Welcome to Meet the Therapist - Please Read

A special forum where you can have direct chat with a certified lymphedema therapist for questions regarding your treatment and daily management of lymphedema. Tom Kincheloe is our moderator for this forum.

Moderators: Birdwatcher, jenjay, Cassie, patoco, tkincheloe, Senior Moderators

Welcome to Meet the Therapist - Please Read

Postby patoco » Thu Jul 24, 2008 10:29 pm

Welcome to Meet the Therapist

This is your chance to chat one on one with a certified lymphedema therapist on questions you may have relating to lymphedema treatment, your management program, how to do things.
User avatar
patoco
Site Admin
 
Posts: 2175
Joined: Thu Jun 08, 2006 9:07 pm

Re: Welcome to Meet the Therapist - Please Read

Postby Liatris » Sat Sep 27, 2008 1:50 am

Hello Tom,

Thank you (and Pat) for making yourself available like this. Hmm... actually I have several questions.
I have been doing a lot of research and I am really frustrated because it is not obvious what the cause of my edema is. I have had skin parasites, that are thought to also be systemic, for about eight years and after their onset is when the whole body edema began. The skin infection first presented as a classic Cutaneous Larva Migrans with the typical red, itchy, serpigenous (squiggly, snake-like), very fast tracking. But, unfortunately for me, it was not just one track with one larva, but hundreds that all traversed the skin on my torso at once. That began after one year of very intense skin symptoms without much visual display. Since all of that began, I have been extremely prone to all sorts of other skin pathogens/infections. My liver was damaged years ago by Tylenol and I cannot take antiparasite drugs. They often do not work anyway.
I believe that, contrary to the usual theory, you can get a clogged lymphatic system from chronic skin parasitic infection due to ANY parasite - NOT just the two or three that are commonly mentioned in the literature. AND, you certainly do not have to leave the country (US) in order to be exposed to parasites !
So it is truly impossible to know how much of this edema is due to parasites clogging the lymphatics, how much is perhaps due to bad heart valves, how much is due to my damaged liver. I cannot have any type of anaesthesia because of my liver problems so heart surgery is out of the question. I cannot even have MLD because I have Lyme infection on my legs. I cannot slide a compression stocking up over the infection on the lower part of my leg because it will bring the spirochetes up to better skin.
I am getting bigger and bigger so fast that I now have the added horror of getting varicose and spider veins from the pressure of the water pooling. I will see an area of my body balloon out and that is immediately followed by new varicose veins. This is horrific because bad veins are going to make all of this even worse. I tried to do some compression bandage wrapping and the veins on the top of my feet are so sensitive (or the associated nerves ?) that even very light wrapping hurts them more than being unwrapped - but I need to do something to keep from getting even bigger.
I will state my questions here separately so that it is easier to address all that I have stated above.

