Tag Archives: Interstitial Fluid

Dr. C "Comments", Men's Health, Prevention, Women's Health

HEALTH: “COMPRESSION THERAPY” REDUCES CHRONIC CELLULITIS & LEG EDEMA

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New England Journal of Medicine (Aug 13, 2020) – In this small, single-center, nonblinded trial involving patients with chronic edema of the leg and cellulitis, compression therapy resulted in a lower incidence of recurrence of cellulitis than conservative treatment.

The researchers have conducted a single-center, randomized, nonblinded trial that aimed to find out an association between the compression therapy and controlled incidents of chronic edema of the leg and people with cellulitis that can be defined as an infection of the skin that involves subcutaneous tissues or the innermost layer of the skin. Cellulitis can be caused by trauma or scratching of other lesions due to animal or human bites that result in fever, extreme pain, and redness of the skin.

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COMMENTARY

I have been using compression stockings for decades, since the discovery of the difference in color of my feet. An evaluation by a vascular surgeon revealed incompetence in the valve of my left popliteal vein. It wasn’t long before I developed small varicose veins.

Comfortable with PREVENTATIVE MEDICINE after a career in ALLERGY, I started wearing Jobst compression stockings, with 30-40 mm of constrictive force. After a decade or so of daily wearing, my big toes started to overlap my second toes, and I began using toe-spreaders; scissor-toe and hammer-toe were my worry, and I wanted to prevent this discomfort.

After a while, I began to notice that the Jobst stockings tended to bunch my toes together. Also, with the developing arthritis in my fingers, it was increasingly hard to get the 30-40mm stockings on without straining my arthritic hands. I now wear OPEN-TOE 15-20mm compression Medi stockings, which are easier to get on, and don’t bunch up my toes.

I still use the visco-elastic toe spreaders. Now, back to the compression stockings for treatment of cellulitis complicating ankle swelling. Of course it works. Beta Hemolytic Streptococci and Staph aureus like nothing better to feed on than a warm pool of interstitial fluid, which is the juice that comprises the ankle swelling.

And BLOOD CLOTS tend to form in the stagnant pools of blood which aggregates in varicose veins, particularly when you are sitting for a long time, such as during a long airline trip. By all means, use compression stockings if you have ankle edema, or even a condition predisposing to ankle edema like varicose veins. Don’t wait for the complication to develop. Be PROACTIVE, and STAY HEALTHY.

–DR. C

Dr. C "Comments", Men's Health, Resources, Women's Health

BLOOD CIRCULATION: THE “LYMPHATIC SYSTEM”

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The pulmonary circuit oxygenates and the systemic arterial circuit circulates several Liters of blood per minute. As this blood trickles through the capillaries, some of it oozes out through the thin endothelial lining, becoming interstitial fluid.

Most of this flud gets back into the capillaries and returns to the heart in the venous return. About 20% of the fluid drains into the LYMPHATIC SYSTEM, through the Lymph nodes, and back into the thoracic duct, into the vena cava, and eventually back into the general blood supply, which recirculates.

The Lymphatic System

The Return of the residual interstitial fluid by the Lymphatic vessels back to the general circulation is important, and if BLOCKED by such things as surgery and parasites, produces a swelling known as LYMPHEDEMA.

But the major importance of the lymphatic vessels is their characteristic cells, LYMPHOCYTES, and their accessory structures, The THYMUS, SPLEEN, LYMPH NODES, AND LYMPHATIC TISSUES is in the development and training of the IMMUNE SYSTEM. The THYMUS can be regarded as an organ to TRAIN Lymphocytes to be functional members of the immune system.

SomeT-cells operate to Help B-cells to produce antibody. These are called Th-4 cells. Others, called Th-8 cells. function to delete cells,

The thymus POSITIVELY selects cells that are prepared to recognize pathogens, and gets rid of cells (NEGATIVELY selects) cells that recognize the body’s own cells.

Failure to do so would result in “horror autotoxicus”, or AUTOIMMUNITY. The Thymus performs most of its functions when we are young.

The LYMPH NODES act as a type of filter for the Lymphatic channels, and intercept most bacteria and other pathogens coming through the lymphatic channes to keep them out of the blood stream. Lymph nodes are present at predictable locations throughout the body.

The Spleen acts as a big lymph node to filter the blood directly, and can intercept organisms that have escaped the lymph nodes. The Spleen can enlarge with certain infections, as with the EB Virus that causes mononucleosis.

Rupture of the spleen is not uncommon with direct blunt trauma to the abdomen. Removal of the spleen can increase susceptibility to blood stream infection. Lymph tissue is scattered throughout the body, like in the Tonsils, adenoids and Intestinal tract.

This Lymphocyte-containing tissue can expand with exposure to infection, and can become cancerous with Lymphomas. It can also enlarge enough to produce local Blockage, as with Adenoids. Lymph tissue should not be removed wantonly, since it may provide protection. There are 2 arms of our immune system.

I have been discussing the ADAPTIVE immune system which recognizes the pathogen, and stores memory of this interaction in “memory T-cells”. The helper T-cells( Th-4) start to multiply and stimulate the B-cells to “clonally” proliferate and differentiate into Antibody-producing Plasma Cells. The Cytotoxic T-cells, which can directly kill Pathogens, also multiply.

The first time this happens with a new Pathogen, Like SARS CoV-2, this adaptive process takes a week or so. But if the same Pathogen comes later, The adaptive immune system is ready, via the Memory T-cells, and springs rapidly into action. The 2nd arm of our immune system, shared with all of our vertebrate relatives, is the INNATE immune system.

The innate system is prepared IMMEDIATELY to recognize certain foreign molecules common to many invaders, and foreign our own bodies. It usually does not have the Power of the innate immune system, but in healthy people does an amazingly good job.

Some people just don’t get sick very often. Do the best you can to be one of these healthy people by getting proper SLEEP, DIET. AND EXERCISE!