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