Imagine having chronic swelling in your arms and/or legs for the rest of your life – this is the reality that a lot of women who have been diagnosed with lymphoedema live with every day.

Lymphoedema is a chronic progressive condition that causes swelling most commonly in the limbs because of “excessive retention of lymphatic fluid”, according to the Cancer Association of South Africa. In 2014, the organisation estimated that around 1.3 million South Africans had some form of the condition.

The condition is not yet curable; it can only be managed with vigorous diligence to treatment (which we’ll get to in a moment).

How does it work?

Academic medical centre Mayo Clinic explains that the lymphatic system is pivotal for maintaining a well-functioning and healthy body. Lymph fluid travels around your body collecting viruses and bacteria – these are carried by the lymphatic system through lymph vessels and, as the process continues, they are eventually flushed out of your body.

Read more: 11 symptoms of breast cancer in women that aren’t lumps

Lymphoedema happens when the lymph vessels become compromised and can no longer efficiently flush out the lymph fluid in specific areas of your body. These are the parts of the body that experience chronic swelling.

There are two types of lymphoedema: primary and secondary. Primary lymphoedema refers to the condition developing on its own, and secondary lymphoedema is when it’s caused by another condition. The primary type is a lot less common than the secondary type and the causes for each are slightly different.

So, what are the causes?

An essay by members of the Lymphoedema Association of South Africa (LAOSA) published in the Sabinet Journal outlines the causes for primary and secondary lymphoedema.

As mentioned, primary lymphoedema is quite rare and it’s an inherited condition. Here are the three main causes:

• Congenital (Milroy’s disease): This condition makes lymph nodes form abnormally and one can develop this from birth to two years old.
• Lymphoedema praecox (Meige’s disease): This condition can cause lymphoedema from puberty to 35 years old. It can also cause lymphoedema during pregnancy.
• Lymphoedema tarda: When lymphoedema develops after the age of 35. Secondary lymphoedema, the most common type, happens because of another condition’s effect on your lymphatic channels. Here are the conditions/circumstances that can cause secondary lymphoedema:
• Surgery: Lymphoedema can develop if any lymph nodes or lymph vessels are removed or damaged during surgery. This often happens with breast cancer patients – lymph nodes sometimes need to be removed to see if the cancer has spread.
• Radiation therapy: Radiation therapy for cancer can scar and inflame the lymph nodes and lymph vessels, which can cause lymphoedema.
• Cancer: Lymphoedema can develop if cancer cells block lymphatic vessels.
• Filariasis: The Centers for Disease Control and Prevention explains that if a mosquito bites someone with lymphatic filariasis, microscopic worms from the infected person’s blood infect that mosquito. When that mosquito bites someone else, the worms go from the mosquito and enter the other person’s bloodstream and eventually travel to the lymph vessels. This invasion to the lymph vessels by the worms can cause lymphoedema.

What are the risk factors and preventative measures?

If you’re currently in treatment for cancer, or you’ve just beaten the disease, older age, excess weight and/or developing psoriatic arthritis could significantly increase your risk for developing lymphoedema.

If you’re about to get surgery for cancer, or you’ve already had it, there are a few preventative measures you can take to reduce your risk of developing lymphoedema, but these are only relevant if the surgery involved the lymph nodes or lymph vessels. You can find this out from your surgeon.

Read more: Here’s what women of every age should know about arthritis

You can reduce your risk by avoiding any type of injury to the affected arm or leg; always making sure to rest your affected arm or leg as much as you can during recovery; keeping the affected arm or leg constantly elevated; avoiding clothes that are too tight; always keeping your affected limb clean, and checking the skin on your affected limb every day. If there are any abnormal changes, get in touch with your doctor. And lastly, never go without shoes or socks.

