What is mmHg?

Many of you have asked what is mmHg or mm Hg (it is written both ways) when we talk about compression hose. “mmHg” stands for millimeters of Mercury. This measurement is the same measurement used to measure your blood pressure as well as the atmospheric pressure. It is the force per unit area exerted by an atmospheric column (that is, the entire body of air above the specified area). When you have a blood pressure reading, such as “120/80 mmHg,” we say it is “120 over 80 millimeters of mercury.” The top number, the systolic reading, measures arterial pressure during the heart’s contraction. The bottom diastolic number assesses arterial pressure when the heart is relaxing between beats, refilling itself with blood. When we talk about compression in garments, is usually expressed as a range, i.e. 20-30 mmHg. That is the range of pressure the garment is capable of exerting at the ankle dependent upon the measurements the fitter takes. Since the compression garments are gradient or graduated, the pressure gets less as it goes up the leg and less as it goes toward the toe.

Compression garments were developed when a person with lower extremity venous insufficiency (a condition  that occurs when the veins in the legs are not working effectively to pump blood from the legs back to the heart) realized that when they went into a body of water such as a swimming pool the increased pressure in the pool relieved the pain and discomfort from the venous condition. The deeper they progressed in the pool, the more relief they felt. From this discovery a very rudimentary wrap developed which reduced the swelling or edema and improved their quality of life.

Through the years, this rudimentary wrap has evolved into the wonderful compression garments we have today. They are available in many different compressions to accommodate the severity of disease. Compression classes
Support hose or support socks fit every lifestyle…from the sheerest, most fashionable stockings, or men’s dress socks to many types of athletic socks for both men and women. The stockings and socks are made of a wide variety of yarns which include nylon, wool, cotton, polyester, acrylic, and Lycra Spandex or Elasthan (Lacra Spandex or Elasthan is the yarn which give the garment its “stretchability”). All are knit in a manner to move the perspiration next to the skin to the outside of the garment so it can evaporate to keep you more comfortable. Many of our clients have several different styles of stockings and socks to fit their myriad lifestyles.

The stockings you wear with compression (mmHg) are not the old “supp hose” your grandmother use to wear. Call one of our Certified Fitters on our toll-free line, 1-844-472-8807, for assistance with the selection of new garments or go to  www.supporthoseplus.com

Here is to healthy legs,

Vanda Lancour

Compression, Physical Fitness and Sports

athletic3May is Physical Fitness and Sports Month. I would like to direct this news letter to our athletes. You would think young, athletic people would have no problems with their legs, but that is not correct. Sports activities which add more weight to the legs (weightlifting, skiing, backpacking) and repetitive motion sports (running, cycling, and tennis) put a lot of stress on the veins in the legs and can damage the delicate valves in the veins and exacerbate venous insufficiency in the athlete.

When athletes are exercising, their muscles require more oxygen. The arteries transport the oxygen rich blood and the active muscles help the veins return the oxygen poor blood to the heart. Once the exercise has ended, there is no calf muscle pump to help the veins return the blood. So the legs of the athlete with varicose veins may begin to ache, throb and feel heavy. If the legs are elevated, this will help the body defy gravity and return the oxygen poor blood to the heart. This is exactly how compression socks or support socks will help the athlete and may in the long run help prevent deep vein thrombosis. Performance socks use science to help professional athletes as well as the week-end warrior maximize performance as well as recovery.

A deep vein thrombosis (DVT) is the formation of a blood clot within a deep vein, usually in the legs. A pulmonary embolism (PE) is blockage caused by a blood clot in one of the pulmonary arteries in your lungs. It usually originates from a blood clot in the legs (DVT).  You would think the athlete less likely to develop blood clots than the elderly. But that is the problem. Health care  providers think the same way so when an athlete presents with Deep Vein Thrombosis (DVT) symptoms, they interpret the symptoms as “muscle tear, “Charlie horse”, “twisted ankle”, or “shin splints”.  Chest symptoms from an athlete with a Pulmonary Emboli (PE) are often interpreted as pulled muscle, inflammation of the joint between ribs and breast bone, bronchitis, asthma, or a touch of pneumonia.

