Signs of Orthostatic Hypotension

Do you remember when you were younger and had a lot more energy? Sometimes you would get up too fast and get dizzy. This is called orthostatic hypotension or postural hypotension.  You may feel dizzy, lightheaded, or even faint. You may not have to get up fast any more to experience the dizzy feeling. This episode may last a few seconds to a few minutes after standing. If it lasts longer than that, you need to visit with your physician to make sure there is nothing else to be concerned about. Orthostatic hypotension can occur in anyone, but can be seen particularly in the elderly and those with low blood pressure.

Some of the signs and symptoms of orthostatic hypotension after sudden standing are:

  • Dizziness
  • Intense feelings of well being or disorientation
  • Lightheaded
  • Nausea
  • Distortions in hearing
  • Blurred or dimmed vision
  • Fainting

Orthostatic hypotension is caused primarily by pooling of blood in the lower extremity caused by gravity. This can set off a chain reaction:

  • Venous return to the heart is compromised
  • Decreased cardiac output
  • Lowered arterial pressure
  • Lowered systolic and diastolic pressure
  • Insufficient blood flow to the upper extremity

Normally the blood pressure does not fall very much when you stand, because it automatically triggers vasoconstriction (narrowing of blood vessels caused by muscular contraction of the muscle in the vein wall). Orthostatic hypotension may be aggravated when there is a lower volume of blood present (bleeding, diuretics, dehydration vasodilators or other types of drugs, or prolonged bed rest). There are also certain diseases which could aggravate orthostatic hypotension, but those are best diagnosed and addressed by a physician.

BPStanding BPSitting

One simple test for orthostatic hypotension is taking the blood pressure while sitting or lying down and again when standing.

A drop in systolic blood pressure of 20 mmHg and/or a drop of diastolic blood pressure of 10 mmHg could be diagnostic. A tilt table test or other tests may also be used.

lwa-ask-your-physician

The treatment of orthostatic hypotension will depend on the cause, but physicians will usually review the medications you are currently taking to
make sure there is nothing that could cause your symptoms. Your physician may recommend lifestyle changes such as increase in fluid intake, standing slowly, and avoid bending at the waist. Sometimes wearing compression stockings will help control the drop in blood pressure you have experienced. Some physicians will recommend a 15-20 mmHg knee high: other physicians recommend a 20-30 mmHg knee high. A knee high garment may be adequate to control a mild drop in blood pressure, but in severe cases, a 30-40 mmHg waist high garment may be required. In any case, if you are having symptoms of orthostatic hypotension, consult with your physician.

SupportHosePlus.com offers many styles of garments your physician may recommend. Remember there is a wide range of athletic, dress, casual, and sheer stockings to fit your lifestyle. Check your latest e-mail for specials and call one of the Certified Fitters at SupportHosePlus.com. Toll-free 1-844-472-8807

If you have orthostatic hypotension please share with us how you and your physicians have been able to manage it, go to the bottom of the blog entry and leave a comment.

Vanda

More Answers To Your Questions

Many of our customers have submitted more questions they would like answered. I would like to share these questions with you as well as my answers.

I purchased my compression socks from a sports store. I have spider veins and am on my feet many hours. When I remove my socks I have indentions and red marks where my knee highs end. Are they too tight?
How to Measure

Without having all the facts, it is very difficult to say. The socks may not have a good release built in the top of the socks. They may be helping you and move your swelling up, but cannot move any further because the socks end. You may need a thigh high garment instead of a knee high. They may be an incorrect size. Why don’t you take your measurements 1st thing when you get up and call one of our Certified Fitters on our toll-free number, 1-844-472-8807, and let us assist in a garment that is appropriate for you?
Here is how to take your measurements:

Measurements should be taken upon arising when your legs are at their smallest.
  • Using a measuring tape measure around the smallest part of the ankle. This will be above the round bones (malleoli) on both sides of the ankle.
  • Next measure around the fullest part of your calf.
  • For thigh length styles also measure around the fullest part of the thigh.
  • *The measurement from the crease in the bend of the knee straight to the floor will also be needed.

For thigh high stockings you will need a length measurement from the glutial fold straight to the floor.

I was told by my OBGYN that thigh high stockings were not appropriate during pregnancy, because they could cut off the circulation in the groin area.

