9 Erros comuns após o diagnóstico do lipedema

Hello! I'm Dr Alexandre Amato, vascular surgeon at Instituto Amato. And today I'm going to talk again about a subject that I love, which is lipedema.

Here are the nine most common mistakes immediately after the diagnosis of lipedema. So, if you went to the doctor, someone told you that you have lipedema. Or you have self-diagnosed, so you think you have lipedema.

And here come the nine most common mistakes. The first of them is to believe that everyone will reach the final stage of the disease. So, when you find out what lipedema has, Google lipedema.

You will see several varicose vein classification images. Stage one, two, three, four. There are other classifications too, and then everyone pays attention to that ending, that stage, the worst of all.

And he says "Oh my God, I'm going to get to this stage. " It is not an evolutionary classification, that is, it does not mean that everyone will reach the final stage, only those who do not undergo treatment will reach the final stage. And when I'm talking about treatment, I'm not talking about surgery, I'm talking about treatment, both conservative treatment and surgery in some cases, but many people are under control of the disease.

So lipedema is a super common disease. 12% of the population has it. And it doesn't mean that 12% of women are desperately seeking help, because they are in control and will stay that way.

No need to worry. The question is if you discovered that you have lipedema and have symptoms, you have to find out how to control the disease, that's right, because if you don't control it, it can progress. The second most common mistake is believing that the next step is to schedule the surgery, schedule the surgery and the solution to the problem.

We have to understand that liposuction is just a tool in the lipedema treatment process and that it is not suitable for everyone. Many people who have lipedema do not need surgery. Surgery can be done, we operate, we are very much in favor of having surgery, but not as a unique treatment or much less definitive, because it won't be.

I have already received patients here who have already been operated on five times by other surgeons and wanted a sixth surgery. Why? Because she believed surgery was the only solution.

And, in addition, liposuction surgery will remove a huge volume of fat. And fat is an endocrine tissue, what does that mean? Our fat cells produce hormones.

They are extremely active in our body. If we remove a huge amount of fat overnight, there will be a huge impact on your body. That's why conservative treatment is necessary.

Conservative treatment beforehand is essential for the success of surgery. See what is written in the international guideline published in the United States about the surgery. Surgery is only indicated after conservative treatment.

Conservative treatment may have been successful or may have failed, but conservative treatment must have been carried out. Surgery is not the first step. The third mistake is to panic or despair when diagnosed with lipedema.

In fact, it's supposed to be comforting to know that everything you felt has an explanation. You are still the same person you were before. The diagnosis will only open up a range of opportunities.

Diagnosing lipedema will now allow you to improve those symptoms that bothered you before. So there is no need to despair, there is no need to despair. Use the diagnosis to your advantage.

The fourth mistake is to start believing everything you hear about lipedema. So, for that there is bioindividuality, I have a whole video talking about bioindividuality. I will indicate it here, but what works for one person will not necessarily work for another person.

And people often want to take advantage of the marketing of the word lipedema. You have to be very careful about who is really being based on science and who is offering adequate treatment, who is trying to get rid of it. See, our first scientific research that we published internationally was in 2019 and the research began in 2017 and in 2017, that was when we believed we had something to add to the international literature on the subject of lipedema.

So we started back then to promote this issue and bring information to the general public. Why do I say this? Because I have a whole playlist of videos about lipedema with reliable information for you.

Filter very carefully what you are hearing in lipedema groups or what you are hearing out there from people who claim to be experts on the subject. The fifth mistake is believing that only with a lot of money you can solve lipedema. This subject is so important that I also made an entire video about it, but this all stems from the fact that you believe that surgery is necessary to treat lipedema.

So, the surgery is expensive, the insurance does not cover it. Since the surgery is expensive, the only solution is to have money to resolve the lipedema and far from that. Most treatment is done conservatively.

These are lifestyle changes that don't require 1 cent. So, you can greatly improve your quality of life without the need to spend money, even medications that are prescribed at some point during the disease, especially at a worse stage of symptoms. They are temporary, they are not lifelong medications.

