Page updated 9/22/10
 |
| |
 |
| |
 |
Lymphland International Lymphedema Online
| 2009-11-11 01:25:11 [Disconnect [ERR]] Darcy 2009-11-11 17:25:16 [Login] mkbmia 2009-11-11 17:25:16 [IP] mkbmia: 2009-11-11 17:25:17 [Join Room] mkbmia -> chat lobby 2009-11-11 17:25:27 [Disconnect] mkbmia 2009-11-11 19:42:53 [Login] donna seidler 2009-11-11 19:42:53 [IP] donna seidler: 2009-11-11 19:42:53 [Join Room] donna seidler -> chat lobby 2009-11-11 19:43:11 [Message] donna seidler -> chat lobby: Hi how is everyone today? 2009-11-11 19:46:33 [Login] tina 2009-11-11 19:46:33 [IP] tina: 2009-11-11 19:46:33 [Join Room] tina -> chat lobby 2009-11-11 19:46:41 [Message] tina -> chat lobby: Hi Donna how are you? 2009-11-11 19:47:00 [Message] donna seidler -> chat lobby: im good i finally found my way in here. ty 2009-11-11 19:47:04 [Message] tina -> chat lobby: I'm glad to see you made it! 2009-11-11 19:47:31 [Message] donna seidler -> chat lobby: what do we talk about in this chat room? 2009-11-11 19:48:12 [Message] tina -> chat lobby: well we have a guest tonight, Dr. Raj, who is coming in to answer questions and talk to patients about lymphedema. He didn't give a schedule to me so I guess we will have to wait and see how he wants to proceed. 2009-11-11 19:48:52 [Message] donna seidler -> chat lobby: thats great. 2009-11-11 19:49:08 [Message] tina -> chat lobby: usually we have different chats during the week that our managers do where we can all share ideas about different parts of lymphedema. One chat we had was a guest Mike Dunn from impedimed who has the new technology to measure lymphedema at stage zero 2009-11-11 19:49:11 [Message] donna seidler -> chat lobby: here in northern alberta we dont have anyone to tell us about lymphedema 2009-11-11 19:49:21 [Login] bonnym 2009-11-11 19:49:21 [IP] bonnym: 2009-11-11 19:49:22 [Join Room] bonnym -> chat lobby 2009-11-11 19:49:29 [Message] tina -> chat lobby: HI Bonny 2009-11-11 19:49:38 [Message] bonnym -> chat lobby: hi hi all 2009-11-11 19:49:40 [Message] donna seidler -> chat lobby: hi bonnie 2009-11-11 19:49:41 [Message] tina -> chat lobby: I know canada lacks alot of therapists and treatment centers too 2009-11-11 19:49:50 [Message] donna seidler -> chat lobby: for sure 2009-11-11 19:49:52 [Message] bonnym -> chat lobby: all do 2009-11-11 19:50:01 [Message] tina -> chat lobby: some of the other countries are really bad, Spain and Peru are 2 of the worst 2009-11-11 19:50:23 [Message] donna seidler -> chat lobby: and you cant get into a treatment centre unless you are directly a cancer patient .. i know i tried in edmonton and calgary 2009-11-11 19:50:58 [Message] bonnym -> chat lobby: I have a vascular surgeon - don't think theres such a thing here as a lymphologist 2009-11-11 19:51:21 [Message] donna seidler -> chat lobby: I did find a ot in peace river alberta who was trained at the cross cancer hospital in edmonton and she has been doing my legs for a couple of months. 2009-11-11 19:51:34 [Message] tina -> chat lobby: that's good you found someone 2009-11-11 19:51:42 [Message] donna seidler -> chat lobby: yes. 2009-11-11 19:52:02 [Message] bonnym -> chat lobby: lymphedema is becoming more well known as time goes on 2009-11-11 19:52:08 [Message] donna seidler -> chat lobby: but finding a good person to measure for compression stocking is something else 2009-11-11 19:52:32 [Message] bonnym -> chat lobby: theres ppl that specialize in just that - I have one 2009-11-11 19:52:33 [Message] tina -> chat lobby: I'm hoping the US will have provisions for us in the new Obama medical plans that would lead the way for other countries but I couldn't get many people to write in over and over to show numbers, the politicians go by numbers because that affects votes for them in the future if they don't listen 2009-11-11 19:52:51 [Message] donna seidler -> chat lobby: Do you have many people from alberta on your chat? usually? 2009-11-11 19:53:03 [Message] bonnym -> chat lobby: politicians - are u kidding - none of them listen 2009-11-11 19:53:30 [Message] tina -> chat lobby: I'm not sure who is from where, we do have Canada members tho, Mac is from New Brunswick 2009-11-11 19:53:43 [Message] bonnym -> chat lobby: me from Toronto Ontario 2009-11-11 19:53:45 [Message] tina -> chat lobby: and Bonny is a member too 2009-11-11 19:53:58 [Message] donna seidler -> chat lobby: oh yah..that is a way in the east..of me. im in northwestern canada. 2009-11-11 19:54:15 [Message] bonnym -> chat lobby: where is every one 2009-11-11 19:54:17 [Login] Jenjay 2009-11-11 19:54:17 [IP] Jenjay: 2009-11-11 19:54:17 [Join Room] Jenjay -> chat lobby 2009-11-11 19:54:22 [Message] tina -> chat lobby: it's still a little early 2009-11-11 19:54:23 [Message] tina -> chat lobby: hi Jen 2009-11-11 19:54:24 [Message] bonnym -> chat lobby: more should be on this site 2009-11-11 19:54:30 [Message] bonnym -> chat lobby: welcome Jenjay 2009-11-11 19:54:43 [Message] Jenjay -> chat lobby: Hi All. 2009-11-11 19:54:44 [Message] tina -> chat lobby: They prob don't want to be the first one in the room, no way of knowing unless you log in 2009-11-11 19:54:47 [Message] donna seidler -> chat lobby: hi jen 2009-11-11 19:54:54 [Message] Jenjay -> chat lobby: LOL 2009-11-11 19:55:12 [Login] Dr. Raj 2009-11-11 19:55:12 [IP] Dr. Raj: 2009-11-11 19:55:12 [Join Room] Dr. Raj -> chat lobby 2009-11-11 19:55:15 [Message] tina -> chat lobby: Jen do you know if the post went on other sites? I sent a copy to Pat 2009-11-11 19:55:21 [Message] tina -> chat lobby: good evening Dr. Raj 2009-11-11 19:55:22 [Message] bonnym -> chat lobby: welcome Dr Ray 2009-11-11 19:55:32 [Message] Dr. Raj -> chat lobby: Hi Tina. Good evening everybody. 2009-11-11 19:55:34 [Message] donna seidler -> chat lobby: Hello Dr. Raj 2009-11-11 19:55:39 [Message] Jenjay -> chat lobby: Not sure Tina, Sorry. 2009-11-11 19:55:49 [Message] tina -> chat lobby: there will be more people it's about 7 minutes to 8 on my clock 2009-11-11 19:56:05 [Message] bonnym -> chat lobby: Tell me Dr Ray what inspired u to become involved in lympedema therapy 2009-11-11 19:56:10 [Grant VIP] tina -> Dr. Raj 2009-11-11 19:56:37 [Login] Flora 2009-11-11 19:56:37 [IP] Flora: 2009-11-11 19:56:37 [Join Room] Flora -> chat lobby 2009-11-11 19:57:13 [Message] Flora -> chat lobby: hello 2009-11-11 19:57:13 [Message] Dr. Raj -> chat lobby: Lymphedema has become one part of my practice. I'm the director of cancer rehabilitation at Carolinas Rehabilitation, and a natural extension of my practice is lymphedema. I've helped to continue a service that was initially run by Paula Stewart, M.D., who is relatively well known in lymphedema. 2009-11-11 19:57:19 [Login] Marbeth 2009-11-11 19:57:19 [IP] Marbeth: 2009-11-11 19:57:19 [Join Room] Marbeth -> chat lobby 2009-11-11 19:57:29 [Message] tina -> chat lobby: Hi Flora and MarBeth 2009-11-11 19:57:30 [Message] Marbeth -> chat lobby: Hi all 2009-11-11 19:57:43 [Message] bonnym -> chat lobby: Hi Marbeth - happy birthday 2009-11-11 19:57:54 [Message] bonnym -> chat lobby: I know of Paula Stewart 2009-11-11 19:57:57 [Message] Marbeth -> chat lobby: thank you Bonny... 2009-11-11 19:58:00 [Message] Marbeth -> chat lobby: :) 2009-11-11 19:58:12 [Message] bonnym -> chat lobby: how long have u been practising 2009-11-11 19:58:15 [Message] Jenjay -> chat lobby: Yeah, MB..Happy Birthday! 2009-11-11 19:58:24 [Message] donna seidler -> chat lobby: hb. mb 2009-11-11 19:58:33 [Message] Marbeth -> chat lobby: Thanks Jenny.. and Donna.. :) 2009-11-11 19:58:36 [Message] Dr. Raj -> chat lobby: She's an excellent resource as well, and I believe she's working out of Birmngham. I have been in practice for lymphedema specifically for over 3 years. 