Who can benefit from compression, you ask? Why, everyone can. This fact alone makes compression a very sellable item. Compression is for the person who’s bound to his desk all day as well as for the person who stands on her feet for hours on end.
“Everyone who’s on their feet all day long should at least be wearing over the counter hose, says Cathy Kellar, certified orthotic and vasectomy fitter with Klein’s Orthopedic and Medical Equipment in Cuyahoga Falls, Ohio. Those in the age range of 50 to 80 should especially be wearing compression, she says. But for the most part, it’s for those with venous problems and lymphedema.
Compression helps to reduce swelling for people with some of the following conditions: venous stasis ulcers, varicose veins and achy legs, says Sally Thompson, manager of Klein’s Orthopedic and Medical Equipment.
Thompson believes if people begin to wear compression hosiery at a young age, they could possibly avoid problems that occur when they get older such as varicose and spider veins and swelling in the ankles.
Most people that aren’t experiencing great problems can get away with over-the-counter type lighter compression and that might circumvent any problems that they might have later on from those kinds of things, Thompson says.
What’s Compression All About? A person who simply has tired, achy legs would need a different level of compression than someone who has venous ulcers. Compression is measured in millimeters of mercury and can range from 15-50 mmHg. Higher levels of compression are typically customized. Lighter compression products start out at 15-20 mmHg, which are for tired, achy legs, mild edema, varicose veins and foot swelling. This level of pressure can also help to prevent vein thrombosis, says Toni Stafford, a customer service representative who is certified in compression garments, at Great Lakes Home Health Care Services in Erie, Penn.
Higher levels of pressure such as 20-30 mmHg is for severe varicosities, for open face ulcers, moderate edema and post surgery. This level of compression also helps to prevent the recurrence of venous ulcers, moderate to severe varicosities during pregnancy and thrombosis. For people who have ulcers, lymphatic edema and varicosities, they typically need 30-40 mmHg. Once you go beyond 40 mmHg, you’re getting into customization. “When the walls and valves in your veins collapse and become damaged, it develops varicosity, edema and (compression) increases that blood flow,“ Stafford says.
Determining the correct levels of compression. For anything above 15-20 mmHg, customers are given prescriptions from physicians. Fitters then measure and assess clients based on the diagnosis and leg shape. If it’s a custom compression hose, then more specific measurements are taken and sent off to the company.
Most insurance companies do acknowledge that there are benefits to compression. Compression, however, is not covered by Medicare, says Diane Harbaugh, vice president of clinical services of Great Lakes Home Health Care Services.
Fostering Compliance. From a clinical perspective, one of the challenges that Harbaugh notices is compliance. Even after being given a prescription from a doctor, some patients come in to get fitted but still may not wear the compression product. This is typically because it is hard for them to put on the compression hose. There are products called stocking donners that were created to help patients get in to the hose, says Harbaugh. Providers should stress to customers that not wearing the hose could lead to more severe swelling, and there’s also a risk of blood clotting, Stafford adds.
The job of a fitter. Fitters receive training by going to different classes and seminars that are typically put on by the manufacturer of the product. As a fitter, it’s imperative to go over a patient’s history and ask important questions to make the appropriate fit. Kellar says it’s important to know the patient’s age, the condition of the patient’s health and whether or not the patient will be able to put the item on without assistance.
Show them ways that will make it easier for them to comply. Providers should ensure that there’s someone at their place of business properly trained in compression, Kellar says. It’s also important to keep an eye out for reimbursement “so that you don’t start doing something that costs you more than you’re actually going to make,” she says.
Wearing compression can be fashionable. When it comes to compression, consumers have many different choices of fabrics, and colors run the gamut: from blue to opaque to sheer, Harbaugh says. In addition to hosiery, there are also nice trouser socks. For the upper arms or lymphedema, there are traditional beige sleeves and gauntlets. But there’s also a product of colorful sleeves and gauntlets called LympheDiva that offers a variety of colors from pink to onyx and patterns from leopard to paisley. Compression hosiery is designed in a breathable material that wicks moisture away from the skin so consumers needn’t worry about overheating.
It’s all about the team. Physicians and fitters must work hand in hand because some doctors aren’t aware of the many different levels of compression. But the fitter can look at the diagnosis to determine what level of pressure will work best for the patient, Stafford says. The doctors give fitters a guideline of what they want to accomplish, making the proper fitting of compression a team effort.
Points to take away:
• Just about everyone can benefit from some level of compression.
• Demonstrate the product for patients.
• Employ fitters who are trained in compression products.
• Compression doesn’t have to be dull and boring. Give your customers different styles and brands to choose from.
• Elderly or weak clients might have a problem getting into compression and may not necessarily have anyone at home to help. Offer products such as stocking donners that can aid in compliance.