What is lymphedema?
It is an abnormal buildup of fluid that causes swelling most often in the arms or legs. It develops when lymph vessels or nodes are missing, impaired, damaged or removed.
Primary lymphedema is rare and is caused by the absence of certain lymph vessels at birth, or there are abnormalities in the lymphatic vessels from birth.
Secondary lymphedema occurs from blockage or interruption that alters the flow of lymph through the lymphatic system and can develop from an infection, cancer, surgery, scar tissue formation, trauma, deep vein thrombosis, radiation, or other cancer treatment.
What is recommended for treatment?
Compression wraps, sequential pressure pump systems, complete decongestive therapy, and maintaining optimal body weight.
Treatment where benefits are balanced with risks: prophylactic antibiotics for recurrent infections.
Effectiveness not established: hyperbaric oxygen therapy.
Not recommended: Drug therapy such as diuretics.
How long will it take to heal my ulcer?
It is difficult to give a simple answer to this question due to the many factors that affect a chronic ulcer. We need to determine the etiology (reason) for the ulcer. How long has it been present? The longer an ulcer has been present, the longer it usually takes to heal. The size of the ulcer? The larger it is, the longer it will take to heal. Other medical co-existing problems (comorbidities)? Conditions that usually take a longer time for a chronic ulcer to heal include diabetes that isn't well controlled, medications such as steroids and immunosuppressive medications, chemotherapeutic medications, radiation therapy, the elderly, nutrition, and one of the most important is the compliance of the patient.
We will use the most appropriate, evidence-based wound care products to achieve healing in as timely a manner as possible.
Does Dr. Millington still take family practice patients?
Unfortunately the volume of wound care patients that are seen daily in the office prohibit the ability to also be seeing family practice patients. We don't have enough exam rooms for both practices, and we also don't have equipment needed for family practice. Finally I can't be taking call 7 days a week for family practice and wound care. There would be no one with whom to share call.
Can I have my child with autism treated at your hyperbaric chamber?
I only work with hospital based hyperbaric chambers that only treat the 14 conditions allowed by the government, which does not include autism, C.P., Traumatic Brain Injury, Old strokes, etc. These conditions are considered "off-label." which means that there isn't enough literature yet for insurance companies and Medicare to allow them to be treated as approved conditions. They may respond and improve with hyperbaric oxygen, but there isn't enough data in to be able to predict good result most of the time. This also means that there is no insurance reimbursement for them
There are free standing clinics who have chambers and do treat the "off-label" conditions. They will usually negotiate a price per treatment that is agreed upon by both parties. I can refer you to one of several clinics who will treat the "off-label" conditions.
What is diving medicine?
Dr. Millington is not only an avid scuba diver and underwater photographer, but also has been certified by NOAA for the past 26 years as a diving medicine specialist. He is the diving medicine physician for several commercial diving companies, and is the diving medical director for both the College of Oceaneering and the Marine Tech Dept of Santa Barbara City College. He is a member of the Dive Board at Santa Barbara City College. He performs scuba physicals for the divers of the National Park Service and of course any sports divers who need a diving physical. He is also available to evaluate divers who may have a particular medical problem related to diving.
Why does my ulcer hurt so much?
Unfortunately many chronic wounds can be painful. Ulcers due to poor arterial blood supply are painful due to lack of oxygen to the wound and surrounding tissue. Ulcers that are due to an immune problem (the body making antibodies against the skin itself) are classically extremely painful. Even ulcers from poor venous drainage can be very painful.
Part of good wound care consists in the evaluation and treatment of the associated pain. If untreated, pain causes increased adrenalin secretion, which can cause blood vessels to constrict, which adversely affects the wound that we are trying to heal. A good wound program will treat the pain either in the clinic itself or by consulting pain specialists. Fortunately once the ulcer has healed, the pain will almost always disappear.