I do not feel properly fit thigh high stockings will cut off the circulation in the groin area. If you have a lot of swelling, they could move the swelling into to the vulva area. Maternity pantyhose are my garment of choice for pregnancy, because the tummy panel will give some support to the fetus and lift it off of the veins. Most maternity pantyhose have elastic in the waist band which can be adjusted or completely removed. That being said, I do have many customers who are pregnant wear thigh high stockings successfully.

I have a group of veins on one leg that always hurts, but especially when I go up and down stairs. What should I do?

Varicose veins usually do not hurt. If you are in that much pain, you should find a good vein specialist and have a complete evaluation. It may not be your varicose veins which are hurting. It could be something else and only a full evaluation can determine the true cause.

My doctor told me I have orthostatic hypotension and I should wear compression stockings. There is so many choices, what stocking should I choose.

As you know, when people have orthostatic hypotension and stand, their blood pressure drops and they may pass out. Compression stocking can help with this. The garment of choice is pantyhose, but many people are able to manage with a thigh high garment. A knee high garment is really not appropriate. The compression usually varies with the severity of orthostatic hypotension. At least at 20-30mmHg is used for this disorder, but sometimes a 30-40mmHg is required.

I have a DVT (deep vein thrombosis) should I wear my stockings 24/7 or just during the day?

You get the most benefit from your stockings when you are standing or sitting (vertical position). They are less helpful when you are sleeping (in a horizontal position). That being said, it depends on the severity of the DVT. It is very important for you start walking and getting exercise as soon as possible. If you are in doubt, consult your physician.

I have been diagnosed with lymphedema. I wear 20-30mmHg compression stockings, but I keep swelling more and more. Help! What should I do?

First you need to find a good lymphedema therapist. Your physician may give you a referral to a lymphedema therapist. The therapist will evaluate your swelling and probably wrap your extremity with layers of bandages to reduce your swelling as well as teach you some special massages you can do yourself later on. Once your swelling is reduced as much as possible, the therapist will recommend garments for you to wear each and every day. Remember you may need to go back into bandages occasionally  for a “tune up”. Lymphedema may not be currently curable, but is controllable if you follow your therapist instructions.

If you have more questions or comments, please scroll to the bottom of the blog entry to leave a comment or ask a question.

Thanks so much to those who submitted these questions,

Vanda


http://www.supporthoseplus.com

What Compression Should I Choose?

Before we discuss what compression to choose, let’s look at how the compression helps control edema and makes our legs feel better. The muscles of the legs act a pump to assist the heart in the return blood flow from the extremities. When veins and valves of the legs become damaged or incompetent, compression stockings provide a little extra “squeeze” to help reduce the diameter of distended veins and help the valves to close. When this happens, the blood flow is increased. The “squeeze” is measured in mmHg compression.

If your physician has not suggested compression of support hose (compression stockings or support socks) to purchase, it can be very confusing. A garment with too little compression for your diagnosis may not contain the swelling. On the other hand, I have clients purchase 30-40mmHg compression because they want to be certain of getting rid of their swelling. Once they receive their purchase, they are even more frustrated because they are not able to don the garment. The correct compression, correct size, and style are some of the secrets to being a successful support hose (compression stocking or support sock) wearer.

For someone with little or no swelling, an 8-15mmHg compression may give the gentle message they desire.

For someone with mild swelling or to prevent varicose veins, a 15-20 compression may give them support they want.

For someone with moderate swelling, a 20-30mmHg compression may give them all the “squeeze” they need.

Here are some guide lines we follow when fitting a new client:

  • 8-15mmHg compression is generally used for
    • Minor ankle, leg and foot swelling
    • Those who want just a little gentle massage to help their tired, fatigued legs
    • A client who is very elderly and has serious heart problems or is not able to don a higher compression
  • 15-20mmHg compression is used for
    • Minor varicose veins
    • Travel (when there is no other leg problems)
    • Prevention of varicose veins during pregnancy
    • Post Sclerotherapy
  • 20-30mmHg compression is used for
    • Moderate to severe varicose veins
    • Moderate swelling (edema)
    • Post Sclerotherapy
    • Prevention of recurrence of venous ulcerations
    • Superficial Thrombophlebitis
    • Post surgical
    • Management of Neuropathy
    • Travel
    • Prophylaxis during pregnancy
    • Burn scar management
    • DVT (Deep Vein Thrombosis) prevention
    • Healing of joint replacement
  • 30-40mmHg compression is used for
    • Severe varicose veins
    • Severe edema
    • Lymphedema
    • Management of active venous ulcerations
    • Prevention of recurrence of venous ulcerations
    • Prevention of Post-Thrombotic Syndrome
    • Management of PTS (Post-Thrombotic Syndrome)
    • Orthostatic Hypotension
    • Post Surgical
    • Post Sclerotherapy
    • Burn Scar Management.

