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Compression Stockings

What are compression stockings?

Compressions stockings also known as TED stockings (thromboembolic deterrent stockings) are now widely prescribed for the prevention of blood clots. These specialized stockings are tighter at the heel and gradually get looser up the leg. This change in pressure gradient is designed to squeeze the lower muscles in the leg and push the blood up to the heart. This squeezing action helps prevent blood clots and maintains the circulation in the legs. Compression stockings also reduce the swelling in the legs which is so commonly seen after standing around at the end of a long day. Once used only in hospitals, compression stockings are now available for home use.

Are compression stockings only for women?

Graduated compression stockings are made for both men and women, and they come in various designs such as knee highs, thigh highs, and pantyhose.

What medical conditions are treated with compression stockings?

Compression stockings are a simple, non-mechanical method of treating conditions such as:

- spider veins

- varicose veins

- lymphedema

- venous ulcers

- post phlebitic syndrome (swelling and discoloration of the leg after an episode of a deep

venous thrombosis)

- deep vein thrombosis

- prevention of blood clots in the legs

Who needs to wear compression stockings?

There are certain risk factors for the development of blood clots in the legs. It is highly recommended that these individuals wear compression stockings. The risk factors for formation of blood clots include:

- obese individuals

- those who have had a previous blood clot

- those who are going for surgery

- those planning a long car or air trip

- those who have had a stroke

- those who are on the birth control pill

- those who have just given birth

- individuals with a prior clot in the leg

- pregnancy

- individuals with cancer

- those who are bed ridden

What should I know about my compression stockings?

The first thing you need to know is the size and strength of compression. You do not want to wear something too tight or too loose. Your health care worker will be responsible for selecting the appropriate gradient of pressure for your stockings.

Stockings also come in two basic lengths: knee-high (worn up to the knee) and thigh-high (worn above the knee). As to which one is the best is not really known. The knee-high is more convenient and easier to wear. The thigh-high is slightly more difficult to put on and needs a garter belt to hold it up (as it has a habit of rolling down the leg). For the majority of individuals, the knee-high is adequate.

How do I put on compression stockings?

Initially most individuals will have difficulty putting on the stocking because all compression stockings are tighter at the foot than higher up the leg. The following guidelines may help putting on the stockings:

1. Make sure both the stocking and your hands are dry. Wear gloves if you have

a pair.

2. Lie down in bed for at least 5-10 minutes with the legs elevated (this will help

decrease the swelling in your feet and legs)

3. Insert your fingers into the stocking as far as the heel pocket.

4. Turn the stocking inside out.

5. Carefully slip your foot into the sock and ease the stocking over your heel.

Make sure your heel fits perfectly into the heel pocket

6. Gently roll the rest of the stocking over the heel up around your ankle and calf.

Do not pull on the stocking as it does not help. Gently massage the stocking

upwards using the palms of your hands.

When should I wear my compression stockings?

For the best results, compression stockings must be worn religiously on a daily basis. One should put the stockings on first thing before getting out of bed. The swelling in the legs is minimal after a night's rest and the stockings are easy to put on.

What should I do if I find the stockings uncomfortable?

If in the beginning the stockings feel too tight, wear them for a few hours each day and then progressively increase the number of hours. Stockings must be worn constantly to be effective. Breaks can be taken in between. It is essential to wear the stockings during the daytime. Night time wearing of stockings is only recommended for completely bed ridden and patients undergoing surgery. Most individuals can take the stocking off before bedtime.

If my legs are swollen, when should I wear my stockings?

For those individuals who have severe swelling of the legs, it is best to stay in bed over the weekend (or at least 12-24 hours) and let the swelling subside. Once the swelling is decreased, the stockings should be put on first thing in the morning. By wearing the stockings all day and night, the swelling will gradually decrease. Then one can wear the stockings during the day and remove them at night.

When should I not wear my compression stockings?

There are some instances when compression stocking should not be worn. These conditions include:

Pain: when one has increasing pain in the leg or foot after wearing compression stockings, it is best to take them off and see a physician

Skin changes: anytime the toes go blue or the skin becomes discolored, stockings should not be worn

Ulcers: if there is skin breakdown, stockings should not be worn



Do compression stockings cause any complications?


In general the answer is NO. However, those individuals who already have decreased blood supply to the legs (severe diabetes, peripheral vascular disease) may not be able to tolerate the compression stockings.



What is the major complaint with wearing compression stockings?


The majority of individuals claim that the stockings feel hot and tight. And in the summer, most individuals are unable to wear them.



Compression stockings- Misconceptions


Compression stockings are only for sick people- False. Everyone can wear them. Besides preventing blood clots, these stockings provide support, comfort and help reduce fatigue.

Compression stockings weaken muscles in the leg. False. Muscles are not affected by the stockings. In fact, walking and wearing stockings tone the muscles and improve blood circulation in the leg.

Compression stockings can never be stopped once started. False. Stockings can be discontinued at any time. During the summer, if the weather is too hot to wear stockings, one can remove the stockings. If one has already recovered from surgery, one can stop wearing stockings. However, walking is recommended afterwards.

How should I take care of my stockings?

Compression stockings are sturdy but can be ruined by poor care. Stockings should be hand washed with soap. They should be gently rinsed and dried in open air. One should not wash or dry them in machines. Compression stockings should be as gently treated as one would treat their face. Most stockings are ruined during washing and drying.

Further, never allow the stockings to come in contact with creams, lotions, ointments, or oils containing acids, lanolin or petroleum. Any of these will ruin your stockings in no time.

How long does one usually wear compression stockings?

The stockings should be worn as long as you are at high risk for forming blood clots. For prevention of blood clots, daily wearing is recommended.

Compression Stockings: Tips

- you must wear them everyday

- compression stockings are easier to put on with rubber gloves

- initially compression stockings are hard to get used to, so start wearing them for a few

hours daily and gradually increase the number if hours

- to get the best results, put on the stockings on first thing in the morning

- remove the stockings out at night (the feeling is soothing)

- for those with dry skin, apply some baby oil at night

- never fold or roll your stockings

- never cut extra holes or snap off the elastic band in the stockings

- wash gently

- a pair will typically last 3-6 months

- if you have pain in the leg or bluish discoloration, remove the stockings

How are these stockings prescribed?

Compression stockings come in various pressure gradients. All compression stockings have the highest gradient at the ankle which gradually decreases up the leg. Your physician or healthcare provider will assess your condition and determine which is the best compression stocking for you. Measurements of your leg will be made and the best sized compression stocking will be prescribed for you. It is very important to have the correct size of compression stocking for the best results.

How and where can I get graduated compression stockings?

Once it is decided that you are a candidate for compression stockings, your health care provider will recommend the best places where you can buy these stockings. Most suppliers of stockings will measure your leg size for the best fit for you. You will also be provided with a leaflet to educate you further on the dos and don'ts about compression stockings. Never buy more than one pair initially to make sure you have the correct size and fit.

Are Compression Stockings covered by insurance?

Some insurance companies do cover the cost of compression stockings if you have are at a high risk for a blood clot. You can check up on your coverage by calling your insurance carrier.

How much do compression stockings cost?

Compression stockings can be purchased with a physician's prescription. They may cost anywhere from $ 60-$120/pair. Most need replacement in 3-6 months. Non prescriptions compression stockings are also available but they do not provide the level of compression required to prevent venous ulcers.





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