NOW WHAT?

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NOW WHAT?

Postby Chris'swife » Mon Jun 11, 2007 10:04 pm

:? Thanks so much for all the replies to my first post. Chris was diagnosed 4 wks ago today and has had 3 weeks of PT - bandaging the left leg, wearing a compression hose on the left and having light drainage massage. We went to PT today and the therapist announced that she had read his records over the weekend and done some reading, and does not think he has responded at all to the therapy. He does sow small amounts of loss after massage, but it comes right back the next day. He is still measuring at or near what he was 3 weeks ago. She feels it is too dangerous to do the massage, even though it relieves his pain and fluid load immensely, because of his congestive heart failure. (His one and only episode of CHF was in 1994.) So now what do we do? I have learned how to wrap his leg, I know how to do the massage but the therapist says it isn't helping. We will have him keep his legs up during the day, and he will continue to do the little exercises she has given him to help release fluid from his leg and ankle. Is he just going to have to live like this the rest of his life? All other things considered, will this shorten his life span, can we expect him to get significantly worse, what-what-what should we do?
Lee
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Postby patoco » Wed Jun 13, 2007 2:29 pm

Hi Lee :)

I think at this point, it would be good to have the doctor connect with the therapist.

What will probably need to happen in to get a clinical stage of his heart condition and this is info that the therapist would probably accept only from a physician.

I have to say, as hard as it is, I would agree with the therapist that the heart condition may make the MLD dangerous. ALso, bandaging by itself isn't going to do a great deal to help. It is more for keeping the swelling down once the leg size is decreased through therapy.

Kinda confused too. CHF is a condition that is chronic (ongoing). When you speak of the last episode, are you meaning heart attack?

Pat
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Postby Chris'swife » Wed Jun 13, 2007 4:34 pm

Hi Pat. When I say he has not had an episode since 1992-3, I mean he has not reached a point where there was any fluid around the heart or lungs or needed to be hospitalized for any reason connected to heart problems. He had a complete cardiopulmonary workup in February and it showed that his heart was not enlarged, was healthy, no plaque buildup in any arteries and no abnormalities. He does have atrial fibrillation and he has frequent tachycardia. It has not diminished his overall heart health. Lung function tests showed very mild COPD, no more than would be expected of an ex-smoker who had allergies and bronchitis throughout his child and early adulthood. His physician completely disagrees with the therapist. She and I both can tell a significant difference (I have pictures to prove it) since he has been in therapy. The PT is retired, only works on a PRN basis and I think his situation is so complicated she doesn't want to deal with it. Last Thursday everything was great and she gave him 2 appts for this week. On Monday she said he was not progressing and didn'tneed any more therapy. Hmmm. His doctor sees no reason not to bandage both legs. We found another certified lymphedema therapist only 20 miles from our home instead of 60, and will see her for the first time next Tuesday. If he gets the slightest bit of firmness in his abdomen I stop the massage; that has only happened once. He feels better and can walk better after massage and wrapping, and if it done carefully, he is fine. I can understand her fear of liability but I also know Chris is in terrific pain and is helped by the therapy.
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