Compression Garments
Q: Do I need to wear a compression garment to manage Lymphedema?
A: Yes. Compression garments are designed to offer a gradual level of support to the area(s) of your body that have developed Lymphedema. Wearing a compression garment will help you control the condition while continuing your daily activities. Our team will work with you to be fitted with a garment that best suits your needs.
Q: My therapist is using words such as: "Compression garment," "Garments," "Stockings," "Hand glove," and "Millimeters of mercury." What do they all mean?
A: These words are used to describe the types of compression product you need to help manage your Lymphedema:
"Compression garment" or "garment" is used to describe compression products that provide support for Lymphedema anywhere in your body;
"Compression stockings" refer to a compression product to treat leg, thigh, or waist-length Lymphedema concerns;
"Hand gloves" describes a compression product to provide hand support. Hand gloves can be made to include individual finger supports;
"Millimeters of Mercury" or "mmHg" relates to an estimated measure of the amount of gradual compression woven into the product. For instance, 20-30mmHg is a garment with a gradient of 20 mmHg to 30mmHg of compression support. The higher the numbers, the more compression support is offered by the product. It is important to be fitted with a compression garment with enough support to control the Lymphedema. You also need to be able to don and doff the garment, and comfortably wear during daily activities.
Don't hesitate to ask us for clarification! We will provide a written summary of our recommendations for your physician and insurance provider(s).
Q: Does Calgary Lymphedema Rehabilitation offer surgical garment fitting services?
A: Yes, we offer our client's a clinic where they can receive treatment, education, and ongoing support for managing their Lymphedema. We want to make it easy for our client's to access the compression products they need to help manage their condition. We believe Best practice means our client, therapist, and garment fitter, MUST work together! This "one-stop" service specializing in Lymphedema management is unique to Alberta!
Our clinic is fortunate to have Elizabeth Bassett, Surgical garment fitter, as a member of our team. Elizabeth joined the clinic with over 14 years of experience measuring and fitting clients with compression garments and working with Lymphedema products. Your therapist will also be involved in planning, measuring and fitting graduated compression garments.
SOME OF OUR UNIQUE SERVICES:
- Our clinic offers daytime and night time Lymphedema compression garments not available with other medical supply stores.
- Our clinic is committed to offer ongoing support to our client's to help manage their Lymphedema. This includes keeping our ongoing clients updated on new products and services as they arise.
- Our clinic offers specialized Lymphedema garments that are not covered by Alberta Aids to Daily living (AADL).
Q: How do I obtain coverage for these compression garments?
A: : If you have extended health-care insurance benefits available, your plan MAY offer coverage for graduated compression garments. Please contact your insurance company for benefit details and requirements for reimbursement PRIOR to setting an appointment for measurement at our clinic. It is your responsibility to ensure you are informed about what your extended health insurance plan will cover. Our team cannot contact your insurance plan due to Health Care privacy law. Your therapist at Calgary Lymphedema Rehabilitation will work with you to provide any necessary documentation.
EXTENDED HEALTH CARE BENEFITS SUMMARY
Q: How do I obtain a compression garment if I plan to use my Extended Health-care benefits?
A: Step 1: Contact your insurance provider to clarify your benefits and coverage details.
Step 2: Complete assessment and treatment with your therapist at Calgary Lymphedema Rehabilitation. Your therapist will provide a written recommendation to your physician for compression garment(s) for their review and signature.
Step 3: Schedule a fitting session with your treating therapist or surgical garment fitter. We will provide you with a receipt and copy of your physician's order. Keep a copy of the receipt and physician order for your records!
Step 4: You submit your garment receipt, physician order, and other insurance paperwork for reimbursement.
If you have access to extended health benefits to cover garment costs, this will usually result in a more efficient and timely means to obtain your compression garments than through the government's Alberta Aids to Daily living (AADL) program. (Refer to page 4 for information about the AADL program)
Q: How much do compression garments cost?
A: The compression garments vary in price by model, compression, size of sleeve, options, and design. We recommend receiving a quote from a certified fitter during the measuring process. You may wish to receive an estimate of costs as you review your extended health benefits prior to deciding how to proceed. In general, custom garments are more expensive than Standard sized garments.
