Blog # 1 Top 10 Takeaways from the 2016 FDRS Conference
Blog # 2  Living and Thriving with a Fat Disorder: Lessons from The Tribe
Blog # 3 Get Moving! The Do’s and Don’ts of Exercising with a Fat Disorder
Blog # 4 Self-Care for Pain and Inflammation
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Top 10 Takeaways from the 2016 FDRS Conference

 

 

Over 250 patients & providers gathered in St. Louis this past April for the Fat Disorders Research Society 2016 Conference: Living with Lipedema and Dealing with Dercum's Disease. Over the course of two days, 23 speakers addressed everything from diagnostic criteria to treatment options to the most effective self-care programs. One thing we heard clearly from conference participants onsite and in the months since is an interest in receiving more regular, actionable communications from FDRS, with practical tips and tools for patients and their care teams.

As we head into the second half of the year, we are taking your advice and putting it into practice. You may have noticed all of the new photos and videos posted to our Facebook page throughout Lipedema Awareness Month in June, and this blog is the first in a four-part series summarizing key takeaways from the conference and highlighting the current state of lipedema care and research. We’ll be sure to keep you informed of ways to get involved and, as always, we welcome your input and suggestions. Thank you for your continued support of our mission to improve the quality of life for individuals living with adipose tissue disorders, and accelerate the search for new treatments and cures.

        1. Adipose tissue disorders are not rare, but proper diagnoses are rarely made[i].      

Lipedema is a chronic, progressive disorder of adipose tissue that occurs almost exclusively in women. It was first described by Allen and Hines [1940] as bilateral enlargement of the extremities thought to be due to abnormal deposition of subcutaneous fat and accumulation of fluid in the lower legs. Characterized by symmetrical swelling of the legs and hips, with tenderness and easy bruising in the affected areas, its etiology remains unknown and it continues to be grossly under-diagnosed. Though there is no official reporting of total known cases, Lipedema is thought to affect as many as 11% of adult women, which amounts to nearly 17 million individuals in the U.S. alone.

 

Dercum’s disease (DD), another disorder of adipose tissue, which is characterized by multiple, painful growths consisting of fatty tissue, is similarly under-diagnosed, though thought to be less prevalent than Lipedema. DD occurs primarily in women, with a ratio of females to males of 5-7:1; the average age of development in one series was 35 years, but it has been reported to develop in children and in adults up to age 80 years. Many cases of peri- or post-menopausal women with DD have been reported suggesting a hormonal component to the development of the disease. Dercum’s pain can become disabling, however the lack of awareness and knowledge about Dercum’s can make reaching a concrete diagnosis challenging. “Before you talk to a doctor,” urged Dr. John Bartholomew, of the Cleveland Clinic “choose one that is trained to listen.” It could mean the difference between charting a path to physical and emotional wellness, and remaining isolated and in pain.

        2. There are no diagnostic tests for Lipedema or Dercum’s Disease; clinicians must rely on medical history and a physical exam.

Despite being first recognized by the medical community over 75 years and 100 years ago, respectively, there are currently no approved diagnostic tests for either Lipedema or Dercum’s. The best way to diagnose both disorders is through manual inspection by a trained physician. Current diagnostic criteria include:

 

LIPEDEMA

DERCUM'S

In 1951, an article published by Wold et al. in the Annals of Internal Medicine proposed a set of six diagnostic criteria for Lipedema which are still in use today, however most providers are either not aware they exist or not trained to properly utilize them. As such, lipedema is often mistaken for lymphedema or dismissed as simple obesity, leaving individuals with the condition at a loss for proper treatment and support. Adipose tissue disorder specialist Dr. Karen Herbst of the University of Arizona’s Treatment, Research, and Education of Adipose Tissue (TREAT) Program shared the existing criteria, along with her own modifications, and called for a more rigorous diagnostic process to be developed.

