lipoedem (PH Indholdsside)

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      <HtmlField Name="FactContent"><![CDATA[<h2>Fakta</h2>
<ul>
    <li>Ved lip&oslash;dem har man dobbeltsidig, symmetrisk, disproportional overv&aelig;kst af fedt p&aring; ben og/eller arme (oftest ben), uden fedt p&aring; f&oslash;dder eller h&aelig;nder</li>
    <li>Lip&oslash;demet giver smerter ved ber&oslash;ring eller tryk</li>
    <li>Der er ikke v&aelig;ske i underhuden</li>
    <li>Lip&oslash;dem kan ikke helbredes, men i nogle tilf&aelig;lde bedres</li>
    <li>Smerter kan holdes nede ved at bruge kompressionsbandage, ved at motionere og ved v&aelig;gtkontrol</li>
    <li>Det er vigtigt at reducere sin v&aelig;gt til n&aelig;r normal BMI, for at lip&oslash;demet ikke skal forv&aelig;rres&nbsp;</li>
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      <HtmlField Name="PageContent"><![CDATA[<h2>Hvad er lip&oslash;dem?</h2>
<p>
Lip&oslash;dem er en kronisk tilstand, hvor der er en us&aelig;dvanlig (uforholdsm&aelig;ssig) og smertefuld ophobning af fedtceller. Lip&oslash;dem forekommer n&aelig;sten udelukkende hos kvinder.&nbsp;</p>
<p>Fedtv&aelig;vet samles (symmetrisk) i depoter, oftest fra taljen og ned, men det kan ogs&aring; forekomme p&aring; armene. H&aelig;nder og f&oslash;dder er ikke p&aring;virkede. </p>
<p>En uforholdsm&aelig;ssig ophobning af fedt uden smerter kaldes lipohypertrofi, eller fedme, ikke lip&oslash;dem. </p>
<p>Trods navnet er der ikke v&aelig;ske i underhuden ved lip&oslash;dem.
</p>
<h3>Hvad er symptomerne p&aring; lip&oslash;dem?</h3>
Smertende fedtv&aelig;v, symmetrisk p&aring; arme eller ben og hofter, der reagerer d&aring;rligt p&aring; v&aelig;gttab.
<h3>Hvordan stilles diagnosen?</h3>
<p>
L&aelig;gen kan normalt stille diagnosen p&aring; baggrund af sygehistorien (arvelighed eller anden sygdom) og de typiske fund. Se figur nedenfor:</p>
<img src="A334EE64955C440F8288C3512D693092-480-186" style="height: 186px; width: 480px;" alt="Graden af lipødem" height="186" width="480">&nbsp;
<h3>Hvorfor f&aring;r man lip&oslash;dem?</h3>
Lip&oslash;dem udvikles ofte i puberteten eller ved andre hormonelle forandringer som graviditet og overgangsalder, men kan ogs&aring; udl&oslash;ses af en skade.&nbsp;
<h3>Er lip&oslash;dem arveligt?</h3>
<p>Der ses famili&aelig;r ophobning af lip&oslash;dem.</p>
<h3>Hvordan behandler man lip&oslash;dem?</h3>
<p>Man kan ikke helbrede lip&oslash;dem, men blot lindre generne ved lip&oslash;demet. Lip&oslash;dem kan behandles med:</p>
<ul>
    <li>V&aelig;gtkontrol</li>
    <li>Kompressionsbehandling</li>
    <li>Bev&aelig;gelsesterapi</li>
    <li>Psykosocial behandling</li>
    <li>Fedtsugning</li>
    <li>Selfmanagement</li>
</ul>
<h3>Hvad kan jeg selv g&oslash;re?</h3>
<h4>V&aelig;gtkontrol</h4>
<p>Det er vigtigt, at man holder en v&aelig;gt s&aring; n&aelig;r det normale som muligt. Hvis man tager p&aring; i v&aelig;gt, forv&aelig;rrer det generne ved lip&oslash;dem. Det fedt der s&aelig;tter sig som lip&oslash;dem er sv&aelig;rt at tabe igen, derfor er v&aelig;gt&oslash;gning et problem ved tilstanden.</p>
<h4>Kompressionsbehandling</h4>
<p>Ved at behandle med kompressionsbandage lindres generne ved lip&oslash;dem ofte. Det er vigtigt, at bandagen/kompressionsbukser benyttes vedvarende, ogs&aring; om sommeren. </p>
<p>I s&aelig;rligt sv&aelig;re smertende tilf&aelig;lde kan man blive udstyret med en form for maskine som meget effektivt hindrer, at der ophobes v&aelig;ske i fedtet p&aring; arme eller ben.</p>
