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Dercum's Disease- Nodular lipomatosis type III
I have a extremily rare orphan disease called Dercum's Disease. Is there any doctor on this site familiar with this disease or has treated anyone with Drcum's? I have type III nodular lipomatosis. many doctors are not aware that the disease exists and patients are often treated poorly, and never diagnosed . It is extremily painful, the disease in a majority of patients causes disability. It is slowly progressive . the type of disease I have can occur in non-obese patients, or patients that are slightly overweight can become obese. there is no cure or treatment for this disease. any advanced treatment are happening in sweden, and UK. one is IV lidocaine therapy which non of the doctors I know use this treatment even those it is considered the best treatment out so far. I guess I am looking for anyone who knows or has treated any patient or if they know of doctors in or around Boston,mass that treat Dercum's.
jhewels I hope I hear from someone
jhewels I hope I hear from someone
I wanted to respond to Dr. Santos, regarding the "side effect" she mentioned about the repeated intravenous lidocaine infusions. I'd like to know what side effects you're referring to.
Also, regarding the cortisone injections, I wanted to mention that it's extremely important that people consult the latest research regarding Dercum's Disease before they inject cortisone or use any other steroid hormones! A lot of the latest research has indicated that the use of steroids in patients with Dercum's Disease, even when used locally, can actually cause the growth rate of the mutated fat cells to explode, suddenly leading to the faster development of diffuse mutated fatty tissue, as well as an increase in the formation of painful fatty lipomas. So please, before considering the use of steroids in any way whatsoever, please have your doctor do a complete check in PubMed for the latest articles. Yes, the Brorson Fagher article is a great resource, but it's still over ten years old. But even they talk about lidocaine infusions as being beneficial under the right circumstances, and if I remember correctly, warn against the use of steroids.
Also, regarding the cortisone injections, I wanted to mention that it's extremely important that people consult the latest research regarding Dercum's Disease before they inject cortisone or use any other steroid hormones! A lot of the latest research has indicated that the use of steroids in patients with Dercum's Disease, even when used locally, can actually cause the growth rate of the mutated fat cells to explode, suddenly leading to the faster development of diffuse mutated fatty tissue, as well as an increase in the formation of painful fatty lipomas. So please, before considering the use of steroids in any way whatsoever, please have your doctor do a complete check in PubMed for the latest articles. Yes, the Brorson Fagher article is a great resource, but it's still over ten years old. But even they talk about lidocaine infusions as being beneficial under the right circumstances, and if I remember correctly, warn against the use of steroids.
MEDICAL PROFESSIONAL
Hi,
How are you? First of all, I commend you for your active role on The Dercum Society and the website. I am not an expert on this rare condition. But like you, I am here trying to help. I read about the article of Drs Brorson and Fagher, and appreciated it despite being more than a decade old. Because of its wealth of information and simplicity, I wanted to share it to others who may also want to understand Dercum's Disease more. I also know that intravenous lidocaine injections or infusions are usually indicated for the treatment of ventricular tachycardia and requires constant ECG and blood pressure monitoring. Like any other medicines, it can also have possible side effects which are usually dose-related and caused by rapid absorption, from hypersensitivity, or diminished tolerance of the patient. Systemic reactions including CNS manifestations (paresthesia, confusion, dizziness, drowsiness,etc); cardiovascular ( bradycardia, hypotension and cardiovascular collapse which may lead to cardiac arrest) and allergic reactions can be expected. Also, lidocaine should be used with caution in patients with bradycardia, those with first or second degree heart block, and severe liver or renal disease. Cortisone injection may be used sometimes because of its effectiveness to some but not necessarily mean the choice of management. It is always recommended (and due to limitations of the internet) that patients seek their primary physicians to discuss the best management plan suited for them. Take care and do keep us posted.