Dercum’s disease was recognized in 1892 as a clinical entity called “adiposis dolorosa”, meaning painful fatty deposits, when Dr. Francis Dercum from the University of Pennsylvania published on three cases. Because lymphatic dysfunction is a part of Dercum’s disease and many early cases of Dercum’s disease are visually and descriptively lipedema, the two disorders are easily mistaken. The lack of awareness and knowledge about Dercum’s, absence of specific diagnostic procedures, and wide variance of symptoms from person to person make reaching a concrete diagnosis challenging. Currently, diagnosis of DD is made by history and a thorough physical exam.

Original Wold, et al. criteria:

  1. Almost exclusive occurrence in women
  2. Bilateral and symmetrical manifestation with minimal involvement of the feet
  3. Minimal pitting edema (when pressure is applied to swollen areas, the pitting does not last); the Kaposi–Stemmer sign is negative
  4. Pain, tenderness or pressure
  5. Increased vascular fragility; easy bruising
  6. Persistent enlargement after elevation of the extremities or weight loss

    Dr. Herbst additions
  7. Arms are affected 30% of the time
  8. Hypothermia of the skin
  9. Swelling worsens with orthostasis (upright posture) in summer
  10. Unaffected by caloric restriction
  11. Telangiectasias (“spider veins”)

 

Cardinal signs (as outlined by Dr. Herbst)

    • Fat deposits
    • Pain in fat deposits for at least 3 months
    • Fatigue (asthenia)
  • 2 accessory symptoms
    • Cognitive change
    • Weight gain
    • Vascular involvment
    • SAT edema
    • Gastrointestinal complaints
    • Joint pain and/or stiffness
    • Shortness of breath/Tachycardia

Dercum’s symptoms may progress to a point of immobility.

 

 

 

 

 

3. Exercise is the cornerstone of treatment for people with fat disorders because it moves lymph fluid, reduces edema, and reduces fat growth.

Although moving may be painful in the short run, the benefits of exercise cannot be overstated. Even a small amount of movement each day serves to strengthen muscles, increase blood and lymphatic flow, boost mood and confidence, and manage stress. Low impact exercise that does not increase lactic acid is ideal. Good options include swimming or other water activities, walking, stationary biking, yoga/stretching, pilates, and whole body vibration. Exercises like these that activate the foot and calf “muscle pumps” increase lymphatic drainage and reduce edema formation in the tissue, relieving pain and inflammation. However, exercise that is too strenuous and deprives the muscles of oxygen can have an adverse effect, increasing pain and inflammation, so balance is important. The type of exercise a patient chooses should depend on the stage they are at. Focus on strengthening, but not aggravating, the areas around the knees and feet, and remember that wearing compression when needed and staying hydrated will further improve outcomes. Watch for our upcoming blog “Get moving! The Do’s and Don’ts of Exercising with a Fat Disorder,” for more details.

4. Eating a healthy diet can help reduce inflammation.

Description: ../../../Desktop/Screen%20Shot%202016-08-09%20at%203.49.44%20AM.pngMany of the speakers, including Dr. Emily Iker, Dr. Karen Herbst, therapist Linda-Anne Kahn, and Dr. Margarita Correa emphasized the value of anti-inflammatory foods in both managing the discomfort associated with lipedema and Dercum’s disease and maintaining a healthy weight and energy level. Dr. Iker, of the Lymphedema Center of Santa Monica, explained how diet can influence the inflammatory response within the body, noting that “lymphatics in the gut make up 70% of the immune system.” A traditional western diet, high in fat, salt, and cholesterol, leads to excessive accumulation of white adipose tissue and “gut leakage,” she noted, with milk fat and fructose having the greatest potential for increasing endotoxins and inflammation. However, patients who followed a Mediterranean-style diet, with reduced intake of simple sugars, dairy, meat, and gluten, and increased intake of green leafy vegetables, colorful fruits, and foods high in omega-3 fatty acids (e.g. salmon, walnuts, flaxseed oil), reported higher energy levels, reduced inflammation, and better responses to exercise and pain management overall. A useful resource which goes into more detail about dietary consideration is the book “Lymphedema and Lipedema Nutrition Guide.”


5. However, fat caused by adipose tissue disorders cannot be lost by just reducing calories and exercising.

Dr. Herbst emphasized to attendees that while diet and exercise can reduce “normal” fat and inflammation, it cannot eliminate Lipedema and Dercum’s fat. Even after certain surgical interventions, such as bariatric surgery, fatty nodules will remain.

