Dr. Sarah Stombaugh:
This is Dr. Sarah Stombaugh, and you are listening to the Conquer Your Weight Podcast.

Announcer:
Welcome to the Conquer Your Weight Podcast, where you will learn to understand your mind and body so you can achieve long-term weight loss. Here’s your host, obesity medicine physician and life coach, Dr. Sarah Stombaugh.

Dr. Sarah Stombaugh:
Hello everyone, and welcome to this week’s episode of the Conquer Your Weight Podcast. I am really excited today to bring on a guest with me. This is Lili Gill. She is a massage therapist and a certified lymphedema therapist, and she is local to me in Charlottesville, Virginia. We were connected probably over the last year or so as I’ve been learning more about lipedema, treating my patients with lipedema. You did hear me say, of course, lymphedema, which is which is what she is in terms of her certification. And we’ll talk about the crossover between some of these conditions. So I’m really excited for us today to talk about the condition of lipedema. And Lili, thank you so much for joining us for today’s episode. Thank you for having me, Sarah.

Lili Gill:
I’m really excited to be here.

Dr. Sarah Stombaugh:
This is great. So tell me a little bit about yourself, your background, and how you came to be area interested in this area of lymphedema and lipedema care.

Lili Gill:
Well, it’s been a circuitous route for sure. I started my life as a concert pianist and I had a master’s and was working in universities accompanying students, and I got to be about 28 years old and started to question things in my life. Am I going to spend my whole life practicing piano and working in a cubicle with other students and performing for unfortunately too small audiences? And I just felt this nagging calling that I had something more to give to the world, and I really wanted to do something of service to people, and I was very interested in alternative health and always used alternative health methods to to keep my own health stable and optimal. And so along the way I got into herbalism and in searching for more classes to learn about herbs, I came across a website for massage school, and it was like the light bulbs went off. I had never thought of massage, I thought of it as a luxury item at that time. This is 1999. I was in a library because the internet was barely out. And so I was looking, and the more I read about a massage school, I thought these are things I am so personally interested in and invested in. And I do yoga and meditate. And so I went to the open house and just learning about the human body was something that just really spoke to me. And I knew that I had the gift of having developed incredible touch sensitivity in my fingers from all the years of piano playing. That when I started learning massage, I was amazed at how much I could feel in the tissues. And the school I went to was fascinating because it’s one of the, I think, the only programs in the country where you actually learn lymphatic drainage as part of your basic program. And lymphatic drainage was the very first modality I learned. So my first introduction to body work was feeling the fluids and what it felt like between the skin and the muscles and developing a very sensitive touch. Later I went on to become a deep tissue therapist because that’s what everybody wanted.

And unfortunately, during that, my first probably 15 years as a massage therapist, I saw maybe one lymphatic drainage client every month or two months. It wasn’t very well known and it wasn’t very recommended. But I’ve seen the shift also happen throughout my career, where the last five, seven years of my career, I was getting more and more referrals from doctors for lymphatic drainage. And I started to notice that I was limited because I only knew how to do the basic lymphatic drainage for people who had no severe comorbidities, no severe medical conditions, and had all their lymph nodes. And so just at the same time that my body was starting to talk to me and tell me stop doing deep tissue work, I sat there and thought, well, what else can I do with my hands that could really make a strong impact and really help people? And I knew right away that it was lymphatic drainage.

So I went and got training at Monarch Education in Blacksburg with Carmen Recupero and learned all about lymphedema and bandaging, measuring, helping people get compression garments, and I learned I took an extra course on oncology so that I could work with people who had lymph nodes removed and learned how to rewrote reroute lymph and specific garments for specific issues with oncology. And lymphedema was definitely a part of that training and mentioned. And one of my teachers there, Susan Isaacs, was amazing, and she talked about lipedema some, but she developed later a course specifically for lipedema, which I had the pleasure of being able to take last spring, and learned much more in-depth detail about the condition. So that’s what brought me here. Mostly my clients, the need and the feeling of actually being able to make a difference and help them get on a path to recovery or maintenance.