How are you? First of all, I commend you for your active role on The Dercum Society and the website. I am not an expert on this rare condition. But like you, I am here trying to help. I read about the article of Drs Brorson and Fagher, and appreciated it despite being more than a decade old. Because of its wealth of information and simplicity, I wanted to share it to others who may also want to understand Dercum's Disease more. I also know that intravenous lidocaine injections or infusions are usually indicated for the treatment of ventricular tachycardia and requires constant ECG and blood pressure monitoring. Like any other medicines, it can also have possible side effects which are usually dose-related and caused by rapid absorption, from hypersensitivity, or diminished tolerance of the patient. Systemic reactions including CNS manifestations (paresthesia, confusion, dizziness, drowsiness,etc); cardiovascular ( bradycardia, hypotension and cardiovascular collapse which may lead to cardiac arrest) and allergic reactions can be expected. Also, lidocaine should be used with caution in patients with bradycardia, those with first or second degree heart block, and severe liver or renal disease. Cortisone injection may be used sometimes because of its effectiveness to some but not necessarily mean the choice of management. It is always recommended (and due to limitations of the internet) that patients seek their primary physicians to discuss the best management plan suited for them. Take care and do keep us posted.
Thank you very much for writing back in such detail. My point in asking about the lidocaine is that, of course every medication administered is going to have side effects. My concern was, the way you first mentioned lidocaine sounded so disparaging. I was concerned that without giving further detail about your concerns about lidocaine, it might sound to an average person like taking lidocaine under any circumstances could be potentially lethal.
The fact is, it's not. In most cases, under the proper monitoring, lidocaine can be quite useful and helpful for people with Dercum's Disease. And not to mention, it can be perfectly safe. So my concern was, the way your first post was written, I was worried that some people might not even ask their doctor about it at all because of how serious your post sounded.
Now that you've very kindly listed the concerns you had, my hope is that now people can take that information to their doctors and consider whether lidocaine infusions might be right for them, with all the proper monitoring and everything.
I've personally had lidocaine infusions before; I used to have them once a month under the care and supervision of an anesthesiologist/pain management specialist. I don't have any of the potential complicating conditions you listed and the very first infusion was done while I was admitted to the hospital. After that, I would have the infusions at the anesthesiologist's office when I went in once a month to get my pain medication prescriptions. The infusion was quite simple and proved to be quite helpful. The lidocaine would be infused over a 30 to 40 minute period, with my blood pressure monitored every ten minutes before, during, and after the infusion.
The only side effects I encountered was feeling a bit, well, drunk for a little while afterward. Of course, sometimes in the beginning some side effects can be worse while you're trying to figure out your body's limit for how much lidocaine can be infused at one time and the proper speed at which to infuse it. Early on, I did have an incident where I started to "snow", where it's almost like you're mildly sedated for surgery. But that was easily corrected by just turning off the infusion, continuing to monitor my blood pressure, and waiting a while to make sure everything was alright. Soon enough, I was fine.
The nice thing for me about the lidocaine infusion, is that it gave me a break from the pain. Sure, like you said, that break from the pain was temporary, but it was still enormously important to me.
Because of the Dercum's Disease, I can't remember a single day in my entire life where I haven't felt some sort of pain. That's a lot of stress for the body to handle and has led to a lot of complicating problems just from the sheer level of inflammation my body has had to deal with. Even though, as you said, the pain relief from the lidocaine infusion is rather short-lived - I only saw any sort of direct pain-relieving benefit for a day or two - those were the only days in my entire life where I was at all pain free. So for me, even just a day without pain made it worthwhile.
On top of just the relief of being able to live for a day or two without pain, I did start to see a cumulative effect from having these infusions done on a regular basis. I know this doesn't sound very scientific, but after having so much pain for so long, it's almost like my body, my mind, and my soul were getting buried in a barrage of white noise. It was like my nerves had been screaming at me so loudly for so long, that I couldn't hear anything else but pain, pain, pain. Everything else was just getting lost in this sensory overload. And because of that, I was always just trying to play catch up. I was always just trying to claw my way out from under this mountain of pain, both past and present.
