For Lymphedema Awarenesss Month March 2024, Lymphie Strong is featuring advocates who are important to our online support community. Today we introduce our new guest blogger: Micky Frackleton PTA, CLT, LMT, CPT, CES, NCBTMB of Interpathway Wellness. We think you will like her series!
#lymphiestrong #movethatlymph #compression #lymphedema
Finding the right compression garment isn’t always easy. As a matter of fact, it can be a test of endurance!
Why You Need Compression.
Compression garments serve as a non-invasive method to prevent swelling after completing therapy. They work by restricting the soft tissue from expanding and limiting the buildup of protein rich fluid. With lymphedema, in addition to lymphatic dysfunction the soft tissue is more prone to swelling repeatedly, due to the soft tissue’s inability to return to its prior shape. But, when combined with movement, these garments enhance venous and lymphatic flow. However, it’s important to note that daytime garments only maintain the shape of the area they cover; they do not lead to continuous reduction.
Where To Turn For Help.
To help you find your garment, seek out connections with individuals who can provide assistance in ordering your garment. If you’ve worked with a Certified Lymphedema Therapist (CLT) or a trustworthy Durable Medical Equipment (DME) provider with a qualified fitter, they have the expertise to accurately measure you and offer experienced guidance in selecting the most suitable garment tailored to your specific requirements. This includes determining the right size, compression level, and fabric type for the particular area on your body. It’s also important to explore whether your health insurance might cover some or all of the costs. Now, let’s delve into two of the fabric options available. There are many other options, but to keep this post concise, I’ll only speak about daytime garments.
What Makes the Difference.
Two common fabric types used for daytime garments are circular knit, ready-made, and flat knit, custom garments. Ready-made fabrics are typically more elastic and light weight, while custom fabrics feature a more structured heavy weave that are effectively sewn to adapt to unique contours. The appropriate compression class is determined based on the lymphatic stage and the location of the swelling. For example, an arm may require a lower Compression Class (CCL) because it is not weight-bearing, while areas of your body that bear more weight will necessitate greater compression force.
The ready made garment tends to work better for individuals dealing with lower-stage lymphedema and who have more natural contours in the affected area. When ordering these, there are specific sizing parameters, with a starting and ending point. To achieve the best fit, it’s advisable to choose sizes closer to the beginning of the range. This not only ensures a better fit but has better control because the weave would remain tighter, also makes it easier for you to don (put on) and doff (take off) the garment with greater convenience.
Custom garments are the most robust and structurally sound options available. These garments involve highly detailed measurements, and your therapist or fitter can incorporate additional features to meet your specific needs. For instance, your therapist can insert a foam pad at the top of the foot, or a relief patch at the back of the knee to enhance comfort and protect the superficial arteries, veins and nerves. These garments are beneficial to the more advance stages of lymphatic disease. Due to their structural integrity, in some cases, it’s possible to use a lower compression class when ordering a custom garment vs a ready-made. The increased stability of the fabric compensates for the reduced compression force, providing effective support.
When It Doesn’t Fit.
Now that you have a better understanding of compression garments, it’s crucial to be prepared for situations where they don’t fit or are causing discomfort. One of the most important steps is to familiarize yourself with the return policy before making a purchase. Ask your Durable Medical Equipment (DME) provider about their policies regarding returns, does it matter whether you’re buying ready-to-wear or custom garments. Another important issue is if they will provide the training in donning and doffing to make sure you can get them on and off yourself or if you’ll need assistance from a caregiver, and most importantly are you able to try them on there before taking possession if they have a no return policy.
It’s essential to know how much time you have to notify them of any issues. If, for example, you’ve worn the garment for a week and it’s no longer staying in place, slipping down, or causing creases at the ankle, this is a problem, and it’s not your fault. Some people hesitate to report such issues, thinking they are to blame, but this is not the case.
Your Certified Lymphedema Therapist (CLT) can be a valuable resource in advocating for you. CLTs have connections with garment representatives and can communicate with them on your behalf. In most cases, manufacturers are very willing to work with you to resolve problems related to a bad fit. They will collaborate with us to ensure that the garment fits correctly. Sometimes, their representatives will even come in to assess the issue firsthand and provide valuable feedback.
Once You’ve Found What Works.
A critical aspect to understanding compression garments is the importance of consistency once you’ve found the right one. Consistency is the key to managing your swelling. Any time you go without compression, your soft tissue can start expanding again. Wearing compression garments inconsistently increases the risk of the garment no longer fitting properly as you may become larger.
Considered The Biggest Barrier.
The greatest challenge that many individuals face when searching for the perfect garment is the cost. If cost were not an issue, everyone would have the ability to get their perfect garment. However, when it comes to custom garments, the price can be genuinely staggering. For those with limited financial resources, affording these garments are completely out of reach.
Additional Resource Information.
The Lymphedema Treatment Act has been successfully passed, thanks to the efforts of Heather Ferguson and her team. This legislation took effect in January 2024, and it is currently applicable to Medicare insurance. It is hoped that other insurance providers will also recognize the value of this act and provide coverage.
Additional assistance can be sought through The National Lymphedema Network garment program. Clinical or organizational level members who are Certified Lymphedema Therapists (CLTs) can apply for coverage on your behalf if you meet the financial need criteria. This program offers a one-time annual provision of both daytime and nighttime garments from reputable manufacturers like Medi, Jobst, Juzo, and Wearease.
Guest blogger: Micky Frackleton PTA, CLT, LMT, CPT, CES, NCBTMB
Owner of InterPathway Wellness, 100 Main Street, Suite 12, Amesbury, MA
Website: https://interpathwaywellness.com
Instagram: https://interpathway_wellness.com
