Q: Do I need to wear a compression garment to manage Lymphedema?

A: Yes. Compression garments are designed to offer a gradual level of support to the area(s) of your body that have developed Lymphedema. Wearing a compression garment will help you control the condition while continuing your daily activities. We will work with you to fit a garment that best suits your needs.

Q: My therapist is using words such as: "compression garment," "garments," "stockings," "hand glove," and "millimeters of mercury." What do they all mean?

A: "Compression garment" or "garment" is used to describe compression products that provide graduated support for Lymphedema management anywhere on your body. Graduated compression garments are available in custom made and standard sizes;

"Compression stockings" refer to graduated compression products used to manage leg, thigh, or waist-length Lymphedema concerns;

"Hand gloves" describes a compression product to provide hand support. Hand gloves can be made to include individual finger supports when needed;

"Millimeters of mercury" or "mmHg" relates to an estimated measure of the amount of gradual compression woven into the product. For instance, a 20-30mmHg garment is designed with a gradient 20mmHg to 30mmHg compression support, with the lighter compression always designed to be at the point closer to the torso. A 20-30 mmHg arm sleeve will offer up to 30mmHg of graduated compression at the wrist, with compression support gradually reducing to 20mmHg at the arm pit, designed to encourage appropriate lymphatic drainage towards the torso. The higher the compression numbers, the more compression support is offered by the product. It is important to be fitted with a compression garment with enough support to control your Lymphedema. Higher level compression garments are not always appropriate. You also need to be able to don and doff the garment, and comfortably wear it during daily living activities. An appropriate fit is also important.

Your therapist will provide a written summary of recommendations for graduated compression garments for your physician and insurance provider.

Q: How do I obtain coverage for these compression garments?

A: If you have extended healthcare insurance benefits available, your plan may offer coverage for graduated compression garments. Please contact your insurance company for benefit details and requirements for reimbursement prior to setting an appointment for measurement. It is your responsibility to ensure you are informed about what your extended health insurance plan will cover. CLR Healthcare cannot contact your insurance company plan to inquire about your benefits due to healthcare privacy restrictions. Your therapist at CLR Healthcare Inc. will work with you to provide any required documentation. Often, the extended health insurance plan will require a detailed physician prescription for graduated compression garments. Your treating therapist will provide a written recommendation that can be submitted to your physician for their consideration.

Q: How much are graduated compression garments?

A: The compression garments vary widely in price by model, compression level, size of garment, options and design. We recommend receiving a quote from your therapist during the treatment sessions to provide an opportunity to review and consider your extended health coverage options. Custom garments are more expensive than standard sized garments. Individual needs may vary widely.

Q: What type of graduated compression garment should I have?

A: The most effective compression garment is one that you are able to consistently wear in your daily living activities that concurrently provides adequate support to help you to effectively manage the Lymphedema. The type of compression garments you need depends on several factors:

  • Our client's thoughts and input;
  • Our client's Lymphedema location, severity, and response to treatment;
  • Our client's medical and other therapy issues;
  • Our client's daily living activities.

Graduated compression garment products become part of your daily wear and serve a vital role in long-term Lymphedema management. The garments need to meet your medical needs while being suitable for your daily living activities and lifestyle. Needs may change over time and with different activities. For example, one graduated compression garment may be more appropriate for work related activities, while another garment is more suitable for your leisure pursuits. Also, Lymphedema care and garment products continue to improve over time offering our clients more choice and options.

Q: What is the difference between a custom garment and standard garment? Which one do I need?

A: Standard or pre-sized garments are designed and fabricated by graduated compression garment companies to fit using pre-established measuring points. If your affected extremity fits within the range on all measurement points, you may be a candidate to wear a standard sized garment. If you have mild or negligible Lymphedema, a standard size garment may be adequate to meet your needs.

In comparison, a custom-sized garment is a made-to-measure product to meet the specifications of your affected extremity. A custom garment will generally provide a better fit for your extremity, and will provide a more consistent level of graduated compression support. Custom garments do require detailed measurements, are more expensive, and require a waiting period to allow for manufacturing and shipping. All custom garments are made either in the U.S. or Europe.

Q: How do I manage the Lymphedema while waiting for the compression garments to arrive?

A: A crucial part of treatment is to work with your therapist to develop strategies to help manage the Lymphedema independently. You may benefit from integrating a combination of:

  • Self-bandaging;
  • A home exercise program;
  • Modified daily living activities;
  • Consistent daily skin care;
  • Periodic follow-up sessions with your therapist;
  • Self-manual lymphatic drainage techniques.

These treatment sessions offers a great opportunity to work on becoming more comfortable developing your skills to manage your Lymphedema independently. Your therapist will be able to offer assistance and feedback to help you in this process.

Q: How long do the graduated compression garments last?