2009-11-11 19:59:02 [Message] tina -> chat lobby: what do you think is the hardest challenge with patients Dr. Raj? 2009-11-11 19:59:10 [Message] bonnym -> chat lobby: we should have more Dr like u - big complaint - do u have any other areas of expertise 2009-11-11 19:59:20 [Login] Mac 2009-11-11 19:59:20 [IP] Mac: 2009-11-11 19:59:20 [Join Room] Mac -> chat lobby 2009-11-11 19:59:27 [Message] Flora -> chat lobby: hi mac 2009-11-11 19:59:31 [Message] Marbeth -> chat lobby: Hi Mac 2009-11-11 19:59:35 [Message] Mac -> chat lobby: hi all 2009-11-11 19:59:43 [Message] Dr. Raj -> chat lobby: To answer Tina, I think the there are many facets that make treating lymphedema difficult. Partly it's th 2009-11-11 19:59:56 [Message] tina -> chat lobby: hi mac 2009-11-11 20:00:20 [Login] mkbmia 2009-11-11 20:00:20 [IP] mkbmia: 2009-11-11 20:00:20 [Join Room] mkbmia -> chat lobby 2009-11-11 20:00:24 [Message] Dr. Raj -> chat lobby: social stigma associated with living with lymphedema. But more specifically, I see that a lot of patients have difficulty with resources to treat the lymphedema (i.e. garments, equipment, etc.). 2009-11-11 20:00:34 [Login] Marbeth 2009-11-11 20:00:34 [IP] Marbeth: 2009-11-11 20:00:34 [Join Room] Marbeth -> chat lobby 2009-11-11 20:00:39 [Login] Marbeth 2009-11-11 20:00:39 [IP] Marbeth: 2009-11-11 20:00:39 [Join Room] Marbeth -> chat lobby 2009-11-11 20:00:58 [Message] Marbeth -> chat lobby: sorry all.. I keep getting booted out.. ? 2009-11-11 20:01:02 [Message] donna seidler -> chat lobby: That is especially true up here in northern alberta. 2009-11-11 20:01:06 [Message] Dr. Raj -> chat lobby: To Bonny, I also specialize in cancer rehabilitation as a whole. Hence I treat many patients with rehabilitation needs, whether it be breast cancer, brain cancer, etc. 2009-11-11 20:01:41 [Message] Jenjay -> chat lobby: Unfortunately, many of us with Medicare have NO coverage for compression garments, devices, bandages and such. 2009-11-11 20:02:07 [Message] Jenjay -> chat lobby: So financially at times it can be a struggle. 2009-11-11 20:02:11 [Message] bonnym -> chat lobby: For some unknown reason my lymphedema popped out of nowhere 3 years ago unknown cause - have the doctors baffled by it - any suggestions as to why 2009-11-11 20:02:14 [Message] tina -> chat lobby: we have been trying to establish patient funds to help others but it's not working well Dr, do you have any ideas about that? I have tried to get patients to petition legislatures with not much luck. 2009-11-11 20:02:29 [Message] donna seidler -> chat lobby: We have coverage for stockings here in alberta with aadl..but its like pulling hens teeth to get it out of them. 2009-11-11 20:03:09 [Message] Jenjay -> chat lobby: Tina, I think we need to focus more on that here, I'd be happy to get on the bandwagon with that one! 2009-11-11 20:04:28 [Message] Dr. Raj -> chat lobby: Unfortunately lymphedema is a troubling problem. It can pop up any time for any patients. Many of the common causes I see are trauma (maybe from an accident), lymph node resection in cancer surgeries, or generalized injuries to the lymph nodes. It can pop up at any time, and maybe secondary to something as simple as excessive use of an extremity. The problem is that once you know you have it, it may not be relevant as to why anymore because the focus then has to become symptomatic treatment. 2009-11-11 20:05:20 [Message] bonnym -> chat lobby: absolutely but its still a mystery to me 2009-11-11 20:05:40 [Message] Marbeth -> chat lobby: Dr. Raj... I find that most doctors are not aware of Lymphedema treatment is there anyway to get the medical field to spend more time teaching about Lymphedema? 2009-11-11 20:05:44 [Message] tina -> chat lobby: thats so true, so many of the insurances though are so discriminatory by treating cancer patients with the complication of lymphedema but not the primary people which is so unfair. 2009-11-11 20:06:05 [Message] Jenjay -> chat lobby: Yes, Tina, it is! 2009-11-11 20:06:50 [Message] tina -> chat lobby: I'm a cancer survivor and have lymphedema but I'm primary lymphedema with secondary cause of trauma from the cancer surgery, so my insurance will not pay which is not fair at all. 2009-11-11 20:07:12 [Message] Dr. Raj -> chat lobby: Regarding coverage, in North Carolina we recently had a bill pass named Dylan's Bill. It was proposed by Heather Ferguson, the mother of a patient of one of my partners. Her son was diagnosed and had no coverage with her existing insurance. She was able to start a petition with a state senator, who pushed the bill through the NC legislature. Effective 1/10, all insurance has to have some guaranteed coverage for lymphedema equipment (though the amount to this date is not determined). She may be a good resource if you are interested in further activity with your own state; her contact is hmff@earthlink.net 2009-11-11 20:07:42 [Message] Marbeth -> chat lobby: I too am primary.. it is very costly 2009-11-11 20:08:02 [Login] Randy Ross 2009-11-11 20:08:02 [IP] Randy Ross: 2009-11-11 20:08:02 [Join Room] Randy Ross -> chat lobby 2009-11-11 20:08:08 [Message] tina -> chat lobby: hi randy 2009-11-11 20:08:13 [Message] Mac -> chat lobby: hi Randy 2009-11-11 20:08:13 [Message] donna seidler -> chat lobby: hi randy 2009-11-11 20:08:17 [Message] Jenjay -> chat lobby: Mine is secondary to my congenital disability. 2009-11-11 20:08:19 [Message] Randy Ross -> chat lobby: Hey Tina! 2009-11-11 20:08:22 [Message] tina -> chat lobby: thank you Dr. Raj I'm going to write to her tonight 2009-11-11 20:08:22 [Message] Marbeth -> chat lobby: Hi Randy 2009-11-11 20:08:40 [Message] bonnym -> chat lobby: sometimes when my compression are removed I have black and blue marks or more veins showing - should I be concerned 2009-11-11 20:08:44 [Message] Randy Ross -> chat lobby: Hi Marbeth, Donna, Jenny and Dr. Raj 2009-11-11 20:08:45 [Message] tina -> chat lobby: Dr. Raj have you gotton a chance to see or use the new impedimed device? 2009-11-11 20:08:45 [Login] Pamrose 2009-11-11 20:08:45 [IP] Pamrose: 2009-11-11 20:08:45 [Join Room] Pamrose -> chat lobby 2009-11-11 20:08:49 [Message] tina -> chat lobby: hi pamrose 2009-11-11 20:09:31 [Message] bonnym -> chat lobby: Randy - am I chopped liver! 2009-11-11 20:09:46 [Message] Dr. Raj -> chat lobby: It is true that many physicians are not aware of lymphedema or it's treatment. However word is starting to spread out. From the cancer world, there has been a signficant push to providing further education regarding lymphedema managment to residents, fellows, and cancer committees. Here at Carolinas Medical Center, we have a very significant lymphedema program and have been getting the word out in the rest of the community. It's a problem much more prevalent that previously acknowledged. 2009-11-11 20:09:53 [Message] Randy Ross -> chat lobby: and especially to you Bonny, I didn't see you yet! 2009-11-11 20:10:21 [Message] donna seidler -> chat lobby: bonnym..I have the same black and blue marks. my dr is not concerned at all because up here theydont know anything about lymphedema 2009-11-11 20:10:43 [Message] Marbeth -> chat lobby: thank you Dr. Raj... It sounds like your facility and medical staff are doing great work. 2009-11-11 20:10:43 [Message] bonnym -> chat lobby: that is a problem 2009-11-11 20:10:57 [Message] bonnym -> chat lobby: Randy I hardly go unnoticed! 