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Personal Note To Our eNews Subscribers
There are no words to convey our shock and sorrow for the victims of recent tragic events, and their families. Everyone in America and around the world, have been deeply affected, and it seems assured that nothing will ever again be as it was.
Along with the sense of horror and sadness, there is admiration. For the heroic efforts of our country's citizenry... the firemen, policemen, medical, emergency and military personnel, and the many volunteers who selflessly are setting aside concerns for their own personal safety. Their bravery makes us doubly proud to be Americans.
As we go about the business of "getting back to normal", it is with a renewed sense of patriotism and concern for our fellow citizens. I hope this note finds you and your family safe and healthy.
As Americans, I'm confident that we will all pull together to overcome this horrific tragedy, and to preserve the American Way of Life, for all future generations.
Tony Reid MD Ph.D
Obesity Survey Results
Several months ago I was asked whether patients who weighed more had worse edema. I reviewed the published literature and there was no information concerning the effect of weight on the severity of lymphedema. As a result, I wrote a survey that sought to answer that question and to also evaluate the effect of lymphedema and weight on quality of a person's life. I used one of the standard surveys we use to assess the quality of life in patients with cancer and modified it to suit patients with lymphedema. W
e have had a tremendous response with several hundred people responding to the survey and many people commenting that they were very happy to see that these questions were being addressed.
I have some of the results of that study. For this analysis, I focused only on women. Many men also responded to the study, but I will analyze their results separately since the height and weight distribution in men is different.
For the analysis I divided the patients into 4 approximately equal groups based on weight. The first chart shows how these patients were divided. The average weight of group one is 133 pounds, while the average weight of group 2 is 175 pounds, group 3 is 224 pounds and group 4 is 337 pounds. While the weight is different among these 4 groups, the average age is about the same at 45 to 49 years. Also, the range of heights is about the same, ranging from 4 feet, 11 inches to 5 feet 9 inches in group one. Gro
up 4, the heaviest group, has a similar range of heights, ranging from 5 feet, 1 inch to 5 feet, 11 inches. So, the age and heights of these 4 groups are similar but the weight for each of these groups is different. If we compare the responses of these 4 groups to several questions, we can assess the impact of weight on lymphedema.
"I am bothered by the effects of lymphedema"
The graph of the responses to this question is shown below. Very clearly, the effects of lymphedema are felt to be worse by those in the greater weight groups.
This does not necessarily mean that they have worse edema, but it suggests that when they do have lymphedema, the effects are worse. These effects could include difficulties moving the affected limb, recurrent infections or difficulties finding appropriate clothing.
"I have swelling"
This question simply asks whether a person has swelling and if so is there a little swelling or a lot of swelling. The responses to this question are interesting. First, it is clear that even the patients in the lowest weight group report significant swelling, with the average being between somewhat and quite a bit. However, the degree of reported swelling increases with each weight group, suggesting that the extent of edema is worse as weight increases. From the previous figure we find that the effects of
lymphedema are worse as weight increases and in that case it appears that the effects are more pronounced as weight increases. For example, a woman of normal weight who reports that she has some swelling is less likely to feel she has significant effects from it than someone with a similar amount of swelling but a greater weight.
"I have infections in the affected limb"
"I use antibiotics for infections in the affected limb."
For some time I have felt that infections are more common among patients who weigh more. In fact, this chart demonstrates that the number of infections and severity increases with weight. Patients in the lower weight group report relatively few infections and infrequent need for antibiotics. In contrast, it is common for patients in the highest weight group to report infections and need for antibiotics. Of course, this does not mean that patients in the lower weight groups do not get infections. I have had
many patients with normal weight who get infections and need treatment. This does suggest that the frequency and perhaps the severity of infections are worse in patients who weigh more.
"Because of weight lymphedema, I have trouble meeting the needs of my family."
These are two related questions that are used in our quality of life studies to assess how an illness impacts family life. When someone cannot do the things necessary to meet their families needs, then the quality of their life may be significantly impaired. Simple things like making dinner or going out for a walk with the family become difficult or impossible. Clearly, as weight increases, it becomes a significant factor in a woman's ability to meet the needs of her family. However, in all groups, they re
port that the edema causes more impairment than weight. This suggests that treating lymphedema can significantly improve the quality of life for all patients, but especially for those whose weight is higher.
There were additional questions that look at the quality of life in greater depth and I will go into those in subsequent editions of eNews. If you have not filled out this survey and would like to do so, it is posted on our website under surveys. Also, if you know of someone who has lymphedema, consider telling him or her about this survey. As the number of patients who fill out the survey increases, the reliability and value of the information also increases. In addition, this survey is not only for patie
nts who are overweight; it is also for patient with normal weight. For example, this study helps show that patients with normal weight are at risk of infections and that perhaps weight reduction will help control lymphedema and perhaps reduce the risk of infections as well. I am trying to assess whether weight reductions plans help reduce lymphedema. If you have experience with weight reduction plans please fill out the survey and describe you experience with lymphedema and weight reduction.
Lastly, if you have a ReidSleeve product, please go to our Owner's Survey. There are some special offers for you.
Tony Reid MD Ph.D