Insurance, location can influence cost of medical procedures

Ask Dr. Keith Roach M.D

DEAR DR. ROACH: When I was younger, I was diagnosed as obese and subjected to all kinds of treatments, including being on a twoweek fast. I was bullied on the playground and badly damaged psychologically by my family. At the age of 75, I was diagnosed with lipedema. Finally, I now have a name for what I am. When I mention this to people in the medical profession, I often get blank stares. Can you comment on this condition? I came to find out about it because someone who knew about it looked at me and saw it. My cardiologist then sent me for an evaluation. I’ve looked this up on the internet, and found blogs from people suffering from this. — J.R. ANSWER: Lipedema is a rare disorder that is often misdiagnosed as obesity or the much more common lymphedema. Despite their similar-sounding names, they are very different. While lymphedema is caused by damage to the lymphatics — delicate vessels that carry fluid, not blood, back to the heart, and which can be damaged by cancer, surgery or trauma — lipedema is caused by deposition of fat in the limbs, sparing the trunk, feet and hands. The fat deposition is painful and can cause fatigue and joint abnormalities. The psychological distress you discuss can be profound. Lipedema is almost never found in men. It most commonly arises at puberty, but can also begin during pregnancy or menopause. Diagnosis at a young age is less common. There are other ways lipedema can be distinguished from lymphedema. Lymphedema generally affects one extremity, not multiple. Lymphedema gets better with elevating the extremity, where lipedema does not. In the lower extremity, lymphedema usually affects the foot; lipedema does not. Lipedema sometimes runs in families. The exact cause is unknown. Lipedema is not obesity; diets are ineffective at treating the condition. Interestingly, people with lipedema have a surprisingly low risk for diabetes, high blood pressure and high cholesterol. Liposuction is emerging as a promising treatment for lipedema. I found much more information at www.curelipedema.org. *** Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYour-GoodHealth@med.cornell. edu or send mail to 628 Virginia Dr., Orlando, FL 32803.