What Compression Level Socks or Hosiery Do I Need?
There are many levels of compression in compression socks and hosiery ranging from light/mild/OTC 8-15mmHg ( mm of mercury ) to 50-60mmHg. There are non-medical, light/mild or Over The Counter (OTC) levels as well as Medical Levels of compression, each level signifying a need for a specific level of intervention to assist your legs. Manufacturers use many terms such as Light, Mild, Medium and Heavy. Most manufacturers will indicate that their OTC products are suitable for most everyone. Nearly All manufacturers indicate that for medical compression socks and hosiery compression levels, you should have a consultation with a healthcare professional capable of providing a diagnosis as well as a prescription if necessary. At Support Hose Store, we urge you to consult with your healthcare professional so you may have the best compression garment suited for your healthcare needs. The Medical Community use many methods to determine the levels of venous disease diagnosed and ultimately the compression levels that patients require. One of the most common standards of measurement is CEAP, as depicted below: http://www.sigvaris.com/sites/default/files/sigvaris_ceap_classifications.png
Which Style Is Right For Me?
Should I wear knee highs? Thigh Highs? Waist High/Pantyhose? What about Maternity? Are the sizes for Plus individuals? What about Open Toe vs Closed Toe? It is difficult for anyone to determine which style is going to work best for you in dealing with your leg issues due to many factors including your leg shape, the progression of leg disorders, personal preference, discomfort level and last but not least, “Doctor’s Orders”. There is something that does apply across all manufactures and that is the best compression garment to wear is one that fits well, is comfortable and one that you will wear consistently. The same applies to the least effective compression garment is the one in your sock drawer! When your healthcare professional provides you with a diagnosis and treatment plan that includes the wearing of medical compression garments, do all you can to follow his/her advisory plan – wear your compression garments and your legs will thank you! Once you decide which style to wear, or perhaps a combination of more than one style to match your work and personal activities, check out the many manufacturer brands Support Hose Store carries, the various Closed Toe/Open Toe choices along with the array of color choices to best suit you.
How Do I Measure Properly?
There are a few good rules to follow, regardless of the manufacturer’s brand you select such as:
1) Measure At The Beginning Of Your Day; in the morning from regular day time folks while early afternoon for evening workers and late afternoon for those who work nights. This is to try to get your measurements when swelling may be minimal or non-existent.
2) Measure Without Shoes on to get the most accurate height measurement.
3) Measure against your bare skin leg areas when possible.
4) When in doubt, call our Customer Service Certified Fitters to discuss your needs. We are here to help you!
What Is The Best Way To Take Care of My Socks and Hosiery Garments?
Each manufacturer has different care and use instructions. Please see the information included with your garment either on the package or inside the package/box.
Is There An Easier Way To Put Compression Garments On?
Compression Socks and Hosiery by nature are tighter than the other socks and hosiery you are used to wearing. By definition, they apply pressure against the outside of your leg to assist in the promotion of better blood and fluid flow and management. SO do NOT be surprised to learn they take a bit of work to get on your legs. There are many “techniques” such as the “heel puppet”. With time, most of us will develop an expertise with the technique that works best for us. See the following URL’s to view video on these many techniques:
HOW TO PUT ON STOCKINGS
HOW TO PUT ON ARMSLEEVES
Most vein diseases are chronic conditions and can be associated with a wide range of health issues. They can impact anyone, but there are some risk factors that increase a patient’s likelihood for developing a vein disorder at some point during their life.
Risk Factors for Chronic Venous Disease
Chronic Venous Disease (CVD) occurs in the peripheral venous system of the legs. Venous valves, primarily in the calf, weaken over time and cause a blood to flow backward. This increases pressure on the peripheral venous system, leading to venous hypertension.
Patients with a history of deep vein thrombosis, varicose veins and other venous conditions have an increased risk for developing CVD. A family history of these disorders also increases a patient’s risk for CVD1. When left untreated, CVD can lead to Chronic Venous Insufficiency (CVI). Risk factors for CVD include:
- Being over the age of 50
- Being female
- Tall height
- Sedentary lifestyle
- Limited mobility
- A family history of varicose veins, venous ulcers or deep vein thrombosis
- Conditions like cardiac disease, diabetes, phlebitis, varicose veins, venous thrombosis and venous obstruction
Chronic Venous Disease Facts
Between 60 and 80 percent of leg ulcers are related to the venous system2. Additionally, CVI impacts nearly five percent of adults in developed nations3, while varicose veins affect as much as 30 percent of the population1.
1. Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation. 2014; 130(4):333-46
2. Nicolaides AN. Investigation of chronic venous insufficiency. A consensus statement. Circulation 2014; 102(20):e126-63
3. Angiology, 1997 Jan;48(1):67-9. Socioeconomic impact of chronic venous insufficiency and leg ulcers. Ruckley CV
Deep Vein Thrombosis
Deep Vein Thrombosis, also called DVT, occurs when blood clots form in the extremities. Clots that form in the legs can travel to the lungs, leading to a pulmonary embolism which can be fatal. Risk factors for developing DVT include:
- Blood-clotting disorders
- Prolonged periods of inactivity
- Heart disease
Commonly referred to PTS, post-thrombotic syndrome can develop after periods of DVT. It is a chronic condition that can lead to permanent disability. PTS leads to more than 2 million lost work days each year.
PTS occurs after the body’s veins have been damaged by DVT, eventually leading to decreased blood flow to the damaged area. This can cause edema, pain and sores.
- Itchy Legs
- Feeling of weakness in the legs
- Swelling in the legs or ankles
- Changes in skin color, especially in lower leg
- Aching or throbbing in legs
- A heavy feeling in the legs
- Leg cramps
- Development of thicker skin in legs
- Varicose veins
- Tight feeling in the calf muscle
- Pain when standing that improves when legs are elevated
- Leg ulcers
Symptoms of Deep Vein Thrombosis (DVT)
- Redness on the leg
- Sudden swelling of the leg
- Skin that is warm to the touch in the area that is swollen
- Pain or tenderness in the leg, which often starts in the calf, feels like a cramp and may present only when standing or ambulatory
Symptoms of a Pulmonary Embolism
Venous disorders, especially deep vein thrombosis, can lead to a pulmonary embolism — a blood clot that travels to the lungs. There are several warning signs for pulmonary embolism that require immediate treatment, including:
- Sudden feeling of shortness of breath
- Chest pain that worsens when taking deep breaths
- Lightheadedness or dizziness
- Sudden fainting
- Increased heart rate
- Coughing up blood
Pulmonary embolisms can be fatal, but receiving immediate medical attention greatly improves the chance for survival. Proactively treating venous disorders can greatly reduce the risk for pulmonary embolisms.
CEAP Classification System
The first step towards managing CVD is classifying your patient’s symptoms. A clinical classification system known as CEAP – Clinical, Etiology, Anatomic and Pathophysiology – was developed in 1994 by an international consensus conference to provide uniformity in reporting, diagnosis and managing CVD.
The CEAP classification system focuses on the clinical aspects on this site, which range from C0, with no clinical or visible signs, to C6, when venous leg ulcers (VLU) are present.
Vein Disease Anatomy
Vein disorders occur when the body’s veins have been damaged. The damage is caused by a variety of factors ranging from lifestyle choices, such as being sedentary and smoking, to medical issues that include cancer, heart disease and blood-clotting disorders.
Vein diseases typically occur in the extremities, often in the legs. Many venous disorders can be linked to patients with a history of deep vein thrombosis, a condition causing blood clots to form in the legs and, therefore, block blood flow. This will lead to painful edema caused by the breakdown of the layers of collagen and elastin that make up blood veins’ walls that inhibit blood flow.
Venous disorders affect several veins throughout the circulatory system. Unlike arterial circulation, venous circulation disrupts the ability to pump blood back to the heart. In the case of DVT, if the blockage becomes dislodged it can travel through your circulatory system. This may lead to a pulmonary embolism, which can be fatal if it goes undetected.
Managing Vein Disease
Most vein diseases are not considered to be life-threatening conditions, and many can be controlled with management. The key to treating vein diseases lies in improving blood flow to the affected area. This can be accomplished several ways.
There are a few things to consider when determining how to manage the disease, including the patient’s age, symptoms, tolerance for various management options and the expected progress of the venous disorder.
- Compression Therapy: This is one of the most common approaches for venous disease management. Compression garments, like those supplied by JOBST®, improve blood flow. These garments, often called compression stockings, use gradient compression to apply pressure to the extremities. This helps improve blood flow and reduces recovery time for patients.
- Medication: Prescription medications are primarily used in conjunction with compression therapy when treating venous diseases. Medication may be used for treatment more often in cases where leg ulcers are present.