2009-11-11 20:11:23 [Message] Jenjay -> chat lobby: I think it's great that the cancer community is becoming more aware of lymphedema, but MD's need to know too that it is not JUST tied to cancer, that other folks get it too. 2009-11-11 20:11:27 [Message] Dr. Raj -> chat lobby: The black and blue could simply be bruising. Likely the reason more veins are showing is due to the increased pressure on the entire arm for compression. I wouldn't be worried unless you notice significant pain, or have a great deal of discomfort while wearing the garment. If either is an issue, you'll need to be checked out. 2009-11-11 20:11:43 [Message] Randy Ross -> chat lobby: Very true Bonny. 2009-11-11 20:11:51 [Message] Mac -> chat lobby: i have milroy's diseease and i am 3rd stage full body is there really any hope for me 2009-11-11 20:12:57 [Message] Dr. Raj -> chat lobby: We actually don't use impedance to measure limb volume. Our initial method of measurement was tape measures, and now we have a perometer we use for general measurements (still measuring circumference rather than actual volume). I do believe though volume is a better measure for lymphedema in general. 2009-11-11 20:14:07 [Message] Mac -> chat lobby: they say it's irriversable and now it's attacking my heart what is next i have to much fluid around my heart i'm carrying over 200 lbs of fluid all over nothing untouched 2009-11-11 20:14:08 [Message] bonnym -> chat lobby: I'm noticing my condition getting progressively worse - for example its getting harder to lift my leg to get into a car etc 2009-11-11 20:14:41 [Message] donna seidler -> chat lobby: bonnym...i am having the same problem.. 2009-11-11 20:15:09 [Message] Jenjay -> chat lobby: Bonny and Donna, are you guys currently in treatment? 2009-11-11 20:15:18 [Message] donna seidler -> chat lobby: yes 2009-11-11 20:15:29 [Message] bonnym -> chat lobby: I've done all that - just compressions now 2009-11-11 20:15:49 [Message] donna seidler -> chat lobby: but only by an ot at a outside alberta hospital 2009-11-11 20:15:49 [Message] Dr. Raj -> chat lobby: Mac . . . There's always hope. I don't doubt that your situation is somewhat difficult. I can't guarantee you that you can have complete reversibility. As a caveat, all the advice I offer here is simply advice and you would likely still need to personally see a specialist for a more detailed plan. Have you met with a certified lymphedema therapists or physician to start your plan of care? 2009-11-11 20:16:23 [Message] tina -> chat lobby: I do rigorous self therapy but I can't move the fluid in the ribs and abdomen so that is progressing. The thing is we need to all have therapy an initial round to get smaller then be taught to do it and have maintenance visits to ensure we are moving it ourselves, that's what I believe would help us all and prevent the cellulitis outbreaks, reduce hospitalizations, and keep some of us working and off disability. 2009-11-11 20:16:31 [Message] Jenjay -> chat lobby: Maybe you both need another course of MLD or CDT. You both should check with your therapists if you have one, I think. Let them know if you think you're getting worse. 2009-11-11 20:17:11 [Message] Randy Ross -> chat lobby: I do consider myself very lucky because I have only had cellulitis one time, my only problem is pain. 2009-11-11 20:17:21 [Message] Pamrose -> chat lobby: Hi Everyone...I'm a massage therapist in Missouri trained in Chikly's Lymph Drainage Therapy...in advanced classes we are taught drainage techniques that are more thorough then MLD. 2009-11-11 20:17:25 [Message] bonnym -> chat lobby: The conditon itself is well known to be progress worse 2009-11-11 20:17:26 [Message] Dr. Raj -> chat lobby: Donna and Bonny . . . If your lymphedema is worsening or not well controlled, I would recommend a refresher for manual lymphatic drainage and decongestive therapy (as noted by Jen). It could be that you need more compression to your garments. Typically the wraps and garments last about 6 months if you wear them religiously, before they have to be replaced. 2009-11-11 20:18:05 [Message] Dr. Raj -> chat lobby: I agree wholeheartedly with Tina. 2009-11-11 20:18:09 [Message] bonnym -> chat lobby: I just got mine one month ago 2009-11-11 20:18:10 [Message] Randy Ross -> chat lobby: I think in Mac's case the main problem is not having treatment available locally. 2009-11-11 20:18:22 [Message] tina -> chat lobby: that's a big problem, we can't afford to do that 2009-11-11 20:18:33 [Message] tina -> chat lobby: and mac has struggled so much and worked so hard 2009-11-11 20:18:39 [Message] donna seidler -> chat lobby: i have continual leg wrappings daily and just now got new compression stockings but they are a bad fit. 2009-11-11 20:18:50 [Message] donna seidler -> chat lobby: i take 2x week massage therapy 2009-11-11 20:18:54 [Message] Randy Ross -> chat lobby: Very true Tina. 2009-11-11 20:19:16 [Message] Jenjay -> chat lobby: Donna...........SEND them back!! 2009-11-11 20:19:23 [Message] donna seidler -> chat lobby: we cant. 2009-11-11 20:19:29 [Message] Mac -> chat lobby: yes they have started treatment and then stopped because my therepist is on maternaty leave we only have 8 therapist in our whole province 2009-11-11 20:19:33 [Message] bonnym -> chat lobby: never had cellulitis in the 3 years having it - thank goodness but the pain sometimes is good and bad days 2009-11-11 20:19:38 [Message] donna seidler -> chat lobby: we pay up front and hope to get them adjusted when we get back home. 2009-11-11 20:19:40 [Message] Randy Ross -> chat lobby: Personally, I have always found the traditional bandaging method to be superior to other things but that is my preference, and it worked well for me. 2009-11-11 20:20:02 [Message] donna seidler -> chat lobby: how do i get rid of the up guy? 2009-11-11 20:20:09 [Message] tina -> chat lobby: Dr. Raj we had a member Charles Wolfe that died from a therapist moving fluid too fast, the fluid went into his lungs and he went to hospitals who said he didn't have pneumonia, wouldn't admit him, by the time his wife found our group and I found a willing doctor to see him, it was too late, he died the day before his appointment, I really want to make sure this doesn't happen again. Many people in our group are really in rough shape 2009-11-11 20:20:53 [Message] Dr. Raj -> chat lobby: If you are interested, the National Lymphedema Network can provide has a nice resource guide regarding treating therapists and physicians (as well as centers) in the United States. They also have further resources for lymphedema support groups in various states and countries. They have a listserve (listerv@listserv.acor.org) for the support groups. 2009-11-11 20:21:39 [Login] Marbeth 2009-11-11 20:21:39 [IP] Marbeth: 2009-11-11 20:21:39 [Join Room] Marbeth -> chat lobby 2009-11-11 20:21:40 [Message] Mac -> chat lobby: i am presently having my 120th bout of cellulitis since 1994 i need better help i keep things very clean but still break out 2009-11-11 20:22:14 [Disconnect [ERR]] donna seidler 2009-11-11 20:22:34 [Message] Dr. Raj -> chat lobby: Unfortunately this is a devestating side effect if lymphedema therapy is completed too quickly and the patient has a lot of fluid to move. My recommendation would be to discuss this with your therapists prior to treatment, and I would (if possible) have a lymphedema physician assist with the program to make sure that the therapist isn't overaggressive. 2009-11-11 20:22:42 [Message] tina -> chat lobby: One of the problems with patients is they all feel so horrible, we hurt, we are overwhelmed by our health that many cannot seem to do anything. We have no money, our doctors don't refer us or know what to do, and we get worse. If a patient came to you Dr. Raj what would you advise them to do? 2009-11-11 20:23:43 [Message] Dr. Raj -> chat lobby: Mac . . . unfortunately with stage III lymphedema, cellulitis is a very common complication. The best treatment we have to mobilize fluid as best you can, maintain very good skin care, treat cuts or scrapes asap and thoroughly, and monitor closely. 