Compression Stocking Usage Poll

[Lethargic Smiles]

I had been diagnosed for POTS for about 5 months when I finally agreed to start wearing compression stockings. Prior to that, I was resistant. I thought they'd be very uncomfortable like the hospital ones. I thought they were unnattractive. Most of all, I thought they wouldn't help! My thoughts were, "I will wear these stupid hose so my doctor will leave me alone about it and move on to the next treatment option. "

I was very surprised to find that after wearing them all day, every day for 3 days, I noticed a difference. On the day of day 4, I decided I'd skip them. I noticed how heavy my legs felt when I stood and noticed how my legs turned reddish. It turns out my doctor actually knew a thing or two, and I did have blood pooling.

I've heard all different kind of recommendations as far as compression stockings, so I'm interested in other people's experiences!

[diabeticgonewild]

It helps, but I have to consistently wear them, and it takes a few hours to feel the benefit. I don't know if it truly reduces my pre-syncope, which is exhausting and is disabling.

I wear compression garments. Not only do I wear hose 40-50 mmHg (Mediven plus), but I wear an abdominal girdle that provides about 10-20 mmHg (http://showcase.designveronique.com/designveronique/index.php/shop/postsurgical/mid-body/non-zippered-body-girdle.html).

I layer. First I put on the abdominal girdle. Then I put on my underwear. Then I put on the compression hose. Using the restroom is not as much of a problem that way.

[Guest Alex]

Hi Lethargic Smiles,

I have tried compression hose (10-15 mmHg compression level I believe) when I was on a combo of midodrine + florinef and experienced a spike in BP shortly after I put them on. Coincidence?! No clue, as I dared not try them again - I chickened out . I am not on those meds anymore, but I doubt I would benefit from compression garments.

Regardless of that, have you ever considered abdominal compression vs stockings? I've read at several articles stating that abdominal compression is effective (maybe more effective than compression hose)

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2888469/

Nonpharmacologic interventions should then be considered. They can be tried in any order or combination based on the patient’s convenience or safety. They work by expanding blood volume (taking in extra fluid and salt), decreasing nocturia (raising the head of the bed), decreasing venous pooling (wearing an abdominal binder, performing countermaneuvers, engaging in physical activity), or inducing a pressor response (drinking a bolus of cold water).

http://onlinelibrary.wiley.com/doi/10.1111/j.1540-8167.2008.01407.x/full

Three measures are often beneficial. The first is physical countermaneuvers. Patients are taught to contract muscles below the waist, typically for about 30 seconds, and the measure could be repeated. This method reduces venous capacity and increases total peripheral resistance. A second approach is to wear an abdominal binder. This reduces splanchnic-mesenteric venous capacity and is especially helpful in patients with poor venomotor tone or are hypovolemic.The third maneuver is water bolus therapy. The subject drinks two 8-ounce glasses of water sequentially. This results in a sympathetically-mediated pressor response that is sustained for 1–2 hours

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3241624/

This is not about abdominal binders, but about the effectiveness of compression garments in general for orthostatic presyncope - I don't recall seeing this article on dinet before and it may help someone.

Best,

Alex

Edited June 3, 2013 by alex74alex

[Pirate]

I've only left the house twice in the last 1 1/2 years without compression stockings. The first attempt was a disaster, but I was not well controlled at that point. I was taking Midodrine when I tried it the second time. It went better, but there was clearly a difference.

When I'm really symptomatic, I'll wear an abdominal binder in addition to the compression stockings. That makes a big difference, but it also makes me nauseous, so I limit that only to times when I really need it.

So in my opinion, both stockings and a binder are helpful, and when used in combination they are very helpful.

[diabeticgonewild]

Thank you alex74alex for posting those articles and links.