ALBERTA AIDS TO DAILY LIVING PROGRAM SUMMARY
Q: How does Alberta Aids to Daily Living (AADL) program work?
A: Alberta Aids to Daily Living (AADL) is a publically funded program that provides financial assistance to people who have a chronic disability or illness, to gain access to authorized basic medical equipment and supplies so they can function more independently in a home or home-like setting. To participate in the program, a person must have a long-term disability lasting six months or more, a chronic illness or terminal illness. Eligible people must also be an Alberta resident and have a valid Alberta Personal Health Care number.
AADL currently pays up to 75% of a benchmark price point for 2 to 3 Compression sleeves, per limb, per annum, from date of authorization. As all compression garments vary in price, AADL has set a base price (or benchmark) for reimbursement of compression garments.
AADL is a government program subject to change and review on an ongoing basis! For clarification of benefits, coverage, and specific questions about benefits, please call: Toll free 310-0000, then (780) 427-0731, when prompted.
PLEASE NOTE:
- AADL's benchmarks rates are NOT the actual retail price of compression products. These benchmark rates are subject to change by AADL.
- AADL DOES pay for 30 mmHg and higher compression class, standard-sized graduated compression sleeves
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AADL DOES NOT provide cost relief for all daytime compression products available for treatment of Lymphedema.
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AADL DOES NOT pay for Standard size, off the shelf, 15-20mmHg, OR 20-30 mmHg graduated compression garments. AADL will only pay this portion on Custom-made 20-30 mmHg graduated compression garments.
- AADL DOES NOT provide ANY coverage for Nighttime Lymphedema compression garments designed to be worn while you sleep.
Effective April 1, 2007 (subject to change) examples of AADL benchmark prices for standard ready made garments are:
- Ready made Lymphedema glove 3 per limb / 12 months: $116.90
- Lymphedema sleeve without gauntlet minimum 30mmHg compression 3 per limb/ 12 months: $55.11
- Lymphedema sleeve with gauntlet of minimum 30mmHg compression 3 per limb/ 12 months: $75.15
- Below knee stocking 30 to 40mmHg 3 pairs per 12 months: $100.20
- Thigh high stocking 30 to 40mmHg 3 pairs per 12 months: $141.95
Effective April 1, 2007 examples of AADL benchmark prices for custom made garments (including fitting fee) are:
- Glove to wrist 2 per limb/12 months: $186.34
- Arm sleeve (wrist to armpit). 2 per limb/12 months: $104.53
- Arm sleeve and gauntlet. 2 per limb/12 months: $128.89
- Hand glove (with individual fingers) to wrist 2 per limb/12 months: $162.03
- Knee length leg support (2 per limb/12 months): $100.40
- Thigh length leg support ( per limb/ 12 months): $128.23
All Benchmark rates, benefits, and authorization procedures are subject to change by AADL.
Q: Do I have to pay part of the costs of this garment if I use this AADL program?
A: AADL is a cost share program. You pay up to 25% of the cost of program benefits, up to a maximum of $500.00 per family per benefit year (July 1 to June 30). For some benefits you may choose an upgraded item. You pay for the additional costs of this item. These additional costs are not included in the $500 cost share maximum. Low income Albertans may be exempt from the cost share. If you are over 65 year of age or a dependent of someone over 65 year of age, you can apply for a cost share exemption from AADL. For more information, please contact AADL toll free at 310-0000, then (780) 427-0731 when prompted.
Q: How do I apply to get this compression garment benefit from AADL?
A: To get AADL authorization and reimbursement for compression garments, there are several steps you need to complete. You MUST be assessed and authorized for AADL benefits BEFORE you receive them. AADL will NOT refund clients who purchase their own medical equipment and supplies without being assessed and authorized first. For more information, call the AADL program toll free at 310-0000, then (780) 427-0731 when prompted.
Step 1: AADL will require a doctor's prescription for the compression garment. You will need to visit you doctor, OR your therapist may contact your doctor to get a prescription. The physician prescription must include the diagnosis, involved extremity, type of compression garment, and compression class of the sleeve. For instance, AADL will accept a physician order for "Class II, 30-40mmHg wrist to axilla (armpit) and a Class II, 30-40mmHg hand gauntlet for Right upper extremity Lymphedema", while a written prescription for: "Compression garment as indicated," WOULD NOT be considered acceptable by AADL. Our therapy team will provide a compression garment(s) written recommendation for your physician's. With a physician written prescription, you can provide this order to AADL authorizers for consideration.