2009-11-11 20:24:47 [Message] Dr. Raj -> chat lobby: Tina . . . That's a difficult scenario. Unfortunately I do see a great deal of patients with limited resources. It becomes very difficult as we have very little free resources (such as samples from vendors, etc.). Unlike pharmaceuticals which have a very profit 2009-11-11 20:24:50 [Message] bonnym -> chat lobby: Dr do u have any other areas of expertise such as being involved with any Physio therapy or massage MLD 2009-11-11 20:25:05 [Disconnect] Pamrose 2009-11-11 20:25:44 [Message] Marbeth -> chat lobby: Dr. Raj can Lymphedema be reversed through some type of veinous therapy? is there such a thing to help the blood flow better? 2009-11-11 20:26:19 [Message] Mac -> chat lobby: dr Raj could you please cleariffy what you mean by mobolize 2009-11-11 20:26:25 [Message] bonnym -> chat lobby: what about stem cells in the future Dr Raj? 2009-11-11 20:26:34 [Message] Dr. Raj -> chat lobby: profitable margins, companies working with lymphedema do not always have the resources to donate supplies and come up with reduced payment plans. For some of our cancer patients, they have grants available to help with compression garments. Generally for patients without resources, we try to work simply on compression bandages and stretch out treatment as long as we can. Once we reach maintenance, we'll move to a compression garment. Then we will continually emphase MLD and home treatment programs to maintain. 2009-11-11 20:26:41 [Message] Jenjay -> chat lobby: I think that, like the pharmeceutical companies, garment companies should offer some sort of patient assistance programs for patients who need treatments and supplies and can't afford them. 2009-11-11 20:27:00 [Message] tina -> chat lobby: I have thought of a program where vendors could advertise and be promoted on lymphedema websites in exchange for some free samples. I have tried writing to them but with no luck nobody will budge an inch. 2009-11-11 20:27:06 [Message] Mac -> chat lobby: i am totally bedridden and have been for three months 2009-11-11 20:27:29 [Message] Dr. Raj -> chat lobby: I don't actually perform MLD or physiotherapy in my clinic, as I have 5 lymphedema therapists who work at Carolinas Rehabilitation in the outpatient setting who perform comprehensive lymphedema management. But I am aware of many modalities currently being used or investigated. 2009-11-11 20:27:59 [Message] Dr. Raj -> chat lobby: By mobilize fluid, I mean simply to move the fluid out of the limb either by MLD or compression. 2009-11-11 20:28:17 [Message] Randy Ross -> chat lobby: Jenny, actually most of the larger pharmaceutical companies do participate in trying to get medications to those that need them and cannot afford them. Their intent is go help people, though of course what they charge others does subsidize this. 2009-11-11 20:28:35 [Message] tina -> chat lobby: mac are you doing any exercise at all even if it's small movements? 2009-11-11 20:29:03 [Message] Jenjay -> chat lobby: I know, Randy.............what I am suggesting is that some of the garment manufacturers could do the same. 2009-11-11 20:29:09 [Message] Randy Ross -> chat lobby: If they could and would reduce their advertising budgets just by say one third, that amount would be enormous and could be put into helping even more. 2009-11-11 20:29:12 [Message] Dr. Raj -> chat lobby: Unfortunately, there are no surgical options to help with lymphedema flow. Currently there is some interest in the use of lasers to break up fibrosis and help to regenerate lymph nodes, but the research to date is anecdotal and not validated in good clinical trials. I am not aware of any other proven venous type therapies that help wiht lymphedema. The mainstay of treatment is MLD and compression. 2009-11-11 20:29:38 [Message] tina -> chat lobby: randy that's what I mean 2009-11-11 20:29:46 [Message] Mac -> chat lobby: oh yes tina i am doing my bed excercise 2x a day and light self massage the best my hands let me manage 2009-11-11 20:29:47 [Message] Dr. Raj -> chat lobby: Though there is interest in stem cells, there is nothing clinically significant available regarding stem cell use in lymphedema. 2009-11-11 20:29:52 [Message] tina -> chat lobby: free advertising within groups or on websites in exchange to help the members who need it the most 2009-11-11 20:30:09 [Message] bonnym -> chat lobby: well with todays modern technology more things should be updated with ppl lymphedema - more research needs to be done 2009-11-11 20:30:15 [Message] tina -> chat lobby: what do you think of Dr. Marga's surgical approach to lymphedema Dr. Raj? 2009-11-11 20:30:24 [Message] tina -> chat lobby: she is doing node transplants 2009-11-11 20:30:31 [Message] Randy Ross -> chat lobby: Tina, I am sure if you approach them they may be interested. 2009-11-11 20:30:38 [Message] tina -> chat lobby: moving the inguinal abdominal nodes up to arm pits 2009-11-11 20:30:39 [Message] Marbeth -> chat lobby: Dr. Raj.. could using a tens unit to help get the blood flowing be dangerous or helpful? say like if Mac wanted to put the tens unit on her legs to get blood flow.. would that help or hurt her? 2009-11-11 20:31:06 [Message] tina -> chat lobby: Randy I have but no takers 2009-11-11 20:31:20 [Login] Flora 2009-11-11 20:31:20 [IP] Flora: 2009-11-11 20:31:20 [Join Room] Flora -> chat lobby 2009-11-11 20:31:21 [Message] tina -> chat lobby: I was thinking if ALL managers wrote the same thing maybe it would make a difference 2009-11-11 20:31:23 [Message] tina -> chat lobby: wb flora 2009-11-11 20:31:35 [Message] Flora -> chat lobby: thank, got booted 2009-11-11 20:31:36 [Message] bonnym -> chat lobby: Dr Raj we are so so ignored - and its so frustrating - my gp never even heard of lymphology 2009-11-11 20:31:44 [Login] Pamrose 2009-11-11 20:31:44 [IP] Pamrose: 2009-11-11 20:31:44 [Message] Randy Ross -> chat lobby: We can talk about that sometime Tina, they are sort of strange as to how one needs to approach them. 2009-11-11 20:31:44 [Join Room] Pamrose -> chat lobby 2009-11-11 20:31:46 [Message] Jenjay -> chat lobby: I think I feel a Lymphland project or two in the making, Tina! 2009-11-11 20:32:00 [Message] tina -> chat lobby: lol you know it jen 2009-11-11 20:32:14 [Message] Marbeth -> chat lobby: LOL 2009-11-11 20:32:16 [Message] tina -> chat lobby: I already wrote Heather as Dr. Raj suggested 2009-11-11 20:32:34 [Message] Jenjay -> chat lobby: Damn, that was quick Tina! 2009-11-11 20:32:41 [Message] Mac -> chat lobby: I have a hope in my heart that someday they will find a away to shunt the fluid as they do shunting of the brain . i often wonder would this work 2009-11-11 20:32:43 [Message] Dr. Raj -> chat lobby: I don't know the full details regarding Dr. Marga's program, but I have seen the website. I would say in principal the idea sounds good, but in practice it hasn't been proven. If it was proven in clinical trials, then there would be a lot more plastic surgeons performing this procedure. 2009-11-11 20:32:44 [Message] tina -> chat lobby: you know me I just right on something 2009-11-11 20:33:05 [Message] Randy Ross -> chat lobby: There truly are those out there in the medical community that do care very much, finding them may be the problem though. 2009-11-11 20:33:08 [Message] tina -> chat lobby: Mac that's an interesting idea 2009-11-11 20:33:24 [Message] Jenjay -> chat lobby: Mac, I worry about moving lymph nodes from one place to another. 2009-11-11 20:33:41 [Message] Jenjay -> chat lobby: We've talked about this at my clinic support group meetings. 