1) I have heard that in order to help out venous problems, that compression can help - but
a) how can you put compression on something that is being blown out from pressure to begin with ?
b) is this pain around the bad veins from pressue from them on nearby nerves and / or pressure from the swelling from the edema from the original lymphedema ? Before the veins got bad, even when the foot was very swollen, I did not get that degree of pain.
c) I am currently taking diosmin(450 mgs) and hesperidin (50 mgs) - 3 times a day and am going to order the micronized version (supposedly more bioavailable) of it called Daflon 500. It is for chronic venous insufficiency and lymphedema due to CVI . Have you had any clients who have used it for CVI and/or LE ? Results ?
d) Have you come across anybody whose LE was increasing so fast that it damaged their veins ? I will restate here that the vein problems came ONLY after each area was "edematized ".
2) If the edema is partly due to heart valve problems - can high level, chronic edema cause damage to the lymphatics ? I think so because of all the skin infections, along with typical cellulitis.
3) Venous insufficiency IS a type of high-protein edema. So even if part of the edema originated from heart failure, I now have a high-protein LE from the vein problem. Any comments on this, please ?
4) From what I understand, if you have decreased levels of protein in the blood (my albumin and total protein were normal on a recent blood test), that that could cause LE by the following mechanism. Proteins hold onto water and if the protein within the blood vessel is LOW compared to the protein level in the surrounding tissue, the water would seek out the protein in the tissue and therefore, cause edema in the tissue. But then I heard something that Casely-Smith said about if protein is low in the interstitium (I think this means the tissue) that that can cause edema. This really confuses me because I have generally gotten the idea that Casley-Smith had thought the former.
a) This seems contradictory to the first bit. Please, comment.
b) I have always associated low blood protein with liver or kidney disease. Does the fact that my blood levels of ablumin and total protein are ok mean that the edema is NOT due to kidney or liver problems ? (Doctors do NOT know about this elementary stuff and do NOT want to know.)
5) Casley-Smith refers to testing the amount of protein in the tissue in terms of pressure (I think) when referring to determining if there is a high protein ( in tissue).
a) How is this tested for? By whom?
6) Do you have any ideas of what I could do ?
7) Do you think that even though my veins are becoming varicosed that I still have a chance to recover so that I can be on my feet for more than an hour before they become very painful ? The impression I have form eveything I have read, is that once you have varicose veins, they never get better and they just ahve to be destroyed. But I have so many that if I had them all destroyed, there would be none left. I cannot have local anaesthesia for that anyway. I am hoping that the Daflon (and pycnogenol) will help the veins enough so that I can start compression bandaging without causing my feet even more trauma from the bandages. Your comment, please.
Thank you so much for listening to all of this. I am suffering so much and not getting any help from doctors. Even doctors who are supposed to know about this stuff are really un knowledgeable. I understand that you may not have all the answers but I appreciate whatever you can tell me.

Liatris
Liatris
 
Posts: 12
Joined: Wed Oct 31, 2007 5:24 am

Re: Welcome to Meet the Therapist - Please Read

Postby tkincheloe » Wed Oct 01, 2008 8:51 pm

Hi Liatris,

Sorry for the delay in responding. Wow! You certainly have a lot of questions, and I will need to research most of them. I am so sorry to hear you are suffering so much and seem to have so little help. I will do the best I can but it will take me a little time. I am not familiar with the type of skin parasites you mention though I am familiar with Lyme Disease, which is treatable with antibiotics.

First question I need to ask is where are you located? I need to know what is available in your area.

As for compression wrapping, compression is absolutely mandatory for venous insufficiency. I understand your issue with the pain but you MUST wrap the legs to improve the blood flow or risk losing your leg(s) to ulcerations and more serious symptoms. Compression, either wraps or garments, will help improve the vascularization to the remaining veins. Your doctor should have told you this, and in some cases it is considered malpractice when a physician does not recommend or prescribe compression garments or wraps.

You might try to ease the painful areas by layering some thin foam or cotton padding over the painful areas and see if that helps. While you certainly can not take Tylenol because of the liver issues, you CAN take other pain medications that won't have affect on the liver. Check with your doctor on this.

As for the parasites, I will look into that as it is unfamiliar territory to me. Can you tell me specifically what the parasite name is? Is there another name for the one you gave, which sounds like a larval form of an adult type parasite? Is it one of the following: Burgia malayi, echinococci, schistosomiasis, cysticercosis, ascarids, taenia or Plasmodium malariae?

Skin parasites can most certainly damage the smaller sub dermal lymphatic vessels, especially if they travel by channeling. If you are not able to take antiparasitic medication, you might want to look into some alternative treatments (with your doctor's okay) such as saline baths for surfacing parasites. There may be topical applications that might help. But the real key is antiparasitic medications, and you may need to contact a disease center for more help.

Without the ability to use anesthesia, you are limited in regards to surgical interventions but we try to avoid surgery anyway except as a last resort or in medical emergencies.

I'm probably not being a lot of help here, but let me read on and see what we can do. In the meantime, get some compression on those legs!!! Then we'll see what can be done about the other edema and the parasite problem.

Tom Kincheloe, OTRL, CLT
Certified Lymphedema Therapist
tkincheloe
 
Posts: 19
Joined: Wed Feb 20, 2008 6:42 pm
Location: Myrtle Beach. SC

Re: Welcome to Meet the Therapist - Please Read

Postby Liatris » Fri Oct 03, 2008 4:41 am

Hello Tom,

Thank you so much for your reply. I will respond with **** before my words.