And even when we talk about surgery, for example, here we have a day hospital, we perform the procedure within our hospital, so we can even offer surgical treatment at a much more affordable price. The sixth mistake is not understanding and separating your complaints. So, when lipedema is diagnosed, the complaints are all together and often my complaint is aesthetic.

My complaint is related to aesthetics, but in fact, inside that bag of aesthetics there is pain, mobility, a feeling of heaviness, there are several other complaints that are linked to aesthetics, but in fact they are separate complaints. What do you mean by that? Because the aesthetic complaint cannot come first.

Mobility has to come first, you have to be moving well. Second come the symptoms, symptoms like pain and swelling. This pain and swelling decreases quality of life.

We have to improve this before thinking about aesthetics. Thirdly comes aesthetics. So, what is common with my patients is that aesthetics lose their value after we start treatment and improve mobility and symptoms.

It doesn't mean that the aesthetics don't improve, the aesthetics improve too. But does that mean you were able to separate the symptoms and understand where they came from? So the pain happens when I do this, so I will avoid the pain.

The swelling happens when I do this, I avoid swelling, that's all. There is already a huge improvement in quality of life and often lessens that initial aesthetic complaint. The seventh mistake is taking tests without consulting a doctor.

Ah, this I have seen very often. So someone calls to make an appointment with a doctor and the secretary gives a list of tests that need to be done. And this is a mistake so big, so absurd, that I could spend hours talking about it.

But I'm going to be very objective. The exams are subsidiary, they are exams to complement what was seen in the physical exam and in the consultation conversation, which is the anamnesis. So if you reverse the order you are either doing a lot of unnecessary examination or even worse, you are trying to put everyone in the same bag.

What does that mean? For a good hammer, every screw is a nail. If you treat everyone the same way, you will fit everyone into a production line.

And the best way to do this is to skip the initial consultation, already asking for additional tests, do you need this patient? I don't know, but the treatment will be the same. I don't even know the patient, but I will always offer the same treatment.

And why am I saying this? Because one of the tests that I see frequently requested for lipedema is lymphoscintigraphy. Lymphoscintigraphy is not a test for lipedema.

It is an exam that will help diagnose lymphedema, which is something else. Lymphedema is very easy to assess on physical examination. The vascular surgeon is the specialist in the lymphatic system and he can assess in one minute whether or not the patient has lymphedema without the need for lymphoscintigraphy.

Ah, but gosh, I like doing tests. Alright, I'll tell you what lymphoscintigraphy is like for you. You will inject between your toes, then a needle will go inside your toes and inject a substance.

This substance is radioactive, and then you will have to wait a long time until you enter an isotope capture chamber. And this camera will measure how much radiation is being emitted by each part of your body. So, see lymphoscintigraphy is being requested left and right and it is an invasive exam, a radioactive exam, painful and extremely uncomfortable and, if the patient is evaluated by a specialist vascular surgeon, there is no need for it at all.

So know that if your doctor is not evaluating you before ordering tests, it is because the treatment will be the same for everyone and certainly their greatest interest is not in your well- being or your quality of life. The eighth mistake is believing that conservative treatment is unsustainable throughout life. In fact, while it is a treatment, it may seem unsustainable, but over time it ends up being an acceptance and a change in lifestyle habits.

And it stops being an effort. It becomes a choice, as you do something and realize that it brings you a benefit. This change will be your choice and not the doctor who is asking or ordering something like that.

So, in the end, it's small things done daily automatically that change the final result. Therefore, conservative treatment is perfectly sustainable throughout life. And this also applies to the ninth mistake, which is believing that the diet is unsustainable for a long time.

As you are asked to go on a diet and you have this weight of a diet it may really seem like it, but as you make a mistake, you escape a little and you realize that you ate something that is bad for you or that you did something that wasn't bad for you. good. You will naturally end up choosing not to make these choices anymore and it will no longer be a diet.

It will be a choice, it ends up being a dietary re-education in a very natural way. It then becomes a life choice and not an obligation. Did you like our video?

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