Q: My 72 years old wife weighs 102 kg and is suffering from Lymphoedema in both the legs for the last 5 years. The right leg has got swollen a lot and the skin of the affected area is getting harder by the day. How do we control this swelling? Can massage, compression bandages and pumps be used for the purpose? She takes medicines for high BP and suffers from hypothyroidism.

A:Examining the information provided, it seems that the lymphoedema of both legs is long standing and is now fully entrenched. It is now changed into Lipo-dermosclerosis. This is the most intractable stage and does not respond well to the usual conservative measures that are mentioned. But in view of the fact the lady is also suffering from hypertension, hypothyroidism, and significant obesity with BMI of 45+, surgical option is also fraught with danger. This leaves one with choice of conservative measures only. My advice would be to stick to compression pumps and if it is possible to get tailor made compression stockings made then combine the two. Massaging is not a good option and may not be of much help, I would also like to emphasise that the drug treatment of the medical conditions like Hypertension and Hypothyroidism are absolutely imperative. Last but not the least is the effort towards weight reduction. This might be tried with the help of a dietician If these measures are to some extent successful and there is weight reduction then surgical option can be reconsidered.