Dr. Sarah Stombaugh:
Oh, that’s amazing. And I love thank you for sharing even back to your concert, you know, concert piano days. I can see exactly how you described it, where that light touch or understanding the differences of a light or more firmer touch and how that translates from piano playing to the human body. What a really neat connection there. I absolutely love that.

Lili Gill:
I used to have clients who said, I think you’re playing the piano on my body.

Dr. Sarah Stombaugh:
I’m actually, I so as an adult, I’m in piano lessons right now. Um, I’d taken them for a couple of years as a child. And now my children are taking lessons, and I decided, you know what? I want to take it as well. And so it’s fun for me to think about that. And when we think about the type of massage that would be used in lymphedema or in lipedema, generally we are talking about a lighter touch because you’re not, you know, hammering in there to get those muscles as you’re really describing for that deep tissue. It’s a much more much more gentle. So I’m curious, because you talk about the shifting of tides, as we’re understanding more about lymphedema as a condition where people experience swelling for a lot of reasons. That can be because of an injury, because of a surgery, because of venous disease, maybe they’ve had blood clots or problems otherwise with their veins, that they’re not functioning properly. Of course, as you describe in the cancer oncology world, especially for patients who’ve had lymph nodes removed, and so working to help to reroute that. And a lot of these principles apply as we think about the treatment of lipedema, which is this abnormal fat mass accumulation. And I feel like really just in the last couple of years, there’s been conversation about lipedema as a medical condition. I’d be curious from your perspective, both in terms of the clients that you see, people coming in, the conversations that you’re hearing around it. Tell me about what that looks like. I guess with people coming in, if they’re asking about it, if you’re diagnosing lipedema unbeknownst to people as you’re doing massage for them. Tell me a little bit about that piece of it.

Lili Gill:
Sure. Yeah, I actually wanted to share that. I got inspired to work more with lipedema because of my clients, because they would come in. And I’ve had a couple of clients come in and educate me more about it. Uh, it was amazing. Some of them would talk to me about all of the resources that are out there, and that’s what got me spurred to take the class. Um, and they would tell their experience. And there’s nothing like hearing somebody’s experience of a condition, of being able to tell you where they’re experiencing pain, how it manifests, what time of day, what just makes it better. Just also when I’m working on them to see with the light touch, as someone who’s used to doing deep tissue, I know for years I would do lymphatic drainage, and still am amazed at that how powerful the light touch can be, and how sometimes I’ll be working on someone and wondering in my head, is this really helping? And then they get up and describe to them how much lighter they feel, how much more movement, how much more freedom. And so I can see the strong connection between the lymph, moving lymph, and the condition of lipedema.

And with lipedema, as opposed to lymphedema, where I tend to stay more focused on lymphatic work with a little bit of fibrotic scar tissue management or fibrotic management in certain small areas. With lipedema, I find myself doing a little more of a combination of the two because there seems to be more areas, depending on the degree of their lip edema. I find often more areas that call for a little bit more myofascial style work. again, it’s a gentle kind of fibrotic management that I do that is both for my training and using my intuition and just talking to the tissues and feeling it. So there’s a very interesting kind of intuition and sensing, feeling the tissue and feeling the quality of the tissue under my fingers as I’m working and moving the fluid in the direction it needs to go, that I can feel with lipedema in a way more strongly than with lymphedema.

