Manual lymphatic drainage (MLD) is a specialised form of touch movement to aid in the movement and flow of lymph fluid. The lymphatic system has vessels and capillaries like the circulatory system carrying cellular debris and nutrients throughout the body. However, unlike the circulatory system it does not have a heart to pump contents through the body. Therefore, it relies on muscle contraction and movement to push fluid through the body to maintain equilibrium. Manual lymphatic drainage massage can be used as an adjunct to a health detoxification program or as an ongoing therapy for conditions of the lymphatic system.
It supports the immune system, the skin and everything in between.
How can it help me?
The list of benefits from Manual Lymphatic Drainage massage is extensive and includes:
Reduction of inflammatory acne.Reduction of fluid retention.Reduce pain and pressure associated with sinusitis and tonsilitis. To improve healing outcomes following surgery or injury.Increase detoxification and reduce the feeling of sluggishness.Encourage fluid movement from lymphoedema affected limbs.Relaxation and stress relieving.
Further indications for MLD:
- Acute inflammation
- Scar Therapy
- Alleviates pain through the gate control theory
- Pre-surgery preparation
- Removal of lymph nodes
HOW MANY TREATMENTS ARE NEEDED?
MLD is light like a feather but has an effect on a cellular level.
The frequency and amount of treatments will depend on the condition treated. Manual lymphatic drainage can be performed immediately pre and post surgery up to twice per day for acute conditions. Generally 1-3 times per week is suitable for many conditions.
Unlike your normal skin tissue, scar tissue has a different form of collagen structure. The collagen in your unharmed skin is laid out in a reticulate formation, with the fibres crisscrossing each other. On the other hand, scar tissue collagen is laid down in a unidirectional manner. It can take up to two years for a scar to reach full maturation and may only resolve to be 80% as strong as surrounding healthy tissue. Therefore, sun protection should be of upmost importance from the very beginning of the healing process.
For the scar tissue, the danger lies in:
- Degradation of non-mature collagen tissue
- Post inflammatory hyperpigmentation
In this formation, the scar tissue is weaker than the normal skin, possessing less durability and elasticity. Exposure to the ultraviolet section of the sun’s rays will damage these fibres, making the collagen fibres not align as neatly which may cause the scar to thicken and result in an unattractive scar.
Exposure of new scar tissue to the sun also more often than not results in hyperpigmentation of the area, due to the increase of inflammation and the effect it has on melanogenesis (the formation of melanin). Melanin is produced in an attempt to protect the vulnerable new tissue. Those with a darker fitzpatrick skin type are at higher risk of developing hyperpigmentation. In simpler terms, this means that the area of and around the scar becomes darker than the rest of your complexion and may appear brown to a deep red. Cosmetically, this is unwanted and it remains a treatment concern for many dermal clinicians in Melbourne, due to the harsh UV of the Australian sun.
HOW DO YOU PROTECT YOUR NEW SCAR FROM SUN EXPOSURE?
With what we have gleaned from this article so far, it is safe to say that the scar needs to be carefully looked after in a bid to prevent a breakdown of the wounds delicate infrastructure.
We recommend that you keep your scar covered with light gauze or cloth because even the most inconspicuous of exposures to sunlight will exert their damage in an accumulative manner.
On any scar that is exposed to the light opt for UV protection topical creams with a sun protection factor of 30 or above (SPF 30), ensuring that the label reads, ‘broad spectrum’. These filter out the harmful parts of the spectrum of the sun’s light, protecting your new scar.
And if your scar has shows signs of darkening there are professional treatments and home care products to lighten which we will discuss in future articles.
Hasan, A. T., Eaglstein, W. and Pardo, R. J. (1999), Solar-Induced Postinflammatory Hyperpigmentation after Laser Hair Removal. Dermatologic Surgery, 25: 113–115.
Scars and UV. (2018). [image] Available at: https://www.newgelplus.com/blog/2017/11/23/scar-needs-sun-protection/ [Accessed 14 Mar. 2018].
Paramedical tattoo, also known as micropigmentation is a specialised procedure that implants pigment just below the epidermis of the skin similar to an artistic tattoo.
However, micropigmentation differs from an artistic tattoo due to:
- The specialist training of the practitioner.
