I can't say how important it felt to be back at aqua exercise! I made it back to the class today and although my knees felt a bit tender I was able to move around fine and fully participate in the class. Other than tenderness the class didn't feel different to before.
Exercising in water is very beneficial for lipodema so before surgery I was going several times a week - I even had a very cold swim in the local swimming pool in Lubeck the night before my surgery! Hubby loved that bit of the trip! ;)
I had been told that I could be in the pool around 2 weeks after surgery but that I had to be sure all my incisions were fully closed. That was a problem with my stubborn knee incision which leaked for ages then after a shower would spot with blood (the tiniest and most frustrating spot but still a spot!) into week 3. When I went to St George's (in week 4) for my appointment, the physiotherapist told me to leave it another week before swimming (but I didn't understand why) so the earliest I could really have swum happily was week 5.
So now I just need to build on my progress and fit the water workouts back into my life again - it has been nice not sitting down to dinner and finding my hands still smell of chlorine!
Sunday, 17 April 2016
Monday, 11 April 2016
Published Research Papers
When I was considering my surgery I was interested to get into the research. I wanted the person carrying out my surgery to be using techniques with an evidence base behind them, and to have carried out follow ups on their own patients and reflected on their techniques.
I felt all surgeons can show you photos of patients who have experienced good results (at least I hope they can!) but how long does it last? What does the future hold? How do different methods of liposuction compare?
I reached the conclusion that there is sufficient evidence of reduced pain, reduced sensitivity, increased mobility and improved quality of life lasting multiple years, and that most patients were not reporting return of the fat to treated areas.
I thought it might be useful to post links to the research papers I've looked at - clearly I read Professor Schmeller/Hanse-Klinik's publications most carefully ;)
You can find papers by going to a site like PubMed and entering a search term like lipodema or liposuction. The search results will then give you titles as links which bring up abstracts (or summaries) of the papers and on the right hand side of the page it will tell you where you can access the full paper from. Via the pubmed site you can purchase the full published papers as a patient for around £2.50 per paper.
There is a 25 patient follow up study out to six months by Rapprich S, Dingler A, Podda M. which had evidence of pain reduction.
Professor Schmeller has co-authored papers going back to 2005 or so on lipodema and liposuction. His 2006 paper had 28 patients benefiting around 12 months later.
Professor Schmeller has carried out two much larger follow ups, most recently along with Dr Baumgartner from Hanse (and another author M Hueppe) where they followed 85 people out to 8 years (December 2015 British Journal of Dermatology). His previous paper for the same journal in 2012 with Dr Meier-Vollrath (looks like she worked at Hanse then) and M Hueppe had an average of 4 year follow up data for 112 patients.
The results were consistent across the two pieces of research, showing long term consistent benefits from tumescent liposuction:
"All patients showed a distinct reduction of subcutaneous fatty tissue (average 9846mL per person) with improvement of shape and normalization of body proportions. Additionally, they reported either a marked improvement or a complete disappearance of spontaneous pain, sensitivity to pressure, oedema, bruising, restriction of movement and cosmetic impairment, resulting in a tremendous increase in quality of life; all these complaints were reduced significantly (P<0·001). Patients with lipoedema stage II and III showed better improvement compared with patients with stage I. Physical decongestive therapy could be either omitted (22·4% of cases) or continued to a much lower degree. No serious complications (wound infection rate 1·4%, bleeding rate 0·3%) were observed following surgery." Quoted from abstract of 2012 paper by Schmeller et al.
I felt all surgeons can show you photos of patients who have experienced good results (at least I hope they can!) but how long does it last? What does the future hold? How do different methods of liposuction compare?
I reached the conclusion that there is sufficient evidence of reduced pain, reduced sensitivity, increased mobility and improved quality of life lasting multiple years, and that most patients were not reporting return of the fat to treated areas.
I thought it might be useful to post links to the research papers I've looked at - clearly I read Professor Schmeller/Hanse-Klinik's publications most carefully ;)
You can find papers by going to a site like PubMed and entering a search term like lipodema or liposuction. The search results will then give you titles as links which bring up abstracts (or summaries) of the papers and on the right hand side of the page it will tell you where you can access the full paper from. Via the pubmed site you can purchase the full published papers as a patient for around £2.50 per paper.
There is a 25 patient follow up study out to six months by Rapprich S, Dingler A, Podda M. which had evidence of pain reduction.