Dr. Sarah Stombaugh:
Well, that makes sense. And I, you know, to take it back and even thinking about this as a lip edema as a definition, I guess I kind of jumped right over that. We’ve talked about it on the podcast before. But when we think about lipedema, it’s this abnormal fat mass accumulation, right? And we see it predominantly in the lower limbs. People, there’s different distributions where people may have it very commonly, we see it in the thighs, we may see it in the buttocks or hip area. Some women do also have it in their lower legs, so in their calves. And then some people do also have it in their upper arms. And commonly you hear it described as these nodules of fat. And I’m sure that’s exactly what it feels like from your perspective. And sometimes, like a bag of grapes or a bag of peas or a bag of marbles, and you can feel that underneath the surface. And I think one of the biggest challenges is that this is different than typical obesity. You know, this is an abnormal fat mass accumulation that’s resistant to diet and exercise changes alone. Sometimes what I see in my practice is that there’s patients for whom their lipedema has almost been masked by other obesity that they’re struggling with. And then as they’re losing weight, it becomes more and more obvious that there’s areas that are more resistant to weight, and we start to be more clear that there may be these abnormal fat mass accumulations. They see these nodules. Um, tell me when a patient comes in and is dealing with that, what kind of language are you hearing them describe their body, describe maybe pains or sensitivities, the way it feels for them. What kind of things are you hearing from their standpoint?

Lili Gill:
Well, the most common is a feeling of heaviness, a heaviness in the limbs, in the legs, sometimes the arms are involved. But that’s the most common. And sometimes they describe that they felt the heaviness even before it manifested. And typically it manifests after a big hormonal change. Sometimes it happens in pure puberty, um, sometimes it’s not until pregnancy or menopause. But I’ve also seen clients where it happens after an accident, some kind of severe accident, where they are for a period of time immobile and their whole kind of lifestyle shifts, and suddenly there’s that causes the hormonal imbalance and they start to accumulate weight distributed in exactly the areas you were talking about, usually the thighs and hip areas. But that heaviness is something that’s prevalent. Pain is another thing that is very common, is not doesn’t have to be, not everyone has pain, but it is pretty common, and it can be everything from just touch sensitivity, like it hurts when somebody touches me, or if I even press my thighs too hard, to just severe chronic pain where they’re feeling it even just laying on the table, they say I can feel pain and tenderness. So, of course, I have to adjust my pressure accordingly, but that pain is something, and that sensitivity is something that I find with manual therapy or with some kind of vibration therapy can be lessened and reduced quite a bit. Um, and other things are just general fatigue. If they’re carrying around a lot of extra weight, there’s a the level of fatigue is greater, joint pain is very common in either knees or hips, uh, a lot of joint issues and easy bruising, unfortunately. And trying to think what else. Yeah, that’s some I’ll see if it comes to me later.

Dr. Sarah Stombaugh:
Yeah, I mean, I think that really covers some of the main things, at least that I’m aware of as well. I’m sure there’s other nuances that that patients may experience. Tell me if a patient comes in and they’re concerned about lipedema, maybe they have a formal diagnosis, or even if they don’t and you’re doing a manual drainage, a manual therapy and a drainage session with them, what is that, what does a typical session look like? I understand it may be variable, but give me some examples of what that could look like for patients.

Lili Gill:
Sure. Yeah, depending on where they are in their journey. I have clients obviously who come to me who don’t even know about it, in which case I, as a massage therapist, can’t diagnose them, but I will tell them your appearance may be a sign of the condition of lipedema, and this is something to bring up with your doctor. but if they come into me already knowing or having the diagnosis, then I can talk to them about compression therapy and the manual therapy we do. We also talk about lifestyle management at home. And so a typical session comes after they fill out their intake. We talk about everything from their history to how they’ve been managing the issues that are most prevalent for them so far. And then I will, depending on whether or not they are there for compression therapy, if they are, then I will do some measuring. Sometimes I’ll do measuring before and after to see if there’s a shift during the session. If not, then I’ll measure them after the session when we’ve moved some of the lymph to see where they are and help them order garments that would be beneficial and helpful for them. And so I will send them links of things to look at. If they are a candidate for bandaging, like if they have lymphedema and lymphedema, which sometimes can happen at the same time, then I may sometimes refer them to a physical therapist or an occupational therapist to get bandaging or get a pneumatic pump. But otherwise, I teach them some self-care, how to massage themselves, how to do some skin brushing or work with a massaging tool, give them recommendations, sometimes the vibration plates, and we can talk about that some more specifically tools that help. But these are all things that I’ll talk to them about and give them tips on, and then set up some follow-up appointments so that we can continue the journey and help them develop good habits and make it part of their daily routine.