Having those lidocaine infusions was almost a way to just reset my nerves. It calmed everything down just long enough for my body to kind of clear out all the pain that had come before and just start over. Because of that, I no longer felt like I was trying to claw my way out from under a mountain of pain. I could finally get ahead of the pain, rather than trying to constantly catch up from behind.
I know that might not make much sense, but it made enough of a difference that after having these lidocaine infusions once a month for a few months, it allowed my doctor to lower my narcotic dosage. When dealing with chronic pain, anything that can be done to lower narcotic dosage is potentially life-saving. Anyone that's suffering through chronic pain, anyone who's facing a lifetime of narcotic use to treat that pain, anything such a person can do to keep that narcotic dose as low as possible is worthwhile. So even though the pain relief from the lidocaine infusion itself was relatively short, having it done regularly did produce positive long-term results in my case. And I've read multiple case studies published in respected medical journals to know that I'm not alone; lots of patients suffering from Dercum's Disease have seen documented, proven improvement from similar treatment plans involving regular lidocaine infusions.
So all I was trying to say was, yes, like any other medication, lidocaine infusions will have side effects and complications. But I wanted to make sure that those complications and side effects were properly explained, rather than just left hanging. Because when someone who doesn't understand medical terminology hears that something *might* be dangerous, or *might* have side effects, that can often discourage them from ever even asking their doctor about it. "Might" suddenly carries such weight, and when the "maybes" aren't properly explained, things can end up sounding so much more definite and so much scarier than they really are.
The reality is, someone who's reading this might not even have any of the complicating factors that you listed. They might be a perfect candidate for lidocaine infusions, or they might not, but they'll never know if they don't ask their doctors and find out for themselves. I just wanted to make sure that the information was out there, so that people who are suffering like I was would have the information necessary to take it to their doctor and perhaps get some help from it like I did.
(Had to split this in half, since it went over the character limit...)
The fact is, it's not. In most cases, under the proper monitoring, lidocaine can be quite useful and helpful for people with Dercum's Disease. And not to mention, it can be perfectly safe. So my concern was, the way your first post was written, I was worried that some people might not even ask their doctor about it at all because of how serious your post sounded.
Now that you've very kindly listed the concerns you had, my hope is that now people can take that information to their doctors and consider whether lidocaine infusions might be right for them, with all the proper monitoring and everything.
I've personally had lidocaine infusions before; I used to have them once a month under the care and supervision of an anesthesiologist/pain management specialist. I don't have any of the potential complicating conditions you listed and the very first infusion was done while I was admitted to the hospital. After that, I would have the infusions at the anesthesiologist's office when I went in once a month to get my pain medication prescriptions. The infusion was quite simple and proved to be quite helpful. The lidocaine would be infused over a 30 to 40 minute period, with my blood pressure monitored every ten minutes before, during, and after the infusion.
The only side effects I encountered was feeling a bit, well, drunk for a little while afterward. Of course, sometimes in the beginning some side effects can be worse while you're trying to figure out your body's limit for how much lidocaine can be infused at one time and the proper speed at which to infuse it. Early on, I did have an incident where I started to "snow", where it's almost like you're mildly sedated for surgery. But that was easily corrected by just turning off the infusion, continuing to monitor my blood pressure, and waiting a while to make sure everything was alright. Soon enough, I was fine.
The nice thing for me about the lidocaine infusion, is that it gave me a break from the pain. Sure, like you said, that break from the pain was temporary, but it was still enormously important to me.
Because of the Dercum's Disease, I can't remember a single day in my entire life where I haven't felt some sort of pain. That's a lot of stress for the body to handle and has led to a lot of complicating problems just from the sheer level of inflammation my body has had to deal with. Even though, as you said, the pain relief from the lidocaine infusion is rather short-lived - I only saw any sort of direct pain-relieving benefit for a day or two - those were the only days in my entire life where I was at all pain free. So for me, even just a day without pain made it worthwhile.
