This article is a transcribed edited summary of a video Bob and Brad recorded in April of 2023. For the original video go to https://youtu.be/XzR2CGTh-Mg
Brad: All right, if you have swollen legs or one leg is swollen and it's from lymphedema, what you would like to do is eliminate that. So one of the biggest mistakes that I've seen in my decades of working with patients is what we're going to explain to you.
Mike: You can fix it very easily with just a little bit of advice.
Brad: Okay, so let's clear up what lymphedema is, lymphedema is swelling in the legs. It's very visual, you'll see it actually swell. It's different than if your leg is swollen up from say an ankle sprain or something traumatic like that. It's very important to understand that the arteries and the fluid or the blood are actually still going down into your leg, and it's returning back up into your system as it should. The lymphedema or the fluid in there is not. So we'll talk about what that fluid is, go ahead Mike.
Mike: So the fluid in lymphedema is called interstitial fluid, that's a mouthful of say, and it naturally surrounds your body tissue and cells all throughout the body, not just in your legs. And this is a normal process and it's supposed to flow out and flow back in, and it carries nutrients and helps bring oxygen to healthy tissues.
Brad: That's right, and the thing that really is important to think about with lymphedema, this interstitial fluid, it is superficial as it flows back. In other words, it's just under the skin. As it comes back up it'll go through your lymph nodes located in the groin area, your lymph nodes filter it and it goes back up into your system, and the cycle starts all over again. But the whole point is, it's superficial, it's just under the skin. And we'll tell you why in just a minute. Okay, So if you do have the swelling, you do not want to self-diagnose your problem, go to a doctor, make sure it's diagnosed by a doctor, that it is a lymphedema problem, and that you do not have other things going on. A real common prescription that the doctors will order is compression garments that will help maintain the size of your legs so that the fluid does continue to work back up into your system.
Mike: So that can be done in a couple of different ways. We have Tubigrip here, which is a nice easy thing to slip on. Some doctors actually have you wrap your legs, that's a whole other animal. Or some type of compression socks. Usually, there's more compression in the toes versus up at the calf muscle, but a large problem we see with these is they start to roll down creating a tourniquet. Now this tourniquet, as Brad said earlier, it's not going to be so tight that it cuts off your blood supply, we don't have to worry about that. But this interstitial fluid is so close to the top layer of the skin that it's going to start pooling in there, so if you actually take it off you can notice there's going to be big indentations where these are rolling down.
Brad: Right, and, remember, the interstitial fluid will get into the ankle into the foot, however, on its way back where it's just under the skin, it hits that tourniquet there, and it bumps against there and it causes all of this excessive fluid. So the compression garment will do its job and help, but with tourniqueting, it actually negates the whole benefits of the compression garment and can make it worse. So you'll see in the photo below that there is the ring, the tourniquet, and then I pull that down and, Mike, you cannot see it but on a real leg where you have tourniqueting, you will literally see a dent all the way around in a ring, and you can clearly understand that that tourniquet is limiting the flow of that fluid back to the trunk or the lymph nodes.
Mike: So what are some solutions to this?
Brad: Wait, even before we get to that. The solutions are very simple and easy to do, which is really good news. Sorry to interrupt.
Mike: The first solution for the patient, or me in this case, is to simply check the wraps they have or their Tubigrip, and just make sure if it's rolled down like that to unroll it if they are able to, not everyone can. So what's the other option, Brad?
Brad: Well, the other option is if the person does not remember to pull them up or they're unable to reach down and pull them up, is hopefully there is a caregiver around that will periodically, every hour or every two hours at the most, will actually come over, check it, and then make sure they're in the right position. If that is not an option and the person will forget or cannot do it, or there isn't another person to help, then we have a pretty easy solution for that.
Mike: So this is called Coban. It's not really a tape, it's a type of wrap that sticks upon itself only, it does not stick on your skin. And what you do, so if you have Tubigrip and it's up, is you simply wrap it around the top portion of it. Now you don't wanna get super tight and cause another tourniquet, just nice and loose and gentle, and see it sticks upon itself like this. So wrap it around just a few times and then you can simply tear it or cut it with the scissors. And, there we go.
Brad: So, again, now this is one inch, I would actually recommend the two-inch wide, it works better. For this situation, it's better to use the 2-inch wide, but it is the same material. You can buy this online, you can get it in medical supplies. Actually, if you want a hint on how to get it cheaper, buy it from a veterinary supply, and this is what I've heard from people who got certified in this. It's exactly the same product but they use it on animals and they sell it cheaper, so you can get it quite a bit cheaper. So wherever you get it from, make sure, you know, you'll just find out it works well, this is actually made by 3M. Again, it does not stick to your skin but it does to itself, and you have a nice way to hold it up. Easy to take off, you simply throw it away and use some more. All right, very good, so simple little tricks to help that tourniqueting problem and really help the lymphedema problem go away. And I've done this with patients, I'm working with this with my mother right now, and, boy, it is really working well if you stay consistent with it.
Mike: If you have any questions or comments, mark them down below. Let us know if this works for you or if you have any other suggestions because the audience feeds off of each other.
Brad: That's right, there are other tricks besides this, I am sure.
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