Asociación Galega de linfedema, lipedema, insuficiencia venosa crónica y otras patologías: FOCUS ON THE TERM ELEPHANTIASIS AND ITS IMPLICATIONS FOR LYMPHOEDEMA - HEREDITARY LYMPHEDEMA - PEDIATRIC AND PRIMARY LYMPHOEDEMA - SECONDARY LYMPHOEDEMA - LYMPHATIC FILARIASIS - LYMPHATIC PODOCONIOSIS

jueves, 31 de octubre de 2019

FOCUS ON THE TERM ELEPHANTIASIS AND ITS IMPLICATIONS FOR LYMPHOEDEMA - HEREDITARY LYMPHEDEMA - PEDIATRIC AND PRIMARY LYMPHOEDEMA - SECONDARY LYMPHOEDEMA - LYMPHATIC FILARIASIS - LYMPHATIC PODOCONIOSIS - RARE DISEASE

Even though elephantiasis is the outcome consequence of severe lymphedema due to lymphatic dysfunction, it is perceived worldwide in texts of health related organizations, that there is a persistent attempt to prioritize and link elephantiasis to filariasis, and so putting in secondary place its incidence and prevalance with regard to the other causes.

Elephantiasis is also projected as if an isolated disease, as if it appears suddenly or without apparent cause, and that the best first treatment option in developing counties, is basic patient self-care (limb washing and elevation), or radical debulking procedure surgery (Charles Procedure) if the first treatment option does not respond.

This healthcare focus and strategy is very important, for it implies and requires no investment in good conservative treatment options. The majority of lymphoedema patients in developing counties are not being treated with compression therapy and garments, and when they get to final Stage-3 elephantiasis, some receive debulking procedure surgery to reduce limb volume, and others try to survive with serious infections such as Dermatolymphangioadentitis-ADLA (Infectious Cellulitis), Sepsis or malignant complications.

These same texts mention the population incidence of elephantiasis in poor regions, but say nothing at the same time regarding the millions of people suffering paediatric and Primary Lymphoedema in these same countries, who are also living in dramatic conditions of undertreatment and in Stage elephantiasis.

It must be understood at a medical level, that if a disease manifests itself with pain and has serious complications, its then considered a priority healthcare matter that needs prompt and regular treatment. So if elephantiasis is portrayed internationally as principally related to filariasis, this subjectively implies that its not such an important risk factor for the rest of causes. And if elephantiasis is presented also apparently as a disease in itself and as if a spontaneous condition, then there is no point treating lymphatic dysfunction in its early and mild first Stag-1 lymphoedema.

There are still today numerous protocols and best practice guides, that define lymphoedema as a non-painful condition or without serious complications. This is one of the reasons why health systems in many countries are not creating specialized Lymphoedema Units, and patients are taught and encouraged not only self-care for maintenance, but also self-treatment for the reduction of their oedema.

It is very important to clearly define what is lymphoedema and its symptoms, what is elephantiasis, what is basic self-care, and what are the best treatment options accepted today for the treatment of lymphatic dysfunction.