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Getting fitted for compression stockings

2/6/2013

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It's that time of year again...time for new stockings!  Generally, compression stockings are supposed to last only a mere six months.  It has been a year since I have had new stockings, so I decided to call my local compression stocking dealer and get the goods.  As it turns out (and much to my dismay) the place where I normally get my stocking prescription filled no longer is in the business of compression stockings, blurgh!  I have gotten my stockings ‘scrip filled there since I started wearing the things.  I had become well acquainted with their staff and had established a routine; I knew exactly what to expect and what was expected of me.  So when I called for my yearly fitting and was told I would have to start fresh with a new company, I was less than thrilled.  They kindly referred me to another local place and so I called and made my first appointment at ActiveLife.  Let me just say, WOW!  I'm impressed.  This place knows exactly what they are doing; they knew what questions to ask me, made sure I had my prescription (and had me fax it over to them before my appointment), plus they had me fill out my “new patient” paperwork all before I stepped foot in their office.  This got me to thinking that it might be helpful to share what you can expect when going for a fitting and the considerations you'll need to make before your appointment.  Here the list:
  • Get a prescription.  This is a probably the most important consideration, and maybe an obvious one; let me elaborate.  You actually don't have to have a prescription to get stockings, you can very easily order them on-line and there are several on-line retailers available (another topic I'll post on later).  However, if this is your first time to the compression stocking rodeo or if you have insurance that will help cover the cost of your stockings, then you definitely want a prescription.  If you have never before worn stockings, you will benefit tremendously by going to see a certified fitter; they are chock-full of helpful information on managing lymphedema and will help you to get the proper stockings for your specific condition(s).  If you aren't new to wearing compression stockings and, as mentioned, you have insurance that will help cover your costs, the only way to take advantage of that benefit is by going to see...yup, you guessed it...a certified fitter.  On-line retailers do not take insurance.  Perhaps someday this will change (wouldn't that be nice?!), but for now the only way to take advantage of those awesome insurance benefits is to have a prescription.
  • What to have on your prescription.  Yeah right, as if this were up to you...that's your doctor's job, right?  Actually, I'd say it depends on your doctor.  When I was first diagnosed with lymphedema by my primary care physician she told me I needed to see a certified fitter and gave me a prescription for TED hose at the 30-40mmHg compression level.  As it turns out, that's not quite what I wanted (those TED hose typically come only in white, yuck!) or needed.  When I was referred to my vein specialist, who ultimately diagnosed my venous insufficiency, he was much more experienced in the realm of writing prescriptions for compression hosiery.  He even had a handy little prescription pad, provided by the Medi brand, that had all of the options written on it (for their brand only, of course, but nevertheless it was quite handy).  So, if your doctor doesn't have this cool, specialized prescription pad for compression stockings, or they simply just don’t know much about compression stockings there are two things that you absolutely must have on your 'scrip: compression level (always written in mmHg, with the three most common levels being 15-20mmHg, 20-30mmHg, and 30-40mmHg) and style (knee-high, thigh-high or pantyhose).  The other things (brand, size, color and fabric type) will depend on what your fitter determines is the best size for you, what brands they stock/re-sell and what your preference is for color and fabric type (some brands sell more sheer products vs. more opaque products and there are advantages and disadvantages to both).  So the take home message is this: be sure to tell your doctor that you absolutely must have the style type of the stocking (again, this being knee-high, thigh-high or pantyhose style) and the compression level (this they should know to do) written on the 'scrip, otherwise, you'll end up contacting them for a new prescription because the fitter that orders your stockings can only order for what has been written on the Rx.
  • Schedule your appointment as early as possible.  Anyone with lymphedema knows that the swelling is at a minimum first thing in the morning- after they've had their legs elevated for an extended period of time.  By getting fitted for your stockings when your legs are at their thinnest, you'll ensure that you are getting the most accurate size stocking that will aim to keep your legs at their skinniest- which is exactly where you want them.
  • Get the insurance stuff out of the way before your appointment.  Depending on your insurance company, you may have to file a pre-authorization form in order to have them pay for your stockings.  The place where you order your stockings should, in theory, do this step for you when you call to schedule your appointment.  Having a pre-authorization does two things: it verifies exactly what your insurance company will cover (ie. how many pairs and how often) and it also insures that you won’t be stuck with an outrageous bill when you go to pick up your stockings because they will have already approved the transaction.
  • Wear your stockings to your appointment, (if you have 'em).  If you follow my advice above and schedule your appointment as early as possible, it won't guarantee that some swelling won't have a least started by the time you actually get to your appointment; especially if you don't leave the house just moments after you've been upright or if you have a long drive to get to your appointment.  If you don't have stockings yet, don't worry, just try to minimize the amount of time between your appointment and when you first get out of bed.
That’s about it!  I am sure that experiences will vary depending on where you get your stockings prescription filled but if you follow this short list of suggestions, hopefully it will help to make the process go smoothly.  Now that you are armed with all the information you need to make sure you get the proper compression stockings...what are you waiting for? 


