Lymphedema is a progressive and chronic condition resulting from the accumulation of lymphatic fluid in the tissues of the body, causing swelling. Swelling results when the lymphatic system cannot effectively drain protein-rich fluid from the interstitium—a fluid-filled space between internal structures such as organs and muscles and the skin.

Lymphedema swelling may appear in different areas of the body, depending on the severity and advancement of the condition. The most frequently involved areas are the arms and legs, where fluid accumulation is typically most apparent. Lymphedema may, however, involve more sensitive or less conspicuous areas like the genitals, face, and neck. Sometimes the swelling can be in the wall of the chest or even the oral cavity itself, causing inconvenience and functional compromise. The place of swelling depends on the nature of the etiology—either primary or secondary lymphedema—and can actually have a deep impact on a patient's life.

Outside of physical pain and deformity, lymphedema frequently has psychological and social costs. Patients can suffer from pain, decreased mobility, and emotional distress because of swelling that is noticeable or because of ongoing therapy.

Primary vs. Secondary Lymphedema: What's the Difference?

Primary Lymphedema is uncommon and usually resultant from birth defects or genetic mutations in the lymphatic system. It occurs in about 1 out of 100,000 individuals.

Secondary Lymphedema is more prevalent, occurring in approximately 1 in 1,000 individuals in the U.S. It arises as a result of injury or blockage of lymph vessels by external factors, including:

• Cancer therapies (such as radiation or surgery)
• Infections
• Trauma
• Chronic venous insufficiency

Primary lymphedema is comparatively uncommon, occurring in about 1 in 100,000 people. It is a result of congenital or genetic malformations of the lymphatic system. Dr. Manokaran clarifies, "This condition can occur at birth, during puberty, or even later in adulthood. It usually happens without a visible cause but is based on the patient's genetic structure."

Diagnosis is generally based on careful patient history and sophisticated imaging procedures like lymphangiograms, lymphoscintigrams, or MR lymphangiograms, which provide visualization of structural defects in the lymphatic channels.

Treatment starts conservatively with manual lymphatic drainage (MLD), compression bandaging, and stringent skin hygiene to minimize fluid accumulation and prevent infections. For advanced cases, surgical interventions such as lymphovenous anastomosis (LVA) are options. "Microsurgical procedures such as LVA are game-changers for patients whose symptoms don't respond to conservative therapies," explains Dr. Manokaran.

Secondary lymphedema is much more prevalent, affecting about 1 in 1,000 individuals in the United States — frequently as a consequence of cancer therapy, infection, trauma, or surgery. "The etiology is widespread," states Dr. Manokaran, "from parasitic infection in the tropics to post-mastectomy swelling in breast cancer patients."

Infection-related cases can be managed initially with antibiotics and anti-inflammatory drugs. But when the condition is chronic, more aggressive interventions are required. These involve surgical removal of fibrotic tissue or advanced reconstructive techniques such as lymph node transfer or super microsurgery, especially when lymphatic function has been severely impaired.

Patient history continues to be a mainstay of diagnosis in secondary lymphedema, since knowledge of the precipitating event can influence the entire treatment strategy.

Symptoms of Lymphedema

Though caused by different factors, both forms of lymphedema share common symptoms, such as:

• Swelling in limbs or proximal regions such as the chest, genitals, and face
• Limited range of motion
• Heaviness and tightness of limbs
• Pain, changed sensations, and color changes in the skin

These symptoms can hinder daily functioning, so early identification is important. "Delayed treatment can lead to irreversible tissue damage," warns Dr. Manokaran.

Is Lymphedema Reversible?

Complete healing is still a pipedream, particularly in cases of advanced status. Still, in stage 1 (early-stage lymphedema), usually reversal is feasible through vigilant treatment. The intent is symptom management, diminishment of swelling, and forestalling progression of the disease.

Early detection is important. Those at risk — including cancer patients, those with a family history, or those in endemic areas — need to watch their bodies carefully and take preventative measures such as lymphatic massage and compression garments.

Management Strategies to Live with Lymphedema

Maintain Skin Integrity

Since lymphedema can impair skin health, daily skin care and moisturizing are very important. Even small cuts or scrapes can quickly become infected, so it's important to clean wounds immediately and apply sunscreen and insect repellent when in the sun.

