Garments: The good, the bad, and the ugly

Disclaimer: Before using compression, get clearance from a medical professional.

Garments are tools we have to keep our swelling in check so we can get on with our day and do the thing we were here to do.

I’m not sure anyone dreams about having to wear a compression garment. Depending your comfort level with your diagnosis, some views might include:

-Revulsion- “You want me to wear that? No way, that will look terrible.”

-Gratitude- “I’m so grateful for this thing that keeps me healthy.”

-Curiosity- “I wonder what options are out there for me?”

-Annoyance- “This thing is so hot and hurts.”

There are two types of compression garments on the market: flat knit and circular knit.

Flat knit garments

Pros: Better contains swelling throughout the day

Cons: heavier fabric may be hotter, usually custom which can drive up cost

Circular knit garments

Pros: Looks like a sock, hose, or leggings; less bulky, more affordable

Cons: Doesn’t contain the swelling as much

A note about custom versus over-the-counter garments. For individuals who have a less “cone shaped” limb or the swelling is worse, an over-the-counter may not fit, thus demanding a custom garment. Custom garments are exactly that; they are fit for you and will contain your swelling better. However, the opportunity cost is increased price.

More about price. Currently in the United States some insurance companies are covering compression garments with special documentation required by a physician which is GREAT! Ten years ago, insurance companies declined to pay because they deemed compression garments cosmetic (insert eye roll). That is a soap box I will cover at a later date. If you don’t have health insurance or your health insurance doesn’t cover compression (like mine- which isn’t that bad of a plan), you will have to plan financially for your compression garments. Compression garments need to be replaced every 6-9 months due to their elasticity wearing out rendering them ineffective. Just like you plan for your budget to include oil changes/maintenance if you have a car, you will have to plan for your compression garments through budgeting. I usually set aside $ 500 for every garment (custom thigh high and toe cap). I’m going to use some Aggie math here and set aside $28-$41/ biweekly paycheck to buy what I need for my health.

My first compression garment was a knee high 20-30 mmHg circular knit garment that was closed toe. I liked it because when I was 19, it looked like the color of my skin and was easy to hide under jeans with closed toe shoes. I later transitioned to an open toe which gave my toes some breathing room. I didn’t like it because I was adjusting to wearing a compression stocking and hadn’t accepted yet that compression garments were now a part of my life. Forever.

As my swelling progressed further up my leg into my thigh (because my lymph blockage is in my groin), I tried using compression hose 20-30mmHg. These can mimic normal panty hose and provide more compression where you need it. Side note: due to the lack of airflow using thick pantyhose, you are at increased risk for things like yeast infections. Wear cotton underwear, be hygienic and be cognizant if you feel like you may be getting one.

After that, I was prescribed a custom chap which is a thigh high that extends on your side body and is usually attached to a belt that goes around your waist. This in theory is the best compression garment for me to contain the right areas. However we all know intention does not always ensure delivery. I HATED this garment because I couldn’t wear the clothes I normally wore, it didn’t fit well on my side body, and it bunched behind my knee. I ended up taking it back to the DME store who sent it back to the manufacturer to modify it to a thigh high. This thigh high was a better fit, however the knee bunching and pain still continued; therefore I didn’t wear it. That’s right. I didn’t wear it because it didn’t fit well.

The most important thing when getting a custom garment is clarifying your expectations for the garment (fit/material/how it will actually wear) and finding a GOOD fitter. If you are interviewing a DME store to be your supplier, questions to ask include:

-Has this fitter been certified by multiple compression companies?

How long have they been certified?

How often do you measure people? (i.e. To gather their previous experience)

I was very naive as a 20 something and didn’t ask these questions to only be disappointed later. I also didn’t understand that the custom compression garments are hundreds of dollars and returning my garment because “I didn’t like it” was a huge disservice to their business. Take home point: Do your homework beforehand. Like dating or a job interview.

The day Kathy measured me was the best day of my compression life. She is one of the coolest people I have worked with due to her knowledge of products and understanding people. She fitted me in Guenters class for a custom thigh high that fit beautifully. It was life changing. I still use a custom thigh high and now a toe cap to this day. I put them on in the morning and get to be a physical therapist during the work week without thinking about my leg. I’m able to focus on other people because of this tool in my tool belt and I’m incredibly grateful for it.

Since getting my custom garment, Cassie has introduced me to some new compression tools like compression leggings which I will layer with my thigh high or new colors that mimic some of the trends of today. I’m so grateful for the variety she has brought to my garment rotation and am looking forward to the new things coming out.

I have gotten creative over the years layering a knee high with a pantyhose or knee high with a circular knit thigh high to give me the compression I need with the visual appeal I want. For example, I’ll wear a circular knit knee high and thigh high with a dress in the summer because it’s less hot and looks better at weddings, events, etc. I’ll wear compression panty ose with a knee high in colder climates with a dress or under leggings to give symmetry to my outfit and keep me warm. Sometimes, I will use compression shorts to add sidebody compression if I notice increased gluteal swelling. I’ll use my old circular knit knee high or thigh high if I’m hitting the beach or pool to give me a little compression while not caring if it gets ruined.

At the end of the day, I decide how I will live my life, God willing. Most of the time my priority is containing my swelling, but on days when I need to look vogue, I’ll get creative. I encourage you to do the same.

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