On top of just the relief of being able to live for a day or two without pain, I did start to see a cumulative effect from having these infusions done on a regular basis. I know this doesn't sound very scientific, but after having so much pain for so long, it's almost like my body, my mind, and my soul were getting buried in a barrage of white noise. It was like my nerves had been screaming at me so loudly for so long, that I couldn't hear anything else but pain, pain, pain. Everything else was just getting lost in this sensory overload. And because of that, I was always just trying to play catch up. I was always just trying to claw my way out from under this mountain of pain, both past and present.
Having those lidocaine infusions was almost a way to just reset my nerves. It calmed everything down just long enough for my body to kind of clear out all the pain that had come before and just start over. Because of that, I no longer felt like I was trying to claw my way out from under a mountain of pain. I could finally get ahead of the pain, rather than trying to constantly catch up from behind.
I know that might not make much sense, but it made enough of a difference that after having these lidocaine infusions once a month for a few months, it allowed my doctor to lower my narcotic dosage. When dealing with chronic pain, anything that can be done to lower narcotic dosage is potentially life-saving. Anyone that's suffering through chronic pain, anyone who's facing a lifetime of narcotic use to treat that pain, anything such a person can do to keep that narcotic dose as low as possible is worthwhile. So even though the pain relief from the lidocaine infusion itself was relatively short, having it done regularly did produce positive long-term results in my case. And I've read multiple case studies published in respected medical journals to know that I'm not alone; lots of patients suffering from Dercum's Disease have seen documented, proven improvement from similar treatment plans involving regular lidocaine infusions.
So all I was trying to say was, yes, like any other medication, lidocaine infusions will have side effects and complications. But I wanted to make sure that those complications and side effects were properly explained, rather than just left hanging. Because when someone who doesn't understand medical terminology hears that something *might* be dangerous, or *might* have side effects, that can often discourage them from ever even asking their doctor about it. "Might" suddenly carries such weight, and when the "maybes" aren't properly explained, things can end up sounding so much more definite and so much scarier than they really are.
The reality is, someone who's reading this might not even have any of the complicating factors that you listed. They might be a perfect candidate for lidocaine infusions, or they might not, but they'll never know if they don't ask their doctors and find out for themselves. I just wanted to make sure that the information was out there, so that people who are suffering like I was would have the information necessary to take it to their doctor and perhaps get some help from it like I did.
(Had to split this in half, since it went over the character limit...)
(Now for the second half of my post... Sorry it got so long! So much to say.) :)
As for Dr. Brorson and Dr Fagher's article, I didn't mean to disparage their work in any way whatsoever. I owe a LOT to Dr. Brorson especially, since he was instrumental in the creation of my website, which you mentioned. Even though I wrote all of the text on the website myself, it was all based on Dr. Brorson's work; I was just trying to translate the medical-speak into layman's terms. And before I ever published any of it, he went through everything I wrote, line by line, to make sure it was all medically and scientifically accurate. So without him, without his research, without his help, my website wouldn't exist today.
But the fact still remains that yes, his article is getting older. More case studies, surveys, and research has been done since, and because of that, our understanding of Dercum's Disease has grown. One piece of that understanding involves the adverse effects that the use of steroids has on the mutated fat cells inherent to Dercum's Disease. Which is why, when you advocated the use of cortisone, I wanted to bring that up. So much of the recent research points to steroids increasing the rate of cellular growth and mutation, and thus, an increase in the exponential growth rate of diffuse painful fatty tissue, as well as the formation of painful fatty lipomas. That's a huge risk, since that's the very root of the problem inherent in Dercum's Disease. After all, what's the point of using cortisone to treat the pain, when all the recent research points to the idea that it could very well end up making the root of that pain worse?