As for compression wrapping, compression is absolutely mandatory for venous insufficiency. I understand your issue with the pain but you MUST wrap the legs to improve the blood flow or risk losing your leg(s) to ulcerations and more serious symptoms.

**** I am acutely aware of needing compression for the LE and the venous insufficiency but I have read about how nerve damage can be permanent and that not doing anything to worsen it is crucial. I don't know how common nerve damage is with LE but I have heard that people will try to avoid further damage by using fairly thick foam with holes cut out over the areas that need to be void of pressure. The problem is that the areas on my feet (esp one foot) are so diffuse that pretty much the whole top of the foot is involved. I am not sure I could logistically work that one out as the sides of the "doughnut" would be on sides of the top of the foot and the "scafolding" structure would not be high enough to create a canopy above the part that needs protecting from the compression. Also, I would imagine that that whole area would then become even more edematous ? I really do not want to make the nerves worse and am wondering if there is any other way around this so that I can still use compression.

Compression, either wraps or garments, will help improve the vascularization to the remaining veins.

**** When you say "improve the vascularization to the remaining veins" do you mean angiogenesis (development of new blood vessels) ?

Your doctor should have told you this, and in some cases it is considered malpractice when a physician does not recommend or prescribe compression garments or wraps.

**** He knows nothing about LE and was completely uninterested in learning even with me willing to spoon-feed information to him.

You might try to ease the painful areas by layering some thin foam or cotton padding over the painful areas and see if that helps.

**** I tried that but it seems that it does not decrease the pressure on it because there is still the very lightly applied compression bandages on top. It takes very little pressure on the damaged nerves to cause pain. I guess they are already being compressed too much.

While you certainly can not take Tylenol because of the liver issues, you CAN take other pain medications that won't have affect on the liver. Check with your doctor on this.

*** I did not want to make you read a "book" so I did not relay everything but I have to address this now since you brought it up. I cannot take any other pain meds either due to the fact that the available ones either utilize the liver detoxification pathways that are malfunctioning (sulfation and glucuronidation) or information on what pathways the drugs use is not available. Despite some trouble with my kidneys, when I am VERY desperate, I use ibuprofen.

As for the parasites, I will look into that as it is unfamiliar territory to me. Can you tell me specifically what the parasite name is? Is there another name for the one you gave, which sounds like a larval form of an adult type parasite? Is it one of the following: Burgia malayi, echinococci, schistosomiasis, cysticercosis, ascarids, taenia or Plasmodium malariae?

*** The diagnosis of CLM is made by the classic visual display. It is caused by various types of hookworms and roundworms. The fact that CLM stage was so extensive in my case, suggests that it could be Strongyloides stercoralis - which is systemic in those with weakened immune systems. But it really could be any of the others. There are about 30 known types of parasites that present with the CLM. Because the parasite travels ahead of the red tracking that develops behind it and because it travels in a squiggly line, it is impossible to predict where to cut in to get one for identification - AND because most labs are notoriously lacking in their knowledge when it comes to IDing parasites, they do NOT even try to get a sample. They figure that the treatment will be the same regardless so they do not bother.

Here is a bit of info on CLM:

The most common cause of CLM is Ancylostoma braziliense, which is a dog and cat hookworm found in the United States, Central America, South America, and the Caribbean.
Other reported, less common, animal roundworms that cause CLM include the following:

Ancylostoma tubaeforme, Ancylostoma caninum, Ancylostoma ceylanicum, and Uncinaria stenocephala (ie, dog hookworms)
Bunostomum phlebotomum (ie, cattle hookworm)
Gnathostoma species (ie, cat, dog, and pig roundworms)
Capillaria species (ie, whipworms found in rodents, cats, dogs, and poultry)
Strongyloides myopotami, Strongyloides papillosus, and Strongyloides westeri (found in the small intestine of mammals)
Nematodes that use a human as a definitive host, such as Ancylostoma duodenale, Strongyloides stercoralis, and Necator americanus (rare causes of CLM)

A duodenale and N americanus usually cause ground itch.
S stercoralis is usually associated with larva currens


Skin parasites can most certainly damage the smaller sub dermal lymphatic vessels, especially if they travel by channeling.