Adopt Supportive Habits

Loose clothing, resting swollen extremities, and the avoidance of constrictive jewelry can all help alleviate discomfort. Proper sitting — with legs flat and the avoidance of leg crossing — can also facilitate smooth fluid movement. Compression wear for regular travelers, particularly by plane, is highly advisable.

Track Symptoms

A symptom diary assists both patients and practitioners in making adjustments to treatment programs. Be on the lookout for changes in swelling, coloration of the skin, or feelings.

Maintain Emotional Wellness

Chronic illness may have psychological consequences. Meeting with support groups or talking with a mental health professional can bring emotional relief and strengthen resilience. "Patients shouldn't underestimate the value of mental health care to treat lymphedema," asserts Dr. Manokaran.

Nourish the Body

A healthy, balanced diet packed with fruits, vegetables, and lean protein benefits the lymphatic system. A healthy intake of water maintains fluid balance in the body.

Although primary and secondary lymphedema are different in cause and treatment processes, both need early diagnosis, individualized treatment, and a multidisciplinary team approach. With greater awareness, patient activism, and improved medical and surgical procedures, living well with lymphedema is absolutely feasible.

Dr. G. Manokaran, MBBS, MS General Surgery, MCh Plastic Surgery at Apollo Spectra Hospital, Chennai in India

A large international study from the University of Cambridge suggests that autism diagnosed early in life is fundamentally different from autism diagnosed later on. The findings, published in Nature, analyzed data from more than 45,000 autistic individuals and showed that the timing of diagnosis often reflects distinct biology and development.

The research team suggests this means that the term "autism" likely describes multiple conditions, not just one.

There are many misconceptions about autism in the media, many believe it can be caused by bad parenting, that it can only affect boys as well as that it can be cured. While these may not be true, can it change overtime or develop into something else?

What is Autism?

According to Mayo Clinic Autism Spectrum Disorder (ASD) is a condition that affects how the brain develops. It changes how people understand and interact with the world around them. This causes challenges in two main areas:

• Social Life and Communication: People with ASD often find it hard to talk with others and socialize.
• Behaviors: The condition also involves having interests or behaviors that are very specific and often repeated.

The word "spectrum" is key because it means ASD affects people in many different ways. Some people have mild symptoms, while others have more severe challenges.

Over time, it can make it hard for a person to manage in social situations, school, or at work. Many children show signs of autism within their first year of life. A few children seem to develop normally at first, but then lose some skills and start showing autism symptoms between 18 and 24 months old.

Early Diagnosis vs. Later Diagnosis: What's the Difference?

The study found two distinct groups based on when a person received their autism diagnosis:

Early Diagnosis (Typically Before Age Six)

These children were more likely to show social and behavioral difficulties from a very young age. Their traits are often easier to spot by parents and doctors, leading to a quicker diagnosis. Their underlying genetic profile is distinct and shares less in common with other mental health conditions.

Later Diagnosis (Late Childhood or Adolescence and Beyond)

These individuals often saw their social and behavioral challenges emerge or become noticeable during adolescence. They have a higher risk of developing mental health conditions like depression and Post-Traumatic Stress Disorder (PTSD). Their average genetic profile is surprisingly closer to that of ADHD and depression than it is to the genetic profile of early-diagnosed autism.

What Role Do Genetics Play In Autism?

The findings show that the difference in diagnosis timing is due to more than just how quickly families access care; it's also linked to genetics.

Genetic Overlap

The study found a strong genetic connection between later-diagnosed autism and psychiatric disorders. This suggests that certain genetic factors might make these individuals naturally more prone to mental health issues.

Lack of Early Support

Researchers also stress that not getting support in early childhood likely plays a role. Going undiagnosed makes people more vulnerable to difficulties like bullying, which significantly increases the risk of mental health struggles later on.

The authors hope these findings will change how autism is understood, studied, and supported, allowing for better help for autistic people of all ages.

Flu Shot: With flu season fast approaching, many people wonder when the best time is to get vaccinated. According to the U.S. Centers for Disease Control and Prevention (CDC), for most people who only need one dose, September and October are the ideal months to get the flu shot. The agency recommends that everyone be vaccinated by the end of October. Still, a percentage of the population believes flu shots aren’t essential and can be skipped.

Who Should Get a Flu Shot Every Year?

The CDC and major medical organizations advise everyone aged six months and older to get a yearly flu vaccination. Despite misinformation circulating online, these recommendations have not changed.