- Pharmaceutical grade pigments are used as compared to unregulated tattoo pigment.
- The techniques used are less aggressive than traditional tattoos and cause less trauma to the skin.
What can be treated?
Paramedical tattoo can recreate, camouflage or disguise body markers such as:
- 3D areola and nipple complex post mastectomy
- Scarring from breast augmentation
- Self harm scars
- Trauma scars
- Surgical scars
- Hair simulation on the scalp
Topical therapies pertain to chemical peeling agents and/or cosmeceutical skin care that may be performed as a course of treatments in clinic or used at home by the patient. Topical ingredients may have a metabolic (has an effect on cellular metabolism), caustic (causes destruction and coagulation of tissue to initiate repair) or protective effects on the skin. The treatment methods may alter as the skin undergoes changes.
INDICATIONS FOR TOPICAL THERAPIES:
Post inflammatory hyper-pigmentation
CONSIDERATIONS FOR TOPICAL THERAPIES:
Some topical treatments may make you more photosensitive and require you to refrain from sun exposure or heat for a duration of time.
With the evolution of the medical world, the bar is being raised higher and at a faster rate than ever before. One of the catalysts for this constant positive flux in the industry is the advent of technology. Many industries have not been left standing, with the long tentacle of technology sneaking in to have a serious impact on things.
In the medical world alone, technology – in all its various forms – is being used across a multitude of disciplines, not just one. Our focus here, though, is virtual reality. VR is mainly associated with gamers but your ordinary couch potato could never have imagined that the same technology that was blowing up three headed, thickly muscled monsters is being used to relieve pain and transform the medical experience of countless patients.
Sounds infeasible, right? Well, not so much. And here is how.
MEDICAL TRAINING IN THE VIRTUAL WORLD
Life is as precious a thing as we can find in this world. It, therefore, stands to reason that the people into whose hands we commit our lives more than stand up to the challenge of saving it. Reading information from a book can only go so far in terms of educating soon-to-be medical professionals in the arena of saving lives. The same holds true for practising techniques on cadavers. I mean; there can only be so many unclaimed bodies in the morgue or those donated to science.
With virtual reality, the said techniques can be perfected through practice and total immersion into a horde of possible medical scenarios. Further progress in the field of VR ensures that not only are simple techniques learnt by first- and second-year students but also complex ones by those in advanced phases of their medical education.
VIRTUAL REALITY SOOTHING REAL WORLD BURNS
The technological inroads in the medical arena are so pronounced that virtual reality is making considerable impact as an adjunctive analgesic therapy for burn victims. This might sound quite ethereal but there have been studies following actual burn victims into whose therapy regimen VR has been incorporated.
Burn victims feel a lot of pain when they are resting and plenty more when their bandages and dressings are being changed. Physiotherapy to increase motion in damaged areas also induces pain. What virtual reality does is that it immerses the patient into another dimension – a digital one – during the procedure they are undergoing. This drags the attention of the mind away from the pain and into the interaction with the virtual world before it.
According to researchers, this kind of distracting and immersive virtual reality can reduce the procedural pain in patients by as much as 50 per cent.
A HELPFUL TOOL IN TACKLING PTSD AND ANXIETY
Post-traumatic stress disorder has been running behind in the shadows for a while now, with many of the concerned authorities not willing to admit to its existence. Those who have faced the truth have tried to help survivors of traumatic experiences through cognitive behavioural therapy with imaginal exposure. This, however, does not entice the patient to call up some of the more traumatic memories so as to relive them.The patients might not want to get in touch with the stimulus that traumatised them but the VR evokes these without the actual risk being present. According to Difede et al. 2007, virtual reality can bridge this gap to emotional engagement. This study was conducted on first responders to and survivors of the World Trade Centre attacks.
In the aforementioned study, the patients donned the VR headset and witnessed various stimuli including planes flying past the towers, normal New York sounds as well as the crashes and the sounds accompanying them. All this was in a bid to get them to confront the feelings they had that day. At the end of it all, the group that used VR therapy showed significant improvement in PTSD severity in comparison to the control group.
