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Lymph-what-oedema

Primary & Secondary Lymphoedema Online & in the Community

What is Medical Compression

As you have now been diagnosed with lymphoedema the next step will be for you to see a lymphoedema therapist.  If your lymphoedema is in your arm or leg, then you will be measured for a compression garment which will help to maintain your swelling  to help keep keep control. This works by putting pressure on the tissues to stop fluid build-up and help the fluid drain from your affected limb.  There is a very good article from MediUSA explaining why support garments are not the same as compression garments.

Understanding Compression

Understanding compression can be confusing which is why you need to work with your lymphoedema specialist.  Compression can be made to measure or off the shelf, but I do recommend strongly that you need to be measured by a lymphoedema specialist as compression comes in a different class, size, strength and styles.  They can also be flat knit or round knit or possibly you could be given Velcro wraps.  

Unique to you

Compression garments should be made for you, using your exact measurements by a lymphoedema specialist.  If your limb needs firmer support or has lost its shape due to your swelling, then you will receive a made to measure garment.   

Flat Knit

Flat knit compression garments are made on a flatbed computerised knitting machine which is programmed to your exact measurements and these garments may have a seam.

Circular Knit

Circular knit garments are seamless and are knitted on a computerised cylinder machine.  They are now made in different colours and patterns and are often in a thinner material.  Suitable for limbs that are more regular in shape and where the skin is supple and hasn't broken down. Available on prescription or off the shelf.  L-W-O members like the fact they can choose their own colour.

 

 

Intermittent Pneumatic Compression Therapy

The photograph is of L-W-O member Jane Hoy

This sleeve is effective therapy for arm, breast and torso lymphoedema and can be used in clinic or at home.

You will be advised by your lymphoedema specialist or therapist if this is suitable for you.

Contraindications:

  • a DVT or pulmonary embolism
  • inflammatory phlebitis
  • acute infection of limb
  • decompensate cardiac failure
  • congestive heart failure
  • severe arteriosclerosis
  • ischemic vascular disease
  • any circumstances where increased venous and lymphatic return is undesirable

Wear compression Everyday

It is important to wear your compression garment all day, but it can usually be taken off at night when you are lying down and resting.  If you are travelling a long distance, especially by air, make sure you wear it for the full length of your journey and for some hours afterwards. You should be given two garments so that you can have one in the wash while you wear the other. The manufacturer will supply washing instructions.  With wash and wear compression they are estimated to last 4-6 months.

If your compression garment is too loose, it won't control the swelling and needs to be refitted. If it is too tight, it will restrict blood flow. If you get pins and needles, pain, or your toes change colour, maybe it's too tight. However, give your compression 5-10 minutes to see if your limbs settle down, if not remove straight away and contact your lymphoedema specialist for advice.

Exceptions to wearing everyday

  • you have an infection (cellulitis)
  • the limb is large and irregular in shape
  • the skin is fragile or damaged 
  • the skin is pitted or folded 
  • leaking lymph fluid

Compression garments used incorrectly can be harmful, and won't help the swelling go down. The material can form tight bands across the skin and even damage it.  If you are in doubt, ask your lymphoedema specialist for advice.  Please remember the above are generalisations and you should be discussing these with your lymphoedema specialist.

Wearing & Removing Compression

During your fitting you will be advised and shown how to put on and remove the garment.

  • Put your garment on first thing in the morning, when the limb is at its smallest, but not immediately after a shower or bath as dampness can make it difficult to put on.
  • There are different applicator aids available to help put garments on and to take them off.
  • Make sure the material is distributed evenly and there are no wrinkles or creases when your garment is on. Wearing a rubber glove on the unaffected hand can help you smooth the garment out.
  • Moisturise your skin at night after you have taken off your garment rather than in the morning, because cream makes hosiery difficult  to put on.

Some of the L-W-O members have found these fun sleeves

to put over their arm compression garments.

 

Kinesio Taping

Compression Hosiery is a great  way of reducing swelling but taping can be just as successful.  Kinesio taping is used to treat severe Lymphoedema.  Unlike the compression garments that you remove at night, Kinesio tape can be used 24 hours a day.  In simple terms the tape moves with you and channels the flow of lymphatic fluid away from the areas it has built up in.  Many of the ladies in members group have been taught to do the taping for themselves.  The tape also comes in a variety of colours which our ladies like. Some of our members use a combination of taping and compression garments. Below is a photograph of Donna Walsh's arm showing how her taping looks. 

 

The taping was done by Craig Hadley who originally comes from Dudley but now based at Los Al Cazares, Murcia, Spain

In May 2019 I was lucky enough to meet Clare Anvar at the MLDUK19 Conference. Clare joined L-W-O in March 2019 and it always great when I get to meet one of our members. She is absolute font of knowledge on Lymphasical Kinesiotaping please take a look at her page because she explains far better that I can the benefits of taping.

Prescriptions and Compression

Prescriptions charges for compression garments not only frustrate and upset our members they also find them very confusing especially as Pharmacies often don't understand how they work either.  This is how British Standard is listed for compression garments and lymphoedema garments.


One item one prescription - so one pair is two items - so two charges


Lymphoedema garments are charged per pair for off the shelf and for multiples of two of made to measure in the same class
If however, the made to measure are different classes then you will get two charges

With all tights except BSN (Elvarex) there is one charge


BSN Elvarex has two charges because it is not listed as tights it is listed as a body bandage plus two thigh highs - an if those thigh components are different classes - three charges

 

 

 

 

Big thank you to Adam Withey from Juzo for the following information.

Compression

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COMPRESSION HOSIERY

It is important to be fitted by someone experienced in selecting, measuring and fitting compression garments.  Your lymphoedema specialist will do this for you. Compression garments are available in different grades of pressure depending on the degree of your lymphoedema. The specialist will request a prescription from your GP for an appropriate garment.

THEY WORK BY:

  • compressing the swollen tissues and stopping fluid from building up
  • helping to move fluid to an area that's draining well
  • providing support
  • allows the muscles to pump fluid away more effectively

 

Please be aware

If you lose weight, or through exercise your affected limb becomes firmer then your compression garment might become loose and therefore will not be doing its job.  Therefore make sure you get an appointment with your lymphoedema specialist to be remeasured.  Their is a tendency these days to discharge lymphoedema patients with a repeat prescription.  If this happens and you feel your compression garment is loose, wrinkles, too uncomfortable to wear then please make an appointment to go back to your specialist and asked to be remeasured.

Washing Instructions

Washing instructions should be provided by the manufacturer – please ensure that you follow these instructions as guarantees do not cover misuse during laundry.  A gentle machine or hand wash is preferable (non-biological, gentle detergent) and no conditioner, as this will tend to damage the elastic properties.  Remove excess water by pressing the garment between a folded towel and allow it to dry naturally. Never put the garments over a radiator or in the tumble drier.

 

Velcro Compression Wraps

Some of our members use Velcro Compression Wraps for compression as the above photograph shows our L-W-O member wearing farrow wraps.  Below photograph shows how the Velcro compression wraps reduced our members swelling so that she is now able to get her normal compression garments on.

Source:

Lymphoedema Framework, Template for practice compression hosiery in lymphoedema. London MEP Ltd, 2006 for Lower Limb Hosiery

Lymphoedema Framework Template for compression hosiery in upper body lymphoedema.  2009, Health Comm UK Ltd., Aberdeen

Big thank you to Adam Withey from Juzo UK for reading through this and making suggestions on how I could improve some elements.

This page was first published 19th June 2019

Last updated 19/06/2019