Question re: compression garments

mine pays for four garments per year. 

I was actually coming to ask a question about garments too -- 

I basically wear my sleeve all the time and I wondered how many women do this?  and do garments wear out with such frequent use?  I try to wash it every night, but it still seems like they start to get less tight after a month or so of constant use. 

I'm just two weeks out from radiation so I think I still need to wear it all the time but maybe not.  It doesn't really bother me -- feels good actually and after all the cancer stuff I'm pretty immune to any looks I get.

lisa_loves_alice - have you seen a CLT?  I have stage 0-1 LE and have seen two different CLT's they both said it would be best to wear a sleeve during the day, everyday, I don't always, but when I do I see that it makes a difference.  They both also told me that they really only last about 6 months before they're stretched out. So in theory if you got two sets every year and alternated wearing them, then they should last a year. 

I see you're pregnant, since you'll be packing your new little blessing around, it would probably be really good to wear it in the daytime.  In know when my grandkids are around and I pick them up alot my arm and hand swells if I don't wear my sleeve.

Binney - You're a riot. I envisioned your picnic at the insurance company and had to laugh.

Hi Marsha - my  insurance covers 3 or 4 sets of garments a year based on medical necessity.  They pay 90% for in-nework and 70% for out-of-network.  However, my experience has been when I go to an out-of-network fitter and then submit the paperwork myself (with a prescription), they dither and eventually pay nothing.  When my hospital-based therapist fits them and sends the order to an in-network vendor, insurance pays the 90%.  I think 2 things contribute to the difference:  1) my therapist writes a detailed letter of medical necessity that is cosigned by an MD, whereas I only submit an Rx, and 2) in-network vendors have the clout to bully insurance companies into paying, whereas I am just a lowly patient.  

Even though getting my garments through a therapist  means waiting weeks for an appointment, that's what I do.  KS1

Sheri, I had posted an article from the National Lymphedema Network on why it's good to go back for 6 month check ups:Also, over time, I've found my need to do MLD/wear compression has waxed and waned. Overall, it's gotten better:

he Importance of a 50,000 Mile Check -up
by Linda McGrath Boyle, PT, DPT, OCS, CLT-LANA

It is not unusual to meet a person with lymphedema who has elastic compression garments that are more than 6 months old. In other words, there has been no evaluation or treatment of the limb or swollen area by a trained lymphedema therapist for as long as the person has had the old garments.

Below is an outline concerning lymphedema management.

Tips for Successful Lymphedema Management: Recommendation Regarding Supplies

Know your insurance.
Which durable medical equipment (DME) companies offer coverage for your lymphedema supplies?
What is your annual bandage and garment benefit?
Replace garments every 6 months if worn daily.
Know the lifespan of bandaging alternatives and replace as recommended by each manufacturer.
Discard short-stretch bandages after one year of consistent use.
Replace open-cell grey foam frequently after 3 months of nightly wear, because they break down easily.
Obtain new closed-cell foams such as orange Komprex after one year of continuous use.
Launder or replace finger and toe bandages frequently to keep them germ-free.
Clean or replace footwear regularly to avoid fungal infections.

The top 10 Reasons to See Your Lymphedema Therapists Every 6 Months
To prevent an infection that could result in a hospital stay.
To prevent the involved area from becoming larger.
To prevent the involved area from becoming firm.
To obtain new garments for consistent and effective compression.
To learn about new and improved lymphedema products that are being invented.
To review your self-care strategies which may change and reduce the time required for your daily routine.
Your insurance company may change your garment benefit.
If your lymphedema worsens, you may need to repeat phase I treatment, which includes daily bandaging, manual lymphatic drainage, skin care, and exercises. If your lymphedema is well-controlled, you may only need one visit for new garment measurements and review of self-care instruction.
Most people more effectively control their lymphedema if they attend regular checkups with their lymphedema therapist.
Last but not least, you'll receive support and encouragement from your lymphedema therapist. You deserve credit for a job well done!

Taking care of your lymphedema is a lot of work and it challenges your ability to perform daily activities. It can also be very expensive. Some people with lymphedema do not wish to return to their lymphedema therapists because it reminds them of a difficult time in their lives. However, controlling your swelling helps to prevent a cellulitic infection that could result in a hospital stay as well as a large and firmer limb. If you do develop an infection, it is important to make an appointment with your lymphedema therapist, as you may need active treatment. You may need to learn new bandaging routines and purchase compression garments with different specifications.

Regular checkups include re-evaluation of fluid volume, tissue firmness, skin condition, body weight, and exercise program. Controlling body weight and exercising regularly are important for persons with lymphedema.

I encourage you to be an educated consumer and find a lymphedema therapist that can be your partner in managing this life-long condition. You can visit lymphnet.org or clt-lana.org to find a list of therapists in your area. When moving or heading south for the winter (snowbird syndrome) please ask your current lymphedema therapist to recommend a new qualified lymphedema therapist.

It is helpful to regularly consult the National Lymphedema Network's website for new and updated information. The website contains reliable information according to current medical evidence or expert opinion.
 

Kira 

Hi Sheri!  My LE is pretty mild so I have been able to control it with MLD and daytime compression sleeves.  I have not needed to wrap at night for several months!  I do see my therapist every 5 to 6 months for a "tune-up" and a pep-talk.  There are days when I forget to wear my sleeve and nothing terrible happens, but I do spend extra time on massage on those days.  My insurance covers the sleeves; I get 3 every 6 months.  You know what else works for me - I use the hand held shower head to do massage. It's fantastic!  I do the little circles with the water stream on my trunk, chest, and arm.  On hot days I use cool water and it's just heaven.  Hope you meet success with your routine!

Snorfia, my LE therapist always tells me to attempt to see what I can get away with--and then I figure out what I have to do to keep it under control.

It's good to re-assess and test our limits, and it's kind of dispiriting to discover that they still exist, but with such great compliance, odds are that things will never progress and have a good chance of getting better.

Kira

Marsha, I'm going to ask Binney to answer--mobility is a HUGE issue, and legs are large, and hard to reach.

Perhaps they can use one of the caresia products for you to bandage over.

12 visits and you're done--what part of chronic disease don't they get??? This is not a back injury!

I'll pm her.

Kira