_________________________________________
Most of the pooling is from the thoracic area to the abdomen first then pooling in extremities at about the same rate as normals. (from another post) http://forums.dinet.org/index.php?/topic/19810-compression-stockings/?p=183352
Going With the Flow – Blood Flow, That Is
Speaker: Marvin Medow, PhD, New York Medical College
Date: March 25, 2010

Recording: http://www.cfids.org/webinar/oi-march2010.wmv
Slides: http://www.cfids.org/webinar/oi-slides-32510.pdf

_______________________________________________

I agree that abdominal compression can be more useful than leg compression. However, for me, the results are not instantaneous. I have to wear the garments for at least 4 hours. I do not wear a binder, I want consistent (not adjustable) compression, so I know if the compression is working or not.

Some girdles are as good as binders. It just depends.

_____________________________________________

For leg compression, I have heard that the Sigvaris brand of compression hose provides abdominal compression (http://forums.dinet.org/index.php?/topic/8088-compression-hose/?p=74289). Juzo does not provide abdominal compression, but a lot of people find this brand most comfortable, especially when custom-made. For heat, Rachel (Admin) said that the 770 series of Sigvaris work best in the heat (http://forums.dinet.org/index.php?/topic/17647-compression-stocking-options/?p=161308).

_____________________________________________

Guest_tearose (former poster on these forums) was a gold mine when it came to compression. Search tearose and compression in the search bar. I hope this helps somebody.

_____________________________________________
Anyways, if it is too hot for compression, maybe you could consider a cooling vest, such as the Arctic Heat brand.

[Canadiangirl73]

I wear an abdominal binder in addition to the compression stockings. I find I get the most benefits from the binder.

[Lethargic Smiles]

Thanks for the links Alex and everyone else for their input!

[Psalm 23]

I wear both an abdominal binder and waist high, 20-30 mmHg compression hose ( as had been recommended by my neuro ). I started out by just wearing the abdominal binder which was extremely helpful and didn't really limit what clothing I wanted to wear but as pooling issues worsened I had to start wearing the compression hose as well. I have only been wearing the hose since last fall and it was after the weather started to cool so I'm wondering how I will be able to tolerate them in the summer. I have tried going without them a few times telling myself I really didn't need them but noticed my legs felt heavier, swollen, appeared discolored and I got symptomatic much more quickly. I don't like the thought of not being able to wear shorts and skirts in the summer ( silly I know ). I did find one company that sells compression capris but they are only 15-20 mmHg. I guess I will see how it all plays out.

Thanks for all the links and input.

Janet

[E Soskis]

What a joy to wear compression garments in the sweltering heat of the South! - just kidding - they are a real hassle to get on, wear, and get off however....wearing them helps me function better than not wearing them - so, the benefits outweigh the negatives. I also find that the abdominal compression is better than just the lower leg - I think it has something to do with assisting to limit the pooling of blood in the mesenteric system of the abdomen (the large blood vessels) - it also helps with the blasted gastroparesis bloating - I guess without the abdominal compression garments, I would look like I swallowed a basketball or was about 12 months pregnant!

[RichGotsPots]

Welcome! I used to wear 30-40 compression socks but switched a year ago to CEP quad sleeves. Same thing in my opinion and much easier to wear and less embarassing

[issie]

Did an experiment while flying. For me wearing the abdominal binder is more helpful. I didn't wear leg compression and only the abdominal binder going on trip (and did great) and wore both on return. I was much more uncomfortable with both on and because I tend to have higher bp's - seemed like I felt way worse. Guessing it caused my bp to be even higher - but, not sure of that. When I travel again - will just go with the abdominal binder and/or lighter strength leg compression.

Guess we don't all need the compression on the legs.

Issie

[Lethargic Smiles]

Alex thanks for those articles.

E Soskis, I just wanted to share that I used to get the baby belly after eating. My mom said when I was in high school, she'd be concerned I was pregnant and not telling her only to see that the baby bump was gone the following day. I found a food allergy (gluten) as well as intolerances (soy, dairy, egg). After eliminating these foods, I no longer get the belly. I also take enzymes with heavier meals. Sometimes I have gastroparesis as well. When its really bad, I turn to medication. Reglan has worked wonders for me. It makes the stomach empty more quickly.