**** Yes, that makes sense - even if they were not in the skin with proximity to the lumph vessels themselves, just the fact that parasites, in general, are processed by the lymphatic system could cause a serious clogging.

If you are not able to take antiparasitic medication, you might want to look into some alternative treatments (with your doctor's okay) such as saline baths for surfacing parasites. There may be topical applications that might help. But the real key is antiparasitic medications, and you may need to contact a disease center for more help.

*** I have done all sorts of baths, anti-parasite herbal regimines to no avail. I have been in touch with numerous doctors who specialize in parasitic diseases and most of them admit that what is known about parasites and their life cycles and what may kill them is just the tip of the iceberg. Those medical professionals who are deeply investigating parasitic infection of humans have numerous patients who CAN take antiparasitic drugs and are not getting well since they are finding that the existing drugs do not kill any and all parasites that exist. They are sequestered in different organs and at different stages of their life cycles, they are less susceptible to being poisoned. The CDC is basically ignoring all of this because they are aware of the fact that the top researchers are finding "new", previously unfound and uncataloged parasites that they know nothing about - never mind how to treat them.

*** People have overcome parasitic infection by maximizing their overall health in a big way. I am attempting to do that. I am a licensed nutritional consultant and before I became too ill to work, I was a medical research consultant so I do know what to do to help my health in general but my real problem is that I need assistance especially now that walking is becoming difficult. I am working on that. I am determined to somehow work it all out and appreciate your help.

Without the ability to use anesthesia, you are limited in regards to surgical interventions but we try to avoid surgery anyway except as a last resort or in medical emergencies.

**** Yes.

When it comes to compression, I cannot slide anything up my feet and legs because of the Lyme infection on parts of the skin. It would spread the infection to the good parts of my skin. When I work out how to get around the nerve damage problem, I cann only use the compression bandages because they wrap around and the part that touches the infected skin will not touch the good skin. So I cannot use a tubular stockinette. I cannot take Lyme antibiotics because of my liver problem. I did treat it successfully in the past with medical ozone (which I am trained to use) but my main problem is lack of assistance in getting things done with my limited mobility.

The only info I have on determining whether a person has high-protein edema within the tissues is that if the protein concentration is 1g/dl or more - it is the case. Of course, my question was how does one test this. I know you do not have the answer now - I just wanted to pass that bit of info on for what it's worth. I am afraid that much information is going to be lost when Judith Casley-Smith is no longer with us and she is very ill now.

I appreciate all your help and need to do all that I can. In the meantime, I am taking some of the safe Benzo-pyrones (unmicronized Diosmin and hesperidin) as well as pycnogenol and am waiting for an American version of Cyclo 3 Forte, a French "drug" which has been well studied for it's use for venous problems. It is composed of an standardized extract of Butcher's Broom, Hesperidin Methyl Chalcone (semisynthetic bioflavonoid), and Vitamin C. I wish I could take Horse Chestnut Seed extract because it has been found to be very helpful with volume in LE but liver problems are a contraindication.

I had to explain a lot to answer your reply. I understand that you need time to look into some of my questions and that is may be too much for you. Since I am capable of researching - maybe with some of the questions, you would know where to refer me to do the actual searching so that you don't have to ? I want you to know that the questions I have asked you I only have done so because I could not find the answers with the resouces I have (the internet). It is possible you have texts that have some of the answers. But again, if you can think of a way to point me in the right direction, please inform me.

Take your time and thanks again.

Tanya
Liatris
 
Posts: 12
Joined: Wed Oct 31, 2007 5:24 am

Re: Welcome to Meet the Therapist - Please Read

Postby tkincheloe » Tue Oct 07, 2008 5:36 pm

Hi Tanya,

Wow!! You have really armed yourself with information concerning your present conditions! I applaud you on your knowledge, much of which is beyond me. I have to admit I have little knowledge of parasitic issues such as yours, but I am willing to learn. I would like to take whatever you share here and file it for future reference.