Dr. Sarah Stombaugh:
Yeah, okay, I love that. And so it’s really, you know, people may see, hey, I’m seeing this massage therapist, but it’s really a much more comprehensive approach that they’re walking away with. Tell me with the compression plate, because I know that’s something that’s a big part of your practice that you’ve started sharing with patients. You do have a compression, or excuse me, a vibration plate. I’m saying the wrong words here, but you have a vibration plate in your office. When I came in to see you, let me take a turn with it, which was fun because I’ve seen them online but never actually used one before. So tell me a little bit about what is a vibration plate and how is it used? What is the purpose? How might patients or clients utilize that? And what are some recommendations for someone who’s interested in learning more about this or what they should look for on their own?

Lili Gill:
Sure. Yeah, vibration plates are beneficial for anyone with lipedema or lymphedema. There are a few things to be careful of. When you’re standing on it, it vibrates, it gives an oscillation. So you’re feeling this vibration. And if you bend your knees, you feel the vibration in your legs and up to about your upper torso. And if you straighten your legs, you can feel it all the way up to your head and your hands. So some people actually incorporate it with workouts. People use vibration for many reasons, including to fight osteoporosis, to increase their metabolism, increase their energy. So there are a lot of other benefits to it, but for lipedema, we’re trying to increase the metabolism, get the fluid, it helps lymphatic fluid stimulate the movement of it. Because any kind of muscular movement, any bodily movement actually stimulates the lymph, lymph movement, which is what we’re trying to do. But there you should be cautious if you have any issues with balance, nausea, chronic venous insufficiency. You can use it while sitting.

So there’s some situations where you can sit down in a chair, put your feet on the vibration plate, and it can give your legs a good sense of vibration, even up to the hips but you’re not putting yourself at risk by moving too much blood through your system or challenging if you have balance issues or vertigo or something. So there are different ways to use it and different precautions you should look into before getting one. but many of my clients who’ve started using them love them. It’s a lovely the one of the nice things is that it’s passive, so it’s it is easier for people who find conventional exercise challenging, so it’s a good way to get things moving. and I use the—I’m not working for LifePro at all—but I do use the LifePro and have recommended it to numerous clients who’ve found it really helpful. I love their Wave Machine, it’s about $170. They have much more high-end products, and many other groups out there, companies out there do make more high-end products, and there are different types of oscillation that you can get into talking with some of their reps to see what they’re beneficial for. I find that the LifePro is something that’s affordable, manageable, uh, that people can incorporate into their daily routine, and that it can help make a difference and help motivate people on their on their journey.

Dr. Sarah Stombaugh:
Okay, that’s wonderful. And so they’ve got treatment while they’re in the office, recommendations of things that they’re doing at home. And I’d love to hear about from, you know, we think this, I would say conservative management, because I think one of the biggest challenges about a condition like lipedema, um, I pray for the day, you know, maybe it’ll be 20 years, maybe it’ll be 50 years before we really understand and can diagnose, treat, and maybe even reverse the condition. But right now, treatment looks very conservative. It looks like some of these things like massage, like compression, like using the vibration plates. We do know that in some cases, patients may undergo a liposuction, a lymph-sparing type of liposuction, in order to help to treat the disease. But it can be really challenging for people who are living with lipedema chronically. So tell me a little bit, if someone’s on a lipedema journey, let’s say they’re working with you, they’re doing regular massage, they’re doing the vibration plate, they have maybe they’re seeing me, you know, there’s some really interesting data now on GLP medications, for example, and helping to reduce inflammation on a more systemic level. They’re doing other things, perhaps like dietary changes and supplements that may be supportive of that as well. What does that look like in terms of maybe the progression of disease? And I know there’s some data in these types of conservative therapy and helping patients to maybe slow the progression of their disease. Tell me a little bit about that piece.

