue is still at the "non- pitting" stage: when pressed by the fingertips, the tissue bounces back without any indentation. Usually upon waking in the morning, the limb or affected area is normal or almost normal in size.
Stage 2 (spontaneously irreversible): The tissue now has a spongy consistency and is considered "pitting": when pressed by the fingertips, the affected area indents and holds the indentation. Fibrosis found in Stage 2 lymphedema marks the beginning of the hardening of the limbs and increasing size.
Stage 3 (lymphostatic elephantiasis): At this stage, the swelling is irreversible and usually the limb(s) or affected area is very large. The tissue is hard (fibrotic) and unresponsive; some patients consider undergoing reconstructive surgery, called "debulking". This remains controversial, however, since the risks may outweigh the benefits, and the further damage done to the lymphatic system may in fact make the lymphedema worse.
Grades
Lymphedema can also be categorized by its severity (usually referenced to a healthy extremity):[citation needed]
Grade 1 (mild edema): Lymphedema involves the distal parts such as a forearm and hand or a lower leg and foot. The difference in circumference is less than 4 centimeters, and other tissue changes are not yet present.
Grade 2 (moderate edema): Lymphedema involves an entire limb or corresponding quadrant of the trunk. Difference in circumference is more than 4 but less than 6 centimeters. Tissue changes, such as pitting, are apparent. The patient may experience erysipelas.
Grade 3a (severe edema): Lymphedema is present in one limb and its associated trunk quadrant. The difference in circumference is greater than 6 centimeters. Significant skin alterations, such as cornification or keratosis, cysts and/or fistulae, are present. Additionally, the patient may experience repeated attacks of erysipelas.
Grade 3b (massive edema): The same symptoms as grade 3a, except two or more extremities are affected.
Grade 4 (gigantic edema): Also known as elephantiasis, in this stage of lymphedema, the affected extremities are huge due to almost complete blockage of the lymph channels. Elephantiasis may also affect the head and face.
Treatment
Treatment for lymphedema varies depending on the severity of the edema and the degree of fibrosis of the affected limb. Most people with lymphedema follow a daily regimen of treatment as suggested by their physician or certified lymphedema therapist. The most common treatments for lymphedema are a combination of manual compression lymphatic massage, compression garments or bandaging. Complex decongestive physiotherapy is an empiric system of lymphatic massage, skin care, and compressive garments. Although a combination treatment program may be ideal, any of the treatments can be done individually.
Compression
[edit]Garments
Elastic compression garments are worn by persons with lymphedema on the affected limb following complete decongestive therapy to maintain edema reduction. Depending on the therapist's discretion, a compression garment may be custom-fit or purchased in over-the-counter, standard sizes. Compression garments are meant to be worn every day to maintain edema reduction and must be replaced on a regular basis. Support garments may be the only Garment of Choice for patients with Scrotal edema.
[edit]Bandaging or wrapping
Compression bandaging, also called wrapping, is the application of several layers of padding and short-stretch bandages to the involved areas. Short-stretch bandages are preferred over long-stretch bandages (such as those normally used to treat sprains), as the long-stretch bandages cannot produce the proper therapeutic tension necessary to safely reduce lymphedema and may in fact end up producing a tourniquet effect. During activity, whether exercise or daily activities, the short-stretch bandages enhance the pumping action of the lymph vessels by providing increased resistance for them to push against. This encourages lymphatic flow and helps to soften fluid-swollen areas.
[edit]Sequential gradient pump therapy
Compression pump technology utilizes a multi-chambered pneumatic sleeve with overlapping cells to promote movement of lymph fluid. Pump therapy may be used in addition to other treatments such as compression bandaging and manual lymph drainage. In many cases, pump therapy may help soften fibrotic tissue and therefore potentially enable more efficient lymphatic drainage. Sequential pump therapy may also be used as a home treatment method, usually as part of a regimen also involving compression garments or wrapping.
A Stanford University medical study showed that patients receiving the combined modalities of MLD/CDT and pneumatic pumping had a greater overall reduction in limb volume than patients receiving only MLD/CDT.[14] However, some therapists have begun to raise concern that compression pumps can cause genital swelling when used on persons with leg lymphedema.
Surgical treatments for lymphedema
Several effective surgical procedures exist to provide long-term solutions for patients who suffer from lymphedema. Prior to any lymphedema surgery, patients typically have been treated by a physical therapist trained in providing lymphedema treatment for initial conservative treatment of their lymphedema. Complete decompression therapy (CDT), manual lymphatic drainage (MLD) and compression bandaging are all helpful components of conservative lymphedema treatment.
Lymphatic vessel grafting
With the possibilities of advanced microsurgical techniques lymphvessel can be sutured and used as grafts, a technique which is well known in vascular surgery. Locally interrupted or obstructed lymphatic pathway, mostly after resection of lymph nodes, can be reconstructed by a bypass using lymphatic vessels. These vessels are specialized to drain lymph by active pumping forces. These grafts are connected with main lymphatic collectors in front and behind the obstruction. The technique is mostly used in armedemas after treatment of mammary carcinomas and in unilateral edemas of lower extremities after resection of lymphnodes and radiation. The method was developed experimentally at the Institute of Experimental Surgery, the Ludwig Maximilians University (LMU) in Munich. It was introduced as treatment in 1980 by Prof. Ruediger Baumeister[16].
