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MICHAEL MASON'S PRESENTATION AT LAV AWARENESS
SEMINAR
Notes prepared by Nerida Smith who
attended Michael Mason’s presentation at LAV Awareness Seminar March 2003.
Michael is
a physiotherapist whose main interest was sports physiotherapy until 1987
when he established Adelaide Lymphoedema Clinic in S.A. His interest in
lymphoedema developed after he acquired a paper written by the Foeldis
regarding their treatment for lymphoedema in Germany known as Complex
Physical Therapy.
Prior to
that he was at a loss on how to help people with the condition.
People
were often told “It's only a swelling, don’t worry”
Michael
considers C.P.T to be the best non-invasive treatment for lymphoedema
available and he encourages people to “Live positively with lymphoedema.”
He went
on to explain that the lymphatic system makes up part of our immune system
and is a transport system for the lymph fluid which exits the blood stream
to nourish the tissues and gather up the waste products from this process.
The body
has 4 lymphatic territories separated by boundaries or watersheds. 2upper
and 2 lower. It is possible for a quadrant to be swollen without the
corresponding limb.
There are
surface lymphatics and deep lymphatics which follow in close proximity to
the blood vessels and nerves. The surface lymphatics are important in the
treating of lymphoedema and the reason why the lymphatic massage pressure is
as the stroking of a cat.
Swelling
occurs when the lymphatic system is impaired. e.g. lymphoedema may develop
in the arm because the capacity in comparison to normal is greatly reduced
because of lymph node removal. Infection will cause increased load and
cause stagnation of the fluid because of the reduced capacity.
Lymphoedema is classified into 2 types – Primary and Secondary.
Primary also known as Milroys, Lymphoedema Praecox and
Lymphoedema Tarda. All of these are a congenital condition classified
according to the age of onset. This often requires yearly treatment.
Secondary following surgery for cancer, radiotherapy, trauma, insect
bite.
Venous
Oedema responds to CPT. This swelling is charecterised by pigmentation
on the lower limb.
Studies
have shown that overweight or obese people are twice as likely to develop
lymphoedema and they only respond half as well to treatment.
Lipodema is caused by an excessive deposition of fat cells – a
pathological condition where the feet are not affected. CPT only helps to
some degree but liposuction is helpful.
Diagnosis of lymphoedema is mostly by clinical evidence and
lymphocintoscans, which enables the tracing of the lymph flow in the limb.
Treatment - many methods have been used - surgery, drugs,
hydrotherapy, compression pumps, laser and complex physical therapy.
Note: For
lymphoedema the use of diuretics is not recommended they remove the water
and concentrate the fluid causing the problem to worsen over time.
· Laser softens the
fibrous tissue.
· Michael has developed
a method called TMER (a routine combing massage and exercise) designed to
stimulate deep drainage. These are available for each affected limb or
limbs.
· Bandaging with low
compression bandages over stockingette and polyester padding
· Exercise -
hydrotherapy, swimming, walking.
Self
management tips.
Avoid
overloading the lymphatics neither underload or overload the lymphatics.
1. Avoid excessive heat
and sunburn
2. Practice good skin
hygiene.
3. Exercise regularly
4. Wear a garment
5. Eat sensibly
6. Listen to your body
7. Schedule periodic
reviews
8. Self massage
9. Compliance with
therapists treatment prescription.
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