Interview with Dr Michele Cazaubon
Hello. Can you introduce yourself please?
Hello, my name is Michèle Cazaubon. I am angiologist, that is to say specialist in vascular diseases … some time! I am cardiologist training. When I started my studies, the Doppler, the functional exploration, saw the day and nobody wanted to put my boss at the Bichat hospital told me “Go Michèle! You have it! “And since we did not leave the Doppler and me!
I am not phlebologist, that is to say that I do not pass the varicose veins but I make the diagnosis of everything that goes: when there are varicose veins, where it goes, where it does not pass, Why there are reflux, why the veins are too big, why they are visible, why they hurt, why they can stop … Ditto for the arteries. My patient is essentially represented by women and especially since I specialized in “big legs” and in the particular lipedem.
Can you tell us more about your work with lipoedema?
So I’m not a “doctor with naked hands”: I have a Doppler ultrasound device that allows me to see inside, see what happens in the legs, to examine the arteries, the veins, The lymphatic vessels, ie the vessels that also participate in the return circulation, and in addition all soft tissues, the subcutaneous tissue in which the vessels circulate. I realized that when women came for big legs, with pains in the legs, blues that appear too easily, varicose veins that increase … and when they were told “the doppler is normal, there is nothing On the arteries and on the veins “they left very happy but on the other hand it was not very satisfying to take charge and propose to improve their situation and possibly use adapted specialists.
That’s why I specialized in the lipoedema which is an adipose cell disease. That is to say, all that is fat. When I say “an illness”: it’s not recognized by WHO for now, it had to be at the beginning of the year but I think they had lots of other problems and they dropped the lipoedema for next year. Anyway it is still a pathology that must be supported in the same way as other muscle pathologies, tendinous, etc.
Can you tell us about the difference between lipoedema and obesity in your opinion? And can you tell us about the percentage among your patients who have this disease? Are your patients well informed? What is the state of mind of your patients when they come to see you?
Before I specialize in the lipoedema, my patient with as many women as men. Now I have a bigger patient of women, practically 99% of my patients who consult for heavy legs are women. The exam begins with an accurate interrogation because you have to know since when these legs have appeared. In general, whether it is the lipedem or cellulite, it appears at the time of puberty. It is aggravated at the time of the great hormonal upheavals, especially during pregnancy or menopause. Most often there are family history: that is, there are big legs of mother in daughter, and in the family all women also have big legs.
It hurts, it gene them. It gene them from aesthetic point of view as we are at a time when it is valued to have big long-free legs it can pose a problem, even social, in work and it can also pose a problem on quality of life, the impression of being treated apart because we have big legs. In short, it is a big problem and it really deserves a care that is the most judicious.
I will not tell them “tomorrow you will have all fines” because it’s not true. In general it is a long-term job, the patient needs to accept certain constraints, for example putting compression socks, do lymphatic drainage, make endermology, and all that with highly competent people. And not go to institute and go under a machine and wait for the result without doing anything. It is really a complete collaboration between the vascular doctor, the patient, of course his doctor treating and possibly the specialist doctor surgeon who will be able to help remove the greasy overload where it is necessary and where it is said to be said. do.
Can you give us more details that, in your opinion, the pathology is transmitted from mother to daughter, there would be a hereditary transmission? Because it is a very recurring question from our patients.
Absoutely. There is work that is made to look for hereditary abnormalities but for now there is nothing that stands out. We sought to know why the fat cells were growing and multiplied as the tumors do but we currently found anything that can suddenly explain what the adipose cells that become too big and too many.
They can multiply extremely quickly?
Extremely quickly and gradually and we have not found a way to curb their evolution. That’s why it’s a little disappointing sometimes because when a patient lost 10 kilos and there is nothing at the legs. I also see patients with morbid obesities, with body mass indices to more than 40. Severe obesities with women over 140 kilograms for 1m70 and they lose half of their weight … and always have big legs. So that’s the first gesture and we’ll have to see what you can do to complete and make them much more suitable.
Do you have things to add?
Yes. I often get better informed patients than some vascular doctors or some generalists who tell them “Good Bah we do not know, there is nothing to do. Play sports and lose weight. “Patients go to the sites, the discussion forums. Some doctors are not interested in lipoedema because there is no treatment really known right now.
Thank you for your testimony.
You can also contact us by phone at 01.45.74.12.25.
You can contact us via the pre-consultation form for an appointment