The method is proved to be effective[17]. Follow up studies showed significant reduction of volume of the extremities even 10 years after surgery[18].
The patients, who had been previously treated with both MLD and compression therapy, gained significant improvements in quality of life after being treated with lymphatic vessel grafting[19]. Lymphoscintigraphic investigations at the Clinic of Nuclear Medicine at LMU showed a lasting enhancement of lymphatic transport after grafting[20].
The patency of lymphatic grafts have been demonstrated by the Institute for Clinical Radiology after more than 12 years, using indirect lymphography and MRI lymphography.
Tissues with lymphedema are at risk of infection.
Lymphedema affects approximately 140 million people worldwide
Lymphedema may be inherited (primary) or caused by injury to the lymphatic vessels (secondary). It is most frequently seen after lymph node dissection, surgery and/or radiation therapy, in which damage to the lymphatic system is caused during the treatment of cancer, most notably breast cancer.
associated with accidents or certain diseases or problems that may inhibit the lymphatic system from functioning properly.
The diagnosis or early detection of lymphedema is difficult. The first signs may be subjective observations such as "my arm feels heavy" or "I have difficulty these days getting rings on and off my fingers". These may be symptomatic of early stage of lymphoedema where accumulation of lymph is mild and not detectable by any difference in arm volume or circumference.
Stages
Stage 0 (latent): The lymphatic vessels have sustained some damage which is not yet apparent. Transport capacity is still sufficient for the amount of lymph being removed. Lymphedema is not present.
Stage 1 (spontaneously reversible): Tissue is still at the "non- pitting" stage: when pressed by the fingertips, the tissue bounces back without any indentation. Usually upon waking in the morning, the limb or affected area is normal or almost normal in size.
Stage 2 (spontaneously irreversible): The tissue now has a spongy consistency and is considered "pitting": when pressed by the fingertips, the affected area indents and holds the indentation. Fibrosis found in Stage 2 lymphedema marks the beginning of the hardening of the limbs and increasing size.
Stage 3 (lymphostatic elephantiasis): At this stage, the swelling is irreversible and usually the limb(s) or affected area is very large. The tissue is hard (fibrotic) and unresponsive; some patients consider undergoing reconstructive surgery, called "debulking". This remains controversial, however, since the risks may outweigh the benefits, and the further damage done to the lymphatic system may in fact make the lymphedema worse.
Grades
Lymphedema can also be categorized by its severity (usually referenced to a healthy extremity):[citation needed]
Grade 1 (mild edema): Lymphedema involves the distal parts such as a forearm and hand or a lower leg and foot. The difference in circumference is less than 4 centimeters, and other tissue changes are not yet present.
Grade 2 (moderate edema): Lymphedema involves an entire limb or corresponding quadrant of the trunk. Difference in circumference is more than 4 but less than 6 centimeters. Tissue changes, such as pitting, are apparent. The patient may experience erysipelas.
Grade 3a (severe edema): Lymphedema is present in one limb and its associated trunk quadrant. The difference in circumference is greater than 6 centimeters. Significant skin alterations, such as cornification or keratosis, cysts and/or fistulae, are present. Additionally, the patient may experience repeated attacks of erysipelas.
Grade 3b (massive edema): The same symptoms as grade 3a, except two or more extremities are affected.
Grade 4 (gigantic edema): Also known as elephantiasis, in this stage of lymphedema, the affected extremities are huge due to almost complete blockage of the lymph channels. Elephantiasis may also affect the head and face.
Treatment
Treatment for lymphedema varies depending on the severity of the edema and the degree of fibrosis of the affected limb. Most people with lymphedema follow a daily regimen of treatment as suggested by their physician or certified lymphedema therapist. The most common treatments for lymphedema are a combination of manual compression lymphatic massage, compression garments or bandaging. Complex decongestive physiotherapy is an empiric system of lymphatic massage, skin care, and compressive garments. Although a combination treatment program may be ideal, any of the treatments can be done individually.
Compression
[edit]Garments
Elastic compression garments are worn by persons with lymphedema on the affected limb following complete decongestive therapy to maintain edema reduction. Depending on the therapist's discretion, a compression garment may be custom-fit or purchased in over-the-counter, standard sizes. Compression garments are meant to be worn every day to maintain edema reduction and must be replaced on a regular basis. Support garments may be the only Garment of Choice for patients with Scrotal edema.
[edit]Bandaging or wrapping
Compression bandaging, also called wrapping, is the application of several layers of padding and short-stretch bandages to the involved areas. Short-stretch bandages are preferred over long-stretch bandages (such as those normally used to treat sprains), as the long-stretch bandages cannot produce the proper therapeutic tension necessary to safely reduce lymphedema and may in fact end up producing a tourniquet effect. During activity, whether exercise or daily activities, the short-stretch bandages enhance the pumping action of the lymph vessels by providing increased resistance for them to push against. This encourages lymphatic flow and helps to soften fluid-swollen areas.
