Dr. Gerlach explains: This is why lipedema causes bruises

Bruises in lipedema - how do they arise? Let's start this time by rolling the horse up from behind. Before I ask you the question "Why do bruises keep appearing on my legs without bumping into myself?" explain, I'll tell you how the whole thing with lipedema started for me and what terrifying theories I had to listen to as a 22-year-old. Today, over 10 years later, I can only smile about it.

"... you must also have constant nosebleeds ..."

The signs misinterpreted

If I really think about it, then until my definitive diagnosis, I was walking around unsuspecting for 5 years and just thought "Oh, I must have a weak vein, just like everyone in my family." - and my grandma and my mother are just very overweight, that's why their legs are so misshapen, everything depends on the food and they also have massive varicose veins…. and pigs are blue and chickens lay Easter eggs.

If people had been as smart as they are today, would everything have turned out that way for me?

As I said, it all started very early. The strange feeling of always being a little more “sturdy” than others. Now and then a feeling of heaviness in the legs after standing for a long time. Initially not every day. But then at some point there were those ominous bruises. Sometimes calf, sometimes thigh, sometimes up to the hips. It didn't particularly bother me at the beginning. I just found it stupid to be covered with bruises in summer. Always these stupid questions from people: “What are you doing all the time? Are you so clumsy at home? "

And everyone, to whom I then replied that I have no idea where the bruises came from and that it would take forever to heal again, didn't believe me.

Blood clotting disorder? Please what?

At some point, when I got too stupid and my legs felt like lead, my path naturally led me to my family doctor at the time. I had just started my studies and was medically completely virginal. Unfortunately, I could still be tied to everything.

So it happened that on the first visit the statement "You tell things ... you just don't notice when you bump into your bed at night ...".

On the next visit, the doctor finally made me say “I am sure you often have nosebleeds too? I guess a blood coagulation disorder ”fear and I had to come to various blood tests and endure an intravenous vitamin cure for 6 weeks, which at that time my parents were allowed to pay kindly with the monthly“ pocket money study allowance ”. And in the end, who would have thought it, you were also medically surprised that this had not brought about a recovery.

So in the end I felt like most of the others - I took it that way and lived with it, even if I gradually got worse and worse. I kept thinking that it was simply a severe, inherited venous weakness.

The explosion in my legs

The all-important turning point came by complete coincidence, when I spent a few years later due to my so-called internship year (formerly also friendly “AIP”, doctor in internship), far from home in a North Sea clinic specializing in surgery. To be more precise, by chance, of all places, in the field of vascular surgery! And that was my luck! Otherwise I would have got my diagnosis a lot later.

I still remember it as if it had only been yesterday: I was in the operating room day after day, assisting the vascular surgeon with various interventions such as B. Vein stripping, vascular prosthesis installation, pacemaker implantation. Excellent! If I wanted to do everything later, that was the plan. Because, I was really good at it and proud to have so much talent as a raw egg that I had my own pacemaker operation even after 2 months. What a career in surgery I would have given!

But, my nasty “Magdalena” (as I call my unloved lipedema, as you know) put a spanner in the works. The long standing in the operating room and now and then wearing a lead apron for x-rays during the operation left my legs overnight explode. Within a week I had unbelievable pain in my legs and the circumference increased from size 34 to 38/40 on the lower body. Everything was pressing, I could hardly stand it.

My then chief physician of the department took me aside and after a few examinations the cat was in a poke, my legs were force-wrapped and in my hands I was holding the first flat-knit supply. I cried like a castle dog and thought my life is over, that's a bad joke!

Uncomfortable certainty

So the child now had a name and from then on I tried day after day to say battle on my unloved Magdalena. An eternal struggle for a lifetime. The feeling that as a young woman you ask yourself "why me of all people please?" And what this disease, which spreads throughout the body, does to you, I'll leave it open here.

The initial question was why everything usually starts with bruises in lipedema and where do they come from?

With lipedema, in the course of its development, there is a symmetrical (equal-sided) increase in the subcutaneous fatty tissue. It grows and grows so by itself…. Let's assume that there are a few extra pounds here and there, so I'm talking about additional normal fatty tissue. Even if it is only a few kilograms. There is then an increasing feeling of tension and pressure due to the increase in the circumference of the entire tissue of the affected extremity, e.g. B. of the leg.

Why is there an increased tendency to bruise with lipedema?

The pressure arises because the large-volume, genetically modified fat cells constrict the healthy surrounding tissue. That is why most of those affected are followed by classic pain to touch or discomfort when touching.

Likewise, lipedema has the effect that the finest blood vessels (so-called capillaries) in this affected tissue gradually become more and more permeable. Tissue fluid and red blood cells escape from these capillaries into the surrounding tissue. Due to the increased pressure, these substances cannot be broken down quickly by the body and sink in place - the bruises in lipedema, i.e. hematomas, arise and are painful. Even with the slightest touch or minimal impact on the tissue, the capillaries burst and they have become extremely sensitive.

Neurogenic inflammation in lipedema

The phenomenon of “neurogenic inflammation” in lipedema is just as little discussed, but is well known. This means that in the affected area due to the said pressure and the prevailing chronic pain, there is also an ongoing, chronic nerve irritation in the tissue.

This in turn maintains the permeability of the blood capillaries wherever a chronic irritation arises or where inflammation is caused, and it is precisely this inflammation that also leads to a disruption of the vascular barrier via chemical messengers. A vicious circle of pain and swelling.

The longer the clinical picture persists, the more the tissue becomes hardened and there is additional lymphedema, which is usually referred to as "lipo-lymphedema".

The only downer in the bucket - life expectancy is not shortened by lipedema, even if the disease is chronically progressive.

And, you can at least change something about the complaints if you are ready to do so and clump instead of spill and, among other things, reduce the proportion of healthy, normal subcutaneous fat and thus reduce the additional pressure on the tissue through weight reduction.

So even with this topic, the statement “You are what you eat” remains a bit. Or?

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