Integrative Treatment for all Types of Lymphatic Filariasis
Oedema or Edema (swelling) is a collection of fluid. Lymphoedema is a collection of lymph fluid in the body tissues; here the normal flow of the lymph is damaged creating the collection of lymph in the extremities
Lymph is the normal body fluid that is present in tissue and circulates throughout the lymphatic system. The movement of fluid through the lymphatic system is done by contraction of muscles and there is also a gentle pumping action from the lymphatic vessels themselves. The fluid is filtered through lymph nodes and then eventually drains back to the blood system through a major vein on the left side of the neck. Lymph flows in one direction towards the blood system and there are tiny valves in the lymphatic channels which aid in this one way flow. When lymph load is increases, fluid accumulates in tissues rather than draining back into the blood stream and lymphoedema develops.
In primary lymphoedema the lymphatic vessels themselves often appear to be abnormal. They can be very poorly developed (hypoplastic) or not developed at all (aplastic). Tiny valves in the lymphatics may also be faulty. The reason for the occurrence is not entirely clear, but genetic abnormalities have been identified in some patients.
Primary lymphoedema can be divided into two main groups.
- Congenital onset primary lymphoedema-the odema which is seen in childhood
- Post pubertal primary lymphoedema-the oedema develops after pubert
Secondary lymphoedema is caused due to damage of the lymphatic vessels surgery, radiation, chemotherapy, accidents and injury due to any reason.
Cancer and Radiotherapy
After certain types of surgery (breast surgery, node dissection for melanoma a(type of skin cancer) the lymphnodes are intentionally removed to reduce the risk of cancer recurrence and to prevent the spreading of the disease to the other part. This can also occur after radiotherapy which can damage lymphatic vessels. In some patients the development of cancers themselves can lead to lymphoedema. This is because sometimes the tumor cells also affect the lymphatic vessels, by blocking them.
Lymptic Filariasis is a parasitic and infectious disease that is caused by thread-like filarial nematode worms which is also known as “microfilaria. The thread-like, parasitic filarial worms Wuchereria bancrofti and Brugia malayi. These worms lodge in the lymphatic system. The worm damages the lymphnodes or causes the dilatation of the lymphatic vessels and impair the flow of the lymph. They live for 5-7 years, producing millions of immature microfilariae (minute larvae) that circulate in the blood. The patients usually present with symptoms like painful swelling on the one / both legs, arms & scrotum, along with fever and redness of the affected part. The skin also becomes much thickened and with over hanging folds which can resemble the foot of an elephant. Filariasis is the most common form of secondary lymphoedema worldwide.
LF is caused by microscopic worm that spread from person to person by the bite of infected mosquito. The microscopic worms pass from the mosquito through the skin, and travel to the lymph vessels. In the lymph vessels they grow into adults. An adult worm lives for about 5-7 years. The adult worms mate and release millions of microscopic worms, called microfilariae, into the blood. People with the worms in their blood can give the infection to others through mosquitoes. The microfilaria damage the lymph nodes and lymphatic vessel by which flow of lymph fluid is impaired and cause massive lymphoedema (elephantiasis) of the legs ,arms breast, genital area .In the early age there are no symptoms, this stage can last for several years. As the disease progresses the skin becomes very thickened and with overhanging folds which can resemble the foot of an elephant.
Cellulitis or Filarial fever is a common soft tissue infection. The affected limb will have the following symptoms.
- Pain and tenderness.
- Warmth of the affected region.
- Erythema (redness).
- Increased swelling.
- Local lymphadenitis (infection of lymphnodes).
This commonly occurs in the lower leg but can develop anywhere in the body. In severe infections the inflammation can spread to the lymphatic vessels (lymphangitis) and cause damage by leading to scarring around the lymphatics as the inflammatory process resolves. Frequent inflammatory episodes lead to swelling because of scarring (damage) around the lymphatic channels
Integrative Treatment For All Types Of Lymphoedema
The patient are provided pre treatment counseling to explain the details of the disease and treatment. Patient details will be documented by counselor. A team of doctors will examine the patient and record the status of the disease. Doctors, nurses and compression therapists will discuss and decide on treatment. Before starting treatment girth and volume measurement will be recorded and it will be repeated on 7th and 14th day or when doctors decide to repeat them .Treatment will be for 15days or 21 days according to the condition of the patient .Complicated limbs with ulcer maggots fever episodes etc ,recent ADLA cellulites or fever episode and large size of the limbs require 3 weeks of treatment. The treatment procedures are mainly aimed to drain the lymph blocked in the legs.
- Skin wash : Meticulous washing and drying of the affected limb will be trained.
- Phanta :The process of soaking the affected limb in herbalized solution to heal microscopic ulcers.
- Yoga exercises: Asanas and pranayama to facilitate the lymph flow. Yogasanas in two session will be trained to the patients by our staffs.
- Massage (Indian Manual Lymph Drainage):The accumulated lymph will be drained manually. IMLD also helps to absorb oil.
- Compression:The affected limb is bandaged in figure of 8; compression will improve the muscle pumping & thus facilitate lymph drainage.
- Swedhana:The patients with hardened limbs showing non-pitting oedema (organized limbs) will be treated with swedana therapy (Ayurvedic heat treatment) ,herbalized steam is passed through a pipe directly over the lymphoedematous leg .This treatment is also called Nadi sweda
The patient has to spend 1½ hours daily to do the self care procedures at home. If the patient can follow all the instruction given during the training period, the reduction rate will be significant. Patient and a care taker from the family will be given training from 3rd day of treatment on the above protocol, to ensure the continuity. By continuing the integrative treatment recurrent inflammatory episode can be controlled and limb size can be reduced thus improving Quality Of Life.
Cost estimation for treatment
Treatment cost will depend on the duration of the treatment and the size of the limb. As the patients attend the pre treatment counseling the girth measurement will be taken, cost estimation software uses this measurement to give the approximate cost of treatment. You can also send the photo of the affected limb from anterior, posterior, medical and lateral aspect of limb to firstname.lastname@example.org tentative before your arrival. The approximate cost of the treatment and duration of the treatment can be estimated .Please click on our photo gallery to understand the position for taking photo.
Blood urine and discharge from the wound will be tested to initiate appropriate treatment. Physical fitness through ECG and circulation to limbs through Ankle brachial pressure index will be determined .Photo of the affected part will be documented.
Follow up dates will be given during discharge .Please take prior appointment for follow up visit. Patients have to spend a day for follow up. During the follow up, counseling will be done again. All the treatment procedures practiced by the patients will be cross checked. Periodic follow ups are done generally at 45, 90 and 180 days to ensure the continuity of the self care. The bystander who was trained on treatment procedure should accompany the patient in order to re-educate the treatment procedure. Please call to 04994 240862,240863 for appointment. We work on all government holidays and Sundays. Working hours- 9.30am-5.30pm.
- We are a day care centre and serve on outpatient basis.
- Accommodation is locally available near to the premises of our Institute as well as in Kasaragod municipal area.
- Self-catering service apartments near IAD are A.M Land-9846247150, Hotel C –Park-8281495434, Kindly speak to them in Hindi, English or Malayalam.
- One bystander along with the patient is encouraged, as to support the patient to continue this home based self-care treatment further.
- You can also book hotels through online services like OYO ,Make my trip etc
If you take up room in Kasaragod municipal area, we provide free pick up to institute