[edit]Sequential gradient pump therapy
Compression pump technology utilizes a multi-chambered pneumatic sleeve with overlapping cells to promote movement of lymph fluid. Pump therapy may be used in addition to other treatments such as compression bandaging and manual lymph drainage. In many cases, pump therapy may help soften fibrotic tissue and therefore potentially enable more efficient lymphatic drainage. Sequential pump therapy may also be used as a home treatment method, usually as part of a regimen also involving compression garments or wrapping.
A Stanford University medical study showed that patients receiving the combined modalities of MLD/CDT and pneumatic pumping had a greater overall reduction in limb volume than patients receiving only MLD/CDT.[14] However, some therapists have begun to raise concern that compression pumps can cause genital swelling when used on persons with leg lymphedema.
Surgical treatments for lymphedema
Several effective surgical procedures exist to provide long-term solutions for patients who suffer from lymphedema. Prior to any lymphedema surgery, patients typically have been treated by a physical therapist trained in providing lymphedema treatment for initial conservative treatment of their lymphedema. Complete decompression therapy (CDT), manual lymphatic drainage (MLD) and compression bandaging are all helpful components of conservative lymphedema treatment.
Lymphatic vessel grafting
With the possibilities of advanced microsurgical techniques lymphvessel can be sutured and used as grafts, a technique which is well known in vascular surgery. Locally interrupted or obstructed lymphatic pathway, mostly after resection of lymph nodes, can be reconstructed by a bypass using lymphatic vessels. These vessels are specialized to drain lymph by active pumping forces. These grafts are connected with main lymphatic collectors in front and behind the obstruction. The technique is mostly used in armedemas after treatment of mammary carcinomas and in unilateral edemas of lower extremities after resection of lymphnodes and radiation. The method was developed experimentally at the Institute of Experimental Surgery, the Ludwig Maximilians University (LMU) in Munich. It was introduced as treatment in 1980 by Prof. Ruediger Baumeister[16].
The method is proved to be effective[17]. Follow up studies showed significant reduction of volume of the extremities even 10 years after surgery[18].
The patients, who had been previously treated with both MLD and compression therapy, gained significant improvements in quality of life after being treated with lymphatic vessel grafting[19]. Lymphoscintigraphic investigations at the Clinic of Nuclear Medicine at LMU showed a lasting enhancement of lymphatic transport after grafting[20].
The patency of lymphatic grafts have been demonstrated by the Institute for Clinical Radiology after more than 12 years, using indirect lymphography and MRI lymphography.
Friday, August 24, 2012
over night hospital visit.
Hello Everyone,
This time it's not for me, I bet your thinking due my last post that it would have to be Hailee in well guess again!
Yep that's right it was for....the husband!. He has been fine ALL day up until 9pm when he first complained of back pain, he went to bed and within 15 minutes came back out to the lounge. He was fully dressed and was clutching his left side. He asked me to ring my mum to come and get Hailee as he needed to go to hospital because he thought he may have appendicitis (your appendices is on the right so I knew it wouldn't be that) he was white as a ghost and started throwing up.
I rang my mum. She told me she was coming and that my Uncle would drive Steve to the hospital. I packed Hailee a bag and waited for them. She came in and said he should have got an ambulance but he didn't want one plus I wanted to go with him and I knew they wouldn't help me in. My Uncle pulled up outside the house, Steve got in and he speed away. I was SO pissed!! I hated seeing him in so much pain and I knew if I stayed home I wouldn't have got any sleep. So mum decided to drive me up to hospital. She couldn't really find a good park so she she parked in the ambo section. I nearly died haha, I'm surprised she didn't get a fine.
I "ran" inside. No one is in the waiting room which is a good sign. Meaning he didn't have to sit there long and was already in a cubical and most likely seen by a doctor... thank god!. I waited outside for a few minutes then a nurse finally let me in. I pretty much ran to Steve's side. My Uncle who was still with him said, "looks like a kidney stone". I saw he was hooked up to morphine, the pain was so bad, I just could see it in his eyes... I wish I could have taken it away.
The nurse asked me a few questions and I mentioned my urologist's name and said that they needed someone to call him and only him (thank good ness he was on rotation) The nurse gave him something else to help with the pain because the morphine just wasn't cutting it (sad face). Pretty much as that hit his veins he was out like a light! coming to it every so often.
My Uncle is still with us (it's now 1am) I told him to go home as I knew he had to work early the next morning. I said if we were sent home we would be ok to find our own way. 10 minutes later the pain started again, doctor came in and said he would be having a CT in the morning. So we weren't going anywhere!!. my Uncle left (with hesitation).
Steve was just moved to a bigger room for the night, which luckily had a bigger/softer more comfy bed (it's now 2.05am). He can now get the rest he needs! As for me I am tired so I shall close my eyes for a little while.
I opened my eyes and looked at my phone, it was 3.30am. Steve hadn't complained about the pain until he woke just after me.