Treatment

LOASA writes that the most effective treatment for this condition is raising awareness on risk reduction strategies. The same risk-reducing methods are also part of the management of the condition. Because there’s no cure, most of the treatment is centred around controlling the swelling and pain. LOASA offers some more methods for risk reduction:

• No drawing blood, vaccinations, acupuncture or taking blood pressure on the at-risk limbs.
• Avoid high-impact sports, carrying heavy items or prolonged repetitive movements.
• Exposure to heat from places like steam rooms, saunas or the sun should be avoided.
• When doing things like washing dishes or gardening, always wear protective gloves.
• Always wear compression garments when exercising and travelling long distances by plane or car.
• Engage in non-strenuous exercise focused on mild contractions of the arm or leg muscles.

“The gold standard for treatment of lymphoedema is complete decongestive therapy (CDT) and consists of manual lymph drainage; compression therapy (includes multi-layered lymphoedema bandaging and compression garments), home care, skincare and exercise.”

In severe cases of lymphoedema, doctors will often recommend surgery to reduce the swelling in your arm or leg.

^{This article was originally published on www.womenshealthsa.co.za}

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Significant inequalities remain in the areas of family affluence, gender and race, Sport England says.

Don’t go to work or send children to school until 48 hours after symptoms have gone, NHS bosses say.

Obese teenagers can have certain brain differences from their thinner peers – changes that might signal damage from inflammation, a new, preliminary study suggests.

Using advanced MRI techniques, researchers found that obese teenagers tended to have signs of decreased “integrity” in the brain’s white matter. White matter contains the fibres that connect different areas of the brain.

Brain structure differences

In this case, lower white-matter integrity was seen in a brain region related to emotional control and “reward” seeking.

The findings, based on 120 teenagers, are considered preliminary. Experts said it’s not clear what they might mean.

But the findings add to evidence linking obesity to certain brain structure differences. Recent studies of middle-aged adults, for example, have found evidence of brain tissue “shrinkage” among those with high levels of body fat – particularly around the belly.

One possibility is that excess amounts of body fat directly harm the brain through inflammation, the researchers suggested.

In the new study, there was a correlation between decreases in white matter integrity and higher levels of certain inflammatory substances in the blood. Teens with those brain changes also tended to have higher levels of the hormones leptin and insulin. Leptin is involved in appetite control, while insulin regulates blood sugar levels.

Dr Harold Bays is a fellow of the Obesity Medicine Association and medical director of the Louisville Metabolic and Atherosclerosis Research Center, in Kentucky.

Other components too

Bays said brain-imaging studies like these provide additional objective evidence that obesity is not just a matter of “willpower”.

“Some people don’t see obesity as a disease and argue that it’s all about behaviour,” said Bays, who was not involved in the study.

But, he said, obesity is actually driven by a range of underlying factors. “Yes, behaviour is a key component,” Bays said. “But there are other components, too, including a neurological one.”

So does extra body fat cause the brain differences? Or do the brain differences feed weight gain?

Bays suspects there may be a two-way street – where, for example, brain differences contribute to obesity, and obesity ramps up inflammation that affects the brain.

But this study does not get at that question.

“This doesn’t tell you anything about the direction of the relationship,” said Allan Geliebter, a senior scientist in psychiatry at Mount Sinai’s Icahn School of Medicine in New York City.

Future studies

It’s also unclear, he noted, whether factors other than body fat – such as diet or lack of physical activity – could be involved.

Geliebter, who was not part of the study, called it “interesting” in part because it focused on teenagers. If brain differences can be seen that early, that’s important, he noted.

Future studies could look at whether such brain differences remain after obese teens lose weight, Geliebter said. That would suggest – though not prove – that obesity causes the brain structure changes, he explained.

In a study published earlier this year, Geliebter and his colleagues found hints that this could be the case. They focused on severely obese adults who were starting weight-loss treatment, through surgery or lifestyle changes only. Four months on, patients who were losing weight showed increases in the brain’s white and grey matter.

Pamela Bertolazzi, a doctoral student at the University of Sao Paulo in Brazil, is scheduled to present the latest findings Dec. 1 at the annual meeting of the Radiological Society of North America, in Chicago.

