06/30/2026
Finding answers in a lifelong pattern -
Diane Banks had always heard about “heavy legs” in her family. She assumed it was simply part of her genetics and did not think much of it. But when her legs became sensitive to touch, painful at times and susceptible to swelling, she knew something was wrong. Now, with the help of the IU Health North Rehabilitation team, she is managing those symptoms.
Banks’ diagnosis wasn’t immediate. Her symptoms worsened after knee replacement surgeries 24 years ago and a severe injury to both ankles 10 years ago. All three procedures led to significant swelling. Then, her diagnosis came earlier this year after a bout of cellulitis in her right ankle. Her physician identified lymphedema in her right ankle and lipedema in her left leg as well as other areas of her body.
Finding the right care
In February, Banks connected with the Rehabilitation team at IU Health North. Certified lymphedema therapists Beth Maier and Carrie Morris treat both lymphedema and lipedema.
“The two conditions often get confused,” Maier explains. “Lipedema is a symmetrical buildup of fat in the legs, and sometimes the arms and the trunk. It creates what appears to be a cuff at the ankle or wrist. Lymphedema is typically one-sided, in one arm or one leg, and is due to swelling, not a buildup of diseased fat like with lipedema.”
“I have been in the course of being treated by Beth and Carrie, who are excellent. I've learned about the disease and how to manage the disease,” Banks adds.
Maier and Morris say lipedema is often misdiagnosed or overlooked, even by trained professionals. Awareness, however, has improved over the past decade.
Meaningful results
Banks completed her treatment in May and has already seen measurable improvements.
“When she first came to see us, she was reading the pain in her legs at about a seven out of 10,” Maier says. “Once we started working with her, and she was doing her home program, wearing her compression garments, using her pump, doing all the things that she needs to do on a daily basis, her pain had dropped to a one out of 10.”
“I've actually lost 10 centimeters from the circumference of my left leg, and five centimeters from the circumference of my right leg,” Banks adds. “So, you can really improve the problem, but you never cure it.”
Understanding two often-confused conditions
Lymphedema is chronic swelling caused by a buildup of protein-rich fluid in the body’s tissues. It typically affects the arms or legs and occurs when the lymphatic system is damaged, blocked or improperly developed.
Meanwhile, lipedema is a chronic, progressive disorder marked by a symmetrical buildup of fat. It primarily affects women, is often painful and typically resists diet and exercise. Common symptoms of lipedema include disproportionate fat distribution, pain and tenderness, easy bruising, swelling and hormonal triggers.
“When you have this incredible swelling in your legs, it's very sensitive to touch. It's very painful to get a massage, anything,” Banks says.
Connecting the dots
For Banks, the diagnosis helped explain years of changes in her body. She was active in early adulthood but gained what she describes as “significant weight” after menopause, which worsened the swelling in her legs.
Over the past year, she lost about 50 pounds with a GLP-1 medication. Still, the size of her legs did not change significantly.
“I'm really not losing that fat out of my legs, and so you can't really cure this,” she says. “You can only manage it, but it's very important to manage it, because it can become much worse.”
Managing the condition
Conservative treatments for both conditions include compression garments, exercise, skin care and manual lymph drainage. Liposuction is also an option for lipedema, though access and insurance coverage can be barriers.
Maier and Morris work together to develop an individualized treatment plan for each patient.
“We have a lot of conversations with our patients about what they've tried in the past, what worked and didn't work, what their preferences are,” Morris says. “Then Beth and I will sit and chat with each patient, talk about compression garments, what we think is best for the person, get a plan together and work it into their plan of care.”
Banks chose conservative treatments, including compression garments, a compression pump and a vibration plate. Even then, finding the right approach took time.
“I wear compression garments every day, and I have about $1,000 of worthless compression garments in my house. Until I met Beth and Carrie, I never got good advice on compression garments,” she says.
Why awareness matters
June is Lipedema Awareness Month, which focuses on improving early diagnosis, increasing clinical education and connecting patients to resources.
For Maier, raising awareness is personal. She lives with lipedema herself.
“I always thought my calves were larger when I was younger, but I just thought it was because I was a dancer and I was in marching band and I had muscle. As I got older, my leg started getting bigger, specifically in my calves, then into my knees and into my thighs.”
After her diagnosis, she began with conservative treatments before eventually pursuing surgery out of state.
Now, she is focused on helping others recognize the condition sooner.
“If we can teach them at a younger age, and they're wearing their compression garments, they're doing all the things, then hopefully their pain is less, hopefully their swelling is less, and hopefully it slows the progression of the disease,” she says.
“I think that one of the biggest problems is educating people,” Banks adds. “I'd heard of lymphedema, I'd never heard of lipedema before this. Managing it is just like managing any other disease. You can't do it passively. You have to do it actively.”
To learn more about Rehabilitation services at IU Health North, visit: iuhealth.org/find-locations/iu-health-north-rehab-services-iu-health-north-hospital
First photo: Diane Banks
Second photo: Beth Maier (left) and Carrie Morris (right)
