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Frequently Asked Questions for the Custom Lower Legging
- Patient is not ambulatory to take initial
measurements. How should the measurements be taken?
- I cannot find the patient’s malleolus to get an
accurate reading of the circumference and length measurement. How do I
proceed?
- Skin folds hang down from the thigh and will rub
against the legging. How do I protect this skin from rubbing against the
garment?
- Patient is experiencing pain, redness, and swelling
in the ankle area. What should I do?
- The legging is beginning to slide down leg due to
substantial reduction. Do I need to order a new garment?
Frequently Asked Questions for the Thigh-High 2000TM
- Patient needs compression for daytime use, will
not bandage, and doesn’t have the strength to pull on elastic stockings,
but the Thigh-High 2000 is for nighttime use only. What can I do?
- Can the length of the garment be adjusted?
- Can the garment be worn without the foam?
- Patient’s measurements fall within two sizes of
the standard sizing chart. Which size should I use?
- Patient has stated that the compression is not as
tight as bandaging was, and does not feel like (s)he is getting the proper
amounts of compression using the Thigh-High 2000. Is this true?
Frequently Asked Questions for the T-3 BootTM
& C-3 WrapTM
- Patient has a venous ulcer as well as Lymphedema, which
garment should I use?
- Patient does not fit a T-3 Boot C-3 Wrap for the
following reasons:
- Fleshy shelves or tissue masses
- Sizes Contradictions
- Length out of range
- Too big for standard size
- Patient has called me every day for a week now
indicating the legging slides too much. What do I tell them?
- Can the length and bands be altered?
- Does the Ankle-Foot Wrap fit inside a shoe?
Frequently Asked Questions for the Measure-UpTM
2001 Arm-Sleeve
- Does
the Measure-Up Arm-Sleeve come in different colors?
- When
measuring the patient with their arm out, large tissue masses are hanging
and causing large jumps in circumference on the measuring chart, is this ok?
- My
garment isn’t the exact length I put on the sizing chart, why?
- Can the length of the garment be adjusted?
- Patient hand is swelling after a week of wear. What
areas should I address with the patient?
- Patient’s
elbow is swelling and arm-sleeve seems too large now. What is happening?
- How will the patient know when the level of compression
needs to change?
- Can
the arm-sleeve be worn for daytime use?
Frequently Asked Questions for the Ready-FitTM
2000 Lower Legging
- Patient lives alone, has no help, and cannot reach
their ankles, any suggestions?
- Patient’s measurements fall within two sizes of
the standard sizing chart. Which size should I use?
- Patient has a limb length of 31cm and the Ready-Fit
2000 is 36cm. Can the length be shortened?
- Patient has called me every day for a week now
indicating the legging slides too much. What do I tell them?
- Patient has decreased in limb circumference by 2cm. Can
the size be decreased?
Take the measurements using the best possible method available (i.e.,
laying down, sitting up, reclining, foot elevated.)
Feel for the boney prominence of the malleolus (if possible) and ask the
patient to assist you in finding it.
Assure the patient is folding a two-ply layer of stockinette over the top
edge of the legging. Try using thin layers of foam underneath the uncovered
shelf.
a. Consult
with physician to dispel possibility of infection;
b. if there is a shelf (tissue mass) insert foam pieces to fill in for missing
volume;
c. call
CircAid Medical for further assistance.
In most cases, no. Refer to the instruction video included with the
custom legging and/or consult with CircAid Medical Products.
Consider if your patient is ambulatory. The Thigh –High 2000 is
recommended for nighttime use due to the full-foam insert, and its one-piece
construction. Your patient would have a limited range of motion if worn during
the day.
If compliance is not an issue, your patient has undergone CDT, and
you believe (s)he is a good candidate for the Ready-Fit 2000 Upper Legging,
you may want to evaluate their qualifications for this garment
- By way of altering it – no.
- By slightly re-positioning it, either up or down - yes
No – the patient’s measurements are taken into
consideration based on the allowance of the foam insert.
Yes – Provided therapist/patient understand garment is
then considered a custom garment, and must be processed as such, including
indication that foam will not be used with cover.
When on the borderline between sizes, consider the
amount of edema present and anticipated reduction. If significant edema is
present and reduction is anticipated, select the smaller size, if edema is
minimal select the large size.