A: Lymphedema graduated compression garment use is a crucial part of long-term Lymphedema management. The graduated compression garments should be replaced every 4 to 6 months depending on use, as the garments wear out over time.

Q: Why don't I get a compression sleeve prior to starting treatment?

A: Compression garments are a vital part of long-term Lymphedema management. However, daytime compression garments are not designed as an active treatment to reduce a swollen, lymphedematous limb. A properly fitted compression garment, worn consistently, and replaced as needed, will help clients to maintain limb size.

Our clinic recommends assessment and treatment to reduce size, volume, and to improve skin integrity prior to compression garment fitting. After the Lymphedema has stabilized in volume and presentation, then fitting with a compression garment to help sustain these improvements is usually more appropriate. Working with your therapist will also provide an opportunity to develop the tools and strategies to help you manage your Lymphedema independently and address any concerns with return to daily living activities.

Wearing a graduated compression garment alone may not be adequate to achieve most effective long-term Lymphedema management. Graduated compression sleeves need to be considered as an important component of an overall comprehensive client self-management program.

Q: How many sleeves do I need? What if the garment is not right for me?

A: CLR Healthcare Inc. recommends clients start with ordering one graduated compression garment. After being fitted with your first garment, we will provide education, support, and follow-up to ensure the Lymphedema is being well managed. Questions to ask yourself and report to your therapist when initially wearing the garment are:

  • How well is the Lymphedema being managed?
  • Does the garment feel comfortable? If not, what is bothering me?
  • Does the garment cause any problems that my therapist mentioned during treatment? Pain?
  • Numbness/tingling? Skin color change?
  • Am I able to return and continue with my regular daily activities? Work? Leisure? Social activities?
  • Can I don and doff the garment independently?

A follow-up session with your therapist with a week or two after receiving the graduated compression garment is strongly recommended. In the interim, if you are having any problems or concerns with your garment, you must contact your therapist and garment fitter immediately to address these concerns. Your therapist is available to assist you in long term management of Lymphedema.

Garment fitting can be a challenging process. Your therapist will do their best to ensure you get the best fit and most comfortable garment possible from the manufacturer. It usually takes clients a period of time to adjust to wearing a garment on a daily basis.

After getting a well fitted graduated compression garment that meets your needs, we recommend ordering a second garment to wear on alternate days. Alternating sleeves may increase the useful life of each garment, and makes it easier to manage with a busy lifestyle. For instance, if you lose or tear one sleeve, you have a back-up available to wear while ordering a replacement. You can also save time with having to wash sleeves less frequently with having multiple garments to wear.

Q: Do I wear my daytime graduated compression garments while I sleep?

A: No. If you will benefit from compression therapy during resting hours, your therapist will recommend a specialized night time/resting compression product. Garments worn out of bed should be removed prior to rest/sleeping hours, washed and hung to dry, then donned the following day after you wake.

Q: What are the products available to help me manage my Lymphedema while I rest?

A: If you could benefit from compression therapy during resting hours, CLR Healthcare Inc. has access to specialized compression products to meet your needs. Peninsula bio-medical; Medi Circaid; Jovipak; and Lymphedema depot; are companies that make or distribute products that can be worn during resting hours to provide Lymphedema management. Some products are designed to be used in conjunction with bandaging, while others have designed a graduated support system to provide compression therapy while at rest.

Q: How do I care for my new graduated compression garment?

A: New graduated compression garments come with written recommendations for appropriate care of the product. In general, graduated compression garments should be placed in a garment bag, and washed daily with a mild non-bleach laundry detergent, warm water, on a gentle cycle, then hung out over night to dry. Do not place the garments in a dryer. Graduated compression garments should be donned and doffed using a pair of rubber gloves to reduce the chance of developing a tear/run in the garment. Your garment fitter or therapist will educate you on how to don and doff the garment. Please refer to the specific wear and care instructions provided when you purchase your garment.

Extended Healthcare Benefits Summary

Q: How do I obtain a compression garment if I plan to use extended healthcare benefits?

A: Step 1: Contact your insurance provider to clarify benefit and coverage details.

Step 2: Complete assessment and treatment with your therapist at CLR Healthcare Inc. Assessment and treatment should preclude graduated compression garment fitting to provide an opportunity to treat the Lymphedema to reduce volume prior to graduated compression garment fitting. Your therapist will provide a written recommendation to your referring physician for compression garment(s) for their review and approval.

Step 3: Schedule a measurement and fitting session. A session may take up to an hour depending on the type of garment(s) being ordered to take appropriate measurements and review options. We will request payment for graduated compression garments and provide a detailed receipt. Keep a copy of the receipt and physician order for your records prior to submission to your insurance company.

Step 4: Submit your compression garment receipts, physician order, and other completed insurance paperwork to your extended healthcare benefits provider for consideration and reimbursement.