Certain groups are at higher risk of severe illness, people over 65, pregnant women, young children, and those with chronic health conditions like asthma, diabetes, heart disease, or weakened immune systems. While about 71% of seniors get their flu shot each year, less than half of other adults do. In children, vaccination rates have declined in recent years, with fewer than 50% receiving the vaccine last year.

Flu Shot: Why Flu Vaccines Matter

Flu vaccines may not prevent every infection, but they are highly effective at reducing severe illness and hospitalizations, says Dr. Sean O’Leary of the American Academy of Pediatrics. Tens of thousands of Americans die from the flu annually. During last year’s severe season, 280 children died from flu-related complications, nearly half of whom had no prior health issues, and most had not been vaccinated.

A rare but serious complication from last season was brain inflammation, which can cause seizures, hallucinations, or even death. Most affected children were unvaccinated.

Flu Shots During Pregnancy Offer Dual Protection

Pregnant women need to be especially cautious. A severe flu infection can lead to hospitalization or even preterm birth. Vaccination protects both mother and baby, since infants too young for their own vaccines benefit from the mother’s antibodies. Research shows flu shots are safe and effective during pregnancy.

Flu Shot: Choosing the Right Vaccine

For adults 65 and older, high-dose flu shots or vaccines with immune boosters are recommended, though a standard flu shot is also effective if those options are not available.

Flu Shot: Cost and Insurance Coverage

Flu shots are generally free under Medicare, Medicaid, and most private insurance plans if administered through in-network providers. Local health departments may also offer low-cost or free vaccines. The at-home FluMist option may require a delivery fee, though insurance should cover the vaccine itself.

Getting a Flu Shot Alongside COVID-19 Vaccine

It is safe to get both the flu and COVID-19 vaccines at the same time. Dr. Philip Huang, director of Dallas Health and Human Services, says this is a convenient way to stay protected. However, availability of COVID-19 vaccines for children may be limited, as federal recommendations have shifted and parents are encouraged to make personal decisions.

Bowel cancer, also called colon or rectal cancer, is one of the most common cancers. It is the fourth most common cancer in the United States, and around 150,000 Americans are diagnosed with colorectal cancer every year, according to the Colorectal Cancer Alliance.

The time it's found makes a huge difference in how well a person does. Catching the disease early makes a huge difference in survival.

If the cancer is caught in the very first stage (Stage One), people have a 90% chance of living for five years or more. That's excellent odds. But if it's found much later (Stage Four), the chance of living five years or more drops to only 10%. The lesson is clear: early checking and spotting symptoms can save lives.

Key Early Warning Signs of Colon Cancer

A doctor known as "Dr. Ben", also known as Medicina y Mente online has highlighted four main signs that could point to early bowel cancer. He stressed that if you see these, you should go to your doctor as soon as possible, especially since some of these symptoms only show up when you use the toilet. Here are the four key things to look out for:

Blood in your stool: This is one of the most common early alarms.

Changes in how you go to the toilet: This doesn't mean just one bad day. It means a big difference in your normal habits, such as going from being constipated (having hard, difficult-to-pass stool) to suddenly having diarrhea.

Losing a lot of weight for no reason: If you lose a significant amount of weight without changing how you eat or how much you exercise, it is a concern.

Feeling extremely tired (fatigue): This is tiredness that doesn't go away, even after rest. This is only a worry if there's no other clear reason for the tiredness.

What Are Some Other Symptoms Of Colon Cancer?

It's natural to feel shy, but the NHS strongly advises people to see a doctor if they have been experiencing any symptoms of bowel cancer for three weeks or longer. Doctors and nurses talk about these things all the time, so please don't be embarrassed. Other symptoms of colon cancer that the NHS mentions include:

• Bleeding from your bottom.
• The constant feeling like you need to go to the toilet, even if you just went.
• Pain in your tummy (abdomen).
• Feeling a lump in your tummy.
• Feeling bloated
• Feeling short of breath.

If your stool is very black or dark red, or you have bloody diarrhea, you need to call 111 or get an urgent appointment with your GP. While these symptoms don't always mean cancer, it is very important to get checked to find out what the problem is.

How To Prevent Colon Cancer?

The best defense against bowel cancer is screening. The NHS offers home testing kits for everyone between the ages of 50 and 74.

These home tests can be analyzed to look for tiny signs of cancer even before you feel sick or notice any symptoms. This is the most effective way to catch cancer at the earliest, most treatable stage.