Sleeve/glove compression ratio

vlnrph

Does it make sense to have a 20-30mm arm sleeve paired with a glove that is only 18-21mm?

My therapist suggested the same compression for the hand but the fitter got me the lower number!

I've only had it 3 days so might consider a return. Gauntlets cause my fingers to become like little sausages. I wrap at night and have not gotten worse. It seems as though one should have stronger force further out the extremity for optimal physiologic response.

Having a puffy hand is not my goal, especially since I have 3 orchestra rehearsals this week and a concert coming up (I'm a violinist and would hate to drop my bow due to stiffness or soreness...) 

Binney4

Vln, you've got it exactly right -- the lighter compression glove is a problem and should be returned. If these are off-the-shelf garments it may be the fitter had the lower compression garment on hand but not the one you need so she gave you that one, but it's not the right combo and you shouldn't accept it. I can't imagine these were custom-made garments, were they? I'd hope any garment maker would know better than to do that.

Good for you for being alert to this problem! Figuring out how the stupid lymph system works is no easy matter, but you've got it! 

Let us know how it goes. Gentle hugs,
Binney

kira66715

Vinrph: just to make it more confusing: you fitter may have put you in a class one Juzo, which is the lower number--it's the European compression class, and I've emailed all over to ask if the actual compression numbers or the compression class are more important, and I'm told that the fabric is an issue.

I'm pretty sure that Juzo Helastic/strong, off the shelf compresssion class 1 are 18-21 mm, yet when they make a custom glove I think it changes to European compression class. It's very confusing, at least to me.

Here's a link to the foryourlegs page for Juzo, and the helastic is the European compression class, while their less expensive gloves are the American compression class.

So, technically, the fitter is putting you in the same compression class for both arm and hand.

http://www.foryourlegs.com/Juzo-3021ACFS-Helastic-Gauntlet-w-Finger-Stubs-18-21mmHg-p-16602.html

I had a young fitter give me the compression class 2 Juzo glove with the compression class 1 sleeve, and my fingers turned purple...

http://www.stepup-speakout.org/proper_fitting_of_lymphedema_garments.htm#Millimeters_of_mercury_and_compression_class"Millimeters of mercury" and "compression class"

Unfortunately, size is not the only consideration in fitting a lymphedema garment. The amount of compression your garment applies will vary according to your specific needs and the stage of your lymphedema. This compression level is measured in units called "millimeters of mercury." It's written in scientific shorthand like this: mm/Hg. (The "mm" stands for millimeters, and the "Hg" is the chemical symbol for mercury.) Compression garments are ordered by "compression class," or the range of compression you need, stated in millimeters of mercury.

Here's a run-down of compression classes recognized in the United States, along with their usual uses (which may vary with individual circumstances):

Class 0: 15-20 mm/Hg - used for those at risk for lymphedema

Class I: 20-30 mm/Hg - used for those at risk, or for early or mild lymphedema

Class II: 30-40 mm/Hg - used for moderate or severe lymphedema

Class III: 40-50 mm/Hg - used for severe or hard-to-control lymphedema

To add to the confusion, European compression classes differ slightly from their US counterparts, like so:

Class I: 18-21 mm/Hg

Class II: 23-32 mm/Hg

Class III: 34-46 mm/Hg

There is a Class IV as well, with higher numbers of millimeters of mercury, but they are rarely used for arm lymphedema.

The fabric used in your garment may be soft (like Juzo's "Varian Soft") or sturdy (like Jobst's "Elvarex"), or somewhere in between. It may feel flexible or stiff, smooth or rough. All these factors add to your sense of the fit of your garment, and to its effectiveness for you as well. An experienced fitter takes fabric choice into consideration in order to provide you with the garment best suited to your specific needs. A compression sensitive person may need a softer fabric to prevent her fingertips from turning an unhealthy shade of purple, while a person who tends to develop fibrosis easily may do better with a firm and sturdy fabric -even if they both require the same compression level-

 Clear as mud, right?

Kira

vlnrph

Both are from Juzo so I thought they "should" correlate with each other. The sleeve was in stock but I had to wait for the glove to be shipped. I may keep it to wear alone - it seemed to help the hand while at work yesterday. Still leaves the problem of what combination to use during more strenuous activity. I would not enjoy having purple knuckles.

The gauntlet was Jobst and I was hoping to find a lighter fabric for better flexibility. Mediven seemed really stiff. Realizing the extra work involved in stitching finger stubs, I'm still having trouble understanding why (with much higher cost), my insurance only covers the same amount! 

kira66715

Vinrph--I think Juzo sleeves are on the American compression class and the gloves on the European. 

The first fitter who got me a Juzo sleeve and glove tried to match the mm of compression, not the class, and I couldn't tolerate the class 2 glove.

I am big fan of medi 95 gloves--not the standard medi glove--I like it better than Juzo off the shelf--but my custom glove is Juzo. (Looks like Medi raised the price. Some of medi is made in North Carolina and some in Germany and where it's made determines the compression class determination):

http://www.brightlifedirect.com/LYMPHEDEMA-PRODUCTS-Gloves-and-Gauntlets/c133_135/p1960/Medi-95-Glove-20-30mmHg-w/Compressive-Fingers/product_info.html