domingo, 7 de octubre de 2018


Millions of people across the world suffer a debilitating, painful and potentially life-threatening disease called Lymphedema. The progressive inflammation and swelling causes pain, discomfort, skin complications and ultimately, severe deformity and disability, leaving men, women and children across the world unable to work, care for their families and lead normal lives.
But the discovery six decades ago, of a physical therapy for the reduction and maintenance of this disease, seemed it was about to change it all. Not only was it an inexpensive treatment, in comparison to expensive drug treatments needed for many other chronic sicknesses, but it was also a powerful means to give back quality of life to patients. With an average of only two weeks of intensive physical therapy, and two compression garments per year, it was possible to reduce the limb size of this inflammatory disease, and even halt the progression towards severe disability.
No time had to be wasted regarding chronic Lymphedema, recognizing that the populations most at risk of this disease, are those least able to afford treatment, and it had sense that international health organizations immediately started treatment programs, and distributing compression garments to all those affected. It should have been the step ahead, for treatment at a global level of this disease, an effective treatment for a tragic and completely preventable outcome, "elephantiasis", also called Stage-3- Lymphedema. It is very important to understand that all non-reversible Stage-3-elephantiasis, first started off as an initial Stage-1-reversible lymphedema.
If Only we hadn’t turn a blind eye, to the treatment of a tragic disease that has plagued mankind for centuries. Now 60 years later, the majority of people who are affected by lymphedema in the world, as many as 300 million, are slowly progressing towards Stage-3-elephantiasis, and permanently disabledThe present situation is unique in medicine, whilst the majority of chronic disease are given the life long medication and health assistance they need, the greater part of patients suffering from lymphedema, are undertreated or not treated at all.

In short, Stage-elephantiasis is not a rare clinical condition, but has stuck around because medicine and many national health care services and policies have looked the other way, the easy way out for not funding the necessary services and compression garments for the treatment of lymphedema, which is why Stage-3-Lymphedema (elephantiasis) continues to persist worldwide. This only shows that the world has failed, and continues to fail, to treat a treatable disease.
Neglected diseases like Lymphedema stand in stark contrast to other chronic diseases like diabetes, which receive the life-long drug treatments they need. The severe recurrent complications like cellulitis, due to lack of access to physical therapy and compression garments, has more probability of leading to life-threatning complications like Lymphangiosarcoma, or Sepsis due to the consequent antibiotic resistant strains.

Across the world people suffer from neglected diseases, conditions that prevail in many countries lacking good health care services, and medical resources. Diseases like Lymphedema typically do not kill immediately, but instead it slowly becomes disabling, leading to terrible suffering, creating losses of capital, worker productivity, and economic growth. Advanced lymphedema or elefantiasis, is characterised by fibrosis and fatty induration of the tissues, which become much more difficult to reduce than in early stages, where the swelling is more characteristically due to protein rich fluid. So to reduce limb volume, more intervention is required at an earlier stage, much more than is currently indicated by some international organizations.

With regard to filarial lymphedema (Lymphatic Filariasis), it is very important that at the present moment and by means of drugs, that there is a goal and campaigns of eliminating filariasis, to prevent the next generations of people being infected. But there should also be a goal and campaigns, for the treatment of the present generations, who are already affected and suffering, from the consequent established lymphostatic oedema. The same happens with lymphedema due to Podoconiosis (lymphatic podoconiosis), which also needs reduction treatment and compression garments, in order to control its progression. Lymphatic edema without treatment or inadequately treated, are more likely to develop very serious or even lethal complications, such as erysipelas, adenolymphangitis, dermatolymphangioadenitis-DLA (cellulitis), necrotizing fasciitis, septicemia (sepsis), lymphangiosarcoma, etc. Elephantiasis will never be eradicated from the world, whilst there are still people that don't have access to good and specialized treatment for lymphedema, whatever its cause.
Lymphedema is universally recognized as a neglected and severely debilitating disease, even though it already has effective treatments. In spite of this, many national health services, even in modern and industrialized countries, allocate little or nothing to treating and preventing Lymphedema, in contrast to the full coverage given to other chronic diseases. No drug or surgical procedure exists that can permanently cure Lymphedema, but this is not an excuse for not funding public health treatments. Funding physical therapy and compression garments, could help in the final push for the eradication of elephantiasis (Stage-3-lymphedema).

Primary and Secondary lymphedema collectively, affect millions of people across the world, most in the poorest areas of the poorest countries. All lymphedema whatever its cause, can drift towards severe deformity, leading to increased disability in men, women, infants and children of all ages. Furthermore, inflammation and infections in young people, leading to absences from school, and dramatically reduced future quality of life and labour productivity. However, lymphedema can be successfully treated, what’s more, preventing its progression and complications in the first place, is completely achievable through increased awareness, and early-stage preventive treatment programs
The U.S. spends over $8,000 per person per year on health expenditures, in comparison the minimum yearly needs of a lymphedem patient, which are two weeks intensive physical therapy, and 2 compression garments. This opens the door to a critique on the disparities in health resources, which are dedicated to lymphedema. Even so, the medical-ethical excuse used by some national health services and organizations, is that even though Gold Standard Conservative treatment is safe and effective, it is expensive, time-consuming and needs certified therapists. Without drastic increases in funding and medical, public and political awareness, the plight of people affected by lymphedema, is unlikely to budge anytime soon.

Less than 20 percent of the world’s population lives in some of the most developed and economically high-functioning countries, and nearly 90 percent of the world’s total financial resources, are devoted to the citizens of these nations. This situation does not reflect the reality, of patients suffering from lymphedema in these countries, since most of them are untreated or undertreated. Many of these High-tech counties are now even implementing, cheap, modified and simple versions of treatment, so as not to fund good treatment. For more information on the simple and modiried treatments. The worst situation for access to treatment is for the low-income countries, where national health services and policies are doing little to nothing about it. Conversely, some global health experts estimate that for every dollar spent on neglected disease control, we get back over $50 in increased ecmic productivity. By increasing awareness and funding of treatments for neglected diseases, the world economies will be making one of the best global investments possible.


Cost of a lymphedema treatment mandate-10 years of experience in the Commonwealth of Virginia
Complete Decongestive Therapy Treatment for lymphedema and its relationship with Patients Psychological and Physical characteristics:
The Psycho-Social Impact of Lymphedema
Effective treatment of lymphedema of the extremities.
Conservative treatment of lymphoedema of the limbs.
The physical treatment of upper limb edema.
Lymphatic drainage of the upper limb. Substitution lymphatic pathways
Phlebolymphedema–A Common Underdiagnosed and Undertreated Problem in the Wound Care Clinic
Why aren’t we curing the world’s most curable diseases?

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