6. Beyond nutrition and exercise, there are several effective self-care options to help manage pain and inflammation.

Currently, there are no causal therapies or cures for fat disorders. Treatment options can be largely divided into conservative treatments to reduce edema and surgical treatments such as liposuction. Occupational therapist Molly Nettles reviewed five different types of conservative treatments for participants, explaining the benefits and considerations of each on improving quality of life and maximizing outcomes. They include: pneumatic compression devices (“pumps”), whole body vibration, dry brushing, manual lymph drainage, and rebounding. Additionally, therapist Edely Wallace explained the value and benefits of lymphatic yoga in increasing lymphatic flow, sharing her personal experience of an accident that left her immobile and how she employed yoga and breathing to improve her lymphatic health and restore function to her legs.

Stay tuned for more details on these and other conservative treatment options in our upcoming blog, “Self-care for pain and inflammation.”

7. Consistency is the key to finding success.

Description: FDRS%20-%202016%20Conference/LF%20screen%20shots/LF%20Conference%20photos/FDRS16_panel3.jpgLipedema patient Briana Garrott urged participants to find a conservative therapy routine that works for them and to stick with it long-term, focusing on wellness over weight. Sharing the lessons of her own journey, which involved weight loss management plans, food eliminations, and extreme fitness training to no avail, she underscored the importance of identifying a realistic food and exercise regimen, and holding yourself accountable to that regimen no matter what. This consistency, she suggests, should not only be reflected in the activities/exercises/food-choices you make on your own, but also the openness and supportiveness of the individuals and community you surround yourself with. “Approach all things with love and kindness,” she suggested, “including yourself.”

 

      8. Before having surgery, see a physician and a certified lymphatic drainage therapist and assess your personal risk.

Description: ../../../Desktop/LF%20Conference%20photos/FDRS-604.jpgDr. Karen Herbst explained to participants that while surgery (such as liposuction or stem cell therapy) can be valuable in managing pain and decreasing symptoms, the decision to undergo these procedures must not be taken lightly. She suggested individuals take the time to optimize their conditions and map their own personal risk in order to maximize outcomes. For example, she pointed out that anesthesia can impair lymphatic pumping, which could be an issue with individuals that already have a highly impaired lymphatic system. She also addressed the implications of hypermobility, sharing how individuals with hyper mobile joints can be more difficult to position in surgery and more prone to anesthesia resistance, increasing the risks of dislocation and waking.

Patients are urged to discuss their risks with a trained provider before committing to surgery. By working with a lymphatic drainage therapist and a physician in advance of any surgical procedures, patients will be able to: 1) identify treatable venous disease, 2) map fibrosis of the tissue to avoid poor healing, 3) create approved home exercise plans for pre- and post-surgery, 4) improve lymphatic flow to improve and accelerate healing, 5) do a basic coagulation workup to understand their clotting risks, and 6) establish a compression plan that aids in preparation and healing. For more on this, watch Dr. Thomas Wright’s presentation “Should I get surgery?”

9. Proactively helping your provider create a comprehensive letter of medical necessity could improve your chances of securing insurance coverage for surgery.

Because lipedema and Dercum’s disease are not well understood, it may be necessary to file a Letter of Medical Necessity for either a proposed treatment or in conjunction with appealing an insurance company denial of coverage. A comprehensive and effectively written letter can make the difference between receiving full or partial coverage for the procedures, and having to pay out of pocket. In the case of liposuction, this can be as much as $10,000 - $60,000. While the letter of medical necessity will be written by a medical professional familiar with the requesting individual’s condition, the background information provided by the patient could dramatically improve the chance of securing coverage. For example, Dr. Herbst recommends that patients pull together the following: (1) a natural history of their disease, including notes on how it has worsened over time, (2) a list of current problems/co-morbidities caused by their disease, (3) a family history – with outcomes – of others affected or assumed to be affected, (4) a list of interventions that the individual has tried, both failed and effective, (5) any findings from previous biopsies (e.g. vascular damage, fibrotic tissue).

