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Postby robin1956 » Wed Apr 04, 2007 5:50 am

does anyone know what a physiatrists is or what they do? my pcp wants me to see one, at first he was 99% sure i had arthitis in my knees, but xrays show nothing. have had terrible pain and swelling in both knees for three months now, personally i believe it is the lymph coming up from my lower legs to just over my knees i can feel the line where it and the pain stops under the skin. of course he is really pushing for me to have the gastric surgery but for some reason i do not think it is a good idea, i have lost forty two pounds in about three months but the pain in my knees only get worse not better with the weight loss of course i am extremly over weight at 5'3" and 252 lbs, does anyone out there who has lymphedema maintain an ideal weight? and if so does it make a difference? i learned about three years ago that i had lymphedema and until about a month ago i had never shed that first tear, now all i seem to do is to try to keep from crying, no one in my family understands least of all my husband, i work at full time job, my mother who is a 78 yr old stroke victim lives with me who i care for, oh well enough of the pity party time to go to work. :(
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What Is a Physiatrist?

Postby patoco » Wed Apr 04, 2007 7:28 am

Hi Ya Robin :)

physiatrist (fizz ee at' trist) is a physician specializing in physical medicine and rehabilitation. Physiatrists treat a wide range of problems from sore shoulders to spinal cord injuries. They see patients in all age groups and treat problems that touch upon all the major systems in the body. These specialists focus on restoring function to people.

To become a physiatrist, individuals must successfully complete four years of graduate medical education and four additional years of postdoctoral residency training. Residency training includes one year spent developing fundamental clinical skills and three additional years of training in the full scope of the specialty.

There are 79 accredited residency programs in physical medicine and rehabilitation in the United States. Many physiatrists choose to pursue additional advanced degrees (MS, PhD) or complete fellowship training in a specific area of the specialty. Fellowships are available for specialized study in such areas as musculoskeletal rehabilitation, pediatrics, traumatic brain injury, spinal cord injury, and sports medicine.

To become board-certified in physical medicine and rehabilitation, physiatrists are required to pass both a written and oral examination administered by the American Board of Physical Medicine and Rehabilitation (ABPM&R). The ABPM&R also has agreements with each of the boards of pediatrics, internal medicine, and neurology to allow special training programs leading to certification in both specialties.

Physiatrists treat acute and chronic pain and musculoskeletal disorders. They may see a person who lifts a heavy object at work and experiences back pain, a basketball player who sprains an ankle and needs rehabilitation to play again, or a knitter who has carpal tunnel syndrome. Physiatrists' patients include people with arthritis, tendonitis, any kind of back pain, and work- or sports-related injuries.

Physiatrists also treat serious disorders of the musculoskeletal system that result in severe functional limitations. They would treat a baby with a birth defect, someone in a bad car accident, or an elderly person with a broken hip. Physiatrists coordinate the long-term rehabilitation process for patients with spinal cord injuries, cancer, stroke or other neurological disorders, brain injuries, amputations, and multiple sclerosis.

Physiatrists practice in rehabilitation centers, hospitals, and in private offices. They often have broad practices, but some concentrate on one area such as pediatrics, sports medicine, geriatric medicine, brain injury, or many other special interests.

Robin, many of the best doctors dealing with lymphedema are physiatrists, such as Dr. Kathleen Francis in New Jersey. Not sure why this is, but seems they are the one speciality that has taken more of an interest in LE.

Let me know how the visit goes, I will be very interested in knowing.

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Postby robin1956 » Thu Jun 07, 2007 6:56 am

well i have had one visit and an mri, i don't go back to see the physiatrist until 06/22/07 but i have gotten the results of the mri, i have a tear of the medial menicus in the left knee and in both knees near bone on bone contact, when i walk now you can hear a clicking sound in my right knee, in the right knee there is an old acl tear and some other stuff but i don't have the results in front of me, i am at work and they are at home, but i am in physical therapy and doing pretty good, i am just worried it may mean surgery on my knees and if so how will that affect my lymphedema of my legs. promised my physical therapist i would quit push mowing my lawn, cause the left knee keeps giving out and i almost end up face down on the ground, but feeling pretty postive about things today, will let you know how the second vist with the doc goes, oh and on the next p.t. visit going to try out a walker. :lol:
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Postby suzeeq » Thu Jun 07, 2007 1:32 pm

Hi Robin, I want to congratulate you on your weight loss. Wow, you sure have your hands full. Your knees sound really painful. I wanted to address the weight issue that you asked about. I do think that it makes a difference. I have LE in my entire left leg and it has spread to my buttock. I have gained 10 pounds over the past couple of years, due I believe to the edema in my leg. But I am still of normal weight for my height. I have not had any complications, no cellulitis or open wounds or leaking of lymph fluid. I am able to work and I walk 2 miles a day, either outside or on the treadmill. I follow a low fat, low carb diet, ( yes I cheat too, love my bagels and cereal) but stay away from fried foods, and just try to eat as healthy as I can. My downfall is my water consumption, which is none and I know better. Just can't seen to get it down. Anyway, if you have bone on bone in your knees, losing weight will not help that issue, but losing weight will affect your overall health. So keep trying and best of luck.
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Postby robin1956 » Thu Jun 07, 2007 8:25 pm

well no good on the weight loss as since march i have gained it all back, but i am pretty sure i am going to go with the bariatic surgery, sometime next year, want to get my knees under control before i start the classes and all for the wieght lose surgery, i am hoping it helps, cause i can't seem to do it on my own, hard to believe three years ago i weighed 120 lbs less and was running three times aweek. well that's past and i have to look for the future. can't wait to see what the doc has to say on 062207 will let all know the results. :o
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