What has your experience been with doctors writing a prescription for compression stockings?  Are they knowledgable?  Do you have to provide them guidance?
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Why I started this website.

1/3/2013

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I have started this site because I feel I have a unique perspective to contribute to those that suffer not only from lymphedema, but anyone that wears compression stockings on a regular basis.  But before I get ahead of myself, I figure I should give you all a little insight into my not-so-distant past.  

I have a rare genetic condition, called lymphedema distichiasis syndrome (LDS), which means I not only have lymphedema of my lower limbs, but I was also born with an extra row of eyelashes.  Lucky me, you say?  Not quite.  As much as I would love to have an extra row of lush, beautiful lashes defining my eyes (let's face it, who wouldn't?) this is only desirable if those lashes are growing away from your eyeballs, not towards them as in my case.  Needless to say, I've long since had them removed via electrolysis.  My memories of having this done are not my happiest.  It's not that the procedure was painful, it was more the way I looked each and every time (was it six?) I had to have it done...swollen tissue, bruises and goop, oh my!  It was quite a sight, but more on this in another post.  

Now to the lymphedema aspect of LDS and what this means for me.  There is certainly a lot to cover regarding lymphedema and I will eventually get to it all, but it's going to take some time.  For the purposes of this post, I will just give a brief overview.  

The onset of my symptoms was so gradual over so many years that I wasn't diagnosed until I was 27 years old, despite having signs of the disease first developing in my early twenties.  My earliest symptoms included mild swelling of my ankles which was always alleviated by elevating my legs; this mostly involved the simple act of going to bed at night.  By the time I awoke the next morning, the swelling would be gone only to return again in the evening.  Over time the swelling got worse, but like I said it was so gradual over so many years that I thought it was normal.  It became my normal.  In fact, for the longest time I simply thought that I had "thick" ankles, which have come to be not-so-affectionately known as cankles.

I eventually developed other symptoms, which were more bothersome, such as intense aching and throbbing in my legs after standing for long periods of time.  As it turns out, I also have something called venous insufficiency, which is often, but not always, associated with certain types of lymphedema.  They are, in fact, two separate diseases, diagnosed in two very different ways.  

Dealing with my venous insufficiency had it's own set of hurdles ranging from trouble getting diagnosed to having a handful of not-so-fun outpatient procedures and minor surgeries.  At at later date I plan on outlining all of this in order to help others that may be experiencing similar frustrations getting diagnosed and letting them know what exactly to expect if they decide to seek treatment.  But for now, I think I've provided enough of a brief history, so  now onto the main point of this post.  Why, exactly, did I start this website?  

The long and short of it is this:  Lymphedema doesn't have a cure, but with a little bit of effort (okay, maybe a smidgen more than a little bit) it can be well managed.  I'd like to share my experiences and the tips and tricks I've stumbled upon to manage this disease.  Particularly, the consistent use of compression stockings.  

I know, I know...ugh, compression stockings!?  The mere mention of these words conjures up images of little old ladies in beige stockings so thick that even if they hadn't shaved their legs in five years it would impossible for anyone to know.  They actually have gotten better over the years but are still far from being sexy.  Despite this, they continue to be the best tool available for managing lymphedema and because of this, I have developed a love/hate relationship with these woven garments of nylon, spandex and elastic.  That being said, the love I have for them for making my legs feel fabulous and keeping the fluid out (or in, where it belongs), definitely out ways my desire to rip them to shreds for defiling my fashion sensibilities.  This is why I started this site: I have decided to embrace them whole-heartedly.  Gone are the days of not wearing shorts, skirts and capris.  I've had enough!  I am done trying to hide the fact that I wear compression stockings.  I am done wearing pants year round even in the dead heat of summer.  I am done wearing the same few outfits over and over again because they disguise the fact that I wear these stockings.  Not wearing them is not an option, and so the only thing left to do is to take the advice of fashion guru Tim Gunn and "make it work".  I've realized that you don't have to hate your compression stockings and you certainly don't have to hide them, you just have to learn how to incorporate them into your wardrobe.  

Join me on this journey as I scrutinize my wardrobe and my lifestyle and find a way to merge these two seemingly opposing worlds of fashion and compression.  And who knows?  Maybe you, too, will be inspired and dare to expose your hose!
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    My name is Christin and I am a compression stocking addict; nice to meet you!  I hope you find this blog both informative and inspiring.  I'll probably be updating weekly, so check in often or better yet follow me on your favorite RSS reader.

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