10. FDRS is currently fundraising for medical research into new treatments for adipose tissue disorders.

FDRS is a US registered 501(c)(3) not-for-profit. We rely entirely on donations and volunteers to enable us to provide support services for those adipose tissue disorders and advance research toward phenotyping and new treatment modalities. A current list of the research initiatives we support is available here. As patients ourselves, we understand the urgent need for expanded awareness, education, and treatment options for adipose tissue disorders, and we work closely with the experts on our Medical Advisory Board to responsibly invest all donations for greatest impact. To support the foundation and our work, visit: http://www.fatdisorders.org/about-fdrs/donate-to.

 

 

[1] [1] Beninson J, Edelglass JW. Lipedema--the non-lymphatic masquerader. Angiology. 1984 Aug;35(8):506-10. PubMed PMID: 6476475.

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Living and Thriving with a Fat Disorder: Lessons from The Tribe

 

This is the second blog in our four-part series summarizing key takeaways from the Fat Disorders Research Society 2016 Conference: Living with Lipedema and Dealing with Dercum's Disease. It highlights practical advice from fellow patients about learning to live and thrive with Lipedema and Dercum’s Disease, and embrace the future with confidence.

Compiled from remarks given by Linnie Hardin, Briana Garrott, and Tina Tranfaglia, who spoke with honesty, compassion, and a wonderful sense of humor about their own experiences navigating Lipedema and Dercum’s Disease, these tips represent a synthesis of the many insights and recommendations shared at the conference.

All three women admitted that it was a journey to arrive at the mindset they now have, but note that if they can do it, anyone can.

  • TIP #1: ACCEPT YOURSELF – “It’s rough,” confided Linnie, who has gained and lost 100 pounds three times as an adult, and was forced into early retirement at age 53 because her legs hurt too much to climb the stairs of her office. “Especially when you get up there in the progression, and the pain is so bad you don’t even want to leave the house. But WE are not lipedema, we HAVE lipedema, and it is important to recognize that this disease doesn’t define us. We choose what defines us. Everybody has a cross to bear; everybody has something. Let’s dress this crap the best we can and get on with it. If we don't make a big deal about our legs, nobody else will.”
  • Tip #2: FIGHT – Once you accept your diagnosis, you can get out in front of the disease and fight it. “Recognize that you are worthy of self-care” said Briana, who first experienced symptoms during the pregnancy and delivery of her first son in 2003. Over the next 12 years, Briana tried everything from elimination diets to extreme fitness plans, none of which had the desired impact of shrinking what she later learned to be her lipedema fat. She struggled not only with the physical burden of her changing body, but also the emotional burdens of hopelessness and isolation. Her diagnosis of stage-two lipedema in 2015 led her to take a whole body approach to becoming well, forgetting weight and size and focusing on how she felt, physically and mentally. She urged participants to find a dietary strategy and low-impact exercise routine that works for them and stick with it, no matter what. “Research, learn as much as you can, educate others, and keep moving forward. Mental health is as invaluable to your wellness as physical health.”
  • TIP #3: GET, AND STAY, ACTIVE – “Go places, do things, enjoy yourself,” said Linnie, whose long-time involvement in music and theater was cut short by the ever-increasing weight and pain in her legs. “It’s so easy to stay inside and hide, but don’t give in to the urge to isolate. When you wake up and get out of bed, that’s a thing right there. Keep going. Exercise, enjoy your hobbies, do things you love. I may not be on the stage, but I still go to the theater every chance I get. We are still beautiful and smart. Be grateful for all of the things we still have. It could be so much worse. Swallow your pride and get on the damn scooter or ask for the bigger chair. You CAN make it work. You CAN keep going out. If people stop calling you, you call them.