Based on my own experience, I won't be using abdominal compression instead of stockings, but I will definitely consider it in addition to them. It sounds like you guys have had a lot of success with abdominal binders and the research I've read is positive. I've taken pictures of my feet with toe-less stockings versus without stockings after standing for only a few minutes. There's such a huge difference! The picture with stockings kind of looked like vampire feet because they were so pale in comparison to the purplish/red tone they take on without them!

Questions/Thoughts for Everyone...

1. How tight do you guys wear the adominal compression gear? I've heard of doctors expressing concern over people wearing Spanx. I know there's a big difference between putting all of that compression on your abdomen for medical reasons versus vanity, but I'm guessing the long term effect could be similar.
2. I wonder if some people feeling worse with compression correlates with them also tending to have a higher blood pressure. They did tilt table tests on people with orthostatic hypotension to see how abdominal binders effected the stroke volume and blood pressure. It showed an average increased stroke volume of 14% and increased blood pressure by 30/14 mmHg. That would be quite a jump for someone who doesn't have low blood pressure. Of course, based on this study, we don't know that it would jump that much if someone wasn't suffering orthostatic hypotension. http://www.ncbi.nlm.nih.gov/pubmed/15241645

3. Do you guys do any exercising? If so, do you wear your compression gear while exercising? On "good" days I try to exercise without it. For one, the gear is very warm to exercise in (not that I'm doing anything too intense to a "normal" person). The second reason is I wonder if I'm training my body to rely on the compression gear. There's no science behind this thought process, it just is what I think/wonder.

Jackie

[Psalm 23]

Hi Jackie,

My answers to your questions;

1. I adjust my abdominal binder to a rather tight fit. It feels most effective for me if worn that way. What has amazed me the most about use of this device is the immense way in which it has helped with what I assume is postprandial pooling, which used to cause me such misery. I also noticed the intermittent aching lower back pain I had suffered with for years disappeared when the binder was on. I have observed some information lately about lower back pain and pots so maybe its related to blood pooling issues and that is why the binder helps my lower back pain. In general, I have found such comfort in my binder I don't like to take it off because when I do I feel a huge rush of what I assume must be blood flooding my abdomen. I have never worn Spanx so I know nothing about that.

3. I actually have my exercise regime posted on the recent exercise poll. I exercise with the abdominal binder on but not the compression hose as they are difficult to get on and I don't exercise for very long unfortunately. I wait and put the compression hose on after I have showered and they basically stay on the rest of the day.

Your thought regarding the body's potential reliance on compression gear is one I have also entertained. It's a bit disconcerting.

Janet

[Lethargic Smiles]

Janet, I've always had terrible back pain since I was an itty bitty thing. It is relieved by intense exercise (60 minutes of interval training 6 days a week) but that isn't an option an anymore. Is your sore back relieved by massage or exercise, or is the abdominal binder the only thing you've found that helps? I'm just trying to figure out if perhaps the fact mine is helped by massage and exercise means it's muscular and not blood pooling. Or could blood pooling cause muscular issues in the back? I have pretty bad back spasming. Anyways, thanks for the response to my questions.

