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The cornerstone of management is decongestive lymphatic therapy (DLT) , which comprises four main components: Manual lymphatic drainage (MLD) : A specialised massage technique that stimulates lymphatic flow and redirects fluid to functioning lymphatic pathways Compression therapy : Multi-layer bandaging during intensive treatment phases, followed by compression garments for long-term maintenance Skin care : Meticulous hygiene, emollient use, and prompt treatment of skin breaks to prevent cellulitis Exercise : Tailored physical activity programmes that promote lymphatic drainage through muscle pump action whilst wearing compression Patients should be educated about self-management strategies , including daily skin inspection, appropriate exercise, limb elevation when resting, and recognition of cellulitis symptoms (increased warmth, redness, pain, or systemic features such as fever)

Weigh yourself daily for 4 weeks at your current dose

They do not predict response to a specific medication, but they describe the biology a clinician is prescribing into, context a prescription alone never captures

In some cases, combination treatments can help lower spironolactone doses while improving results

My medication arrived properly in cold-chain packaging, an insulated foam box with non-sweat ice packs