Strange to say but time seems to go so quick when you're in hospital. I think/say that every time I'm a patient but honestly even being a loved one of said patient time goes quick! Hmm I wonder why that is?.
It's now 6.30am both of us have had a rough night. Yes I spent the night in ER with him, sleeping every hour for aprox 20-30 minutes in my wheelchair (it was pretty comfy). The night nurse came in to check on us and said to me that she had ordered me breakfast... that's so nice of her! Poor Steve can't have any though. He says he isn't hungry at the moment but is thirsty, so I had been giving him ice all night. We are hoping to be on top of the list for the CT scan this morning, well it didn't pan out that way!.
Fast forward a few days.....
It's now Friday and he has only been home for a just over 24 hours. The doctor was hoping that Steve could "pass" the stone on his own but decided that due to him not getting any better he would be operated on the next morning! BEST NEWS I'VE HEARD ALL WEEK!!! I got a phone call from the urologist at 5.30pm Wednesday night to say he had just come out of surgery.
Both Hailee and I are SO glad to have him home, he is still not 100% but defiantly on the mend.
Night all <3
This time it's not for me, I bet your thinking due my last post that it would have to be Hailee in well guess again!
Yep that's right it was for....the husband!. He has been fine ALL day up until 9pm when he first complained of back pain, he went to bed and within 15 minutes came back out to the lounge. He was fully dressed and was clutching his left side. He asked me to ring my mum to come and get Hailee as he needed to go to hospital because he thought he may have appendicitis (your appendices is on the right so I knew it wouldn't be that) he was white as a ghost and started throwing up.
I rang my mum. She told me she was coming and that my Uncle would drive Steve to the hospital. I packed Hailee a bag and waited for them. She came in and said he should have got an ambulance but he didn't want one plus I wanted to go with him and I knew they wouldn't help me in. My Uncle pulled up outside the house, Steve got in and he speed away. I was SO pissed!! I hated seeing him in so much pain and I knew if I stayed home I wouldn't have got any sleep. So mum decided to drive me up to hospital. She couldn't really find a good park so she she parked in the ambo section. I nearly died haha, I'm surprised she didn't get a fine.
I "ran" inside. No one is in the waiting room which is a good sign. Meaning he didn't have to sit there long and was already in a cubical and most likely seen by a doctor... thank god!. I waited outside for a few minutes then a nurse finally let me in. I pretty much ran to Steve's side. My Uncle who was still with him said, "looks like a kidney stone". I saw he was hooked up to morphine, the pain was so bad, I just could see it in his eyes... I wish I could have taken it away.
The nurse asked me a few questions and I mentioned my urologist's name and said that they needed someone to call him and only him (thank good ness he was on rotation) The nurse gave him something else to help with the pain because the morphine just wasn't cutting it (sad face). Pretty much as that hit his veins he was out like a light! coming to it every so often.
My Uncle is still with us (it's now 1am) I told him to go home as I knew he had to work early the next morning. I said if we were sent home we would be ok to find our own way. 10 minutes later the pain started again, doctor came in and said he would be having a CT in the morning. So we weren't going anywhere!!. my Uncle left (with hesitation).
Steve was just moved to a bigger room for the night, which luckily had a bigger/softer more comfy bed (it's now 2.05am). He can now get the rest he needs! As for me I am tired so I shall close my eyes for a little while.
I opened my eyes and looked at my phone, it was 3.30am. Steve hadn't complained about the pain until he woke just after me.
Strange to say but time seems to go so quick when you're in hospital. I think/say that every time I'm a patient but honestly even being a loved one of said patient time goes quick! Hmm I wonder why that is?.
It's now 6.30am both of us have had a rough night. Yes I spent the night in ER with him, sleeping every hour for aprox 20-30 minutes in my wheelchair (it was pretty comfy). The night nurse came in to check on us and said to me that she had ordered me breakfast... that's so nice of her! Poor Steve can't have any though. He says he isn't hungry at the moment but is thirsty, so I had been giving him ice all night. We are hoping to be on top of the list for the CT scan this morning, well it didn't pan out that way!.
Fast forward a few days.....
It's now Friday and he has only been home for a just over 24 hours. The doctor was hoping that Steve could "pass" the stone on his own but decided that due to him not getting any better he would be operated on the next morning! BEST NEWS I'VE HEARD ALL WEEK!!! I got a phone call from the urologist at 5.30pm Wednesday night to say he had just come out of surgery.
Both Hailee and I are SO glad to have him home, he is still not 100% but defiantly on the mend.
Night all <3
Wednesday, August 15, 2012
my struggles with lymphedema [info.]
Hello Everyone,
today I thought I might tell you all the story of how I came to live with Lymphedema. But first I thought I should explain what Lymphedema actually is:
Lymphedema is a condition of localized fluid retention and tissue swelling caused by a compromised lymphatic system. Some of that tissue can turn "nasty" and become infected. Lymphedema affects around 140 MILLION people worldwide.