Being an athlete and being apparently healthy does not guarantee they will not get blood clots. There are several risk factors that put the athlete as well as the non-athlete at increased risk for DVT and PE…

  • Traveling long distances to and from sports events. It does not matter if it is by plane, bus, or car
  •  Dehydration (during and after a sport activity)
  •  Significant trauma
  •  Immobilization (wearing a brace or cast)
  •  Bone fracture or major surgery
  •  Birth control pills and patch, pregnancy, hormone replacement therapy
  •  Family history of DVT or PE
  •  Presence of inherited or acquired clotting disorder (Factor V Leiden, prothrombin 20210 mutation, antiphospholipid antibodies, and other clotting defects or deviancies
  •  Presence of a congenital abnormal formation of the veins
  •  May-Thurner Syndrome (narrowing of the major left pelvic vein)
  •  Narrowing or absence of the inferior vena cava (the main vein in the abdomen
  •  Cervical rib causing thoracic outlet obstruction

Built to performWhen an athlete works out, the muscles of the body act as a secondary pump to help move the blood back to the heart. The athlete also has a slower heart rate than the average person. During performance that is wonderful, but at times, that can be detrimental. After a work out or when the athlete travels the heart does not move the blood through the circulatory system as quickly as when the athlete is exercising. This is when a sock of at least 15-20mmHg is extremely important. It keeps the blood from pooling in the deep veins and forming a DVT.

Call one of the SupportHosePlus.com Certified Fitters on our toll-free number, 1-844-472-8807, for assistance with the selection of performance and/or recovery socks to enhance performance or prevent DVT and PE.

Enjoy your day!

Vanda Lancour

Let’s Keep Your Legs Looking Great

EnlargedVeinAndDamagedVein

Chronic Venous Insufficiency (CVI) is one of the leading causes of swollen feet, ankles, and legs. There are several things that can cause CVI. In CVI the butterfly valves which help blood move from the lower extremity back to the heart are damaged (incompetent) and do not close properly. Ultimately long-term blood pressure in the leg veins that is higher than normal causes CVI. Prolonged sitting or standing can stretch the superficial vein walls and damage the valves. Compression stockings and compression socks help the veins to close by applying a specific amount of pressure to the leg (this is the compression which your physician recommends). The compression stockings and compression socks also work with the muscles of the lower extremity to act as a secondary heart pump to move the blood out of the lower extremity and back to the heart.

  • Ankle swelling
  • Tight feeling calves
  • Heavy, tired, restless or achy legs
  • Pain while walking or shortly after stopping

At the end of the day, someone with CVI may experience only slight swelling and their legs may be tired and heavy. Now is the time to visit your physician and get some compression socks or compression stockings to keep the CVI from becoming worse.

  • Family history of varicose veins
  • Being overweight
  • Not exercising enough
  • Being pregnant
  • Smoking
  • Sitting or standing for long periods of time

If you have a parent who has had varicose veins, if you are overweight, or if you sit or stand for long periods of time, again now is the time to visit your physician and get some compression socks or compression stockings to keep the CVI from becoming worse.

CVI can be diagnosed by your physician by reviewing your patient history and a physical exam. The physician may also measure the blood pressure in your legs and examine any varicose veins you may have. To confirm a diagnosis of CVI, the physician will usually order a duplex ultrasound or a venogram. A duplex ultrasound uses sound waves to measure the speed of blood flow and visualizes the structure of the leg veins. A venogram is an x-ray that uses a dye (contrast) which enables the physician to see the veins.

Chronic venous insufficiency is usually not considered a health risk; your physician will try to decrease your pain and disability. In mild cases of CVI, compression stockings or compression socks may alleviate the discomfort and swelling. Physicians usually use a 20-30mmHg compression stocking or a 20-30mmHg compression sock for this. The stockings will not make the varicosities go away, but is the least invasive treatment.