2009-11-11 20:33:49 [Message] tina -> chat lobby: it would be hard tho as the lymph is all over the body not in 1 area 2009-11-11 20:33:51 [Message] Flora -> chat lobby: phone call 2009-11-11 20:34:15 [Message] Jenjay -> chat lobby: My worry would be what would happen to the areas the nodes were moved FROM??? 2009-11-11 20:34:18 [Message] Randy Ross -> chat lobby: I don't think that moving the nodes is a good idea or works very well at all but someone can correct me if I am incorrect on that. 2009-11-11 20:34:21 [Message] Jenjay -> chat lobby: Dr. Raj?? 2009-11-11 20:34:23 [Message] tina -> chat lobby: I have always wondered about cloning nodes and doing implants 2009-11-11 20:34:34 [Message] Flora -> chat lobby: back 2009-11-11 20:34:37 [Message] bonnym -> chat lobby: lets concentrate on Dr Raj while he's here - u ppl can discuss things privately 2009-11-11 20:34:38 [Message] tina -> chat lobby: why not use the person's own nodes, duplicate them and add some more in 2009-11-11 20:34:50 [Message] Dr. Raj -> chat lobby: Regarding TENS units, you have to be careful providing electrical stimulation to a limb affected by lymphedema. Two risks that you have to be aware of his warming of the lymphatic fluid in the limb, which could cause further difficulties regarding worsening of lymphedema and a medium of infection. You also have to worry about sending an electrical impulse through an affected limb in general if your sensation is impaired. This could cause burns to the skin, and thus worsening of the lymphedema. In general, I wouldn't recommend TENS for this purpose. Anything that could increase blood flow the limb could also worsen the lymphedema. 2009-11-11 20:35:36 [Message] bonnym -> chat lobby: how bout a regular massage therapy doing a strong massage 2009-11-11 20:35:47 [Message] Marbeth -> chat lobby: oh.. good to know.. thanks Dr. Raj 2009-11-11 20:35:49 [Message] bonnym -> chat lobby: for therapeutic use 2009-11-11 20:36:00 [Message] bonnym -> chat lobby: not MLD 2009-11-11 20:36:17 [Message] tina -> chat lobby: regular massage is ok but not strongly you have to go lighter as to much pressure can cause trauma and that's not good 2009-11-11 20:37:13 [Message] Randy Ross -> chat lobby: I think the preferred method for massage in lymphedema is a very soft touch. 2009-11-11 20:37:18 [Message] bonnym -> chat lobby: good to know Dr Tina 2009-11-11 20:37:21 [Message] bonnym -> chat lobby: lol 2009-11-11 20:37:38 [Message] Dr. Raj -> chat lobby: Just remember with a lymph node transplant, you would have to worry about where the lymph node was removed from. You also have to realize that lymph nodes are very delicate structure (probably more delicate than arteries or veins that are commonly used for bypass surgeries). Technically this would be a very difficult procedure. I would be hard pressed to find many surgeons comfortable attempting this procedure with traditional techniques. 2009-11-11 20:38:37 [Message] Randy Ross -> chat lobby: It would have a big risk factor to it and I agree Dr. Raj, most surgeons would not want to even go there. 2009-11-11 20:38:39 [Message] bonnym -> chat lobby: no lymph nodes were removed - and yet I got lymphedema - can u explain that 2009-11-11 20:39:01 [Message] Flora -> chat lobby: same for me bonny 2009-11-11 20:39:12 [Message] Dr. Raj -> chat lobby: So cloning nodes would come along with stem cell work. I think there are probably some great minds out there thinking about it (actually there is some laboratory research regarding creating lymph node tissue out of stem cells). But there are a host of variables regarding this in terms of translating newly created lymph tissue to functional lymph nodes in the body. Tina, can you clarify the question regarding implants? 2009-11-11 20:39:16 [Message] Mac -> chat lobby: just trying to hold to hope something comes about in my lifetime thank you DR raj i appreciate you giving me your time 2009-11-11 20:39:20 [Message] mkbmia -> chat lobby: Dr. Raj I have just starting going in for pain management and the Dr is sending me for other testing as he does not think I have LE (says LE does not start yrs later as mine did)...one of the treatments he has suggested is a "neurostimulation therapy". Would this hurt or help? I have LE in both legs and it is moving its way up my body. I also want to thank you for coming in to talk to everyone :) 2009-11-11 20:40:10 [Message] Randy Ross -> chat lobby: Great question mkbmia if you are referring to spinal cord stimulation. 2009-11-11 20:40:18 [Message] bonnym -> chat lobby: same here mkbmia 2009-11-11 20:40:39 [Message] bonnym -> chat lobby: mine started at a very late age 2009-11-11 20:41:05 [Message] Pamrose -> chat lobby: get another doctor. 2009-11-11 20:41:12 [Message] mkbmia -> chat lobby: yes Randy I am, and it scares me to death. there are other issues I have to deal with the spine and drug use yrs ago so I am just really worried about ti 2009-11-11 20:42:07 [Message] Dr. Raj -> chat lobby: The problem with stronger massage involves the level of tissue that you are compressing. Typically, lymph nodes are present in the surface of the affected extremity (in the more superficial layers of skin). When you do deep massage that compresses all the skin, you accidentally compress the lymph nodes so significantly that they will not move fluid at all (rather they get squashed, kind of like when you push hard on a straw and close it off). When you let the pressure off it reopens. Lymph nodes (unlike veins) do not move fluid as quickly or freely due to their decreased diameters and lack of the heart to push the fluid through. Normally lymph nodes move fluid with muscle action (i.e. when you walk or move, the muscle motion helps to secondarily move lymph fluid). So in the end deep tissue massage is not likely a great treatment for lymphedema. 2009-11-11 20:42:10 [Message] Randy Ross -> chat lobby: I think to understand spinal cord stimulation, as it was just said to me earlier today "it is very similar to how a spinal epidural would be used in obstetrics very routinely". 2009-11-11 20:42:12 [Message] bonnym -> chat lobby: Dr Raj - can't seem to understand why I got it in the first place at age 59 - now that u all know!! 2009-11-11 20:42:48 [Message] bonnym -> chat lobby: and had it for 3 years 2009-11-11 20:42:54 [Message] Randy Ross -> chat lobby: I got it in March 2007 Bonny and I have a supicion what the trigger was though I cannot prove it. 2009-11-11 20:42:57 [Message] bonnym -> chat lobby: its very late in life to be born with it 2009-11-11 20:43:09 [Message] bonnym -> chat lobby: what 2009-11-11 20:43:21 [Message] bonnym -> chat lobby: I got it 2007 also 2009-11-11 20:43:23 [Message] tina -> chat lobby: what randy 2009-11-11 20:43:31 [Message] tina -> chat lobby: mine was 97 2009-11-11 20:43:32 [Message] Randy Ross -> chat lobby: that is why they put "tarda" on the end of the diagnosis of primary lymphedema. 2009-11-11 20:43:38 [Disconnect [ERR]] Mac 2009-11-11 20:43:54 [Message] bonnym -> chat lobby: isthat like retarded Randy - lol 2009-11-11 20:44:02 [Message] bonnym -> chat lobby: ha ha 2009-11-11 20:44:24 [Message] Randy Ross -> chat lobby: Not quite Bonny but we do all need to have a sense of humour about something that is so elusive and different with each of us. 2009-11-11 20:44:30 [Message] Dr. Raj -> chat lobby: Regarding the pain management doctor, it is not true that lymphedema cannot start later (years later). I have a patient currently who had it present 26 years after initial lymph node surgery. I am not aware of neurostimulation therapy, and if you truly have lymphedema, neurostimulation does not help withe movement of lymph fluid through the limb. Neurostimulation therapy in rehabilitation is referred to something very different than movement of fluid. I wold get clarification about that as well. 2009-11-11 20:45:13 [Message] Dr. Raj -> chat lobby: Looks like I just lost a bunch of messages. I apologize in advance if I missed someone's question. I'm starting now with Randy's post about spinal cord stimulation. 