There are quite a few "stages/grades" which I will talk. Lymphedema can be inherited (know as primary) lymphedema OR like myself it can be caused by an accident or injury to the vessels (known as secondary). It happens when lymph nodes are dissected via surgery or something like radiation therapy.
In my case I think (yes still not 100% sure) that after I had major surgery on my spine, to place a rod and screws onto my spine to correct the scoliosis. The doctors actually took out or "snipped" one(1) or more of my lymph nodes. Which in turn caused as you read before damaged to them and I now have to live with lymphedema.
To diagnose or to detect lymphedema early is difficult. The first signs may be subjective observations such as "my arm feels heavy" or "I have difficulty these days getting rings on and off my fingers". But unfortunately I was unable to tell as my legs are effected and the worst one being my left leg I have no feeling in at all.
Stages
Stage 0 (latent): The lymphatic vessels have sustained some damage which is not yet apparent. Transport capacity is still sufficient for the amount of lymph being removed. Lymphedema is not present.
Stage 1 (spontaneously reversible): Tissue is still at the "non- pitting" stage: when pressed by the fingertips, the tissue bounces back without any indentation. Usually upon waking in the morning, the limb or affected area is normal or almost normal in size.
Stage 2 (spontaneously irreversible): The tissue now has a spongy consistency and is considered "pitting": when pressed by the fingertips, the affected area indents and holds the indentation. Fibrosis found in Stage 2 lymphedema marks the beginning of the hardening of the limbs and increasing size.
Stage 3 (lymphostatic elephantiasis): At this stage, the swelling is irreversible and usually the limb(s) or affected area is very large. The tissue is hard (fibrotic) and unresponsive; some patients consider undergoing reconstructive surgery, called "debulking". This remains controversial, however, since the risks may outweigh the benefits, and the further damage done to the lymphatic system may in fact make the lymphedema worse.
Grades
Lymphedema can also be categorized by its severity (usually referenced to a healthy extremity):[citation needed]
Grade 1 (mild edema): Lymphedema involves the distal parts such as a forearm and hand or a lower leg and foot. The difference in circumference is less than 4 centimeters, and other tissue changes are not yet present.
Grade 2 (moderate edema): Lymphedema involves an entire limb or corresponding quadrant of the trunk. Difference in circumference is more than 4 but less than 6 centimeters. Tissue changes, such as pitting, are apparent. The patient may experience erysipelas.
Grade 3a (severe edema): Lymphedema is present in one limb and its associated trunk quadrant. The difference in circumference is greater than 6 centimeters. Significant skin alterations, such as cornification or keratosis, cysts and/or fistulae, are present. Additionally, the patient may experience repeated attacks of erysipelas.
Grade 3b (massive edema): The same symptoms as grade 3a, except two or more extremities are affected.
Grade 4 (gigantic edema): Also known as elephantiasis, in this stage of lymphedema, the affected extremities are huge due to almost complete blockage of the lymph channels. Elephantiasis may also affect the head and face.
Treatment available
Treatment for lymphedema varies depending on the severity of the edema in the effected limb. Most people with lymphedema follow a daily routine of treatment as suggested by their physician or certified lymphedema therapist. The most common treatments for lymphedema are a combination of lymphatic massage, compression/bandaging. Complex decongestive physiotherapy is system realistic of lymphatic massage, skin care, and compressive garments. Although a combination treatment program may be ideal, any of the treatments can be done individually.
Surgical treatments for lymphedema.
Lymphatic vessel grafting. With the possibilities of advanced microsurgical techniques lymph vessels can be sutured and used as grafts, a technique which is well known in vascular surgery. Locally interrupted or obstructed lymphatic pathway, mostly after resection of lymph nodes, can be reconstructed by a bypass using lymphatic vessels. These vessels are specialized to drain lymph by active pumping forces. These grafts are connected with main lymphatic collectors in front and behind the obstruction. The method is proved to be effective. Follow up studies showed significant reduction of volume of the extremities even 10 years after.
Next time I post (which I am hoping with be Friday) I will be talking about my own experience with Lymphedema. Hope you all enjoy the rest of your week!!
Amanda <3.
today I thought I might tell you all the story of how I came to live with Lymphedema. But first I thought I should explain what Lymphedema actually is:
Lymphedema is a condition of localized fluid retention and tissue swelling caused by a compromised lymphatic system. Some of that tissue can turn "nasty" and become infected. Lymphedema affects around 140 MILLION people worldwide.
There are quite a few "stages/grades" which I will talk. Lymphedema can be inherited (know as primary) lymphedema OR like myself it can be caused by an accident or injury to the vessels (known as secondary). It happens when lymph nodes are dissected via surgery or something like radiation therapy.
In my case I think (yes still not 100% sure) that after I had major surgery on my spine, to place a rod and screws onto my spine to correct the scoliosis. The doctors actually took out or "snipped" one(1) or more of my lymph nodes. Which in turn caused as you read before damaged to them and I now have to live with lymphedema.
To diagnose or to detect lymphedema early is difficult. The first signs may be subjective observations such as "my arm feels heavy" or "I have difficulty these days getting rings on and off my fingers". But unfortunately I was unable to tell as my legs are effected and the worst one being my left leg I have no feeling in at all.
