Archives for posts with tag: low level laser

One of my clients, Chris, has very kindly given permission for me to share her photos and reports to write this blog.

Chris is what I’d call a very “motivated” client.  She is determined that she will kick lymphoedema’s butt, no matter how many times I tell her that she can control it with good maintenance but it will always be a part of her life.  She believes in positive thought and who am I to knock that?

Chris first came to see me in January 2016 at the age of 72, complaining of swelling and discomfort mainly in the left lateral chest wall and through to her back as well as her upper arm.  She had had a squamous cell carcinoma removed in the area (as well as many others in different parts of her body), along with a total axillary clearance and radiation to the area.  The swelling became noticeable almost as soon as the radiation finished in October 2015.

She had a number of physiotherapy sessions prior to coming to see me but hadn’t found these beneficial. I checked her self-clearing technique (she was directing fluid to the armpit so we adjusted that and I showed her how to do deep breathing as well).

Over the last year we have used a number of techniques.  Manual Lymphatic Drainage is the main therapy used but I have also added Low Level Laser and deep fibrosis techniques.

Chris uses a Mobiderm arm sleeve day and night (she finds this more comfortable than elastic compression sleeves).  There are days that she does use her normal compression sleeve as well, but she finds the Mobiderm more effective.

I have fitted her for a compression vest which she also wears daily, with Mobiderm swell spots inserted in the areas of greatest fibrosis. Photo below

Chris uses her own low level laser daily at home – she has a Pulse Laser.

Once a week she applies kinesiotape down her arm and across her back – she takes this off just before coming to her MLD sessions and reapplies once she gets home.

She swims daily in the ocean when it is warm enough and does a lot of walking (she delivers pamphlets every day) and running.  She is incredibly fit, active and full of energy (she credits the energy to taking lots of spirulina, but I can’t vouch for that – she’s just full of life!).

After a few months of treatment Chris went to Mt Wilga Hospital for a three week intensive course of treatment. She now has a very personal relationship with Dr Helen Mackie!

Even though visually you cannot tell Chris has lymphoedema, she is aware of it constantly and it affects her daily life.  So she went to see Dr Mackie and the surgical team at Macquarie Hospital in October 2016, to see if perhaps there was a surgical solution to her issue.

She spent about four hours with the team, being measured with different diagnostic tools and when using Indocyanine Green (ICG) Fluorescence Lymphography, they found she had some issues in the dorsum of her hand but that her arm was ok. There was also an issue in her lateral chest (where she had the most discomfort) and no evidence of functional lymphatic vessels, with no lymph movement down to the lower abdomen. She did however have a strong pathway across her chest to the opposite side, as well as one on her back going in the same direction. And the scans showed up lots of fibrosis in the chest wall which needed to be broken up with deep friction massage.

Armed with that information, we were able to tailor her treatment with a real focus on breaking up the fibrosis using laser and deep work, as well as stretching of the arm/shoulder area.

Chris had follow up scans on 23rd March 2017 and the difference was quite astonishing! She had a new pathway going from her armpit down into the abdomen and the fibrosis had reduced significantly. So much so that they felt she wasn’t a surgical candidate and she should continue the conservative treatment in the pathways that are now available!

If only more people had access to scanning using ICG – it has been a very useful tool for customising Chris’ treatment and has been beneficial in her progress which in turn has made her much more comfortable with her lymphoedema.  There have even been times when she’s chosen not to wear all her compression for a few hours and she’s enjoyed the freedom that’s given her.

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Three weeks ago I had a new client come to see me.  Denise is a 63-year-old woman who had a sore, bruised and swollen thigh.

Her upper leg started to swell on Christmas Day for no reason at all.  She had a large lump/bump laterally on her knee.  She was sent for various tests … an MRI, ultrasound, x-ray … all were clear.

Then, about ten days before coming to see me, Denise developed bruises down her thigh.  No injury.  No trauma of any kind.  Her doctor took a sample of fluid from the swelling on her knee and found that it was actually dried blood – that was tested and given the all clear.  The last injury she could remember on her leg was a “cork” she’d received over forty years before.   Her doctor thought that perhaps the blood came from that incident but there was no conclusive evidence.

She had not been able to weight-bear the week before coming to see me, her leg had been too swollen and painful.  Her knee was so painful it had stopped her from playing lawn bowls and she couldn’t bend it to go up and down stairs.  Lawn bowls is the only exercise she’s been able to get since she had back issues three years ago, when she spent three weeks in hospital and walked for six months with a stick.

Denise was given a referral to see a knee specialist after a scan showed a possible bone on bone scenario, the report basically said she needed to get a new knee, but her GP disagreed with that finding and felt she needed another opinion.  The specialist looked at her scans and agreed, her knees were fine and they were not the cause of her problems.

She has multiple health issues including a prior clot that had made its way to her lung and polycystic and multi cystic kidney disease.  But none of these could be responsible for her leg swelling.

What brought Denise to me was a segment on A Current Affair called “Neck Pain No More” which featured Low Level Laser treatment for a number of conditions.  She had called the business featured in the segment and her name and number was taken but they were so overwhelmed with enquiries, they said they’d call her back (they still haven’t).  Two weeks later she was in my clinic because she had done a google search and found that I had a Low Level Laser.  I’d post a link to the segment but when I tried to watch it online I could find the text but the video was incorrect (I have written to ACA to ask them to fix it, they are working on it).

So, here are some photos of Denise’s leg when she came to my clinic that first day.

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We decided to do some manual lymphatic drainage as well as laser and Denise wanted to work intensively, as she was going away for three months and wanted to feel better before she went.  The trip was in two weeks from the day she came to me.  That first day we did 15 minutes of laser and the rest was lymphatic drainage.  At the start her knee was painful when I touched it but by the end of the session her pain levels were down.

We did four treatments the first week and three the second, increasing the amount of laser to 25 minutes.  Each day the swelling and bruising reduced.  Most days she felt her walking improved but the bending was still restricted.

By the fourth treatment she felt she could get out of chairs easier.  At the fifth treatment the bruising was almost gone and the ladies at the bowling club had “diagnosed” her with bursitis.  She had gone home and googled the condition and felt it fit for her.  I must point out, this is not a medical diagnosis, it’s peer diagnosis. But she was happy with that.

By the last treatment she could get in and out of her car much easier and the bruising was gone and swelling was down.  She was a happy lady when she set off on her trip.

Here are some photos taken on her final treatment.

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