    This was a sentiment echoed by Tina, whose combination of Lipedema and Dercum’s have significantly restricted her movement and energy in recent years, but who pushes herself to stay physically and mentally active regardless. “I am still learning my new limits, and my brain hasn’t yet caught up with my body, but I know if I’m working, or out with friends, I’m not thinking about how much pain I’m in. I’m not wallowing in it.”
  • TIP #4: ASK FOR HELP – Other people like to help; it makes them feel good, the women reminded us. Outsource what you cannot do yourself, and embrace what you can. Don’t be self-absorbed. Do things for others and don’t hesitate to ask them to do things for you. Sure, it might feel a little embarrassing to have to ask for something special the first or second time, but get over it. “Everyone will understand and if they don’t, that’s their problem,” says Linnie. For example, Linnie uses a seamstress. “I don’t have many clothes, but the ones I have fit my body and give me a sense of style. It doesn’t cost very much, and it makes me feel better and more confident about the skin I’m in.
  • TIP #5: SEEK DOCTORS WHO LISTEN TO YOU, EVEN IF THEY DON’T FULLY UNDERSTAND – The number of fat disorder specialists around the country is limited, and not everyone will have the ability to access them all the time, noted Tina. But just because you may not be able to see a trained provider on a regular basis doesn’t mean you shouldn’t seek medical help when you need it. Choose doctors who listen to your concerns and work with you to map a path forward. Don’t underestimate the role we can play as educators and advocates for our disease. Awareness can start one provider at a time.
  • TIP #6: FIND YOUR TRIBE – “Remove negative influences from your life,” suggested Briana. “Approach all things with love and kindness, including yourself. If there are people in your life who are pulling you down, let them go. Surround yourself with a team of individuals who support your wellness and want what's best for you.” Whether it is something as simple as joining a Facebook support group or something as complicated as breaking away from a troubled relationship, by building the right network, you can begin to let love in.




    Linnie, Briana, and Tina are living proof that our fat disorders don’t have to slow us down. We’re in this together, and our “tribe” is strong. To watch their complete remarks from the conference, visit this link for Linnie, this link for Briana, and this link for Tina.

    You can also find up-to-date information on support groups, current research, relevant literature, and patient resources at www.fatdisorders.org

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Get Moving!
The Do’s and Don’ts of Exercising with a Fat Disorder

This blog is the third in a four-part series summarizing key takeaways from the  Fat Disorders Research Society 2016 Conference: Living with Lipedema and Dealing with Dercum's Disease. One of the most popular topics discussed at the meeting was how to map out and stick to an exercise routine that fits the needs and abilities of individuals living with adipose tissue disorders. While there is no one-size-fits-all solution, there are a number of helpful do’s and don’ts that can get help you get – and stay- moving in a safe and healthy way.  

Together with eating an anti-inflammatory diet, exercise is one of the most important tools for managing a fat disorder. Though eating well and exercising will not make fat disorders go away, they can help to lessen the severity of symptoms, slow disease progression, and improve both mental and physical health.

Even a small amount of movement each day can have an outsized impact on lymphatic flow and pain reduction, which is why it is important to understand the safest and most effective exercise regimens for every stage of your disease. What is right for a stage one Lipedema patient may not be right for a stage three Dercum’s patient, and vice versa. To balance the health benefits with the risk of inducing more pain or creating an adverse effect, it is helpful to create a game plan in advance, something you can reasonably commit to on an ongoing basis that has been approved by your doctor.

“It’s not about the weight you lose, it’s about the life you gain,” noted physical therapist Sonja Maul at Fat Disorders Research Society Conference earlier this year. “In addition to improving strength and stability, the benefits to mood, control, weight management, and general health cannot be overstated. But exercise is a very personal thing. You need to explore a little to find out what motivates and feels right to you, regardless of what others may be doing.”

 

What is the lymphatic system, and why is it important?

The lymphatic system is part of the circulatory system and also a key part of the immune system, made up of a network of lymphatic vessels that carry a clear fluid called lymph to the heart.

Like the cardiovascular system, the lymphatic system is comprised of channels, vavles and filters. However, unlike the cardiovascular system, there is no “pump” to keep things moving. Instead, the lymphatic fluid is forced through the system by the action/contraction of muscles and breathing.

Exercise activates the foot and calf “muscle pumps” increasing lymphatic drainage, reducing edema formation in the tissue, and reducing the risk of additional obesity.