Research presented at meetings is considered preliminary until published in a peer-reviewed journal.

Lower IQ scores

For the study, her team used a specialized MRI technique to assess the brains of 59 obese and 61 normal-weight kids, aged 12 to 16. The investigators focused on a measure called fractional anisotropy, or FA: If it’s reduced, that suggests lesser integrity in the brain’s white matter, Bertolazzi explained.

Overall, the study found, obese teens had a lower FA in certain areas of white matter, compared to normal-weight kids. The affected areas control appetite and emotions.

Bertolazzi said her team hopes to do exactly what Geliebter described – repeating the MRI measurements in the same teens after the obese group goes through a weight-loss programme.

Other studies, she noted, have shown that obese kids tend to have lower IQ scores than their thinner peers, though it’s not known whether that is due to any effects of obesity on the brain.

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Alcohol-free drinks are increasingly consumed in an effort towards more mindful drinking. “Booze without the booze” is a movement that’s growing globally, and South Africa, which ranks sixth globally as a nation of drinkers, is also slowly joining the movement. And if you want to stay off alcohol, you have plenty of options to choose from as there are already several popular brands on the market.

Food24 notes that the 0% beer category is potentially the biggest trend in beer since the introduction of the Lite category several years ago. But while these beverages have been designed to emulate the traditional taste of alcoholic drinks, there are a few important factors to bear in mind:

Are they really 100% alcohol-free?

Not always. According to the South African Liquor Products Amendment Bill, an alcoholic beverage is labelled as such when it contains no more than 0.5% alcohol by volume.

There are many “alcohol-free” drinks that claim to offer the same taste as their alcoholic counterparts, but without the alcohol, Rhys Evans, Managing Director of ALCO-Safe notes, adding that the label and marketing are misleading, as quite a few products contain around 0.3%–0.5% alcohol.

“Many alcohol-free wines also contain trace amounts of alcohol as they have been ‘de-alcoholised’ – comparable to decaffeinated coffee which still contains traces of caffeine,” explains Evans. Non-alcoholic drinks can also still play a role in contributing to liver damage. The University of Wisconsin Hospital & Clinics Liver Transplant Program therefore recommends refraining from alcohol-free wines altogether.

Can non-alcohol drinks trigger a breathalyser?

Since the percentage of alcohol in these drinks is so incredibly low, Evans comments that even if you consume multiple drinks, you are unlikely to blow a positive result on a breathalyser.  

However, if you, for example, consume twenty 330ml Savanna Non-Alcoholic ciders within an hour, the drink, which contains 0.3% alcohol, could put you over the legal limit. For this reason, the advertising regulator ruled earlier this year that television advertising must reflect this information, reports Business Insider.  

Health24 reached out to Distell, which owns Savanna, and was told that the company was the first to introduce a non-alcoholic cider to the South African market and it was simply a means of responding to the “evolving consumer needs, in particular, moderation and responsible drinking”.

“Our labelling for alcohol and non-alcohol products complies with all applicable regulations. In particular, non-alcoholic products are classified in the Foodstuffs Act as a product with the alcohol level above 0.05% but under 0.5%. Currently, Distell has two non-alcoholic offerings on the market: Savanna Non-Alcoholic Lemon and the JC Le Roux non-alcoholic range,” they said. 

But on a more serious note, these drinks can actually be dangerous for recovering alcoholics.

Trigger for recovering alcoholics

Sobriety can be tough. For many recovering alcoholics, it’s a hotly debated question, but Evans explains that alcohol-free beverages are a “big danger zone”.  

“Even small amounts of alcohol can be dangerous to an addict, but it goes beyond the simple presence of alcohol.  

“Alcoholism is more than a physical addiction – it is also a mental addiction, and force of habit plays a significant role.” 

The similar smell, taste, and even the shape of the bottle or glass of the non-alcohol drinks could all be triggers for recovering alcoholics and could cause a relapse, adds Evans.  