In the meantime, please allow me some time to review your symptoms and medication regimen to see if what help I can offer.

I will be quite honest with you -- it sounds like you have carried your own research to limits far beyond what I know about LE with regards to the venous issues you have (complicated by the liver contraindications), the parasites, and the "exposed" or sensitized nerve branches. While you have my deepest respect for the research you have already conducted, you also have my deepest empathy and understanding for not having found the relief you are seeking and thus having to suffer with these conditions as you are doing.

Again, allow me to look at this and see if I can get some other professionals involved. Perhaps we can find an answer at least to one or two of your medical issues.

Hang in there!

Tom
tkincheloe
 
Posts: 19
Joined: Wed Feb 20, 2008 6:42 pm
Location: Myrtle Beach. SC

Re: Welcome to Meet the Therapist - Please Read

Postby Liatris » Tue Oct 07, 2008 6:51 pm

Hi Tom,

Thank your for your empathy and willingness to help. I wonder if any of your colleagues would know any way around the nerve problem on top of the feet and on the soles as well. If there was some way of circumventing that, it would be a big plus to be able to bandage. Of coure, as much as I would like to wrap my legs, not wrapping the feet would cause they to get even worse. Tom, is this type of nerve problem uncommon with LE ? Is the development of varicose and spider veins uncommon ? I wouldn't think so because of the pressure but I have not heard much discussion of it with regard to LE.

As much as I would like you to have the answers, I am realizing more and more that many complications related to LE have not been successfully -- hmm... figured out. Whatever you find out will be appreciated.

Thank you,

Tanya
Liatris
 
Posts: 12
Joined: Wed Oct 31, 2007 5:24 am

Re: Welcome to Meet the Therapist - Please Read

Postby tkincheloe » Tue Oct 07, 2008 7:59 pm

Hi Tanya,

I'm currently researching some of your questions, particularly with regards to the pain in your feet. I'm taking more of a systematic approach to one problem at a time. Let's focus on the leg issues for the moment.

My Foldi textbook on LE for Physicians and Therapists has excellent information on both vascular issues and LE and their relationship to one another. However, reading it is one thing; deciphering it is another. And in the process, particularly in your case, a lot of questions are raised. Let's take some of these questions and see if we can't narrow it down somewhat.

My first question is: Have you had any history of DVTs (deep venous thrombosis) in your legs?

Have you had a doppler study of the lower extremity done on the vascular system, particularly the veins?

Can you be more specific about the "nerve pain" -- is it a result of direct damage to the nerve fibers? Myelin sheath? Chemical changes in neurotransmitters? If you can narrow the nerve "damage" a bit to the best of your knowledge that would help. As I am finding out, there are more than one reason for nerve pain to occur, and it can be related to LE or be something completely different.

Is the pain in your feet more intense when standing or walking? Does elevating the feet relieve the pain?

With regards to your question about compression improving vascularization, I am refering to improved up-flow of blood through weak and/or damaged veins, usually the result of damage to venous valves. Compression helps weak/damage veins overcome the forces of gravity and improve venous flow and the exchange of fluids between arteries, veins, and even lymphatics resulting in healthier tissue function. This is particularly important in post-DVT syndrome, Chronic Venous Insufficiency, and other venous and arterial maladies. And, yes, spider veins and vericose veins can occur with LE but only if venous insufficiency is also present. It is not rare since LE can also affect venous flow.

I will continue reading up on this but will be asking more questions as I go along so bear with me.

Tom
tkincheloe
 
Posts: 19
Joined: Wed Feb 20, 2008 6:42 pm
Location: Myrtle Beach. SC

Re: Welcome to Meet the Therapist - Please Read

Postby Liatris » Thu Oct 09, 2008 12:21 am

Hi Tom,

I will answer with ****

I'm currently researching some of your questions, particularly with regards to the pain in your feet. I'm taking more of a systematic approach to one problem at a time. Let's focus on the leg issues for the moment.

*** Thank you. Good idea.

My Foldi textbook on LE for Physicians and Therapists has excellent information on both vascular issues and LE and their relationship to one another. However, reading it is one thing; deciphering it is another.

