Class 3 tights and reducing swelling

[caroline111]

I have lymphoedema in my legs but it has become a lot worse in my right leg in the last year. I posted a few months ago about this problem and the replies were very helpful. It has been extremely difficult to find the right compression and I am desperate to reduce the swelling. I recently tried circular knit tights compression Class 3 and found them a nightmare to get on. After a lot of effort I got it on the right leg but just didn't have the energy to get it on the left leg. The clinic wanted me to try this before they would consider giving me flat knit! As I couldn’t properly try the class 3 tights I couldn’t make a case for flat knit and am worried they could be equally uncomfortable.

I have now settled for Class 2 tights and Class 1 thigh high stocking for the right leg. However, about one or two inches below my right buttock the tights go into a ridge however much I adjust them and I think this is causing the flesh to harden at the back of the thigh. The ridge doesn’t happen on my left thigh. An experienced lymphoedema nurse who I see privately for lymph drainage massage says she thinks it is because I need smaller size tights. I am 5-ft 7 and I currently wear size 3 and have done since I got lymphedema 11 years ago. I can’t really understand how smaller tights would help.

Also, I’m aware from answers to my last post that only bandaging could reduce swelling in my right leg. I cannot get that done by the NHS here and I am considering going to the Wittlinger Clinic in Austria.

I would be really grateful for any views people may have on any of these points:

1) how to get class 3 tights on and off without a nightmare struggle?

2) How effective are the aids which can help to get the tights on?

3) Why do my current class 2 tights ridge below my right buttock? Would smaller size tights help?

4) Given that only bandaging will reduce the swelling in my right leg, is there a cheaper alternative to going to the Wittlinger Clinic?

[CCT67]

Hi Caroline Indeed there are options nearer to home for having Complete Decongestive Therapy (CDT) or Decongestive Lymphatic Therapy (DLT) which multilayer bandaging is one component of for limb reduction.

Look on MLDUK site using the code therapist search link for a qualified lymphoedema practitioner (denoted by DLT) for a therapist nearest to you.

If you are going to have CDT then you’ll want to wait for treatment to have fresh measuring for leg garment. Part of CDT is putting the patient into proper compression afterward. It sounds like you might very well benefit from being in flat-knit, as flat-knit is lymphoedema specific compression whereas circular knit is designed for Venus issues but can be worn by lymph patients with mild lymphoedema.

The aids to don compression can indeed be very useful some take the hang of how to use them after which they are extremely helpful I personally like the slippy donning aids of which there are quite a few to choose from. A lymph therapist can help you learn how to don and doff

Your current garment being ill-fitting under your buttock may be a function of being circular knit, or perhaps class so perhaps you could try class 2?

By moving into flat-knit, the class of garment likely suitable for you would be lower compression class than circular knit, as flat-knit garments provide much more containment and support than circular knit provide.

MLDUK.org.uk

[caroline111 in reply to CCT67]

Thank you. It has been extremely difficult persuading the clinic I attend to give me flat-knit. I'm going to have another go once I have had decongestant treatment

[CCT67 in reply to caroline111]

As part of CDT you’’ll be fitted with new garments. The private lymph therapist can write to your GP with all the garment information/ codes so that your GP can issue a script (in the exact same way your clinic nurse would). Your local lymph clinic sounds rubbish I’m afraid. Sounds like the lymph nurse doesn’t have much Lymphoedema treatment training. While some nurses have a very good knowledge level others don’t. Sadly yours sounds like the latter.

[Sue737400]

Hi Caroline,

The best way to get compression garments on is to use gloves with a rubber grip on the palm. These help to grip the fabric and then you can smooth them into the right place.

Regards

Sue

[caroline111 in reply to Sue737400]

Hi Sue Thank you for your reply. Would yellow rubber gloves be OK? Or is it best to get gloves with just rubber grip on the palm?