Professor Schmeller has co-authored papers going back to 2005 or so on lipodema and liposuction. His 2006 paper had 28 patients benefiting around 12 months later.
Professor Schmeller has carried out two much larger follow ups, most recently along with Dr Baumgartner from Hanse (and another author M Hueppe) where they followed 85 people out to 8 years (December 2015 British Journal of Dermatology). His previous paper for the same journal in 2012 with Dr Meier-Vollrath (looks like she worked at Hanse then) and M Hueppe had an average of 4 year follow up data for 112 patients.
The results were consistent across the two pieces of research, showing long term consistent benefits from tumescent liposuction:
"All patients showed a distinct reduction of subcutaneous fatty tissue (average 9846mL per person) with improvement of shape and normalization of body proportions. Additionally, they reported either a marked improvement or a complete disappearance of spontaneous pain, sensitivity to pressure, oedema, bruising, restriction of movement and cosmetic impairment, resulting in a tremendous increase in quality of life; all these complaints were reduced significantly (P<0·001). Patients with lipoedema stage II and III showed better improvement compared with patients with stage I. Physical decongestive therapy could be either omitted (22·4% of cases) or continued to a much lower degree. No serious complications (wound infection rate 1·4%, bleeding rate 0·3%) were observed following surgery." Quoted from abstract of 2012 paper by Schmeller et al.
Saturday, 9 April 2016
Week 5 - thanks aunty flo!
I can't believe I can post pictures of me in my undies, but hesitate to say that it was my period! I've been feeling tender around the thighs and knees, which made me really feel like I was going backwards. I had a bit of a panic about it. It isn't very painful, nor is it constant, but it wasn't something I'd been feeling so far (not since the bruising faded away around the end of week 4). I then realised it was my time of the month so hope the tenderness will fade away.
I can't tell if I was getting swollen - I didn't feel that different, but I don't really tend to feel swelling. I could see a little in my post surgery feet in week one, but other than that I find I am staring at areas where my compression has dug in, wondering if that is "normal" swelling or quite what to make of it.
My scars are really improving (becoming less red mainly). I've been putting bio-oil on them since around week 4, once I was sure all my scars were dry. Bio oil has quite a gentle scent so isn't overpowering and isn't making me greasy. I am rubbing a drop into each scar morning and night.
The footless Sigvaris Diaphane arrived - I wish they hadn't :( They are Class 2 but UK rather than EU class 2. I tried wearing them but they don't feel supportive enough so I was aching in my thighs after a few hours. I feel my EU class 2 ETO tights are far more supportive for running around in, so unless I wear these in the heat, I can't imagine them being any good :(
My Veni tights arrived and the brown is quite nice but they do feel more rough than the Sigvaris Comfort. The Comfort have a cotton soft feel, whereas the Veni feel more artificial and dry.
Sadly I couldn't try them out for a day as they came with a manufacturing fault - a small hole in them! I used the delivery note to find an email address for Haddenham and sent them a photo to report the problem. The delivery note said to report faults within 2 days of receipt and although they came in the week I waited for the weekend to open them properly, so I'm hopeful they won't be difficult about that.
I can't tell if I was getting swollen - I didn't feel that different, but I don't really tend to feel swelling. I could see a little in my post surgery feet in week one, but other than that I find I am staring at areas where my compression has dug in, wondering if that is "normal" swelling or quite what to make of it.
My scars are really improving (becoming less red mainly). I've been putting bio-oil on them since around week 4, once I was sure all my scars were dry. Bio oil has quite a gentle scent so isn't overpowering and isn't making me greasy. I am rubbing a drop into each scar morning and night.
The footless Sigvaris Diaphane arrived - I wish they hadn't :( They are Class 2 but UK rather than EU class 2. I tried wearing them but they don't feel supportive enough so I was aching in my thighs after a few hours. I feel my EU class 2 ETO tights are far more supportive for running around in, so unless I wear these in the heat, I can't imagine them being any good :(
My Veni tights arrived and the brown is quite nice but they do feel more rough than the Sigvaris Comfort. The Comfort have a cotton soft feel, whereas the Veni feel more artificial and dry.
Sadly I couldn't try them out for a day as they came with a manufacturing fault - a small hole in them! I used the delivery note to find an email address for Haddenham and sent them a photo to report the problem. The delivery note said to report faults within 2 days of receipt and although they came in the week I waited for the weekend to open them properly, so I'm hopeful they won't be difficult about that.
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