Stages
Stage 0 (latent): The lymphatic vessels have sustained some damage which is not yet apparent. Transport capacity is still sufficient for the amount of lymph being removed. Lymphedema is not present.
Stage 1 (spontaneously reversible): Tissue is still at the "non- pitting" stage: when pressed by the fingertips, the tissue bounces back without any indentation. Usually upon waking in the morning, the limb or affected area is normal or almost normal in size.
Stage 2 (spontaneously irreversible): The tissue now has a spongy consistency and is considered "pitting": when pressed by the fingertips, the affected area indents and holds the indentation. Fibrosis found in Stage 2 lymphedema marks the beginning of the hardening of the limbs and increasing size.
Stage 3 (lymphostatic elephantiasis): At this stage, the swelling is irreversible and usually the limb(s) or affected area is very large. The tissue is hard (fibrotic) and unresponsive; some patients consider undergoing reconstructive surgery, called "debulking". This remains controversial, however, since the risks may outweigh the benefits, and the further damage done to the lymphatic system may in fact make the lymphedema worse.
Grades
Lymphedema can also be categorized by its severity (usually referenced to a healthy extremity):[citation needed]
Grade 1 (mild edema): Lymphedema involves the distal parts such as a forearm and hand or a lower leg and foot. The difference in circumference is less than 4 centimeters, and other tissue changes are not yet present.
Grade 2 (moderate edema): Lymphedema involves an entire limb or corresponding quadrant of the trunk. Difference in circumference is more than 4 but less than 6 centimeters. Tissue changes, such as pitting, are apparent. The patient may experience erysipelas.
Grade 3a (severe edema): Lymphedema is present in one limb and its associated trunk quadrant. The difference in circumference is greater than 6 centimeters. Significant skin alterations, such as cornification or keratosis, cysts and/or fistulae, are present. Additionally, the patient may experience repeated attacks of erysipelas.
Grade 3b (massive edema): The same symptoms as grade 3a, except two or more extremities are affected.
Grade 4 (gigantic edema): Also known as elephantiasis, in this stage of lymphedema, the affected extremities are huge due to almost complete blockage of the lymph channels. Elephantiasis may also affect the head and face.
Treatment available
Treatment for lymphedema varies depending on the severity of the edema in the effected limb. Most people with lymphedema follow a daily routine of treatment as suggested by their physician or certified lymphedema therapist. The most common treatments for lymphedema are a combination of lymphatic massage, compression/bandaging. Complex decongestive physiotherapy is system realistic of lymphatic massage, skin care, and compressive garments. Although a combination treatment program may be ideal, any of the treatments can be done individually.
Surgical treatments for lymphedema.
Lymphatic vessel grafting. With the possibilities of advanced microsurgical techniques lymph vessels can be sutured and used as grafts, a technique which is well known in vascular surgery. Locally interrupted or obstructed lymphatic pathway, mostly after resection of lymph nodes, can be reconstructed by a bypass using lymphatic vessels. These vessels are specialized to drain lymph by active pumping forces. These grafts are connected with main lymphatic collectors in front and behind the obstruction. The method is proved to be effective. Follow up studies showed significant reduction of volume of the extremities even 10 years after.
Next time I post (which I am hoping with be Friday) I will be talking about my own experience with Lymphedema. Hope you all enjoy the rest of your week!!
Amanda <3.
Friday, July 13, 2012
OUCHIES....I'VE HURT MY KNEE [act 2]
continuing on from my last post....
So there I was sitting in the eating room for about 2 hrs, sleeping on and off. That's what my body does when i've hurt myself, it uses up the only energy I do have left to help the injured part.
I was finally called into the ER and they asked me to get on the bed so I could be examined. I said "sorry to be rude but there is no way in hell I am getting on that bed, as soon as I lay down and my leg is flat the pain is at it's worse". "Ok" they said "stay in the chair as long as you can" A doctor came in to find out my history (which is literally a medical book in itself) I told him what I had done, told him the medications I am allergic to and he walked off.
Another doctor walked in a while later and asked me to get onto the bed so he could examine my leg. I was hesitant but knew if I was to get an x-ray I had to get onto that bed. I informed this new doctor of what I had done, within 5 minutes an orderly came and took me to x-ray, I bought Steve with me incase they wanted me off the ER bed and onto one of theirs. Lucky for me I got to stay in the bed... thank god.
I had 3 pictures taken of me knee/leg. I had no idea what time it was by then but I was sleeping on and off, they came in gave me some pain killers and explained to me what I had done. Well because I was half asleep what I thought I heard them say was completely wrong and I was informing friends/family of the wrong info. They said I could leave as soon as a physcio therapist came to fit me with a brace. He arrived at 5pm. I have to wear my lovely brace for 4 weeks. As soon as he put it on the pain went away immediately... yay!!