“For some alcoholics, just the act of holding a wine glass could prove to be problematic, even if the glass contained something as innocuous as fruit juice.” 

Hence, despite the shift to mindful drinking habits, Evans advises that it’s best for people in recovery to stay away from this “dangerous territory”.

Bearing this in mind, Distell responded to their role in promoting responsible drinking:

“Importantly, our commitment to responsible drinking is unwavering. We respect the rights of adults who choose whether or not to consume alcohol or non-alcohol products.

“As Distell, we run and fund several campaigns aimed at promoting responsible drinking and educating consumers on the dangers of alcohol abuse, and we remain committed to the guidelines prescribed by Government to address its concerns about alcohol-abuse-related harm, and the South African alcoholic beverages industry,” the company said, adding:

“While we are very excited and encouraged by the appeal and continued interest in our non-alcoholic products, at the same time, our position around the importance of drinking responsibly has not and will not change. We are taking additional steps to convey and drive home the responsible drinking message. One of them is a brand-led educational campaign on traditional and social media platforms to explain what it means if a product is classified as non-alcoholic.” 

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Compiled by Zakiyah Ebrahim

NHS leaves patients stuck on ‘hidden’ waiting lists for months, a BBC investigation shows.

A hospital’s pain management of Adam Hurst, who had a rare hernia, was “inadequate”, bosses accept.

Doctors warn people cannot trust the authenticity of drugs bought from rogue online pharmacies or dealers.

Researchers say the prototype pill could ultimately offer women more contraceptive choice and control.

Remember just a few days ago when it was revealed to the world that people were actually exposing their buttholes to the sun? Now, it seems that celebrities are hopping on the butt–sunning bandwagon—and they're getting some painful results.

Josh Brolin, one of the stars of Avengers: Endgame, revealed on Instagram that he recently tried the trend—and the 51-year-old actor suggested that people do not try it at home. 

“Tried this perineum sunning that I’ve been hearing about and my suggestion is DO NOT do it as long as I did,” the 51-year-old captioned an image previously posted by influencer @metaphysicalmeagen.

RELATED: So, Perineum Sunning is a Thing Now—Here's Why Doctors Definitely Don't Want You to Try It

“My pucker hole is crazy burned and I was going to spend the day shopping with my family and instead I’m icing and using aloe and burn creams because of the severity of the pain,” he continued. “I don’t know who the f–k thought of this stupid s–t but f–k you nonetheless. Seriously,” he completed his rant, adding next-level humor hashtags “#blackholefriday,” “#blackholesun,” “#severeperineumburns,” “#santamonicafiredepartment,” and “#assholecare.”

Of course there were so many hilarious comments to follow, including one from Ryan Reynolds who simply wrote "Bwahahahahahahha!!!!!" But it was Amy Schumer for the win, with her take: “This is what will finally get people to react to climate change including me,” she wrote.

All laughter aside, this new butt-sunning trend is not something to take lightly—and should definitely be avoided, since the perineum (the small area between the penis or vagina and anal opening) is a super-sensitive area of the body.

RELATED: A Severe Sunburn Caused A 16-Year-Old Girl To Develop Protruding Blisters On Her Back

“As a dermatologist, I cannot recommend any sun exposure without sun protection,” Nazanin Saedi, MD, Director, Jefferson Laser Surgery and Cosmetic Dermatology Center, said. “These areas just like other areas of the body do need sun protection and clothing tends to provide that.”

David E. Bank, MD, founder of Mount Kisco's The Center for Dermatology, Cosmetic & Laser Surgery, added that it is “actually dangerous,” as the “skin is particularly sensitive.” In addition to a potential sunburn, as Brolin experienced, eventually it could result in an increased risk of skin cancer, he added.

In case you were thinking about indulging in this latest tanning trend, it's probably wise to use Brolin’s butthole-burn experience as a reason to refrain—it could save you a whole lot of pain. 

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