Lili Gill:
Well, what I’ve seen with my clients, the ones who’ve really been successful, have managed to incorporate a lot, all of those elements somehow into their lifestyle. And that can be challenging and more challenging for some, depending on, you know, if you have dependence and what kind of career you have and lifestyle at home. So I find that the ones who can carve out daily time every day to do their vibration, to do whether it’s pumping or exercise, or one of the most beneficial things is getting in the water, doing water exercise. So people who can manage to get all of these things somehow into spread out in their week tend to fare the best. I have seen some patients actually get to the point where they where they can finally get that joint replacement that they’ve been dying for, the knee or hip replacement that many doctors won’t do when you’re above a certain weight. And when they finally get it, interestingly enough, after the initial swelling from the surgery goes down, I’ve seen their volume of their legs go down as well. I mean, not comparing to normal, but down at least 30%.

Dr. Sarah Stombaugh:
Wow, 30% is huge.

Lili Gill:
Yeah, when you’re talking about somebody with a very large, you know, that’s it’s to see the volume go down significantly, yeah, it’s huge to and which means that they’re more mobile and able to do more exercise. and so I’ve seen positive effects from a combination of the conservative therapy, and I’ve seen great results from the new medications. I’ve also seen people who’ve had liposuction, and that’s not a be-all-end-all because it can come back. So they continue with their home care and their work that they need to do to maintain and keep it from coming from returning. so it is a lifelong you know process. I think I find that the clients that learn to accept that this is a condition you live with and how can I best incorporate the therapies into my daily or weekly life seem to profit the best and maintain or even reduce, reduce the weight that they’re carrying around.

Dr. Sarah Stombaugh:
Yeah. Yeah, absolutely. Well, and I think you know, sharing numbers like a 30% reduction in volume. I mean, that’s a really significant change for someone who’s been struggling with, you know, you think about the heaviness of a limb, both from a pain standpoint, from a fatigue standpoint, from a balance standpoint, that can imagine that was really life-changing for someone to see that type of that type of improvement. Absolutely. Absolutely. Amazing. Well, tell me, because one of the things I’m thinking about too, you know, we think about the number of patients who have lipedema that may not be diagnosed with it. Estimates, you know, if we talk about a Caucasian female, interestingly, this is a disease that presents really only in females. I think there’s maybe other conditions that can present in men, where I saw a case report of like one guy who had it, but I’m not totally clear. It looks like it’s exclusively a female medical condition. And when we look at the rates in Caucasian females, it’s anticipated to be about 10%, is what I’ve read, which is really a huge number of patients. You know, you think about what that looks like in our community, for example, there are certainly not that many people who have received the diagnosis of lipedema. And I think there’s a lot of women who are really struggling because they feel like I’m trying to lose weight, my body’s not changing in the way that I want it to. You know, why, you know, I have these stubborn areas. You’ll hear people say, like, oh, I got my mom’s legs or I got my grandma’s legs, you know, all the ladies in my family have this, you know, that there’s huge genetic components to lip edema. But I’m curious when you’re seeing that person and maybe thinking, okay, this may be lipedema, maybe a patient comes to you, they’ve self-diagnosed, they’re asking about it. What are the things that you’re empowering them to go back and ask their physician? What are some of the resources that you might share with them in terms of maybe getting a formal diagnosis or understanding their condition a little bit more?

Lili Gill:
Yeah, well, I got reached out to the Lipedema Foundation recently and they sent me some great materials. If you look at their website, Lipedema Foundation, they have pamphlets that explain the condition, talk about the therapies. They also have printouts that you can take to your doctor that can help because not all doctors are trained in it. And so what I’m finding is that the more newly, the younger newly trained doctors very often have a little bit more training about it than ones who went to school a while back. But this handout is catered to doctors to help give them guidelines for diagnosing. And so if I have a patient who says that their doctor doesn’t know what it is or said it was, you know, obesity or thinks it’s just lymphedema, I give them one of these handouts and it can be printed off the website too, and say, why don’t you take this back to your doctor and let them look over it?