- Chemical Therapy: Chemicals are injected into the veins to cause scarring, leaving the vein unable to transport blood. The circulatory system automatically compensates to return blood to the heart through healthy veins, and the damaged veins are eventually absorbed.
- Surgery: Surgical procedures are performed to directly alter the blood flow away from damaged veins. Surgery may also be performed to repair, remove or transplant the affected veins.
Contact Our Customer Service Team to Learn More About Compression Therapy
JOBST is a leading manufacturer of gradient compression garments throughout the world. To learn more about the garments we offer, please call our customer service team at 1-800-515-4271.
Anatomy of the Lymphatic System
The lymphatic system is responsible for the production, transport and filtration of lymph fluid throughout the body. In addition to its important circulatory functions, the lymphatic system also has important immunological functions.
The network of lymph vessels is divided into:
The lymph capillaries form the beginning of the lymphatic system. Here, large molecules (proteins) and interstitial fluid are absorbed and flow towards the pre-collectors, which channel the lymph fluid into the larger collectors.
The collectors have valves similar to veins which determine the direction of flow. The lymph collector segment bordered by a distal and proximal valve is known as a lymphangion. Here, the lymph flow is supported by intrinsic contractions of the lymphangion which is regulated by the sympathetic nervous system and lymph volume.
Lymph transport is also facilitated by several extrinsic factors:
- Breathing (diaphragm)
- Muscle contractions
- Vasomotion (pulsation of arteries)
- Negative pressure in central veins
- External compression:
- Manual lymphatic drainage
- Short stretch bandages
- Gradient compression garments
On its way into the circulatory system, lymph passes through lymph nodes, which are stationed throughout the body. While the axilla and inguinal areas are the most well known for lymph nodes, the head and neck also contain a large quantity, as do the intestines.
The main functions of the lymph nodes are:
- Filter bacteria, toxins and dead cells
- Produce lymphocytes for fighting infection
- Regulate protein concentration in lymph
Finally, the lymphatic fluid is returned to the circulatory system throughout the major lymphatic trunks, such as the thoracic duct. Approximately two liters of lymph flow into the blood circulation every day.
Learn More About Lymphedema
To find out more about how lymphedema impacts the body, or to learn more about how compression therapy can help make the disorder’s symptoms more manageable, contact our customer service and speak with a member of our team.
Stage 0: the Latency Stage
A subclinical state where swelling is not evident despite impaired lymph transport. This stage may exist for months or years before edema becomes evident.
Stage 1: Mild Stage
Early accumulation of fluid relatively high in protein content that subsides with limb elevation. Pitting may occur. An increase in proliferating cells may be seen.
Stage 2: Moderate Stage
Limb elevation alone rarely reduces swelling and pitting may or may not occur as tissue fibrosis develops.
Stage 3: Lymphostatic Elephatiasis (Severe Stage)
Pitting is absent and trophic skin changes such as acanthosis, fat deposits and warty overgrowths begin to develop.
Seeking Treatment for Lymphedema
Early detection and management are essential in limiting the effects of lymphedema. Once lymphedema is diagnosed, the goal is to delay or even prevent the progression of the disease. JOBST® gradient compression garments help facilitate your commitment to compression therapy in all stages of management.
Gradient compression garments are one of the leading and most effective management options for long-term lymphedema treatment.
What is Gradient Compression?
Gradient compression garments apply more pressure distally while gradually decreasing pressure as the garment travels up the extremity. Gradient compression helps encourage and facilitate fluid movement for patients affected by lymphatic and venous disorders. With gentle pressure, gradient pressure allows vessels in the circulatory and lymphatic systems to absorb more fluid from tissues. The result is increased absorption of tissue fluid and decreased swelling.
Why Use Gradient Compression?
Gradient compression is an efficient way of managing edema caused by lymphatic and venous disorders. By increasing pressure on tissues, more fluid returns to the lymphatic and circulatory systems so it can be transported to the rest of the body while improving edema. All of this helps reduce the risk of further development.
Removing excess fluid reduces the risk for infection while combating edema. The compression garments offered by JOBST also help reduce the size of superficial veins by keeping them from filling with too much blood and expanding. Increasing pressure also helps encourage fluid to flow back towards the heart.
Learn More About Gradient Compression
If you’d like to learn more about how gradient compression can help improve circulation, reduce swelling and treat the symptoms of lymphedema and vein diseases, contact our customer service team at 1-800-515-4271 and we’d be happy to answer your questions.
Compression garments are necessary for the effective long-term management of lymphatic and venous disorders.
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