Know what works for you, and what doesn’t. People come into the clinic and tell us that they have received therapy before without success. I often ask, “What didn’t work?” If you don’t know why therapy didn’t work, then it won’t work later using the same methods. Therapy needs to have the correct combination of MLD, exercises, compression and skin care. Often, people are under compressed, in wrapping, garments or both. A good fitting garment should be measured at the end of treatment and allow you to be free of wrapping in the daytime with only a single layer of material – giving you new freedom of movement.
Not all fitters are the same. Some are trained on the job with very little experience while others have tremendous knowledge. Some certified therapists have never treated for years and don’t always know what to choose, while others work in the field all day. Ask what their experience level is and how often they fit people. Experience with your diagnosis is paramount when it comes to fitting. I recently tried to place an order with a DME company, and they sent a letter back saying that in 32 years of doing compression they have never ordered anything in the realm of 40-50 compression and doubted the need for such garments. I have 20 years in the field. Clearly the owner outranked me in time with compression but not in experience with lymphedema. Make sure that who you are using is familiar with lymphedema and all levels of compression. That way you can be sure that they are not afraid to use high compression or custom when needed.
Be sure to ask your therapist questions. Remember, they are working for you and with you. In order to get good treatment you will need to be sure you and they have the same expectations. Begin with the end in mind. What goals for treatment will you need to meet in order to have success? Other questions should be: how aggressive will treatment be; how many weeks will therapy last; what compression garments are you going to use for day and night time? The end of treatment is not always the end of success or reduction for you – it is simply the end of maximal reduction until your next garment fitting or treatment in six months.
Don’t hold back. Lymphedema should not limit your life or sense of adventure. Get a personal trainer or join the gym after therapy to continue your success. You’ll need different compression garments for different activities. If you go running, do you pull out your running shoes or golf shoes? Compression garments are part of your new gear and need to match the activity, but do not have to get in the way. I have some patients who have compression class 3 circular knit socks for occupational activities and compression class 3 (or 4) flat knit stockings for adventure running. Sometimes you have to match the right product to the activity you are doing. It is the same as wearing your fancy shoes in a marathon. You wouldn’t wear heels, right? Wear the right gear for the activity and get back out there!