And yeah, and I have had a couple of patients come back and say, yeah, their doctor agrees that it’s lipedema. So there are little ways of unfortunately it’s sometimes it feels like the patient has to educate the doctor in certain ways, which I hate to I hate to say, but when it’s a little bit lesser known and lesser um yeah, when doctors aren’t as well trained in in recognizing lipedema versus lymphedema, then then we do our best means is through patients to help doctors understand the condition better and to recognize it. And the main things to point out are where the fat distribution is. There is also that common thing about many of my lip edema patients eat very lightly. I mean, when I talk to them about their diet, I’m amazed. You know, I mean, I eat more than a lot of my patients, and yet they’re struggling with this aching that that just won’t stop. And so, you know, when you’re looking putting these pieces together, it doesn’t quite line up with typical obesity or some of the fluid, the way it’s symmetrical and it’s not affecting certain areas, but it’s on both sides, it’s not the same as lipedema. You know, it maybe it doesn’t go down when you lift your leg, when you raise your legs. So there are different ways that you can tell the difference between lymphedema and lipedema. And so lipedema, it doesn’t occur in the feet and hands. Very often, if a person with lipedema has very large legs, the feet will also swell. Not always, but pretty typically. So there are many different signs to look at, and family history, as you mentioned before, is a big one.

Dr. Sarah Stombaugh:
Well, and I appreciate you mentioning the Lipedema Foundation. I think that is such a wonderful resource, and they are really empowering patients to advocate for themselves. And so some of these resources, um, as well as teaching clinicians to understand this. So we’ll make sure to link that in the show notes to today’s episode. So anyone who is listening, they can definitely visit the lipedema foundation. I think it’s dot org, as well as then look at some of the resources they have there. So we’ll link that. And I think it’s challenging to diagnose this condition, and that’s a fully clinical diagnosis. You know, we think of a lot of other health conditions. And it’s like, oh, you have prediabetes, here’s your A1C, or here’s your fasting blood sugar that’s elevated. You have elevated cholesterol, here’s the labs that correspond to an elevated cholesterol. You know, so many different health conditions, even if it’s an imaging test or you know, a blood test, there’s lots of other, it’s more than just the signs and symptoms that we’re seeing clinically, there may be those other metrics that we’re not really able to see here in the same way. And so it really is taking a thorough history, examining the patient closely, um, and all of those pieces. And so I’m so glad you mentioned that. And for anyone who’s thinking, hey, maybe this is me, make sure to check out the diagnosing it, bring that to your physician and ask them. I think is really important. Well, this has been wonderful, Lili. Let me ask you I think you and I could just talk all day about this, really, you know, poorly understood, or I shouldn’t say poorly understood, but less commonly understood. There’s less people who are aware of this condition. It’s becoming more and more common that people are talking about it. And it’s really exciting for me to have someone in our community who is able to treat and support patients in this way. Are there things that we haven’t had a chance to talk about today that you really want to make sure my audience is aware of?

Lili Gill:
Well, I the one thing that stands out is I mentioned very quick shortly, but I want to emphasize the water piece. When I did my lipedema training in Blacksburg, they took us to a swimming pool where we had a water tai chi class, which was just amazing. And I know this isn’t even available here in Charlottesville, but for 45 minutes we were in the water just doing very slow, gentle movements. And I can’t tell you the amazing feeling besides the fact that once I got out, I knew that it’d move my lymph because I needed to urinate very badly. The sign always, whenever I work on a client and I know that lymph has moved, you know, is that need for elimination and a very healthy response. So being in the water, you don’t need to be doing laps, you don’t need to be doing aerobics even. You can just be in the move in the water moving and walking and doing gentle movements with your arms and legs, and that water against the skin is actually helping, giving you a lymphatic drainage massage.