2009-11-11 20:45:29 [Message] mkbmia -> chat lobby: lol Randy, I never had one of those, all my kids were born without drugs...I have halucinations due to acid that was given to me without my knowing 2009-11-11 20:46:07 [Message] Dr. Raj -> chat lobby: It could have been anything Bonny. maybe excessive force when gardening outside. Maybe lifting a child. Unfortunately to backtrack and find a cause is particularly difficult for most of my patients. 2009-11-11 20:46:20 [Message] Marbeth -> chat lobby: Dr. Raj.. as in the case with Mac if LE is attacking her heart.. what can she do to get the fluid off her heart? 2009-11-11 20:46:21 [Message] mkbmia -> chat lobby: Dr Raj, his reason for treating me with this is for the pain I have, he is trying to treat the nerve pain 2009-11-11 20:46:28 [Message] Randy Ross -> chat lobby: Spinal cord stimulation uses radio waves to block the pain messages. 2009-11-11 20:48:27 [Message] Dr. Raj -> chat lobby: Got it. So regarding the nerve pain, there is a possibility that your pain is secondary to nerve compression (usually presents as a tingling or burning pain). I'm not sure what the neurostimulation technique would be, other than desensitization (which does have a role). Other options for intractable pain include oral medications (agents like amitriptyline, gabapentin, duloxetine), or more aggressive pain management methods such as spinal injections. 2009-11-11 20:49:04 [Message] mkbmia -> chat lobby: ok thank you 2009-11-11 20:49:16 [Login] Mac 2009-11-11 20:49:16 [IP] Mac: 2009-11-11 20:49:16 [Join Room] Mac -> chat lobby 2009-11-11 20:49:20 [Message] Randy Ross -> chat lobby: wb 2009-11-11 20:49:22 [Message] Flora -> chat lobby: wb mac 2009-11-11 20:49:42 [Message] bonnym -> chat lobby: Dr I just started taking oxy - but only take it occasionally 5 mg - is there any harm in that when not abused 2009-11-11 20:49:45 [Message] Mac -> chat lobby: ouch got booted lol 2009-11-11 20:50:10 [Message] Randy Ross -> chat lobby: I am not going to touch that one, nope. 2009-11-11 20:50:13 [Message] Marbeth -> chat lobby: LOL I did too earlier.. LOL 2009-11-11 20:51:04 [Message] Dr. Raj -> chat lobby: The trick with lymphedema fluid to the heart is that it's not actually attacking the heart. When you perform MLD or compression, the fluid finds one of two way out. It can either go back to the veins, or find other lymph nodes. Inevitably however the fluid goes back into the blood stream, and then causes a significant load of fluid that the heart simply cannot pump. In normal physiology, a person would urinate out the fluid after it passes through the heart. But if the fluid is so overwhelming that it affects the lungs or heart, then fluid should be moved more slowly and there may be a need for aggressive diuresis (with something like a water pill). Unfortunately, there are no easy solutions for lymphedema of this magnitude. So any treatment should be performed under close supervision of a physician. 2009-11-11 20:51:32 [Message] Dr. Raj -> chat lobby: That's an appropriate treatment Bonny. 2009-11-11 20:52:09 [Message] bonnym -> chat lobby: well it only numbs the pain but still anything helps 2009-11-11 20:52:20 [Message] tina -> chat lobby: what do you think is an appropriate amount of diuretics Dr. Raj? 2009-11-11 20:52:33 [Message] Dr. Raj -> chat lobby: It's a start. The only true way to treat the nerve pain from lymphedema is limb volume control 2009-11-11 20:52:40 [Message] bonnym -> chat lobby: thought duretics worsen it 2009-11-11 20:52:48 [Message] Randy Ross -> chat lobby: Personally I have found that the more pain management techniques I use the better my success. 2009-11-11 20:52:56 [Message] Marbeth -> chat lobby: Dr. Raj.. is something like prednisone (sp?) dangerous for a person with LE? 2009-11-11 20:53:01 [Message] Dr. Raj -> chat lobby: Tina . . . It just depends on the patient's overall physical conditioning and functional status. I t 2009-11-11 20:53:31 [Message] Dr. Raj -> chat lobby: I typically don't use diuretics for treatment of my patients. If I need to, I will likley enlist the help of a cardiologist to make sure the treatment prescribed can be handled by the patient's heart. 2009-11-11 20:53:46 [Message] tina -> chat lobby: say in Mac's case, she's stage 3, so would it be good for her to be on diuretics while in therapy and an antibiotic too since she's prone to cellulitis 2009-11-11 20:53:47 [Message] bonnym -> chat lobby: think prednison short term is alright but its got terrible side effects 2009-11-11 20:54:07 [Message] Dr. Raj -> chat lobby: Diuretics don't necessarily worsen lymphedema per say, but they don't help the actual lymphedema. They only help with the increased volume of fluid in your circulatory system (arteries/heart/veins). 2009-11-11 20:54:37 [Message] bonnym -> chat lobby: interesting concept 2009-11-11 20:55:07 [Message] bonnym -> chat lobby: does food trigger off the pain 2009-11-11 20:55:10 [Message] Dr. Raj -> chat lobby: The concern with using prednisone from my end wouldn't actually be with lymphedema, but would be with a decreased immune response if you developed a cellulitis (i.e. a cellulitis could run wild if your immune system is not up to snuff). 2009-11-11 20:55:12 [Message] bonnym -> chat lobby: certain foods 2009-11-11 20:55:37 [Message] Marbeth -> chat lobby: oh.. good point.. :) 2009-11-11 20:56:05 [Message] bonnym -> chat lobby: takes a bow! 2009-11-11 20:56:38 [Message] Randy Ross -> chat lobby: There is about five minutes left if anyone has a question or comment or needs clarification from Dr. Raj. 2009-11-11 20:57:20 [Message] bonnym -> chat lobby: we can always pay him overtime! 2009-11-11 20:57:26 [Message] Dr. Raj -> chat lobby: I think short of prescribing for Mac, she would probably need a cardiology eval prior to initiating diuretic therapy. Part of this would be an echocardiogram to measure cardiac function. I find that prophylatic antibiotics generally only makes me feel better; you do have to worry about prescribing prophylatic antibiotics long term as bacteria can develop resistance, and thus cause a situation where the antibiotic prescribed may no longer be effective for the said bacteria. Typical courses of abx treatment for my patients is 14 days. We only go long term (up to 6 weeks) with very significant hospitalization with more serious complications. 2009-11-11 20:57:50 [Disconnect [ERR]] Pamrose 2009-11-11 20:57:59 [Message] Dr. Raj -> chat lobby: I am not aware of specific foods triggering pain from lymphedema (whether nerve pain or physiological pain). 