Chronic Venous Insufficiency

More serious cases of Chronic Venous Insufficiency require sclerotherapy, ablation, or surgical intervention such as stripping to correct the problematic vein. This is usually done by a vascular specialist or vascular surgeon. During sclerotherapy a chemical is injected in the affected vein or veins and a scar will form from the inside of the vein. During ablation a thin, flexible tube (catheter) with an electrode at the tip will heat the vein walls at the appropriate location to seal the vein. When a vein stripping is done one of the saphenous veins is removed. The physician will make a small incision in the groin area and usually another in the calf below the knee. The veins associated with the saphenous vein will be disconnected and tied off and the vein removed. There are other surgical procedures which are done to improve your leg health. After one of the above procedures 20-30mmHg compression stockings are usually put on and you are told to wear them for a certain length of time. Some physicians will tell their patients on their follow-up visit that it is no longer necessary to wear the compression garments. For me, this is where I have some concerns. If the real underlining cause of CVI (such as family history of varicose veins, being overweight, not exercising enough, smoking or sitting or standing for long periods of time) has not been corrected why would you not continue to wear compression stockings to keep from developing CVI again.

Compression stockings and socks have come a long way in the last few years. They no longer look like the garments our grandparents wore. They look like ordinary stockings and socks and can improve the quality of life. The stigma of wearing compression garments is in the past.

Let’s wear our compression stockings and socks to keep our legs looking great!

Vanda

http://www.supporthoseplus.com

Defy Gravity

The condition of men’s legs are not something that they are concerned with; they don’t sit around and talk about varicose veins while drinking a beer and watching a game for the FIFA World Cup or their favorite sports program. Perhaps the condition of their legs is at least something they should think about and talk to their physician. About 10-15% of younger men have varicose veins whereas about 20-25%of the young women experience the problem. As I wrote about last week, it’s the women who will seek a physician’s advice about varicose veins and not the men. Most men think varicose veins are no big deal…a woman’s problem. Think again. By the time men are in their sixties between 50 and 60% have varicose veins.

Exercise regularly...It's important to involve your calves. It is the calves that act as a secondary pump to return the blood to the heart.

When sitting or standing for prolonged periods of time, blood pools in the lower extremity expanding the vein walls. Over time the veins loose their elasticity and do not return to their taut state. Some people (both men and women) have a genetic preponderance to varicose veins. If one of your parents has vein disease (venous insufficiency), you have about a 33% chance of developing it. If both of your parents have venous insufficiency, your chance jumps up to 90%.

  • Exercise regularly…It’s important to involve your calves. It is the calves that act as a secondary pump to return the blood to the heart.
  • Wear compression hose… Some physicians recommend everyone wear knee-length compression stockings—even if they don’t have signs of varicose veins. The compression of the stockings assists the calf muscle in pumping the blood from the ankle back to the heart. Usually a 15-20mmHg or 20-30mmHg compression is adequate.
  • Watch your diet… Foods high in sodium may cause your body to retain more fluids and swell.

Some people experience no symptoms with varicose veins, for others, the varicose veins hurt (throbbing, aching or burning). Other people experience itching or the vein feels hot, and many experience swelling in their legs. Symptoms are usually less severe in the early morning and worse at the end of the day (after standing or sitting for prolonged periods of time). The cause of the pain may be nerve irritation. As varicose veins dilate, they can begin to press against adjacent nerves.

Some athletes relate that their legs feel fine when training, but a short time later the legs that have varicose veins begin to ache, throb and feel heavy. If they lie down and elevate their legs, they feel better. While an athlete is exercising, their muscles required more oxygen. So the oxygen rich blood is transported through the arteries and the muscles helped the veins return the oxygen poor blood to the heart. When the exercise is completed, there is no calf pump action to help the veins return blood to the heart resulting in pooling of blood in the lower extremity. Elevating the leg helps the body defy gravity and return the blood to the heart (just as compression stockings and socks do).

Sports which add more weight to the legs such as weightlifting, skiing, backpacking and repetitive motion sports such as running, cycling and tennis put a lot of stress on the veins in the legs. These activities can damage the delicate valves of the venous system and exacerbate the venous insufficiency. There are positive and negative reasons to exercise or not, but they cancel each other out. So stay active and defy gravity by wearing compression socks!

Visit your primary care physician so he can make arrangements to have them checked out and defy gravity by wearing compression socks.

If your legs ache and swell, it could be a bigger problem than simply overdoing it at last week’s soccer game. And even if your legs aren’t in pain, if you’re seeing weird vein patterns, chances are there could be something wrong. Visit your primary care physician so he can make arrangements to have them checked out and defy gravity by wearing compression socks.

