what is this ?

[emad]

Hi all ;

I have 65 years woman ,her legs like this image !

Any one have seen that before ,what is it ??

Regards
Emad

[nari]

emad,

Bilateral lower limb lymphoedema.

It is part of the elephantiasis disease, but can occur in all four limbs in many instances; after surgery to remove lymph glands, such as pelvic dissections, or mastectomy.
Physiotherapists treat the condition fairly successfully with a system called "complex bandaging" -highly specialised bandaging with layers of cotton wool, and an exercise program.
But I think the person in the photo may be beyond help.

Nari

[emad]

Thanks Nari ;

I searched for it through the web to find you are correct , the last image is an image of real elephant lower limbs ,because i did not know it really .

Here you are a another image for human patients .

http://www.somasimple.com/images/lymph.jpg

Firstly , i do not try to address the lymphedema ,but i have patient like that experiences ROM of both knees reachs only 90 ,as well from time to time sciatic pain develops ,which could be severe .

Regards
Emad

[fapt]

hi emda,
This case is so marvellously and is that your patient?
I have never seen this before.....
How could we do for this patient?
I have no ideal....i want to know...:angel:
Thanks!!

[bernard]

Emad,

It looks as an Elephantiasis (http://elephantiasis.freeyellow.com/) as Nari told you.

[cedric]

il y a un bon livre sur le DLM et sa prise e charge globale
de RV CLUZAN et de la kiné chef dont j'ai oublié le nom...
je te retrouve les coordonnées du bouquin..

[bernard]

Cedric,

Thanks, but Emad doesn't understand French. ;)
I will take a look for an English version but IMHO, we are a bit "short" with such cases?

[emad]

Hello Cedric ,Bernard & F;

Bernard ;

Could you make the image appeared with the post ,by the way sometimes i attach image which comes appeared , on the other hand i can not make the image appeeared.

i do not know how to address this patient from our point of view as therapists ,but i try to apply neurodynamics ,this patient suffers so much , she can not lie comfortable for hours on one side .

Regards
Emad

[cedric]

sorry i thought that bernard was the first to post
this kind of case needs lots of works: (according to cluzan and francoise alliot <=nothing in common with the defense ministery)
- electrotherapy
- lymphatic drainage (leduc method)
- specific bandage
- exercices with bandage

patients follows an intensive treatment during a month or two.
plus regular physio during a year

[CGilson]

I realize this entry is late in comparison to the original posting, but I felt the need to add my two cents. The picture is obviously of someone with very advanced lymphedema of both extremities. But I'm very upset to hear that we as therapists think we cannot help these people. In a number of specialty practices these patients are receiving a manual technique which involves massaging the tissue to soften the skin and allow the lymph trapped in the interstitial spaces to be redirected to the appropriate lymphatic drainage vessels. I personally do not treat these patients, but my friend Tracey Towlen, MPT specializes in this treatment at the Norton Clinic for Lymphedema and Physical Therapy. If anyone wants contact information please email me: christinab_4@hotmail.com

[bernard]

Welcome Christina (? picked in the email adress)

If the case is really an Elephantiasis (http://elephantiasis.freeyellow.com/) manual lymphatic drainage is useless at first intent. There is a bacterial infection that must be cured. Once this task is achieved our intervention becomes possible.

[anjuphysio]

hi am a pt from india the patient in pic i think is beyond any help byt i think that faradism under pressure and ankle toe movts with isometrics of lower limb might help