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Update on second Sapl surgery

Well hello everyone. It's been 4 week and 3 days since I had my right leg done. My lower leg is already as small as the left leg that was done 17 months ago. My thigh is smaller but still has a ways to go. Between this surgery and the one on my left leg 17 months I have lost a total of 30 pounds. Imagine not pulling that around anymore. Yay!. I am still very sore on my leg and nights are the worst. However, nothing that I cant deal with. I am so happy with the results thus far. On Thanksgiving day. I was able to wear a pair of tapered pants. First time in 15 years. It felt great. Since I still am sore. I am taking it easy. I rest when I need to rest and I walk for a mile or two during the day. I hope this helps anyone who is thinking about this surgery. I'm very happy with results. Wishing you all health and happiness.

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That’s great news! Are the nights worse because you are sleeping in a class 3 stocking? Are you still wearing a class 3 on your left leg at night? Preparing myself for my SAPL to be done in a few weeks. Hoping for successful results! As always, thank you for sharing.

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So I am still wearing class 3 on right leg as it has only been 4 weeks. While the class 3 can be uncomfortable to some degree, it is not the reason for discomfort. I have an area at the ankle that just seems to get aggravated when I lay down. It may be that I just notice it more than during the day. I do take off the garment for a half hour or so and put arnica jell on it. That helps some. I had a similar issue on the left leg initially. Just part of my healing process I guess. As for my left leg, I wear a very light garment at night and sometimes nothing on it at all. Mostly nothing at all on the left.leg at night. Having said that, i check my leg out for ANY swelling in the morning. Plus I measure it frequently. So far so good. I probably quit wearing it as much right around the one year mark. I started by leaving it off for a couple of hours then longer. So far so good. Every person is different. I wouldn't try it before a year and I would discuss with my doctor. Also, I put it on first thing in the morning. If my right leg does as well as my left, I will be beyond thrilled. So far my right calf has gone done and looks to be a little smaller than my left but they are close in size. My right thigh has a ways to go still and I am just now getting out for longer walks. Let me know if you have any other questions. Good luck.

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Hi glad that you see the good results of tthe surgery. My question is. Have you had any cellulitis infections before? If yes are you taking antibiotisc for life? if not are you taking antibiotics post surgery? How long? Sorry for too many questions but I think about surgery also in the future but my problem is I have bouts of cellulitis when reducing antibiotisc (for life) and so scared what would be after surgery...

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Hello. Yes I have had cellulitis several times before. I have only had it once since in 18 months. I do not take antibiotics regularly. I took for 2 weeks during and after surgery. I keep a bottle of antibiotics with me especially if I am traveling as when I have gotten it the past it came on fast. Keeping some with me just gives me peace of mind and time to get to a hospital. The SAPL surgery is supposed to help cut down on recurrence of cellulitis. Hope the answers your questions. Let me know if you need more info.

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HI Snaomi.

Thank you for your updates about your treatment and experiences of SAPL.

I am a plastic Surgeon in Oxford and perform LVA and VLNT for lymphoedema. In early 2019 our group is off to Malmo to see Hakan Brorson to learnt about his version of SAPL. We have also spoken to Jay Granzow but haven't had the opportunity to visit Ca yet but it's on the list! I'm interested to know your post operative compression. Brorson's approach is maximum compression 23 hours a day, however other groups around the world have a more relaxed approach. I read with interest that the first leg you had done is now in class 1. Could you expand on your compression regimen a little as I am really interested in what the minimum you have found works and how you titrate your compression against swelling. If you don't want to put details on the web then you can email me at info@olp.surgery

The other thing I'm interested regarding the compression / massage post op is how it is delivered if you live far away from Dr Granzow's practice. How does he effectively manage it from afar?

Our team in Oxford really want to provide this sort of surgery as we feel it provides great option for some patients. However we really want to be sure we can provide safe and effective post operative management for a group of patients from throughout the UK / Europe who we may need to manage from a distance.

Keep up the great work and would love to hear more about your progress.

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Hello doctor. I will try to answer your questions as best I can. Regarding compression, my 5herapist measured my leg when surgery was finished and she ordered the garments. While waiting for garments my legs were wrapped and remapped every 2 days until garments arrived. As for the garments, my doctor has me wear a class 3 against skin and a class 2 on top of that. At night I am to remove class 2. On my first leg I was able to stop wearing class 2 after about 9 months. If I am going to have a very busy day I may put class 2 back on. At about a year I started wearing a class 1 at night and sometimes none at all. It seems to work for me.

Regarding getting to doctor and therapist, I live about 7 hours from where Dr. Granzow and his team are. I stay at an extended living hotel for a week to 2 weeks after surgery. This last surgery I was able to go home a week later. I have a very good local therapist that I see here at home and she coordinates with Dr. Granzow's therapist. The first month i dont try to see my therapist as my leg is to sore. My first appointment will be tomorrow. She will measure my legs. In January I will fly down south to see Dr. Granzow and the therapist and they will order me new garments. After that my local therapist will order after measuring and discussing with Dr. Granzow's therapist. Dr. Granzow uses a total team approach. Everyone knows what is going on and when. Since having my left leg done 18 months ago, I have only had 1 bout of cellulitis. I keep antibiotics with me just in case I need. Dr. Granzow is very good even long distance at being involved. If I call he responds within hours. When I had cellulitis he was on the phone with my local hospital and doctors. I will say that things improve weekly but it takes about a year and a half for leg to feel pretty normal again. However, y loi u can do most things and will probably feel more energetic not carrying all that fluid around. I hope this answers some of your questions.

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Second response... my left leg that I had done 18 months ago I will always wear a class 3 during the day. At night I go lighter. If I have a busy day or it is extremely hot my leg may swell a little. Like a half cm. It goes back down over night. I still massage my legs several times a week and every couple of weeks with therapist. This has been a great experience for me not to mention how it has helped me with my every day outlook and energy.

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Many thanks for your detailed response. So I take it that your leg that is 18 months following surgery is in class 3 during the day but you can step down to class 1 at night currently. I wish you continued success following your surgery. Regards

AJR

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