We frequently have patients ask us at SuppotHoseStore.com, what is the difference between a compression garment and a lymphedema pump? The simple answer is that these are two different solutions to reduce swelling in your arms and legs. As an example, let’s begin with the knowledge that humans have stretchy skin and that lymphedema is the result of the body’s retention of fluids which causes swelling of the legs and arms. In order to get rid of excess fluid in the limbs, first a controlled, external pressure must be applied to the limb, which can be accomplished with both solutions. When compression garments are utilized, several layers of materials including compression bandages, plain or paste bandages, multi-layer bandage regimens, and finally compression stockings, gantlets and gloves are placed on the affected extremity. The number of layers required can be reduced by using the Caresia Bandage Liners under the bandages. Our good friends at lymphnotes.com tell us that there are two phases to each pump treatment. “The preparatory phase, which must be performed first, is Manual Lymph Drainage to prepare the lymphatic vessels to receive the fluid that will be moved by the drainage action of a pumping. When the preparatory phase is not completed properly, the lymphatic system is not ready to receive and transport the lymph that is moved by the pump. When this happens, the lymph is forced into the surrounding tissues where it can cause additional damage.
In a home setting, the preparatory phase is performed by the patient as self-massage, or by a caregiver as Simple Lymph Drainage (SLD). This preparation must be carefully completed to prevent any damage to the tissues.
In the drainage phase, the pump settings are adjusted to the appropriate pressure level before the garment is donned. Then the pump is activated for the appropriate period of time while the patient rests comfortably with the affected limb in the recommended position.
The movement of the pump stimulates the flow of the excess lymph out of the affected limb as if were flowing following the movements of the muscles. When the lymphatic system has been properly prepared, this fluid will flow into the lymphatic vessels and eventually be returned to the bloodstream.
After a session on the pump is finished there are still two more step to be completed:
First: Remove the pump garment and then perform a brief M-L-D session on yourself by working from the end of the treated limb upward toward the terminus to help the released fluid return to the cardiovascular system.
Second: Put on a compression garment. If you use the pump in the evening, put on your night compression garment (the Caresia Bandage Liner transitions to a night time garment or a JoViPak garment). If you use the pump during the day, put on the knit compression garment that you wear when you are active.
Unless you complete these steps, the fluid released by the pump will flow back into the tissues instead of draining properly as it returns to the circulatory system. And, unless you don a compression garment, the tissues will soon be swollen again.” This is simply what many of us must do in order to maintain limb size. You can take a barrel full of water pills, but excess fluid will never leave your limbs without applying external pressure.
There are many different reasons a limb or other body part can swell. If constant compressive forces are applied to a limb so as to produce higher levels of compression at some sites on the limb, and lower compression at other sites, the compression is termed gradient compression. We carry the top four major manufacturers of gradient compression stockings – Jobst, Mediven, Sigvaris and Juzo. True gradient compression stockings have the greatest compression at the ankle with the compression gradually decreasing up the limb, thus improving circulation, helping to maintain limb size, keeping excess fluid from accumulating in the limbs, and improving overall health. Keeping the fluid off your extremities by maintaining constant compression helps your heart, lungs, and kidneys not to be compromised. The effectiveness of compression therapy depends mainly on the exerted pressure and the knitted material the garments are made from. This is the reason that some people need flat-knit garments rather than round-knit (circular knit) products, for more static stiffness. Don’t confuse static stiffness with stiff material, as most high-end compression garments, like the Jobst, Mediven, Sigvaris, and Juzo products we carry at SupportHoseStore.com are soft to the touch.
What is the fluid, when I swell? This is another common question. Some refer to swelling as water retention, when in fact, what you are retaining is water and lymph fluid. Lymph fluid contains water and waste fluid, so it is of the utmost importance to rid your body of these excess fluids to maintain a healthy body and immune system. Compression stockings can help you do this.
So in order to maintain limb size, a constant force is necessary throughout the day, every day, and a lymphedema pump, or pneumatic compression device is not a constant force, is very expensive, at best only partially covered by insurance plans, and is not mobile. Perhaps in conjunction with properly fitted compression garments, a pump might be helpful but it is not constant enough in order to maintain correct limb size, and keep your limbs from swelling. Therefore the most practical way of maintaining your reduction is to wear properly sized, comfortable compression garments daily.
If you feel you are experiencing signs of undiagnosed lymphedema, consult your physician or lymphedema specialist and then call us for assistance.
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Or call us at 1-800-515-4271, and one of our Certified Fitters will be happy to help you.
Vanda and the Support Hose Store Team