"Diet Can't Remove It"...The Identity of the 32kg 'Mass' on the Belly

Severe Lymphedema Developed 2 Years Ago Leads to ICU Admission
Health Insurance Classifies Surgery as Cosmetic... Support Denied Notification

A story has emerged about a British man suffering from 32 kg of swelling in his abdomen?equivalent to the weight of a young child?who has not been able to receive proper treatment.

The British daily The Sun introduced the story of Allen Bromyard (48), who lives in Long Eaton, Derbyshire, UK, on the 6th (local time). He has been suffering from lymphoedema causing a lump to form in his abdomen for two years but has not been able to undergo surgery. This is because the UK National Health Service (NHS) classified the lymphoedema removal surgery as cosmetic and rejected funding twice.

While the surgery was delayed, Bromyard’s condition worsened, and in August he developed sepsis, requiring a two-week hospital stay. Six of those days were spent in intensive care. He described his condition at the time, saying, "I almost died. The swelling had descended to my knees and was so bad it needed to be removed." He added, "The lymph fluid lump is 5 liters, and I can’t reduce it through dieting, so what am I supposed to do? It always feels like I’m carrying a dead child. The lymph fluid would leak from the bandages, and there was a time when the bandages I used for a week weighed 80 kg," expressing his pain.

Bromyard, a farmer who has raised cattle, has become unable to care for his cows due to lymphoedema, making it difficult to sustain his livelihood. He said, "I have farmed all my life, but I can no longer work, so I had to sell my cows." Because of his illness, Bromyard must stay in bed and has damaged knees and hips to the extent that simple tasks like climbing stairs or driving have become difficult.

Lymphoedema is swelling caused by an abnormal accumulation of lymph fluid, which plays a role in maintaining the body’s immunity and removing waste. Large lymphoedema cases like Bromyard’s require surgery and a long recovery and rehabilitation process, resulting in high treatment costs. Bromyard found it difficult to bear these costs alone and requested NHS support twice. The NHS can refuse funding for cosmetic or non-essential surgeries. However, despite Bromyard’s serious condition, the NHS regarded the surgery as cosmetic.

Regarding the refusal of Bromyard’s surgery funding request, a spokesperson for the Derby and Derbyshire NHS said, "We cannot comment on individual cases," but added, "Some treatments are generally not provided by the NHS, and if treatment falls outside the scope of existing services, individuals may request private funding." Bromyard is currently preparing a third application for NHS support with his surgeon, general practitioner (GP), and the head of the lymphoedema clinic at Nottingham University Hospital.

Meanwhile, lymphoedema is classified by cause into congenital, primary, and secondary types. Congenital lymphoedema is present from birth. Primary lymphoedema has an unknown cause and mainly occurs in females between childhood and their 30s. Secondary lymphoedema is caused by surgical lymphatic vessel blockage due to malignant tumors, parasites, surgery, and other factors.

In the early stages of lymphoedema, most patients experience pitting edema, where pressing the skin with fingertips leaves an indentation. Later, the skin tissue becomes fibrotic, hardens, and thickens, making the swollen area heavy and uncomfortable, often accompanied by pain. Severe lymphoedema can reduce the mobility of the arms and legs. Treatment should begin as soon as possible after lymphoedema develops. The first approach may be a massage therapy called 'manual lymphatic drainage' to help drain lymph fluid, along with conservative treatments such as compression therapy and exercise. Patients who do not see satisfactory results after more than a year of these treatments may consider surgery.