Sunday, June 23, 2013

Lymphedemas can cause the development of neuropathy such as the one accompanying diabetes

As I discussed in the last week post, the neurologist whom I helped with his neck problem started referring me patients.   (Those not familiar with this narrative please click here)

Recently he called me about one a relatively healthy 72 year old man, who developed typical neuropathy such as the one accompanying diabetes, while as the patient couldn't even be diagnoses as being in pre-diabetic stage.  So he contemplated on this case and for a while couldn't come to any conclusion.

When he introduced this case, the doctor mentioned that the patient’s had high level of cholesterol and was taking statin (cholesterol lowering) drugs.  From my experience I knew that people who take statin drugs usually develop edema, especially in the ankle area and I shared this observation with the doctor.  The doctor recollected that although his patient’s heart was functioning normally as well as other vital organs like kidneys, liver, etc. he did have some edema in the ankle area.  I offered that this lymphedema could compress nerve and thus could promote neuropathy.  The doctor was surprised and noted that he couldn't find any scientific literature supporting that fact that edema could be the cause of neuropathy.  As he promised to do more investigation on the matter, he also asked me to do something in reducing the size of this lymphedema.  

I was glad to be of service in this case since Medical Massage has a special protocol for lymph drainage that significantly reduces and in most cases eliminates edemas.  Since in this particular case we dealt with lymphdynamic edema, I expected it to be gone pretty fast.

When patient arrived, he was mildly sad and depressed, because he loved to play golf and the neuropathy was preventing him from enjoying his game.  He was complaining that the last three months he wasn’t really himself and no one knew what the problem was.  He was even afraid to drive because he couldn’t control his reactions.

From the first treatment I significantly reduced edema size.   I knew that it could come back, informed him about it and recommend  him to come back for treatments.  At next visit, edema was still there, but to my surprise it didn’t return to the same size. 
Subsequently I performed eleven more treatments.  The patient’s feet regained normal color, the edema has practically disappeared as the symptoms of neuropathy. Because nerve damage wasn’t permanent, after twelve treatments nerve, in absence of edema, recuperated.

The doctor investigated the patient, called me and said that he was amazed at the clinical outcome.  He also suggested that based on these results we should try this method with other patients and should write a paper.  His suggestion was based on the fact that he had the hard time finding any description of such results in the scientific literature.  I was doubtful in regard of such a paper.  For me the interesting observation was no the fact that lymphedima could cause neuropathy. I was taught of this connection long time ago during my school studies and clinical practice. Sometimes, post surgical patients who developed lymphedemas due to ankle area traumas also develop neuropathy.  In the case of diabetes, the vessels that supply blood to nerves are damaged.  Thus people who suffer diabetes eventually also develop neuropathies.  Interestingly, when edema is not caused by diabetes, although the mechanics of the disorder is different, its effect on nerves is similar.  Edema compresses the region it interrupts the normal blood supply to nerves and eventually causes neuropathy. I didn’t want the article would come across as an example of a well known saying: “everything new is just well forgotten old.”
To me the interesting aspect of this clinical experience was that even though the patient continued taking statins, lymphedema and accompanying it neuropathy didn't come back.  Three weeks after the treatments were stopped; the patient reported no swelling and no neuropathological symptoms.  This fact might be deserving of an article.





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