Vanda

March is DVT Awareness Month – What is a DVT

March is DVT Awareness Month. This month I would like to address DVT (deep vein thrombosis) to inform you and your loved ones what a DVT is, risk factors of a DVT, and the symptoms of DVT.  I want you to become an activist and recognize when medical attention should be obtained. Roughly 600,000 people in the United States are affected by DVT each year. Not all of these are hospitalized. We all fear AIDS, breast cancer and traffic accidents, but what about DVT?  DVT kills more people every year than these maladies combined!

So what is a DVT and how is it formed? The arteries transport the oxygen rich blood away from the heart which is a one way pump. The veins are thin-walled blood vessels that carry oxygen poor blood from the tissues back to the heart. In order to move the blood against gravity the leg In order to move the blood against gravity the leg   In order to move the blood against gravity the leg Calf Contraction and Relaxation muscles squeeze the deep veins to move the blood back to the lungs and heart.muscles squeeze the deep veins to move the blood back to the lungs and heart. Wear support hose to prevent DVTmuscles squeeze the deep veins to move the blood back to the lungs and heart. The human body has three types of veins; superficial veins which are the veins that are close to the skin (the ones that you can see), deep veins which lie within the muscle structure within the body and perforating veins which connect the deep veins to the superficial veins. The veins contain one-way valves for the return of the blood back to the heart. When these valves do not close, stagnation of the blood can occur and a deep vein thrombosis (DVT) can form most often near a venous valve. The DVT can permanently damage the vein wall and valve with scarring or fibrosis which can cause them to become incompetent resulting in reflux (backward) flow of blood and venous congestion. Compression socks and stockings work as a secondary pump and along with the calf muscles close the valves to move the blood back to the heart. Consult with your physician to determine if you have risk factors and seek advice on appropriate preventative measures, including the amount of compression to wear. We carry many compression socks and compression stockings which can help prevent DVT. Please check out our JobstMediSigvaris and Juzo support socks and support hose. Did you know all of the manufacturers offer a extensive line of garments which range from athletic socks, men’s dress and casual socks to women’s opaque and sheer thigh high stockings and pantyhose so that each of us can choose a style or styles that are targeted at our lifestyle?

Next week we look at Risk Factors for DVT…

Let’s all get out there and let our friends know about DVT,


Vanda
www.supporthoseplus.com

More Questions You Have Asked

Our clients have certainly given us some questions that need to be addressed. One of the main concerns seems to be that of being able to don and doff (put on and take off) their own compression stockings. Staying independent is important to all of us. One question that was asked is if there is a donner for support pantyhose similar to the one for knee high or thigh high support socks. Yes there is. However I do not recommend using it. I believe it is one thing to have one leg in a donner trying to pull up a support sock, but to have both legs involved in a donner I feel could lead to a nasty fall.

It seems everyone wants to know the easiest way to put on support pantyhose. I would like to share with you how I put my panty hose on. I wear 20-30 pantyhose and it takes me about 5 minutes and a bit of patience to put my stockings on in the morning. While it is not an easy task, it is really no more difficult than putting on a pair of knee high stockings. The hardest part of putting on any lower extremity compression garment is getting it over the heel. First I will repeat what I said last week, never gather the stocking. I use the Sigvaris Donning Gloves to put on my support pantyhose. I call them my “magic green gloves”. They enable arthritic hands to have better grasp. I use the little “nubbies” to pinch and pull the stockings up. They also protect my stockings from my fingernails. Even when I have the Sigvaris Donning Gloves on, I use only the balls of the finger tips to grasp the stockings.

First I sit down and with out my “magic green gloves” I pull the stockings on one leg as far as I can.  (For me, it is easier to start with the left leg.) Then I put on my gloves and pull the stocking up and over my heel and then up my leg as high above the knee as I can by pinching the garment and pulling it up. Then I start the other leg into the stocking and use the gloves in the same manner to pull the stocking up to the same level.

When I have them as high up my legs as I can get them while sitting down I remove the gloves, stand up, and pull the stockings up and over my tummy. Once this is accomplished, I put the gloves back on and start at the ankle of each leg and re-stretch the stockings by pinching and pulling all the way up the leg.

Then I take the gloves off and place my hands in the back of the stockings with my palms out. I push away from the body and lift up without grabbing the stockings. This seats the crotch of the pantyhose.