**** Yes, I know what you mean.

My first question is: Have you had any history of DVTs (deep venous thrombosis) in your legs?

***** Absolutely not. I say that emphatically because I not only did not have anything like DVT, but I did not have any varicose veins or a even a single spider vein before my legs increased so much in volume. The vascular problems are so obviously related to the pressure on them. Several months ago, my legs began to increase in volume at an incredible rate. An area would balloon out over the persiod of a few days to a week and , boom - the spider veins would develop directly over that area. The varicose veins took a little longer than a week to occur. There is another interesting to point. I had the edema for many years where it had reached a certain volume and had stabilized there. One factor that may have caused the acceleration of the edema is that for the four years previous to it getting worse, I was eating 2 cups blueberries a day. The bioflavonoids in them I think are part of the benzo-pyrones so tauted to help both vein integrity as well as LE in general. It was around the time that I stopped eating them that the edema and veins got worse. I have to say, though, around that time, I also a lot of skin infection very probably due to the mouse invasion in my home.


Have you had a doppler study of the lower extremity done on the vascular system, particularly the veins ?

**** I was going to but, when the vein trouble became obvious, I realized that a test for CVI was not necessary - varicose veins = CVI. And due to the rate at which they began to develop, I felt that I should do what I could to slow the progression down. A very large part of slowing it down, is keeping off my feet. Last time, I took the time to be on my feet more than usual, in order to go to get a blood draw and an echocardiogram, my feet took such a beating and it took three days for them to return to their normally painful/dysfunctional state. It is not so much the pain that worried me, but the fact that I caused more damage. Standing on them causes more veins to blow out and that is something that seems irreversible and will add to the overall problems significantly. I just received the "Rusperin C" and hope that it will help the veins. As sick of frozen blueberries as I am, I am starting back on them.

Can you be more specific about the "nerve pain" -- is it a result of direct damage to the nerve fibers? Myelin sheath? Chemical changes in neurotransmitters? If you can narrow the nerve "damage" a bit to the best of your knowledge that would help. As I am finding out, there are more than one reason for nerve pain to occur, and it can be related to LE or be something completely different.

**** There are a lot nerves on the top of the foot (along with blood vessels) that apparently (according to an LE instructional dvd) need to be protected because they are particularly vulnerable - I guess because of the pressure of the edema. This pain is much more so on the top of the right foot. My right foot is also larger than my left - the reverse was true just naturally before any edema. At a time that the pain there began, I saw some veins there become prominent - all of a sudden. This leads me to believe that the vein problem is related to the pain. Not necessarily that the vein problem caused the pain, but perhaps the increased pressure from the edema there blew out the veins and that same edematous pressure simultaneously caused an increase in pressure on the nerves. Of course, the veins screwing up can also, in and of itself, cause edema due to their negative effect on surrounding tissue. So, it could be that the general existing edema put pressure on the veins, they blew out and as a result - more edema (and pressure on the nerves) due to vascular insufficiency.

One thing I do know for sure is that the less I am on my feet, the better. It is not undoing the problem, but is slows down the rate at which they become more damaged. The disadvantage to having my feet up the way I do is this - I sit in a chair with my feet up on a fairly stable TV tray table. That helps keep my feet and calves and knees from swelling , but since I have whole body edema, this creates a problem for my thighs and butt and torso. My thighs and butt become much bigger over time and I think I understand why. Particularly because of my increased volume and therefore, weight, the pressure on my butt, with my legs up like that, is quite high. The lymphatic fluid from my feet and calves has nowhere to drain. There is a downward slope between my knees and the tops of my thighs so the fluid drains towards the tops of my thighs and is all stopped when it gets to my butt that has so much pressure on it from the chair below it. It is far from perfect, but what I do is get up before too long and walk around a bit so that the fluid can get passed my butt and head upwards to drain - not that it does that very well but I think that it does help slow down the increase in the thighs and butt volume during my awake and up and around time period . What would be much better would be if I could lie on a foam wedge (like a slant board) so that my whole body was elevated - so to speak. That way my whole body, including my poor neglected thighs and butt and torso and arms could drain. With the way I currently sit with feet and calves on the TV table, my butt and thighs really get large - especially if I do not get up often. But, standing up is generally not good. I am substantially larger when I lay down to go to sleep at night than I am when I get up after lying down. In the beginning of the edema, I would go back to my normal size by morning - not so now. I am 5' 6" and I used to be an acceptable 130-140 pounds. When I went to get the echocardiogram, I saw a scale, got on it and was horrified. I have gained 70 pounds and know that much, if not all, is water weight. The problem with lying on a slanted wedge is that I will not be able to even work on my computer as I do now with my legs up.It is hard enough getting things done as it is. But I would do it as much as I can - once I can clear the area of a room out and get my old massage table out of the attic and purchase a custom-made wedge to place on it.