2009-11-11 20:58:07 [Message] tina -> chat lobby: Dr. Raj, i've known Mac for a long time, she does good in therapy, comes along really well, then suddenly when the fluid is disturbed too much, she gets really sick, heart flutters and cellulitis, she's laid up in the hospital, gets more fluid buildup and starts over and over. what would recommend for her? 2009-11-11 20:58:30 [Message] Dr. Raj -> chat lobby: I wish. My work doesn't even pay me overtime for the stuff I normally do for pay :) 2009-11-11 20:58:48 [Message] bonnym -> chat lobby: ur a good man 2009-11-11 20:59:31 [Message] bonnym -> chat lobby: Randys got lots of money - he can always pay u 2009-11-11 20:59:33 [Message] bonnym -> chat lobby: ha ha 2009-11-11 20:59:41 [Message] tina -> chat lobby: haha randy can pay! 2009-11-11 20:59:53 [Message] Randy Ross -> chat lobby: I was going to say that Dr. Raj, it is kind of your call as to when we end. 2009-11-11 21:00:17 [Message] bonnym -> chat lobby: Randy u the nitetime monitor are u 2009-11-11 21:00:17 [Message] Dr. Raj -> chat lobby: I think Mac's situation is very difficult. There are no easy solutions for lymphedema of this magnitude. My thought would be she would need very close follow-up wiht a lymphedema physician. If need be Tina, ou can contact me on my e-mail regarding Mac's situation and if need be I can try to give her treating physician's some advice if they would like. 2009-11-11 21:00:19 [Message] bonnym -> chat lobby: ha ha 2009-11-11 21:00:23 [Message] Randy Ross -> chat lobby: I think most physicians find that they never get compensated for all tha they do. 2009-11-11 21:00:33 [Message] Jenjay -> chat lobby: Dr. Raj, can we get your contact info one more time before you go? 2009-11-11 21:01:12 [Message] bonnym -> chat lobby: we can open up a clinic all of us - Dr Raj and the gang here eh 2009-11-11 21:01:14 [Message] bonnym -> chat lobby: ha ha 2009-11-11 21:01:18 [Message] Marbeth -> chat lobby: Dr. Raj.. you have been wonderful and very informative.. we really appreciate your taking you time to come talk with us... 2009-11-11 21:01:27 [Message] bonnym -> chat lobby: ditto to that 2009-11-11 21:01:35 [Message] tina -> chat lobby: taht would be nice wouldn't it? Lymphland clinic 2009-11-11 21:01:40 [Message] Mac -> chat lobby: thank you for everything 2009-11-11 21:01:43 [Message] bonnym -> chat lobby: always good to learn 2009-11-11 21:01:45 [Message] tina -> chat lobby: boobs 2009-11-11 21:01:59 [Message] Randy Ross -> chat lobby: Yes, definitely thank you very much Dr. Raj and I hope that you can come back again, you have been extremely helpful tonight. 2009-11-11 21:02:30 [Message] Mac -> chat lobby: i feel hopefull again 2009-11-11 21:02:33 [Message] bonnym -> chat lobby: very informative and have helped - thx again for ur kindness and time 2009-11-11 21:02:45 [Message] Randy Ross -> chat lobby: Never ever give up on hope, never ever. 2009-11-11 21:02:51 [Message] Dr. Raj -> chat lobby: Let me get in touch with Tina, and we'll figure out a better way to keep in touch. My work e-mail probably isn't the right way to go for a variety of reasons. But if you have internet access, you can google me (Vish Raj, M.D.). My workplace is Carolinas Rehabilitation (in Charlotte) and we have links that give a general idea of what we do. 2009-11-11 21:03:02 [Message] Mac -> chat lobby: i hear you randy ty dear 2009-11-11 21:03:14 [Message] tina -> chat lobby: I really appreciate your coming into the room too Dr. Raj, we would love to have you come back again, we had members who had problems getting into the room, they didn't have java ect so maybe in Jan after the holidays if you'd like to rejoin us, we could do that. 2009-11-11 21:03:19 [Message] Randy Ross -> chat lobby: Very welcome my dear. 2009-11-11 21:03:48 [Message] Dr. Raj -> chat lobby: Thanks everybody for your time. I can help in the future. Sounds like a plan Tina. We'll be in touch . . . . 2009-11-11 21:03:52 [Message] bonnym -> chat lobby: bye bye Dr Raj - u been wonderful 2009-11-11 21:04:04 [Message] tina -> chat lobby: if you guys have questions or anyone in the group does, email me them and I can send to Dr. Raj so he's not overwhelmed with mail 2009-11-11 21:04:10 [Message] Flora -> chat lobby: thank you dr raj 2009-11-11 21:04:34 [Message] tina -> chat lobby: I really appreciate your kindness Dr. Raj 2009-11-11 21:04:39 [Message] Marbeth -> chat lobby: ditto 2009-11-11 21:04:47 [Message] Dr. Raj -> chat lobby: My pleasure. You guys take care. . . 2009-11-11 21:04:53 [Disconnect] Dr. Raj 2009-11-11 21:04:55 [Message] tina -> chat lobby: you too and good night 2009-11-11 21:04:57 [Message] Randy Ross -> chat lobby: If there were more like you Dr. Raj, maybe we could find a cure. 2009-11-11 21:05:22 [Message] bonnym -> chat lobby: u missed him Randy 2009-11-11 21:05:25 [Message] bonnym -> chat lobby: ha ha 2009-11-11 21:05:25 [Message] tina -> chat lobby: I'm glad he came, I wish we'd had more members show up but maybe he would have been overwhelmed 2009-11-11 21:05:26 [Disconnect] Jenjay 2009-11-11 21:05:45 [Message] Randy Ross -> chat lobby: I think it would have slowed the system down if more had come. 2009-11-11 21:05:56 [Message] bonnym -> chat lobby: next time always next time 2009-11-11 21:05:59 [Message] Mac -> chat lobby: we for sure but wow he did not misss answering all question 2009-11-11 21:06:02 [Message] Marbeth -> chat lobby: It was very nice that he came to talk with us.. 2009-11-11 21:06:04 [Message] mkbmia -> chat lobby: Thank you for having him in tonight....everyone have a good night. hugs 2009-11-11 21:06:16 [Message] tina -> chat lobby: night mk 2009-11-11 21:06:22 [Message] Randy Ross -> chat lobby: good night and don't give up on pain management, it works. 2009-11-11 21:06:30 [Message] Marbeth -> chat lobby: nite mk 2009-11-11 21:06:41 [Message] Mac -> chat lobby: GN mkdmia 2009-11-11 21:06:46 [Message] tina -> chat lobby: we can do another one in Jan with him maybe 2009-11-11 21:06:55 [Message] bonnym -> chat lobby: great idea Tina 2009-11-11 21:07:03 [Message] Marbeth -> chat lobby: that would be great Tina.. 2009-11-11 21:07:05 [Message] tina -> chat lobby: I'm trying to get us guests 2009-11-11 21:07:06 [Message] Marbeth -> chat lobby: :) 2009-11-11 21:07:17 [Message] tina -> chat lobby: I thought about supply people 2009-11-11 21:07:18 [Message] mkbmia -> chat lobby: Im trying not to Randy, it just sucks cause my dr wont treat me unless I do what they say at the pain clinic and messing with my spine just scares me lol 2009-11-11 21:07:23 [Message] Randy Ross -> chat lobby: Call Marlys Witte 2009-11-11 21:07:29 [Message] tina -> chat lobby: you can randy 2009-11-11 21:07:33 [Message] tina -> chat lobby: :D 2009-11-11 21:07:37 [Message] tina -> chat lobby: biggrin 2009-11-11 21:07:42 [Message] Marbeth -> chat lobby: LOL 2009-11-11 21:07:44 [Message] Randy Ross -> chat lobby: I already delegated it to you lol 2009-11-11 21:08:03 [Message] bonnym -> chat lobby: how do u send a private message on here?? 2009-11-11 21:08:15 [Message] Randy Ross -> chat lobby: What would be great is getting both Dr. Witte's together in the room. 2009-11-11 21:08:22 [Message] Marbeth -> chat lobby: click on a name and it will bring up a box 2009-11-11 21:08:40 [Message] Randy Ross -> chat lobby: Unfortunately he passed away a few years ago. 2009-11-11 21:08:43 [Message] tina -> chat lobby: i'll change some of the icons 2009-11-11 21:08:53 [Message] tina -> chat lobby: and get rid of the u p wazzzup one 2009-11-11 21:09:02 [Message] bonnym -> chat lobby: Marbeth Marbeth 2009-11-11 21:09:07 [Message] tina -> chat lobby: I think some of the vendors 2009-11-11 21:09:17 [Message] bonnym -> chat lobby: send me one and tell me 2009-11-11 21:09:23 [Disconnect] mkbmia 2009-11-11 21:09:25 [Message] tina -> chat lobby: if I could get some to come to chat or advertise free on lymphland maybe we could get samples 2009-11-11 21:09:48 [Message] tina -> chat lobby: I have alot of ideas but they don't seem to work 2009-11-11 21:10:34 [Message] tina -> chat lobby: well u guys I have to get my butt to bed have to get up early tomm 2009-11-11 21:10:43 [Message] tina -> chat lobby: take care and see you in the group. night 2009-11-11 21:10:48 [Message] bonnym -> chat lobby: nite nite all 2009-11-11 21:10:51 [Message] tina -> chat lobby: zzz 2009-11-11 21:10:54 [Message] Flora -> chat lobby: nite tina 2009-11-11 21:10:56 [Logout] tina 2009-11-11 21:11:01 [Message] Marbeth -> chat lobby: nite Bonny 2009-11-11 21:11:10 [Message] bonnym -> chat lobby: have