In the typical treatment of lymphedema, a patient begins by bandaging 23/24 hours a day, and once the volume of a limb stops decreasing, the patient is then prescribed a garment. Garments are worm daily to maintain the reduction in swelling, but they do not reduce the volume. For this reason, the patient continues to bandage at night, or will wear a special nighttime compression garment.
Daytime garments help to stop lymphedema from getting worse. Sleeves, gloves, gauntlets (fingerless gloves), knee- and thigh-high stockings, pantyhose, bras, camisoles and shorts are all available in varying degrees of compression. Generally after bandaging, a patient goes into a Compression Class 2 (30-40 mmHg) sleeve/Compression Class 3 (40-50 mmHg) stocking. If a patient has mild lymphedema or is preventing it, Compression Class 1 (20-30 mmHg) sleeve or Compression Class 2 stocking (30-40 mmHg) is appropriate.
Garments are to be worn daily and not to be slept in, with the exception of certain bras. You should put them on as soon as possible in the morning. You need to wear them when you are doing any form of exercise.
Some health insurance plans cover at least a portion of the cost, so check with your provider. A doctor's prescription is required for all garments of Compression Class 1 or higher. You should have two garments so that you can wear one and wash one.
- Cover the whole area that is swollen
- Not stop you moving normally
- Not have any baggy or loose areas
- Be comfortable, just giving firm support that is not too tight
- Be measured just for you
- Be replaced every 3 to 6 months--they lose shape with washing, and the pressure they put on the tissues may change.
*Taken from www.cancerresearchuk.org
In place of bandaging at night, you may be able to wear nighttime garments. Nighttime garments are one-piece that can easily be pulled on over limbs that have been already reduced in size (by bandaging). These custom-made garments can be worn overnight to reduce the edema because the compression in gradated, just like bandages. Tribute, made by the Solaris company is the garment CHPT recommends; Mary Jo Provenzano is a distributor and can order your custom garment, with a prescription from your doctor. With prior approval, some insurance companies cover a portion of the cost of the garment.
Mary Jo Provenzano, RN, is a certified lymphedema and mastectomy fitter, located within CHPT. Mary Jo is a distributor of daytime and nighttime garments, including Juzo, Jobst, LympheDivas, Sigvaris, Medi, and Solidea, as well as mastectomy bras and prostheses by Amoena, Anita, Bellisse and Wearlass.