For our returning clients, are you having problems such as your garment not containing your edema or your garment is rolling, pinching or otherwise not fitting properly? Call our Certified Fitters at 1-844-472-8807. Your problems could be due to wrong compression, wrong size, or wrong garment. For example a knee high 20-30mmHg from one manufacturer does not fit the same as the same garment from another manufacturer. Even different styles of garments from the same manufacturer (such as casual compared to dress) can fit different.

In conclusion a properly fitting compression garment of the proper compression and correct style can make your legs happy!
Our goal at SupportHosePlus.com has always been to help you improve the quality of your life!

Vanda

Quality of Life Enhanced by Support Hose

Merry Christmas from SupportHosePlus.com

This time of the year, stories of miracles are wonderful to hear. While what we have to share is not a miracle, being able to enjoy a better quality of life is a miracle.

We get to know a great many of our customers, they become our friends and some of them share their personal story of how support hose has changed or improved their life. This month I would like to share a couple with you. I will not share their real name, but you might see yourself in their stories.

I was at a health fair and a gentleman walked by and said he had retired about three years ago and began having symptoms of what he believed to be Restless Leg Syndrome. He continued, “I suffered tingling in my feet and legs at night, sometimes mild leg pain and general leg discomfort that made it difficult to sleep. I tried everything I could think of (even some over the counter medications) to ease the discomfort so I could get a descent nights sleep, but nothing seem to help.”

He had a pair of thigh high TEDs which were placed on his legs after surgery sometime back. He dug them out of the bottom of his drawer and started wearing them at night. The Restless Leg Syndrome symptoms went away immediately.

He continued to share, “I now wear knee high compression stockings to bed every night and no longer suffer with the leg symptoms!”

In instances such as this gentleman, we recommend starting with a low compression stocking like our Jobst SensiFoot Sock which is an 8-15 mmHg compression. If that does not help, we sometimes recommend going to a 15-20 mmHg compression. Usually the lower compression such as the SensiFoot gives the leg a gentle massage and alleviates the problematic symptoms.

A recent email I received revealed an entirely different reason our clients wear compression stockings or support hose:

“Thank you for your service to my wife and I in this past year.

I thought I would let you know the condition my wife has that causes her to need to wear your support hose. It may help you realize the diverse needs out here that your products meet.”

“We have been married 43 years. She is 64 and last year had hip surgery to address a problem caused by a bad leg fracture suffered in a ski accident at college some 45 years ago. The hip finally needed replacement. The night after her surgery she began to suffer extreme low blood pressure resulting in her fainting whenever she would stand up. After an air ambulance trip to Mayo Clinic in Minnesota she was diagnosed with “Pure Autonomic Failure”*. To address her bouts of syncopy (fainting) she was prescribed both medications and the Juzo support hose. She has tried to reduce both her use of the drugs ordered for her, and the use of the support hose, but has found that she can only keep strong both in blood pressure readings and in energy for daily living by steady use of both. This is why she wears the Juzo hose, and we are grateful we can order it from you.”

Yes, being able to enjoy a better quality of life is a miracle. If you have stories you would like to share, please send them to customerservice@supporthoseplus.com and we might choose your story to share at a later date.

While I am thinking of it, prices will increase on some support stockings in January. The increase will be up to 2-5% so order your stockings now at a savings.

Wishing you a Merry Christmas and Happy Holidays,

Vanda, Rod, Brent and the Support Hose Plus Team

*Pure autonomic failure, or Bradbury-Eggleston syndrome, is a degenerative disorder of the autonomic nervous system (that part of the nervous system which controls the body’s organs) presenting in middle to late life, affecting men more often than women. The disorder appears to be confined to the sympathetic and parasympathetic nervous systems. the symptom that usually brings patients to the physician is orthostatic hypotension, or a fall in blood pressure with standing. The orthostatic hypotension may be described as dizziness or faintness upon standing. It is worse in the morning, after meals or exercise, or in hot weather.

Remember, being compliant with wearing your Jobst, Mediven, Sigvaris, or Juzo compression stockings and support hose is the key to keeping your legs and body healthy.

Thank you for shopping with Support Hose plus

Vanda

Remember Stockings make great gifts or stocking stuffers