a good nite 2009-11-11 21:11:13 [Message] Marbeth -> chat lobby: nite Tina 2009-11-11 21:11:14 [Message] bonnym -> chat lobby: bye for nite 2009-11-11 21:11:23 [Message] Marbeth -> chat lobby: ok.. so it is party time now?? LOL 2009-11-11 21:11:24 [Message] Mac -> chat lobby: night bonny 2009-11-11 21:12:03 [Message] Marbeth -> chat lobby: or not? 2009-11-11 21:12:04 [Message] Marbeth -> chat lobby: LOL 2009-11-11 21:12:11 [Disconnect] bonnym 2009-11-11 21:12:14 [Message] Randy Ross -> chat lobby: oh Marbeth, we know what happens when you get us started. lol 2009-11-11 21:12:19 [Message] Mac -> chat lobby: i will party with you marbeth 2009-11-11 21:12:29 [Message] Marbeth -> chat lobby: All right Mac 2009-11-11 21:12:36 [Message] Randy Ross -> chat lobby: You are being awfully quiet Flora, I miss you! 2009-11-11 21:12:58 [Message] Mac -> chat lobby: randy dear do you mind i party with marbeth lmao 2009-11-11 21:12:58 [Message] Flora -> chat lobby: sorry, it's been a very long 2 wks for me 2009-11-11 21:13:09 [Message] Randy Ross -> chat lobby: Hey, Marbeth and I already found a room. lol 2009-11-11 21:13:18 [Message] Flora -> chat lobby: it's ok with me, might cheer me up lol 2009-11-11 21:13:24 [Message] Randy Ross -> chat lobby: I know Flora, I hope you are feeling better. 2009-11-11 21:13:33 [Message] Marbeth -> chat lobby: Lol oh yeah.. Lol 2009-11-11 21:13:54 [Message] Flora -> chat lobby: no you don't know it all... i just got my report yesterday 2009-11-11 21:13:56 [Message] Randy Ross -> chat lobby: Told you not to post that pic! 2009-11-11 21:13:58 [Message] Mac -> chat lobby: lol got room for me in that roomlol 2009-11-11 21:14:02 [Message] Marbeth -> chat lobby: So who has the chocolate? 2009-11-11 21:14:16 [Message] Marbeth -> chat lobby: Yes we always have room for you in that room Mac.. 2009-11-11 21:14:18 [Message] Flora -> chat lobby: i got the virtual chocolate 2009-11-11 21:14:22 [Message] Marbeth -> chat lobby: LOL 2009-11-11 21:14:29 [Message] Marbeth -> chat lobby: that was soooo funny... 2009-11-11 21:14:37 [Message] Mac -> chat lobby: we agreed to post it but yea all my claims are going to have to be in ink now lol 2009-11-11 21:14:42 [Message] Randy Ross -> chat lobby: no, but someone else asked if they could and I said, nope, just for two since you started the whole thing. lol 2009-11-11 21:14:46 [Message] Marbeth -> chat lobby: Flora ... I knew you woul bring the chocolate.. LOL 2009-11-11 21:15:10 [Message] Marbeth -> chat lobby: How funnnnnnny... LOL 2009-11-11 21:15:14 [Message] Flora -> chat lobby: well it has to be virtual, cause i can't eat chocolate...... grrrrr 2009-11-11 21:15:36 [Message] Marbeth -> chat lobby: oh... but you can eat something else good with us.. 2009-11-11 21:15:36 [Message] Randy Ross -> chat lobby: I just love being here! All this wonderful female energy!! eh Mac? 2009-11-11 21:15:53 [Message] Flora -> chat lobby: i have choc covered cherries, strawberries and cut banana with choco 2009-11-11 21:15:55 [Message] Marbeth -> chat lobby: Oh you two.. get a room... LOL 2009-11-11 21:16:00 [Message] Mac -> chat lobby: yea my litlle flirt 2009-11-11 21:16:06 [Message] Randy Ross -> chat lobby: moi? 2009-11-11 21:16:15 [Message] Mac -> chat lobby: yes toi 2009-11-11 21:16:21 [Message] Randy Ross -> chat lobby: not my fault this is basically a female disorder. 2009-11-11 21:16:31 [Message] Mac -> chat lobby: lol 2009-11-11 21:16:35 [Message] Marbeth -> chat lobby: Lol gag... Lol 2009-11-11 21:16:41 [Message] Marbeth -> chat lobby: JK... 2009-11-11 21:16:47 [Message] Randy Ross -> chat lobby: There is alway room for everyone. 2009-11-11 21:16:59 [Message] Marbeth -> chat lobby: OH Flora that all sounds sooo ogod.. .LOL 2009-11-11 21:17:04 [Message] Marbeth -> chat lobby: opps good.. 2009-11-11 21:17:16 [Message] Flora -> chat lobby: knew what you meant 2009-11-11 21:17:20 [Message] Marbeth -> chat lobby: LOL 2009-11-11 21:18:18 [Message] Mac -> chat lobby: flora hun i will call tomorrow befor eyou get busy i have missed our time together 2009-11-11 21:18:27 [Message] Flora -> chat lobby: k 2009-11-11 21:18:52 [Message] Marbeth -> chat lobby: ok.. jealous here Mac..??????? 2009-11-11 21:18:59 [Message] Marbeth -> chat lobby: where is my call??? LOL 2009-11-11 21:19:14 [Message] Flora -> chat lobby: not too early..... got to get my beauty sleep you know 2009-11-11 21:19:15 [Message] Mac -> chat lobby: mar i callled you 2 days ago 2009-11-11 21:19:27 [Message] Marbeth -> chat lobby: yeah.. but I want more Mac time.. 2009-11-11 21:19:34 [Message] Mac -> chat lobby: oh i know that one flora lol 2009-11-11 21:19:55 [Message] Mac -> chat lobby: sorry rand ygot the rest lol 2009-11-11 21:20:04 [Message] Marbeth -> chat lobby: LOL darn you Randy.. LOL 2009-11-11 21:20:37 [Message] Marbeth -> chat lobby: Well guys... 2009-11-11 21:20:39 [Message] Randy Ross -> chat lobby: well, she did misunderstand totally 2009-11-11 21:20:42 [Message] Marbeth -> chat lobby: guess what time it is ... 2009-11-11 21:20:51 [Message] Randy Ross -> chat lobby: so early? 2009-11-11 21:20:55 [Message] Mac -> chat lobby: mac time lol 2009-11-11 21:21:04 [Message] Marbeth -> chat lobby: LOL yes.. is Mac time.. LOL 2009-11-11 21:21:19 [Message] Marbeth -> chat lobby: and... time for me to get off here.. 2009-11-11 21:21:34 [Message] Randy Ross -> chat lobby: Mac has had me for two hours lol 2009-11-11 21:21:48 [Message] Marbeth -> chat lobby: So fun while it lasted.. but the Chocolate is gone now.. and so must I... 2009-11-11 21:21:57 [Message] Marbeth -> chat lobby: LOL she had you at Hello...LOL 2009-11-11 21:22:03 [Message] Mac -> chat lobby: already marbeth 2009-11-11 21:22:05 [Message] Flora -> chat lobby: ok mar...... take care 2009-11-11 21:22:32 [Message] Flora -> chat lobby: yea, i think she ate most of it........ i'm a good cook you know......... lol 2009-11-11 21:22:38 [Message] Randy Ross -> chat lobby: she tucked me into bed last night. 2009-11-11 21:22:38 [Message] Mac -> chat lobby: gn marbeth and omg that is my favorite song 2009-11-11 21:22:55 [Message] Marbeth -> chat lobby: take care you guys.. nite nite..LOL 2009-11-11 21:23:00 [Logout] Marbeth 2009-11-11 21:23:02 [Message] Randy Ross -> chat lobby: she got mad though cuz I fell asleep first. 2009-11-11 21:23:20 [Message] Mac -> chat lobby: yes but it was nice still 2009-11-11 21:23:30 [Message] Randy Ross -> chat lobby: Good to see you Flora, stop by more often, you are missed but we do understand. 2009-11-11 21:23:53 [Message] Randy Ross -> chat lobby: Good nite Mac!! I is goneeeeeeeeee 2009-11-11 21:23:55 [Message] Mac -> chat lobby: gn flora i will call in the afternoon love 2009-11-11 21:23:55 [Message] Flora -> chat lobby: ok, i know when to leave....... lol 2009-11-11 21:23:58 [Logout] Randy Ross 2009-11-11 21:24:17 [Message] Mac -> chat lobby: it's ok he's on the phone with me 2009-11-11 21:24:20 [Message] Flora -> chat lobby: ok mac 2009-11-11 21:24:25 [Message] Flora -> chat lobby: nite and take care 2009-11-11 21:24:41 [Message] Mac -> chat lobby: night dear much love hun 2009-11-11 21:24:50 [Message] Flora -> chat lobby: maybe i should stay and be a moderator......... lol 2009-11-11 21:25:15 [Message] Flora -> chat lobby: \or should i say, supervise........??????? 2009-11-11 21:25:19 [Message] Flora -> chat lobby: night 2009-11-11 21:25:24 [Message] Flora -> chat lobby: hugs to you both 2009-11-11 21:25:33 [Logout] Flora 2009-11-11 21:25:35 [Message] Mac -> chat lobby: flora no moderating me dear 2009-11-11 21:26:06 [Disconnect] Mac 2009-11-11 21:39:16 [Login] bonnym 2009-11-11 21:39:16 [IP] bonnym: 2009-11-11 21:39:16 [Join Room] bonnym -> chat lobby 2009-11-11 21:39:21 [Disconnect] bonnym |