I've personally seen in my own life the harm that can be caused when using steroids of any form in a person suffering from Dercum's Disease. A few years ago I had my tonsils out and after the surgery, my throat started to swell to such a point I was having difficulty breathing. My doctor tried everything he could, but nothing was working and my breathing was getting worse. He had no other choice but to administer steroids so that I could breathe, but he administered it with the full understanding of the risks that steroids cause to patients with Dercums Disease. Because he understood that, he used as small of a dose as possible to allow me to breathe.
But even still, I've suffered years of set backs because of it. Sure, he had no other choice, he had to use steroids. I understand that and I don't blame him at all. But the reality is, steroids caused a whole host of problems, from an increase in the growth rate of my diffuse mutated fat, as well as a huge exponential increase in the growth and development of painful lipomas. I've never had much of a problem with lipomas; up until that point, I was dealing with the type of Dercums Disease where it's mostly just the diffuse painful fatty tissue. But ever since my doctor administered those steroids, suddenly I'm finding lipomas everywhere.
So like I said in the beginning, any medication is going to have risks. Any surgery is going to have risks. Anything you do in life, medical or otherwise, has risks. But it's important to understand those risks and weigh your actions accordingly. After my own experience, after all the research I've read, after everything I've seen, using any form of steroids on a patient with Dercum's Disease is an unacceptable risk, in my opinion. Unless, of course, you have no other option, as my doctor did. But even still, my doctor altered the typical indicated dosage of steroids in that instance, because he knew of the risks and altered his plan accordingly, in order to keep me safe.
It's all about weighing risk and benefit. So please, anything anyone reads on this forum or anywhere online, don't take our word as gospel. Don't take anyone's word as absolute gospel. And if anyone claims to be an absolute, end-all-be-all expert, question their motives. No one has absolute authority on anything, because no one person can know everything there is to know. Make sure that whatever you read, before you decide on anything, make sure that your doctor looks for the most recent research on Dercum's Disease available through PubMed (your doctor will know what that is if you're unfamiliar with it.) Make sure you talk to as many people as possible to gain as much information as possible. Between you and your doctor, weigh all the risks and benefits, then decide for yourself. Only you know your own body. My experience may be totally different from yours, Dr. Santos' experience may be totally different from yours. You know yourself best. Your doctor knows you better than we do. All you can do is take as much information as possible, share it with your doctor, encourage your doctor to do research of their own, and then proceed carefully, cautiously, prayerfully, and intelligently. That's all anyone can do, all anyone can ask for. Especially when dealing with a condition as rare, confusing, and complicated as Dercum's Disease.
As for Dr. Brorson and Dr Fagher's article, I didn't mean to disparage their work in any way whatsoever. I owe a LOT to Dr. Brorson especially, since he was instrumental in the creation of my website, which you mentioned. Even though I wrote all of the text on the website myself, it was all based on Dr. Brorson's work; I was just trying to translate the medical-speak into layman's terms. And before I ever published any of it, he went through everything I wrote, line by line, to make sure it was all medically and scientifically accurate. So without him, without his research, without his help, my website wouldn't exist today.
But the fact still remains that yes, his article is getting older. More case studies, surveys, and research has been done since, and because of that, our understanding of Dercum's Disease has grown. One piece of that understanding involves the adverse effects that the use of steroids has on the mutated fat cells inherent to Dercum's Disease. Which is why, when you advocated the use of cortisone, I wanted to bring that up. So much of the recent research points to steroids increasing the rate of cellular growth and mutation, and thus, an increase in the exponential growth rate of diffuse painful fatty tissue, as well as the formation of painful fatty lipomas. That's a huge risk, since that's the very root of the problem inherent in Dercum's Disease. After all, what's the point of using cortisone to treat the pain, when all the recent research points to the idea that it could very well end up making the root of that pain worse?
I've personally seen in my own life the harm that can be caused when using steroids of any form in a person suffering from Dercum's Disease. A few years ago I had my tonsils out and after the surgery, my throat started to swell to such a point I was having difficulty breathing. My doctor tried everything he could, but nothing was working and my breathing was getting worse. He had no other choice but to administer steroids so that I could breathe, but he administered it with the full understanding of the risks that steroids cause to patients with Dercums Disease. Because he understood that, he used as small of a dose as possible to allow me to breathe.