So I highly encourage the other thing, obviously, is that it lifts the weight off the joints and it’s not painful. so if you can find a way to safely and to comfortably get into the water, that is probably the best exercise ever that you can get. If you can’t, then walking, any anything that gets movement going in your body stimulates lymph, it helps your metabolism. So even the most gentle movements. I even have people who are bedridden, just pumping their feet, pumping their feet if they can, do some kind of leg, leg, bent leg like almost like bicycling motions, um, or even just tightening your muscles and releasing and tightening and releasing. Things like that all it change the pressure of the muscles against the skin, which encourages lymph movement. So the one thing I want for everyone to think of or just be mindful or inspired by is to continue moving, keep moving, keep the body moving.

Dr. Sarah Stombaugh:
I love that. One I love that you really, you know, certainly the role of water, we think of the pressure, as you said, the effect of gravity and pulling off of the weights and not having so much weight bearing down on the joints can be really helpful. But we think of these gentle movements, and I think even when we look at long-term success with exercise and weight management, whether we’re talking about lip edema, whether we’re talking about lymphedema, or honestly any other condition, you know, a lot of times I think we have this idea of what exercise is. And some people sometimes we have this idea of I have to be in the gym and I have to be huffing and puffing, and I have to be lifting maybe a certain amount, or I have to be a certain amount of sweaty, or I have to be there a certain amount of time. And it’s amazing how gentle movements can really make a huge difference in our overall health, both our mental health and our physical health. And so I’d like to emphasize that even for someone listening who maybe doesn’t have lipedema, I think the gentle movements play such a huge, huge role in helping our body and in this way that we sort of lovingly reconnect with our body rather than beating up on our body, which I think is sometimes the way people approach exercise.

Lili Gill:
Yeah, I think you’ve put that very, very beautifully. But it’s true. Sometimes we do think if we don’t, no pain, no gain, or sweat. And there is definitely a role for that kind of exercise if your body’s up able to do it. But if your body can’t, it isn’t a reason not to not to still be kind and loving to your body and just keep moving. There’s plenty of people who lived very healthy lives who never went to gym. They just you know lived by being active, just moving and yeah, walking and being active. Yeah.

Dr. Sarah Stombaugh:
Yeah, gyms are such a modern-day creation. You know, I think only in the states do we have this number of gyms and so many people who belong to them. And yet we’re as unhealthy as ever. And so I think it says a lot about how are we reconnecting, how are we understanding some of these different pieces. So I thank you again for pointing out that gentle exercise piece. Tell me if people are, especially if they’re in Charlottesville, Virginia, but even if they’re elsewhere, where can people learn more about you? If someone is interested in working with you for massage, how can they learn more about you?

Lili Gill:
Well, I have a website and that’s Lili Gill, L-I-L-I-G-I-L-L dot massage therapy.com. Um, I do have a very full practice, so I will say right away that very often my new clients have to wait a little bit to get in. But I do take some new clients, and if I can’t take a new client, I will refer out. Unfortunately, Charlottesville has a little bit of a desert when it comes to compression therapy. Uh, we have some challenges finding enough therapists for the need. so sometimes you there is a wait and very often I do have clients come to me while they’re waiting to get their bandaging therapy with the PTs and OTs. So, but yeah, you can find me through my website and contact me, and I will see if I can put you on my waiting list and get you in as soon as possible.

Dr. Sarah Stombaugh:
That’s wonderful. And we’ll definitely make sure to have that in the show notes as well, alongside all of the information we talked about earlier with the Lipedema Foundation. Lili, thank you for joining me today.

Lili Gill:
This has been such a pleasure. Thank you so much, Sarah. I really enjoyed it.

Dr. Sarah Stombaugh:
All right, wonderful. And for everyone listening, thank you for joining us for today’s episode. Make sure to check out Lili on her website as well as the lipedema foundation.org. We’ll see you all next time.