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The price of a new replacement turbocharger can be staggering. If the turbocharger failure is of the normal wear, then rebuilding may be an option. The bad news is that rebuilding a turbocharger is beyond the scope of most home do-it-yourselfers. Start closing the valve and exhaust gases spin the turbocharger faster, making it compress more air than if the wastegate was open. When the wastegate is completely closed, all exhaust gas is routed through the turbo. Wastegate in an aircraft exhaust system. Wastegates come in three basic flavors: fixed, manual and automatic.
How Gareth Bale's sticky tape is helping cancer patients: Relief for thousands as sports science finds the answer to a lingering side-effect of treatment
- Michael Gannons, 63, from Luton, has lymphoedema and uses Kinesio tape
- Athletes like Gareth Bale use it to stop injured muscles overstretching
- Applying to stretched skin reduces pressure on lymphatic system
Published: 01:04 BST, 11 March 2014 Updated: 09:32 BST, 11 March 2014
Michael Gannons was at the end of his tether. For three years he had suffered from painful swelling in his left leg, which started at the top of his thigh but spread right down to his ankle and then, in January this year, to his groin and abdomen.
Michael has lymphoedema, a chronic disorder that occurs when the lymph system - a network of tiny vessels that drains fluid, or lymph, from the tissue and back into the bloodstream - doesn't function properly. This leads to a build-up of fluid, causing swelling, pain, loss of mobility and increased risk of infection.
Then Michael learnt about an unlikely remedy - Kinesio tape. This is the brightly coloured tape athletes, such as Real Madrid footballer Gareth Bale, use to help prevent muscle injury, but it is increasingly being used by specialists caring for people with lymphoedema. After three weeks of treatment, Michael's swelling has been dramatically reduced.
Real Madrid footballer Gareth Bale (right), used Kinesio tape to help prevent muscle injury, but it is increasingly being used by specialists caring for people with lymphoedema, like Michael Gannons (left)
Around 200,000 Britons are thought to suffer from the condition. It occurs either as a result of an abnormality from birth - 'primary' lymphoedema - or, more typically, when the lymph system is damaged or blocked as a result of surgery, injury, obesity or cancer treatment.
In cancer patients it usually affects the arms and legs, as the lymph nodes - small glands connected to the lymph vessels that collect bacteria and other harmful substances in the lymph fluid - are commonly removed to stop the disease spreading.
Michael developed lymphoedema in 2010 after surgery to remove a few cancerous lymph nodes in his groin. Two years previously he'd had a malignant mole removed from his left calf and it was thought that cancer cells had travelled up his leg.
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'After the operation the top of my left leg blew up like a balloon,' says the 63-year-old biomedical scientist, who lives with his wife Ruth, 66, in Luton, Bedfordshire. 'I found it hard to walk and couldn't drive.'
Every day for five months he had to go to hospital to have a litre of fluid drained from his leg.
When the swelling eventually subsided, Michael says: 'I jumped into my car and drove to Scotland to see a friend - I was finally free.'
But a few weeks later the lymphoedema returned, now affecting his whole leg. He was referred to a lymphoedema clinic at his local hospital, where he was given compression stockings, bandages and manual lymphatic drainage - massage to encourage lymph fluid to leave the swollen area.
But he found these had a limited effect and the compression garments and bandages could be uncomfortable. Then, early last year, CT scans revealed new tumours in his groin.
After three weeks of treatment, Michael's swelling has been dramatically reduced
Because these were blocking lymph nodes, fluid gradually built up in his abdomen and scrotum and worsened in his upper leg.
Finally, fed up with the wait at the clinic, in January he went private and was offered Kinesio taping.
Kinesio tape is essentially elastic cotton tape with a medical adhesive on the back. For athletes, applying it over injured muscles is thought to stop them overstretching and returns the muscle to a neutral position, relaxing it and preventing further injury. With lymphoedema, applying it to stretched skin 'lifts' the skin, reducing pressure on the lymphatic system underneath - this encourages lymph fluid to drain, explains Jane Wigg, a lymphoedema specialist nurse based in Dudley. This is different from compression garments, which encourage fluid into the lymphatic system by applying compression (or pressure).
A Chinese study, published in 2009, showed that Kinesio taping worked as well in women with breast cancer-related lymphoedema as bandages, and was easier to use and more comfortable.
'Kinesio taping is particularly helpful in problem areas such as the top of the arm or leg, or the breast, where compression garments don't cover or cannot be fitted easily,' says Jane Wigg.
'Lots of my patients swear by Kinesio taping,' says Anne Dancey, a consultant plastic surgeon with a special interest in lymphoedema at the Queen Elizabeth Hospital, and BMI The Priory, both in Birmingham.
Michael underwent three weeks of intense treatment where Kinesio tape was applied to his thigh, reaching up to above his belly button and over his groin. It was removed and replaced every two days - 'I barely felt it,' he says.
At the end of the treatment his leg was 8in smaller in circumference - 'it had contained a stone of fluid and that's gone, so it looks the same as my other leg and there is no fluid in my abdomen or scrotum,' says Michael.
'Now I can do all the things I couldn't before, such as driving, running and playing football - I can live a normal life.'
He still uses compression stockings to encourage fluid to move to working lymph nodes, but these only reach his thigh, so he uses them in conjunction with Kinesio taping in other areas. Thanks to the tape, he no longer needs constrictive bandages. But while Kay Eaton, a consultant nurse in cancer and supportive care, who runs the lymphoedema service at University College London Hospitals, agrees that Kinesio taping may help, she says patients must be fully assessed before treatment.
For a lot of people Kinesio taping can help to control lymphoedema but it isn't a standalone treatment, adds Karen Friett, chief executive of the Lymphoedema Support Network charity.
It must be done by a skilled therapist, says Jane Wigg: 'They need to know where the fluid is draining to and be able to follow the lymphatic pathways.'
There are also surgical treatments for lymphoedema. Liposuction can help by removing the fatty deposits that build up with the fluid over time as a result of accumulation of proteins and other changes to the tissue. This fat can't be pushed away with massage or bandaging.
The lymphoedema returned, now affecting his whole leg
However, while liposuction can help if compression stockings are put on straight after the fat is removed, it doesn't correct the problem in the lymph system.
For severe cases Anne Dancey offers lymph node transfer, where healthy nodes are removed and transplanted to the problem area, though this is not yet approved by the National Institute for Health and Care Excellence (NICE).
Ms Dancey's concern is the 'postcode lottery' across the UK for access to treatment: 'Many people are forced to spend thousands to go private - some of my patients even go to France. Services are very overstretched.
Kbb Turbocharger Manual Lymphatic Drainage System
'It's seen as only a complication of surgery. And there's an attitude that cancer patients shouldn't moan because their life has been saved by treatment that has given them lymphoedema, when it's a completely debilitating condition. People get infections constantly, can't work, can't wear clothes they want and it affects self-esteem.'
Lymphoedema is 'under-recognised and complex', agrees Kay Eaton. 'If it's diagnosed early, treatment can be very effective but this is often not the case.'
Furthermore, the Lymphoedema Support Network says those with non-cancer-related lymphoedema - at least half of all patients - find it harder to get treatment because the NICE guidelines only cover cancer patients, particularly those with breast cancer (one in five develop lymphoedema).
Michael Gannons considers himself lucky to have been able to afford private treatment. He is delighted with Kinesio taping and now plans to go on holiday. He says: 'I'm going to enjoy wearing shorts this summer.'
lymphoedema.org