But even still, I've suffered years of set backs because of it. Sure, he had no other choice, he had to use steroids. I understand that and I don't blame him at all. But the reality is, steroids caused a whole host of problems, from an increase in the growth rate of my diffuse mutated fat, as well as a huge exponential increase in the growth and development of painful lipomas. I've never had much of a problem with lipomas; up until that point, I was dealing with the type of Dercums Disease where it's mostly just the diffuse painful fatty tissue. But ever since my doctor administered those steroids, suddenly I'm finding lipomas everywhere.
So like I said in the beginning, any medication is going to have risks. Any surgery is going to have risks. Anything you do in life, medical or otherwise, has risks. But it's important to understand those risks and weigh your actions accordingly. After my own experience, after all the research I've read, after everything I've seen, using any form of steroids on a patient with Dercum's Disease is an unacceptable risk, in my opinion. Unless, of course, you have no other option, as my doctor did. But even still, my doctor altered the typical indicated dosage of steroids in that instance, because he knew of the risks and altered his plan accordingly, in order to keep me safe.
It's all about weighing risk and benefit. So please, anything anyone reads on this forum or anywhere online, don't take our word as gospel. Don't take anyone's word as absolute gospel. And if anyone claims to be an absolute, end-all-be-all expert, question their motives. No one has absolute authority on anything, because no one person can know everything there is to know. Make sure that whatever you read, before you decide on anything, make sure that your doctor looks for the most recent research on Dercum's Disease available through PubMed (your doctor will know what that is if you're unfamiliar with it.) Make sure you talk to as many people as possible to gain as much information as possible. Between you and your doctor, weigh all the risks and benefits, then decide for yourself. Only you know your own body. My experience may be totally different from yours, Dr. Santos' experience may be totally different from yours. You know yourself best. Your doctor knows you better than we do. All you can do is take as much information as possible, share it with your doctor, encourage your doctor to do research of their own, and then proceed carefully, cautiously, prayerfully, and intelligently. That's all anyone can do, all anyone can ask for. Especially when dealing with a condition as rare, confusing, and complicated as Dercum's Disease.
Hello everyone.. I wrote here in the past and was wondering..I have lipomas /lumps all over now all different shapes and sizes...clusters of small hard pealike ones,, larger doughy moveable ones..along w/ hard ropelike fatty areas .. along with sooo many other issues? symptoms that i wonder if its all ONE BIG ISSUE or more than one thing going on at once....hard to say...each Dr. has its own theory..and NONE know about Dercums.! So.... my questions are.... 1) would it make sense if some pains and symptoms started before ever feeling lumps anywhere for it to be dercums? 2).. what if i have tons of pain constantly but not necessarily to touch the lumps/lipomas? would that still make sense dercums? some lipomas do hurt to touch but mostly i just get pain inthe "area" i have them...ex.. have tons on my ribs and abdomen.. but only a few hurt to touch (also..they dont stick out..cant see them but can feel them .. grow inward ) but i get alot of pain it seems INSIDE my abdomen or feel like the pain comes from inside the ribs.. does that make sense.. does anyone seem to have enlarged lymph nodes with this ? or any changes or lumps in their breasts? lastly..what imaging out there actually shows the lipomas? they seem to blend with reg. fatty tissues... havent shown up on ultrasounds or mri yet...?thanks . sorry to bombard you all with so many questions.. it seems people with this are the only ones with any info on this disease. thanks .. be well! nicole
Looking for a Dr to discuss the possibility of dercums disease myself. Im in upstate New York but willing to travel if need be. My acupuncturist was the one who mentioned that I had numerous lipomas on my back, hip and leg and when I started researching lipomas this really seems to fit me perfectly. Any help is really appreciated.
Thanks.
:)
Thanks.
:)
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