MINDFULNESS IN HEALING
A person goes through a lot of things when they are sick. Apart from the physical faults brought on by the disease or injury, there are emotional aspects related to the experience of being sick and being in hospital. So inasmuch as the doctor might cure the disease, the patient might not be healed. This is because curing is the elimination of the disease whereas healing is the restoration of the person to their better self both physically and mentally.
Mindfulness, on one part, is the ability of the medical professional to get in touch with their compassionate and empathetic side; in a sense feeling what the patient is feeling. This connection between patient and healer goes a long way in ensuring that the patient emerges from the ordeal happy and satisfied. It is this understanding between both parties that elicits self-healing qualities within the patient, augmenting the other therapies being administered.
Patients who are in hospital for a long time can start to get detrimental thoughts swirling around their minds.
Mindfulness comes in handy in such a situation, allowing the patients to get a better outlook on life, fostering healing. Techniques like meditation focusing on breathing and specific objects can make mindfulness take hold faster.
Guess what, though? Virtual reality ties back into this aspect of healthcare as well. In some patients it is difficult to get the practices of mindfulness down. VR can be used to make this process simpler. A study by Nararro-Haro et al. 2016 showed that a patient in a bad mental state could be taught mindfulness to prevent self-hurt.
In this instance, both visual and audio stimuli were included in the virtual experience. The sounds and video encouraged the patient to observe and not focus on anything particular. In a sense, this urged the patient to be mindful of this virtual world, a practice that is transferrable into the real world.
SO, WHAT LIES AHEAD FOR VIRTUAL REALITY IN HEALTHCARE?
In the tech world, the ones and zeros can rearrange into any format to solve many a problem. Virtual reality is so adaptable that the medical realm has not even seen the entirety of just the tip of this iceberg.
Stress is a known factor that impedes the healing process. It takes a decent amount of effort to keep the stress at bay and virtual reality can help in a substantial way. Immersing patients into environments with soothing and relaxing sounds and images via VR eases the stress out of them. If and when virtual reality harnesses the power of relaxation, healing will have gained another technologically advanced comrade.
The adage goes, “Seeing is believing.” Virtual reality will further reinforce this when healthcare professionals take it on for making diagnoses of hard to reach areas in the human body. Some areas in the body are so minute that there is limited understanding of their mechanisms of function. VR can provide a front row seat to the simulated action of never before seen activities in the body.
In the plastic surgery niche, virtual reality can be used to show clients what they will look like before any invasive procedures can go forward. In an interactive form of the technology, one wears the headset and steps into a virtual world with a vanity mirror that shows them what their desired appearance will be. They can then be able to prance around, pout, and tilt angles to see if the look fits or even suggest alterations which are instantly in put into the VR software by the plastic surgeon.
With technology, nothing seems to be out of the bounds of possibility.
References:Malloy, K. M., & Milling, L. S. (2010). The effectiveness of virtual reality distraction for pain reduction: a systematic review. Clinical psychology review, 30(8), 1011-1018.
Hunter G. Hoffman, Gloria T. Chambers, Walter J. Meyer, Lisa L. Arceneaux, William J. Russell, Eric J. Seibel, Todd L. Richards, Sam R. Sharar, David R. Patterson; Virtual Reality as an Adjunctive Non-pharmacologic Analgesic for Acute Burn Pain During Medical Procedures, Annals of Behavioral Medicine, Volume 41, Issue 2, 1 April 2011, Pages 183–191
Stefan Schmidt. The Journal of Alternative and Complementary Medicine. October 2004, 10(supplement 1): S-7-S-14.
Nararro-Haro, M. V., Hoffman, H. G., Garcia-Palacios, A., Sampaio, M., Alhalabi, W., Hall, K., & Linehan, M. (2016). The use of virtual reality to facilitate mindfulness skills training in dialectical behavioral therapy for borderline personality disorder: a case study. Frontiers in psychology, 7, 1573.
Difede, J., Cukor, J., Jayasinghe, N., Patt, I., Jedel, S., Spielman, L., … & Hoffman, H. G. (2007). Virtual reality exposure therapy for the treatment of posttraumatic stress disorder following September 11, 2001. Journal of Clinical Psychiatry, 68(11), 1639.
Virtual Reality in Healthcare. (2018). [image] Available at: http://hitconsultant.net/2016/06/30/virtual-reality-patient-experience/ [Accessed 14 Mar. 2018].