Is the pain in your feet more intense when standing or walking? Does elevating the feet relieve the pain?

**** Yes, to both questions. However, even with my feet up - I can wiggle my bad (right) foot and get a stabbing pain. I should mention that even the underside of my feet are really painful as well as the tops. I think that the underside pain is also, in part, related to the vein complication. I think that vein problems may be more prevalent in people with LE than is thought because of this - When I recently attempted to bandage my feet and legs (and unwrapped because of the pain), I noticed varicose veins that I otherwise did not see - the feet being wrapped for only several minutes, compressed the tissue back enough to SEE the varicose veins that were otherwise not seen due to the surrounding edema enveloping them !!! Although, I suppose anyone who does bandaging would see them and take note of them.

TOM Said : With regards to your question about compression improving vascularization, I am refering to improved up-flow of blood through weak and/or damaged veins, usually the result of damage to venous valves. Compression helps weak/damage veins over come the forces of gravity and improve venous flow and the exchange of fluids between arteries, veins, and even lymphatics resulting in healthier tissue function. This is particularly important in post-DVT syndrome, Chronic Venous Insufficiency, and other venous and arterial maladies. And, yes, spider veins and vericose veins can occur with LE but only if venous insufficiency is also present. It is not rare since LE can also affect venous flow.

*** Thanks for clarifying that - I understand. When you say that vein problems can occur with LE but only if VI is also present - you know what I am thinking ! With my vein problem being caused by the edema. Since I malabsorb nutrients, it is possible that my situation with vein integrity is more extreme than the average person with LE. Also, the rate at which the recent increase in volume occurred could account for the venous damage.

I will continue reading up on this but will be asking more questions as I go along so bear with me.

**** Thank you very much, Tom. Take your time. I will personal message you a link to the Casley-Smith article on Benzo-pyrones use in LE, in case you have not seen it. There are some benzo-pyrones, aside from coumarin, that I think probably are safe - the bioflavonoids, for one. The article I will send the link for is a synopsis of a lot of hard work on the part of the two LE researchers from Australia - it is very interesting. You may already be familiar with their work.

Tanya
Liatris
 
Posts: 12
Joined: Wed Oct 31, 2007 5:24 am

Re: Welcome to Meet the Therapist - Please Read

Postby 1phatleg » Fri Nov 07, 2008 12:06 am

hello pat. thank You very much for this web site. My question is : i have edema on the right leg from knee down , some times thigh high. I NEED to know all about shoes. where is a good store or shoe ( san diego) As it is now I am wearing these big army boots. All my fluid sits at the ankle ?????????????? Help .
1phatleg
 
Posts: 4
Joined: Mon Oct 13, 2008 12:52 pm
Location: California

Re: Welcome to Meet the Therapist - Please Read

Postby lacemaker » Thu Jun 25, 2009 12:22 pm

I wear crocs a lot. they are very comfortable and do not put pressure on my bad foot. OK one is a bit looser but I can live, and walk, with that. I now have winter crocs with laces, golf crocs and slipper crocs for the winter and all I need now are skiboot crocs and I would be a very happy bunny!
lacemaker
 
Posts: 9
Joined: Tue Jun 13, 2006 6:52 am


Return to Meet the Therapist

Who is online

Users browsing this forum: No registered users and 2 guests


cron