<h4>Bev&aelig;gelsesterapi</h4>
<p>Motion er ogs&aring; vigtigt. Hvis man ikke kan dyrke andet sport, er tr&aelig;ning i vand eller sv&oslash;mning gavnligt. Det mindsker belastningen af leddene, og vandet ud&oslash;ver et let tryk p&aring; fedtv&aelig;vet.</p>
<h4>Psykosocial behandling</h4>
<p>Det er vigtigt for en person med lip&oslash;dem at erkende, at der er tale om en kronisk tilstand, hvor forskellige tiltag kan lindre, men ikke behandle til helbredelse.&nbsp;</p>
<p>Personer med lip&oslash;dem kan have udbytte af aktiviteter som mindfulness og yoga, og dermed f&aring; en bedre mental kontrol over smerterne. Kontakt med andre personer med lip&oslash;dem kan bidrage positivt.</p>
<h4>Fedtsugning</h4>
<p>D&aelig;kkes ikke i offentligt regi. Patienter med lip&oslash;dem m&aring; forvente at skulle d&aelig;kke udgifter til eventuel fedtsugning selv. </p>
<p>Der er intet videnskabeligt grundlag for, at fedtsugning har langtidseffekt p&aring; smerterne.</p>
<p>Ved mistanke om lip&oslash;dem skal man udelukke andre sygdomme. </p>
<h4>Selfmanagement (egenbehandling/egenomsorg)</h4>
<p>Der er tale om en tilstand, hvortil der ikke endnu findes en egentlig behandling og fuld viden om udl&oslash;sende &aring;rsag. Det er derfor vigtigt at l&aelig;re sig selv at h&aring;ndtere tilstanden, b&aring;de fysisk og psykisk. </p>
<p>Det er n&oslash;dvendigt at till&aelig;gge sig nye livsstilsvaner. En person med lip&oslash;dem skal b&aring;de forholde sig til smerterne og et udseende, der kan afvige fra et &oslash;nsket selvbillede.</p>
<h3>Hvordan undg&aring;r jeg at f&aring; eller forv&aelig;rre lip&oslash;demet?</h3>
<p>Ved at bruge kompressionsstr&oslash;mpe/bandage, motionere samt undg&aring; at tage p&aring; i v&aelig;gt kan man selv bidrage til, at tilstanden ikke forv&aelig;rres. </p>
<p>Det er desuden vigtigt at erkende og forholde sig til tilstedev&aelig;relsen af overv&aelig;gt. V&aelig;gttab mindsker generne ved lip&oslash;dem.</p>
<p>Personer med lip&oslash;dem har meldt tilbage, at dybde b&oslash;rstning fra fod mod lyske, og antiinflammatorisk di&aelig;t, sammen med ovenst&aring;ende har hjulpet dem.</p>
<h3>Hvorn&aring;r skal jeg s&oslash;ge hj&aelig;lp?</h3>
<p>Ved nye opst&aring;ede smerter, eller uensartet nyopst&aring;et h&aelig;velse, skal du s&oslash;ge hj&aelig;lp for at udelukke anden sygdom.</p>
<h3>Hvordan udvikler sygdommen sig?</h3>
<p>Lip&oslash;dem er en varig tilstand, der kan holdes i ave ved v&aelig;gtkontrol og kompressionsbehandling.</p>
<p>Personer med lip&oslash;dem er p&aring;virket i forskellig grad. Generne vil derfor ogs&aring; variere betydeligt fra person til person. Som regel f&aring;r man det bedre, hvis man f&oslash;lger r&aring;dene ovenfor.</p>
<h3>Er lip&oslash;dem farligt?</h3>
<p>Nej.</p>
<h3>Hvor udbredt/hyppig er lip&oslash;dem?</h3>
<p>Det vides ikke, hvor mange der har lip&oslash;dem, Tal mellem 1 ud af 3500 kvinder og op til 8 % af kvinder forekommer i litteraturen.</p>
<h3>Vil du vide mere?</h3>
<ul>
    <li><a rel="noopener noreferrer" href="https://dalyfo.dk/viden-om-lipoedem" target="_blank">Viden om lip&oslash;dem</a> - Dansk Lymf&oslash;dem Forening</li>
    <li><a href="~/link.aspx?_id=853E9B419EFE48F482F083E0D8BEA826&amp;_z=z">Lip&oslash;dem - for sundhedsfaglige</a></li>
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]]></Media>
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