[Sue737400 in reply to caroline111]

I’d definitely give them a go and see if they work. Best of luck 😃

[Thomas45 in reply to caroline111]

I use ordinary marigold type yellow kitchen gloves, with Jobst Elvarex made to measure class 2 flat knit. They come with a blue slippery material piece to fit in the front of the foot, to guide the compression garment over the foot and ankle.

[caroline111 in reply to Thomas45]

Thanks Thomas I will try this.

[Anne16]

Hi Caroline,

I have primary lymphoedema in both legs. Was originally prescribed Class 2 circular knit thigh hi stockings, but I found they gave e quite a sore band around the top of my thighs which became very painful to the extent I went down to knee highs. These eventually became too difficult for me to put on in the morning, and at one point just below the ankle bone they became almost like a tourniquet.

I have had multi-layering bandaging a few times and whilst it certainly does reduce the swelling, I found it to be very temporary. Plus, I found the fact I was unable to drive the car very problematic, as I am the sole carer for my disabled husband (we are both in our 80's).

Since then I have been wearing Class 2 flat knit knee highs without any bad effects. Although I have to admit that some days when my legs are particularly painful, I resort to removing them before the end of the day.

I do hope you find this helpful hope you get things sorted very soon.

Good luck. x

[caroline111 in reply to Anne16]

Thank you Anne. It's interesting that you also got a band around the top of the legs. I'm wondering if it's to do with the fact that the circular tights aren't made to measure - one size doesn't fit all!

[Anne16 in reply to caroline111]

Hi Caroline,

Yes I believe that to be true. They only go up to a certain size anyway and I was in the highest one from the beginning. The flat ones are certainly more comfortable and do indeed keep the swelling under control, but because they are so thick I find it difficult to buy shoes I like to be honest. I only have small/short but fat feet and even a size 5 shoe is too long for me. I shouldn't complain really, there are far worse than me, as a vascular consultant told me when I was referred to him by the lymphoedema clinic. I have to say we did not part on friendly terms!!

[caroline111 in reply to Anne16]

He sounds awful, I bet he didn't have lymphoedema! Glad you said something to him - perhaps he'll think more carefully in future.

[Perido]

Hi Caroline, regarding your tights that form ridge below your right buttock. Maybe you need shorter tights rather than overall smaller ones?

A custom made class 2 flat knit is likely to control your swelling better than a class 3 circular knit and you won't necessarily find it more difficult to put on - both require donning aids such as rubber gloves.

In my experience circular knit garments often don't fit well as many of us don't fall neatly into the size ranges. I have relatively thin ankles and fat thighs and didn't get good graduated compression in circular knit. This formed part of my case for getting made to measure flat knit.

[caroline111 in reply to Perido]

Thank you. I'm going to keep trying for flat-knit.

[Hidden]

I got Decongestive Lymphatic Therapy (DLT) done on the NHS in January at St George's Hospital, Tooting, London, which has the leading clinic in the UK. See if you can get a referral from your GP before trying Austria.

I would have no confidence in a clinic that cannot recommended anything as elementary as donning aids.

In my experience lymph drainage massage is a waste of time but DLT produces excellent results. I lost 5 kg because of it

[sklava]

Hi, our daughter is a paediatric patient at St Georges, in London. They showed us some bandaging techniques and then measured her for garments afterwards. We have done ALOT of research since then and used lots of different bandaging materials and techniques. We now use a private therapist to measure our daughter for flat knit garments every three months and order them on prescription from the GP. In times of Lock down we even measured ourselves and got it signed off by the therapist. I could email you some video's/ info on different bandaging products if you'd like to get in touch? We also tried several different brands of compression stocking.

[caroline111 in reply to sklava]

Thank you sklava. Videos or info on bandaging would be very helpful.😊

[Perido in reply to caroline111]

Googling on 'Kelly Sturm bandaging youtube' should bring up some videos.

[caroline111 in reply to Perido]

Thanks Perido. Never thought about looking on YouTube. Doh!