Do’s and Don’ts of exercising with a fat disorder

When done properly, moderate exercise can not only reduce pain and improve lymph flow, it can also reduce the risk of comorbidities such as heart disease, diabetes, cancer, and depression. Individuals with fat disorders need to take extra care, however, not to overstrain their muscles and joints, as too much strain takes oxygen away from the muscles and increases pain and inflammation. The substance made by the body when muscles become strained and oxygen deprived is called lactate. This lactate, or lactic acid, can build up in the bloodstream faster than it can be burned off, causing cramps and nausea. To protect yourself, begin any exercise routine gradually, taking time to build up your strength. This is of particular importance to individuals with hypermobility.

Following is a list of exercise do’s and don’ts compiled from the comments and advice of physical therapist Sonja Maul, occupational therapist Molly Nettles, and yoga instructor Edely Wallace.

 

DO:

DON'T:

1.     Start slowly (esp. Dercum’s Disease)

2.     Prioritize low-intensity activities

3.     Discuss proper exercises with your doctor or physical therapist BEFORE
starting a routine

4.     Consider making water a part of your plans

5.     Protect your joints

6.     Find your motivation – is it gadgets? Rewards? What keeps you going?

7.     Know your target heart rate

  • The American Heart Association notes that a “normal” target HR range is 50-80% of an individuals’ maximum predicted heart rate (220 minus age)

1.     Engage in movements that overstrain

2.     Do weight-bearing exercises that build up excessive amounts of lactic acid (jogging, etc.)

3.     Let anyone else set your pace – you know what feels right for your body

4.     Aggravate the areas around your knees and feet

5.     Ignore your joints

6.     Start a strenuous daily routine that doesn’t let your body heal between tough workouts

7.     Forget to hydrate

 

Where to start?

As Maul noted, exercise is a very personal thing, driven by each individual’s level of fitness, physical capability, motivation, and endurance. While there is no one exercise everyone with an adipose tissue disorder MUST do to, there are certain types of exercises that generate the best results with the least amount of strain. They are:

  • Swimming/Pool exercises: This is the number one type of exercise recommended for reducing edema (swelling), as being vertical in the water offers a natural gradient compression with pressure increasing the deeper you go. Water-based exercise supports painful joints and the pressure of deep water on the legs helps improve lymphatic and venous function.
  • Walking: Unlike jogging, which strains the knee and back, walking provides a way to strengthen, not aggravate, the areas around knees and feet. Using poles, sometimes called Nordic walking, helps to distribute force away from the knees.
  • Biking: Cycling, particularly on a stationary bike, is another frequently suggested form of exercise for lipedema. Because it can be done seated, less weight is placed on the knees and back.
  • Pilates/Yoga: Pilates and Yoga are good for hypermobility, a common issue in those living with fat disorders, and also provides the added benefit of core strengthening exercises. Some people find that slow-moving yoga does not help move the lymphatic system enough, so look for an instructor who moves at a good pace.
  • Whole Body Vibration: There are many potential benefits to whole-body-vibration, from weight loss to increased bone density to improved blood and lymphatic circulation, however there have also been debates about the possible harms of these stationary machines. By working the core and improving balance, whole body vibration machines are designed to stimulate the lymphatic system with less movement.

Talk with your care provider about planning an exercise routine that would be right for you.
For more information, visit http://fatdisorders.org/society/patients/exercise.

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Self-Care for Pain and Inflammation

 

This is the final blog in our four-part series summarizing key takeaways from the Fat Disorders Research Society 2016 Conference: Living with Lipedema and Dealing with Dercum's Disease. As mentioned in our Top 10 Takeaways blog, exercise, paired with a healthy, anti-inflammatory diet, is the cornerstone of care for fat disorders. However, beyond nutrition and exercise, there are several effective self-care options to help manage pain and inflammation outside of surgical intervention.