No,
the arm-sleeve involves the elbow joint so range of motion is limited. For
active patients, the arm-sleeve is disruptive during day wear and high levels
of activity. For inactive patients it may work; however, a therapist or
clinician will need to be involved in the final decision to wear the garment
during the day.
No,
it is available with a black compression shell with red neoprene measuring
strip, and a covered removable
foam padding in red.
Typically
this is ok because someone from CircAid Medical will contact you to work this
situation out. Generally, if you find that masses are soft enough that they
will redistribute to other areas while in the garment, we will ask you to
re-do the measurements with arm resting on a table to help simulate this.
Because
the garment is made of a series of 2” straps and corresponding d-rings, the
garment’s length can only change in 2” (5cm) increments. This limits us
from manufacturing to specific lengths without altering the consistency of the
strap spacing.
The Thigh-High 2000 does feel different than bandaging feels. There
are not as many layers, and the level of compression is based on a method that
feels both firm and comfortable. To this end, make sure the patient has
gone over the instructional video and in particular, understands the band
engagement, adjustment, and tightening sections, as well as La Place’s Law.
Habit changing alternative #1: This garment is the perfect answer for
patients that are "on board" – want to heal their ulcer, lead
independent lives, take care of their legs; but can’t pull on stockings and
want another option to add to their bandaging skills. Although patient with
Lymphedema conditions fair better in the Ready-FitTM
2000 (see alternative #2), a fresh perspective on an easier method may be the
answer they’re looking for. The three band legging the T-3 Boot / C-3 Wrap
is a good introduction for transitional patients like these.
Habit changing alternative #2: You may be treating a patient that has a
broad perspective about their condition and their healthcare arrangements.
You, the therapist/fitter, and patient may envision a garment that will last
longer than three months (like the T-3 Boot and C-3 Wrap) that addresses
long-term needs. The recommended garment would be the Ready-Fit 2000 with a
minimum life of one year.
- Fleshy shelves or tissue masses
- Sizes Contradictions
- Length out of range
- Too big for standard size
- Size under the Ready-Fit 2000
- Custom legging may be required
It’s working! It may work more effectively if the patient showers
in the evening and applies the legging prior to rising from bed in the
morning. This will alleviate the constant need to adjust the bands, as they
become loose due to the calf muscle pump working against the garment. In this
way, the patient has not given gravity the opportunity to allow fluid to fill
in the lower extremity.
No, this compromises the fabric’s stitching and delicate nature of the
mesh material. If you are considering alterations based on your comparison of
measurements vs. the sizing charts, take additional measurements as referenced
on the Ready-Fit 2000 sizing chart to avoid the cost of a custom-made garment.
In some cases – yes. Each patient situation is different, as we have
discovered. The majority of patients we have talked to enjoy the use of the
ankle-foot wrap inside a shoe that had to be sized too large for their foot
due to pre-existing edema.
In other cases – not much edema may be present begin with so the
ankle-foot wrap is reserved for nighttime use.
Yes, its length (only) can be altered by up to
1" (2.5cm). Refer
to written and video instructions.
See
your patient after one month of wear to check and adjust the compression
levels if necessary. Your patient may indicate sometime in the future that
not enough compression is being felt. This is an indication to check the
sleeve to assure the proper amount of compression is being used.
- Assure sleeve’s edge does not extend over the wrist
bone and onto the hand.
- Is the compression level set to a firm and
comfortable compression? Re-check
the level and assure patient is applying and setting the bands properly.
- Make sure patient understands how to use measuring
card and that the compression level is not too high.
- Evaluate how patient is wrapping hand.
Hand should be covered or wrapped prior to setting any of the
arm-sleeve bands in place.
- Consult
with physician to dispel possibility of infection
Make sure the elbow crease of the
sleeve is lining up with the elbow. Also, check the length of the arm-sleeve
to assure it does not ride up into the axilla, and alter the length as
indicated in item #4.
Consider alternatives outside of the CircAid garment and revisit the
possibility when at least one of the above issues has changes.
Yes, one- two bands can be trimmed from the bottom of the legging.
Refer to both written instructions and the instructional video for further
details.
Yes, the circumference of the bands can be decreased by up to 2.5cm by
slitting between the bands. Refer to both written instructions and the
instructional video for further details.
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