Apparently I have torn my anterior crucial ligament (just like what footballers do). The doctor said that if I was able to walk I may have had to have a knee reconstruction. OMG!! As soon as I heard that I started hating myself, something so trivial, something I do everyday and I have really damaged my knee. I started getting depressed and knew I was unable to look after Hailee, I didn't want her to see me so sad. Luckily my mum was able to watch her for a few days so I could get my head sorted. I knew I needed to get on with things, I knew it would take me twice as long to get out of bed, to get dressed, to be able to do everyday things like laundry (lol). But I had to get on with life.
It's been just over 3 weeks now. I still have pain, again only when I am in bed, so I am on Pan- Forte. I feel as like the top of my leg is hanging on by a thread when I take my brace off during the day, it really isn't the nicest feeling at all!! Actually until the weekend just gone I hand't taken it off since they put it on me in the hospital.
Well that's my big new for this week (LOL) I am hoping to be back to normal in a week or 2. Let's wait and see huh... I shall keep you all updated on how I am feeling.
Night all. I hope you have a wonderful weekend.
Stay safe!
Amanda <3
So there I was sitting in the eating room for about 2 hrs, sleeping on and off. That's what my body does when i've hurt myself, it uses up the only energy I do have left to help the injured part.
I was finally called into the ER and they asked me to get on the bed so I could be examined. I said "sorry to be rude but there is no way in hell I am getting on that bed, as soon as I lay down and my leg is flat the pain is at it's worse". "Ok" they said "stay in the chair as long as you can" A doctor came in to find out my history (which is literally a medical book in itself) I told him what I had done, told him the medications I am allergic to and he walked off.
Another doctor walked in a while later and asked me to get onto the bed so he could examine my leg. I was hesitant but knew if I was to get an x-ray I had to get onto that bed. I informed this new doctor of what I had done, within 5 minutes an orderly came and took me to x-ray, I bought Steve with me incase they wanted me off the ER bed and onto one of theirs. Lucky for me I got to stay in the bed... thank god.
I had 3 pictures taken of me knee/leg. I had no idea what time it was by then but I was sleeping on and off, they came in gave me some pain killers and explained to me what I had done. Well because I was half asleep what I thought I heard them say was completely wrong and I was informing friends/family of the wrong info. They said I could leave as soon as a physcio therapist came to fit me with a brace. He arrived at 5pm. I have to wear my lovely brace for 4 weeks. As soon as he put it on the pain went away immediately... yay!!
Apparently I have torn my anterior crucial ligament (just like what footballers do). The doctor said that if I was able to walk I may have had to have a knee reconstruction. OMG!! As soon as I heard that I started hating myself, something so trivial, something I do everyday and I have really damaged my knee. I started getting depressed and knew I was unable to look after Hailee, I didn't want her to see me so sad. Luckily my mum was able to watch her for a few days so I could get my head sorted. I knew I needed to get on with things, I knew it would take me twice as long to get out of bed, to get dressed, to be able to do everyday things like laundry (lol). But I had to get on with life.
It's been just over 3 weeks now. I still have pain, again only when I am in bed, so I am on Pan- Forte. I feel as like the top of my leg is hanging on by a thread when I take my brace off during the day, it really isn't the nicest feeling at all!! Actually until the weekend just gone I hand't taken it off since they put it on me in the hospital.
Well that's my big new for this week (LOL) I am hoping to be back to normal in a week or 2. Let's wait and see huh... I shall keep you all updated on how I am feeling.
Night all. I hope you have a wonderful weekend.
Stay safe!
Amanda <3
Tuesday, July 3, 2012
OUCHIES...I'VE HURT MY KNEE :( [act.1]
It was a normal night in our household we had just finished dinner, Steve was drying Hailee off from her shower when I decided I wanted to get changed into something warmer.
It was Wednesday night around 7pm [27th]. I was getting changed on my bed, rolled over on to my stomach and heard the loud POP!! I also felt this sharp pain radiate down my right leg. I instantly knew that I was in trouble. Hubby was in the ensuit and said he heard it too.
I sat up in my chair went and watched t.v for the next three hours it never hurt. What? I can't understand why..what's going on (I thought I may have "popped" it back into place when I sat in my chair. BUT as soon as I crawled into bed and lay down I knew everything was WRONG!. I cried on and off.
Had some panadol to try get some sleep and tried to convince Steve not to go to work because I needed to go to hospital straight away. Thursday morning I woke u, I couldn't get out of bed so luckily my Mum was here to pick miss Hailee up to take her to daycare(she does every week...thanks Mum).
As soon as she left I rang Steve at work and begged him once again to come home. He came home 2 hours later. I was feeling ok in the car, until I got the the hospital when I just wanted to throw up like I had been doing the night before.
You can read the rest on Thursday...hehe sorry guys it's late and I'm tired.
Night!!
Amanda <3
Thursday, November 24, 2011
I'm out but not myself
Hello Everyone,
I'm out of hospital (I have been for almost a week). Though I am out I'm not myself :(
I felt fine in there.
I came home took my pills/ felt worse than ever.
I went to my GP to change them.
That was 2 days ago.
These new ones haven't kicked in yet.
I just want to be back to 100%.