Several presenters addressed the range of conservative treatment options available to patients with adipose tissue disorders, and that information has been compiled and summarized below. It draws from:

  • Occupational therapist Molly Nettles’ review of the benefits and considerations of five common treatments, and how to maximize their outcomes;
  • Therapist Edely Wallace’s explanation of the value and benefits of lymphatic yoga and deep breathing on increasing lymphatic flow;

 

Conservative treatment options include:

  • Pneumatic compression devices (“Pumps”) – Pumps can be used at any stage of lipedema (I-IV), Nettles explained, and allow for more personal control and fewer therapy visits. Meant to augment, not replace, professional therapy and compression garments, the effectiveness of these devices when used correctly is high. For example, a trial of Flexitouch found a nearly 80% decline in cellulitis among users, a nearly 35% reduction rate in therapy visits, and 20-40% reduction in outpatient hospital visits. Nettles recommended that patients invest in a pump with new technology (e.g. multiple chambers vs. single chamber units), and monitor effectiveness regularly.
  • Whole body vibration – The rapid contraction and relaxation of muscles that occur during whole body vibration works as a pump on the blood and lymphatic vessels, stimulating circulation and increasing flow. Nettles explained how whole body vibration increases serotonin levels and energy metabolism, building bone density and advancing flexibility and strength. She also flagged several contraindications, such as thrombosis, joint implants, pulmonary embolism, retinal conditions, and pacemakers, among others.
  • Dry brushing – This low-cost, easy-to-do intervention involves using a long-handled brush with natural bristles to stimulate skin and promote lymph drainage. By increasing surface circulation, it activates the lymphatic and immune systems, and also exfoliates and invigorates skin.
  • Rebounding – Using a mini-trampoline, this gentle bouncing technique moves lymph fluid by changing tissue pressure and creating G-force. It causes core muscles and large muscle groups to contract, resulting in the rhythmic compression of the veins and arteries, which more effectively moves fluids, both blood and lymphatic, through the body and back to the heart. Beyond anecdotal evidence, however, the long-term clinical benefits of this technique have yet to be proven.
  • Manual lymph drainage (MLD) – Nettles pointed to evidence that this gentle massage technique which relies on a light pressure applied in rhythmic circular movements  reduces swelling and volume of extremities, and curbs bruising and fluid accumulation. When combined with other conservative treatments, it has been shown help control capillary fragility and reduce pain by encouraging the natural drainage of the lymph vessels from affected tissue. Dr. Eva Sevick-Muraca further underscored the power of MLD in a compelling video depicting the increased lymph flow experienced by a patient with a Dercum’s lipoma during a drainage treatment procedure.
  • Lymphatic Yoga – Unlike blood, which moves as a result of the heart pumping, the lymphatic system moves as the result of muscular contractions. Through sequential poses, coupled with specific breathing techniques, the anatomy of the lymphatic system can help move the lymph fluid, improving health and reducing pain. Wallace demonstrated a series of specific techniques which involved applying pressure to the neck and shoulders and stretching the spinal column, which she noted impacts lymph fluid in the legs
  • Breathing – Wallace also explained the importance of proper diaphragmatic breathing, demonstrating when and how to inhale and exhale for maximum impact. If you aren’t breathing deeply or moving regularly, your lymph fluid is most likely not flowing as well as it could.  As the body goes from inhale to exhale there is a change in intra-abdominal pressure. This change creates a vacuum which helps push sluggish lymph fluid up the Thoracic Duct on its return to the Venous Angle where it will connect with the venous system. Diaphragmatic breathing helps pump the lymphatic fluid and detoxify the body, triggering a relaxation response. Wallace stressed the importance of breathing as a way to become more aware of unconscious tensions that could prevent the flow of lymph fluid throughout the body.
  • Compression garments – These can serve to dramatically improve comfort and function for individuals with adipose disorders. A variety of garments were demonstrated by Yvonne Russell and Sonja Mall in the session “Compression show and tell.”

 

 

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NEWSLETTERS

November 29th, 2016   Giving Tuesday

November 1st, 2016   Call for Presenters

October 21st, 2016  Lipedema and Dercum's Photo Essay; Conference

July 14th, 2016   CME Announcement

June 1st, 2016  Lipedema Awareness Month

May 6th, 2016  Conference Photos and Review

January 29th, 2016  Conference Reminder

December 29th, 2015  Major Research Announcement

December 1st, 2015  Giving Tuesday; New Videos Released

October 15th, 2015  Lipedema and Dercum's Conference and Updates

April 7th, 2015  Conference update

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