You know you have to wear a compression sleeve to manage your lymphedema but you’re not quite sure where to start. If you visit your local durable medical store and next to the oxygen mask, you see a dusty, beige and scratchy sleeve. The store assistant sizes you up visually to be a medium and send you on your way. Do not go home with this sleeve. The only way a compression sleeve can work to improve or prevent lymphedema is if it is precisely matched to your needs including size, length, compression and most importantly comfort & appearance. We always say; a compression sleeve cannot improve your lymphedema by sitting in a drawer!
Do not guess your size + length
You’re a medium in your shirt and you’re pretty tall, so you need a medium, long sleeve, right? Wrong! Be sure to measure your arm to the specifications of the sleeve manufacturer to find out your garment size. Be sure to measure your arm to find out the correct length for your garment. Just like clothing sizes vary from brand to brand, sleeve sizing is completely different between compression garment manufacturers and there is no shortcut to finding out your correct size in a different brand without using your measurements. If you have existing swelling and your arm size is changing, it is also important to remeasure your arm when you purchase a new garments to make sure you’re getting the compression you need!
Do not guess your compression class
This is one of the biggest questions we get asked. How much compression do I need? And, unfortunately, it is a question we are simply unable to answer. As a guide, Class 1 (20-30mmHg) compression is less compression (not as tight) and is used to manage light lymphedema and preventatively for those at risk for lymphedema and Class 2 (30-40mmHg) compression is more compression (tighter) and is used to manage existing lymphedema swelling. But figuring out how much compression you need and when to wear your sleeve isn’t as simple as following the guidelines. Your doctor, physical therapist or lymphedema therapist would recommend a compression class to you based on your swelling, treatment and self-care routine. For example, if you have existing swelling and are going through treatment to reduce the swelling such as Complete Decongestive Therapy (CDT) or Manual Lymph Drainage (MLD) regularly and you’re doing some wrapping, then your therapist might recommend a Class 1 garment to maintain compression when your arm isn’t wrapped or your therapist might also recommend that you wear a Class 2 sleeve instead of doing any wrapping at all. And that’s why we can’t stress enough that a compression class should not be chosen arbitrarily and that it is important to discuss how much compression you need with your doctor and/or therapist to make sure you’re getting the right amount of pressure you need to meet your end-goals when it comes to lymphedema management.
Do not choose a garment that you dislike
You figure out your sizing and compression and you finally purchase a compression garment. You’re not crazy about the garment you get, but your doctor says you need one so you get it. As a good patient, you put the garment for the first few days, but as time goes on, the task becomes dreadful and there comes a day when you just leave your garment in the drawer, never to be seen again. Does that sound familiar? Don't let this be you!
A compression sleeve sitting in your drawer cannot manage your swelling, so be sure to get a garment that you know you will wear. Think about it as a purchase of any other garment you’d regularly wear. Would you wear hot, itchy, beige pants regularly? Then why would you wear a hot, itchy, beige sleeve? Be sure to evaluate what factors are important to you in your sleeve. Is it comfortable? Is it moisture wicking? Is it breathable? Is it available in bright colors, patterns or with crystals? Once you figure out the fit you need, then figure out which garment features are a priority for you. Whether you want to blend in or stand out, it is YOUR sleeve, get a sleeve that makes YOU happy! Yes, having to wear a sleeve can be a chore but getting a sleeve that you love can make it less of a daunting task. Remember, a sleeve will only work for you if you wear it, so make sure to get a sleeve that you love!
Do not continue to wear a garment that is uncomfortable in any way
It will take a little bit of time to get used to wearing a compression sleeve. Even though a compression sleeve is delivering a constant pressure and containment to your arm, it should not cause discomfort. If you feel uncomfortable in your garment, speak to your doctor or therapist as soon as possible.
There are a two common causes for compression discomfort:
Whether it is the top band being too tight and causing a tourniquet at the very top of your sleeve (this is common with sewed in elastic bands) or the wrist being too tight, causing your hand and arm to change colors. Take note of any tourniquets, as they can adversely affect lymphedema by causing fluid to build up at the tourniquet point.
Binding is a fold in the compression sleeve fabric that restricts lymph flow. Be cautious of these at the elbow and inside of the forearm.
Just like having a sleeve that is too tight and causes a tourniquet can be a negative, so is having a sleeve that is too loose at any point. A loose garment at the wrist can reverse the graduated compression of the garment, so instead of the tightest part being the wrist, pushing the fluid up toward the body, with a loose wrist, the fluid can be pushed into the hand, palm and fingers. A garment can also be loose at the top of the arm, this is less dangerous, because in the graduate compression spectrum, you want the least of your compression to be at the top of the arm. But it causes discomfort in having to constantly pull it up and straighten it out, which can attribute to the point above about having a garment that you simply have no desire to wear. Additionally, having a loose sleeve at the garment top can cause the garment to fold over itself and cause a tourniquet.
Do not continue to wear a garment that is worn out
You found a sleeve that you really love, it is the right size, the right compression, it’s not too tight or too loose, it looks great and is so comfortable. But one day you take it out of the drawer and it feels different, it is looser and when you take it off, the elastic doesn’t snap back to it’s shape. That can only mean one thing, your beloved sleeve need to be replaced. The typical lifespan of a sleeve that is being worn and laundered regularly is 4 to 6 months. After that time, the elastic fibers in the sleeve are exhausted and no longer retract to provide the adequate amount of compression. Have a few garments and rotating them is a great way to extend their lifespan. We always get asked about insurance coverage for garments and unfortunately in the USA, all insurance companies and the plans within those companies vary greatly. It is important to call your insurance to find out if they cover compression sleeves, what you need to provide for the garments to be covered and how many sleeves are covered.