I hate feeling like this!.
I guess my body is trying to tell me it's time to slow down.
To slow down after the horrid month I had last month.
Ok time to lay down and get some rest...blog again soon.
<3
I'm out of hospital (I have been for almost a week). Though I am out I'm not myself :(
I felt fine in there.
I came home took my pills/ felt worse than ever.
I went to my GP to change them.
That was 2 days ago.
These new ones haven't kicked in yet.
I just want to be back to 100%.
I hate feeling like this!.
I guess my body is trying to tell me it's time to slow down.
To slow down after the horrid month I had last month.
Ok time to lay down and get some rest...blog again soon.
<3
Thursday, June 10, 2010
what is Spina Bifida
Spina Bifida is a developemental birth defect caused by an incomplete closure of embryonic neural tube. I have whats called Spina Bifida Myelomeningocele which is the worst of all 4 forms of SB, which leads to most people having a disability, like myself.
Spina Bifida can be surgically closed after birth, but this doesnt mean normal function can be restored to that part of the spinal cord. SB can be decreased by upto 75% when the mother takes a daily intake of folic acid upto 3 months before conseption. [When my mother was pregnant this was not known my family was told it was genetics that caused my SB].
The unfused portion of the spinal column allows the spinal cord to protrude through an opening and looks like a cricket ball on the back of the baby. That portion of the cord and nerves are damaged and or are not properly developed. Because of this there is usually a fluid filled sack surrounding the spina cord.
Signs and symptoms:
Children with SB often have what's called Hydrocephalus, this is excessive fluid on the brain (everyone has this fluid which our brain essentually floats in). According to the Spina Bifida Association in America over 73% of people with SB are allergic reaction to latex.
Pathophysiology:
Spina Bifida is caused by failure of the neural tube to close during the first week of pregnancy. In a normal baby the neural tube closes occurs around 28 days after fertalization. Spina Bifida does not follow a direct path of heredity. Studdies have shown that a woman who bares one child with SB have about a 3% chance risk of having another baby with it.
It is now recommeneded that all women who are wanting to get pregnant should take a folic acid supplement 0.4mg a day is the recommended dose. For women who have already had a child with SB should take 4-5mg a day.
Please see a doctor before taking these supplements though.
Prevention:
There is no single cause of SB nor is there a known way to prevent it completely. But as I said before folic acid somehow has been known to help lower the risk. Food sources with folic acid - whole grains, dried beans, leaf vegetables and some fruits.
Screening During Pregnancy:
Most neural tube defects can now be detected during pregnancy by testing the mother's blood and having a detailed fetal ultrasound. SB can be associated with disability as in Downs Syndrome because these pregnancies may result in a spontanious miscarraige. Genetic councilling and further genes testing can be done such as amniocentesis. Though now days ultrasound screaning for SB is parshly responsible for the decline in the defect, as many parents decide to terminate the pregnancy out of fear that the baby will have poor quility of life. But with Modern medical care and more being researched the quility of life for many SB kids has greatly improved.
Spina Bifida can be surgically closed after birth, but this doesnt mean normal function can be restored to that part of the spinal cord. SB can be decreased by upto 75% when the mother takes a daily intake of folic acid upto 3 months before conseption. [When my mother was pregnant this was not known my family was told it was genetics that caused my SB].
The unfused portion of the spinal column allows the spinal cord to protrude through an opening and looks like a cricket ball on the back of the baby. That portion of the cord and nerves are damaged and or are not properly developed. Because of this there is usually a fluid filled sack surrounding the spina cord.
Signs and symptoms:
Children with SB often have what's called Hydrocephalus, this is excessive fluid on the brain (everyone has this fluid which our brain essentually floats in). According to the Spina Bifida Association in America over 73% of people with SB are allergic reaction to latex.
Pathophysiology:
Spina Bifida is caused by failure of the neural tube to close during the first week of pregnancy. In a normal baby the neural tube closes occurs around 28 days after fertalization. Spina Bifida does not follow a direct path of heredity. Studdies have shown that a woman who bares one child with SB have about a 3% chance risk of having another baby with it.
It is now recommeneded that all women who are wanting to get pregnant should take a folic acid supplement 0.4mg a day is the recommended dose. For women who have already had a child with SB should take 4-5mg a day.
Please see a doctor before taking these supplements though.
Prevention:
There is no single cause of SB nor is there a known way to prevent it completely. But as I said before folic acid somehow has been known to help lower the risk. Food sources with folic acid - whole grains, dried beans, leaf vegetables and some fruits.
Screening During Pregnancy:
Most neural tube defects can now be detected during pregnancy by testing the mother's blood and having a detailed fetal ultrasound. SB can be associated with disability as in Downs Syndrome because these pregnancies may result in a spontanious miscarraige. Genetic councilling and further genes testing can be done such as amniocentesis. Though now days ultrasound screaning for SB is parshly responsible for the decline in the defect, as many parents decide to terminate the pregnancy out of fear that the baby will have poor quility of life. But with Modern medical care and more being researched the quility of life for many SB kids has greatly improved.
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