[Psalm 23]

Jackie I'm so sorry. How awful to have terrible back pain develop at such an early age. Back pain can be so debilitating. I didn't actually have any problems with my back until after I had major surgery. I had to have one of my kidneys removed and for pain control an epidural was left in for two days so until recently I had always blamed the chronic lower back pain I was left with on the epidural. In addition though to the intermittent episodes of intense bone aching lower back pain I was left with after the surgery, I started having problems with episodes of dizziness, shortness of breath, tachycardia, palpitations, upper abdominal distention after eating ( I was assessed by a surgeon and a gastroenterologist who could not determine the cause ) etc. Sound familiar. Lol. Some vague symptoms of dysautonomia had developed years earlier after I had meningitis but pots symptoms hit me after the kidney surgery. Of course I can not say with any degree of certainty that blood pooling is the cause of my lower back pain except that it is an interesting coincidence that wearing my abdominal binder completely eliminates the problem and something else of significance that I realized a long time ago was that sitting or laying down eliminated the pain. Prior to wearing the binder I had never really found anything else that helped much. My problem has never seemed muscular and I have never had spasms. It's always felt very deep and aching.I'm sorry about your back spasms.That sounds like such a miserable thing to deal with. I think in the end it's pretty difficult to determine with any degree of certainty how things connect with one another or what is resulting in what especially in the land of pots. I hope you find some relief soon.

Janet

[Lemons2lemonade]

I wear them on really bad days. I would say the help by about 5-10% which can make a huge difference when you are operating at 70%. Dr. Lenoards online is a great place to get them cheap.

[jknh9]

I wear them on bad days and to recover after exercise. Mine are sleeves that go from my ankles to my knees. The brand is CEP, got them at a running store. I think they help somewhat when I don't feel well. I'm not exactly sure about the compression, but I think it's around 15 mmHg.

[rubytuesday]

I had Rx for strong compression thigh highs. It took me > 30 minutes to put them on and 2 of us to get them off (after I struggle another 30 minutes). I have arthritic hands and hips/knees and the force needed to don the things and get them off seemed to put my legs/feet and hands in all kinds of contorted positions. I would work so hard that the skin would be rubbed raw around my ankles and never could get through a wearing without a burst vessel in my foot that then made it painful to wear even a shoe until it healed. I tried lesser compression and knee highs but with fluid/blood pooling in the legs/feet, being cut off at the knees, my feet and legs would be really swollen with the knee highs (not good). Needless to say, I discussed these experiences with my cardiologist who did not seem to object to my not wearing them as he had prescribed. I did give them a good try.

[Confusedguy]

I wear Under Armour Compression shorts when at the gym. I'm not sure they help much and aren't the most comfortable item but it certainty can't hurt so I wear them.

[Akgirl]

Rubytuesday, there is only one manageable way to putting on compression stockings!! Believe me, I feel your pain. When I first tried getting the suckers on my husband likened it to wrestling a alligator. I am not doing so well at the moment but as soon as I feel like my brains working a little better ill try to find a link on the proper way to put them on. The pharmacy never showed me, it was my physical Therapist who finally clued me in!! But they make such a HUGE difference for me. I literally cannot leave my house without them or I will have to be in my wheelchair. I also wear spanx over the top of the compression stocking. Not comfy, but better than a wheelchair!! Or breaking my head open from fainting.

[clairc]

Rubber gloves. That's what I use to put on compression stockings. I can't manage without them. I get packs of the thin latex disposable gloves and they grip the fabric of the stockings so you can pull them up properly. It still pulls at my joints and it's still a bit of a struggle but they really do help.

[Lethargic Smiles]

They also make special gloves just for putting on stockings.

[imre]

There is also stocking donners, google compression stocking donner.

[MarkA]

I usually only wear my knee high on long drives in the car. I tried waist high but they were a PITA!

[gjensen]

I was laughing picturing everyone struggling with them, and then the discussion about more gear just to get them on.

I struggled with them to, and had my wife come help me. It was bad enough that I felt like I was putting on panty hose. I was trying to think of the name of the person that recommended them to me. I will not say the word that I was using as a replacement. LOL.

Here I was trying to get them on to help manage my heart rate and high blood pressure, and giving myself a heart attack trying to get them on.

I did get the hang of them after a couple wrestling matches. I can get the full set on and off pretty quick now.

I think that they might help, but I am not certain yet. I am so up and down. If I can prove a small improvement they would be worth it.