So where do I start? My desk is covered with photos of patients who have lower extremity lymphedema secondary to obesity. These patients and their therapists are obviously frustrated for they feel they have come to the end of the road. Unfortunately, all too often that is true. As I’ve said before, a JoViPak® garment may not be their best answer. What is?
As a European-trained lymphedema therapist, I never thought I would say this - the best answer may be a pneumatic pump! I was thrilled to learn that Lympha Press® has expanders for their pumps and they are currently focused on finding solutions for the morbidly obese. So think about it: these patients are past the point of being able to exercise and most of them still have their inguinal lymph nodes. So why not get them on a pump? How else are we going to get the fluid moving? With Lympha Press’ new bariatric pant design that also drains the truncal area, the patient’s lymphedema should come down fairly quickly. At that point I’ll be happy to make a JoViPak garment for the patient – particularly if they have fibrosis. We may even be able to provide JoViPak padding for use under the pump if it helps speed the process and/or makes the patient more comfortable.
You have to know by now that I can’t ignore the other major piece to this obesity puzzle and that is nutrition. Stay tuned, as I’ve just finished reading a marvelous book that I’m sure will be helpful for all of us.