If the color or appearance of the stockings is uneven, I put on the gloves and use the flat of the hand to rub gently up or down the leg to adjust the stocking so it has an even appearance.

peel a banana3

Now that we have managed to put on stockings or socks, how are we going to get them off? I have had clients become so frustrated and panicked that they cut (yes, cut) a very expensive garment off. Same thing applies here as when putting on a compression garment…never gather the garment (or allow it to roll) when removing it. It becomes like the rubber band again and extremely difficult to remove. Instead start at the top and pull the garment down allowing the garment (it does not matter if it is a knee high, thigh high, or pantyhose) to slid on itself until you are able to pull it off your foot. The stocking slides on itself.  Peel your socks off just like you peel a banana.

If the “Peel a banana” method is not working for you, we have another option the Mediven Butler Off. The Butler Off looks similar to a shoe horn. There is a handle on top for pushing and a “tooth” to help push the garment off. The Butler Off is not meant for use with sheer support hose, but with more substantial garments. The Butler Off is not to be used to help push yourself up from a sitting position.

How to Use the Medi Butler Off for Removal of Stockings or SocksHow to use Medi Butler Off

  • Slide the tip of the horn under the top band of the stockings.
  • Now push the handle gently downwards: the far end of the horn slides down your calf and then over your heel. During the whole process the inner surface of the horn should remain in contact with your skin. At the same time the “tooth” helps push the stocking downwards. In order to regain contact with your skin you can start again with the horn a little higher and then continue with the downward movement if necessary.
  • As soon as you reach your heel lift your heel up. Then tilt the stick downwards a little to guide the horn along the underside of your foot. Caution: Make sure you do not press the stocking against the ground with the doffing aid. Otherwise the stocking may be damaged. Now push the handle forwards gently: the stockings slides off your foot, but stays on the horn.

There are more ways to don and doff compression stockings or support socks that these, but perhaps this will get you started. If you have comments or more questions, please click on the title of this newsletter, More Questions You Have Asked, scroll to the bottom of the blog, and leave your message as a guest.

Vanda
www.supporthoseplus.com

 

Support Hose – Questions You May Have Asked

I had a gentleman email me the other day asking how to sort his compression socks into pairs. This started me thinking…there are questions we get asked over and over again so I thought I would devote a few newsletters covering some of these questions.

How can I sort support socks so I don’t embarass myself by having on mismatched support socks?

mismatched socks

    Compression socks are dyed so very heavy that it is often very difficult to tell the difference between blue, brown and black until you have mismatched socks on! (Even in this photo one sock is brown and the other back.)
  • You should get your socks in really good light. They are much easier to pair that way.
  • You could put each pair in a separate lingerie bag when you remove the socks. They are always paired that way.
  • When you receive your new socks, take a few running stitches in the top of the socks. Use a different color for each pair.

Is there any way to make support socks or support stockings with silicone tops stay up?  
wiping silicone band with alcohol small

    After you have had your socks or stockings with a silicone band for a little while (less than the 4 – 6 month life of the garment), they may start to slide down.

  • Sometimes you will get a body protein and lotion (accidental application) build up on the silicone band (even if you wash these garments every night).
  • Take a wash cloth dampened with rubbing alcohol and wipe only the silicone dots or silicone strips. This could be done weekly as a deterrent to garments sliding
  • This will restore the tackiness of the silicone.

 

Is there an easier way to put support hose or support socks on someone else?

Donning a Sock

    I have clients who are caregivers make comments about how hard it is to put compression support hose or support stockings on someone else.

  • To begin with, never and I mean never, gather the compression sock or stocking like you would an ordinary sock or stocking. The garment becomes like a rubber band and you cannot stretch it open far enough to insert the toes… no matter how strong you are, it is next to impossible. Fold the top of the sock down until you are right above the heal pocket.
  • Insert your thumbs into the opening and stretch the garment open. (You are only stretching two layers of support sock and not a clump of support sock).
  • Next sit next to the person you are going to put the stockings on and pull the garment on them as though you were pulling the garment onto your leg.
  • It is many times easier to pull a sock or stocking on than try to push one on!

If you have questions or comments, scroll to the bottom of this blog and leave your comment or question as a guest.