Step 2: After receiving the doctor's prescription, you will need to go to your local AADL authorization center to complete the authorization process. In Calgary, AADL is located at: 4020 - Bowness Road N.W. Ph#: (403) - 943-2100. Please contact the center for hours of operation, and to schedule an appointment. They can also provide you a list of approved surgical garment fitting companies where you can elect to be fitted with a compression garment.
If you are currently receiving Home Care services, clinical staff can assist in providing authorization for these compression garments.
Step 3: After receiving authorization, you need to make an appointment with a Surgical garment fitter at an authorized vendor, to be measured for an appropriate compression garment. Refer to Page 8 and 9 for lists of vendors.
Step 4: After receiving the compression garment from the Surgical Garment fitter, schedule a follow-up session with your therapist at Calgary Lymphedema Rehabilitation to review sleeve fit, use, and care of the garment.
Q: Where can I find out more information about the AADL program, current vendors, and coverage in your area?
A: The Calgary Aids to Daily Living program is operated by the Calgary Health Region and is not part of the AADL Program. Calgary Aids to Daily living is the contact point for assessment of clients. Call the AADL office: 310-0000, then (780) 427-0731 when prompted. or check out their website:
http://www.seniors.gov.ab.ca/aadl/av/manual/index.asp
Q: Can Calgary Lymphedema Rehabilitation authorize OR order your garments through Alberta Aids to Daily Living (AADL)?
A: No, Calgary Lymphedema Rehabilitation and staff are not employed by any Alberta regional health authority (ex: Calgary Health region), therefore, we ARE NOT allowed by be authorizers for this program. Since this clinic is NOT a CHR funded rehabilitation program, AADL will NOT allow Calgary Lymphedema Rehabilitation's team to either authorize for compression garments we measure. Our funding is through the Alberta Cancer Board, and NOT the Calgary Health region.
Our client's who choose to pursue authorization and coverage through AADL are responsible for contacting and co-ordination with the AADL program and their authorizers.
Q: Will your therapist at Calgary Lymphedema Rehabilitation make a recommendation for you to see a specific AADL approved fitter or vendor through AADL program?
A: No. Calgary Lymphedema Rehabilitation does not endorse any specific garment fitter or authorized vendor of compression garments through AADL. We will provide you and your physician a recommendation for the specific type of garment you need to help you manage your Lymphedema. The AADL authorizer will make the final decision as to the type of garment AADL will authorize. The AADL authorizer DOES NOT have to authorize or approve the compression garments recommended by your treating therapist and physician. It is important to develop a comfortable working relationship with a garment fitter. Compression garments typically need to be replaced every 4-6 months. A fitter can help you monitor changes in your Lymphedema through taking accurate, consistent, and regular measurements over time.
Q: Who are the AADL vendors that sell graduated compression garments? Where are they located? This enclosed list was posted on AADL website effective March, 2007:
Vendor List: Compression Garments (Custom Made) Calgary Health Region
CALGARY
ABILITY MEDICAL SUPPLIES LTD 3439 26 AVE NE (403) 263-9994 0000300601 001
BLAIN MACLEAN PHARMACY (1990) LTD 3407 26 AVE SW (403) 249-7515 0000049249 001
CALMEDI & SURGICAL SUPPLIES INC 160-4411 16 AVE NW (403) 663-8777 0000298843 001
HEALTHCARE & REHAB SPECIALTIES 629 1 AVE NE (403) 262-7595 0000096829 002
HOME CARE MEDICAL SUPPLY CENTRE 9309 MACLEOD TR SW (403) 252-2266 0000096196 001
MEDICHAIR CALGARY SOUTH 7413 MACLEOD TR SW (403) 252-5366 0000023360 001
SHOPPERS HOME HEALTH CARE #8301 STADIUM MALL 21-1941 UXBRIDGE DR NW (403) 662-2211 0000050451 003
SHOPPERS HOME HEALTH CARE #8302 25A-180 94 AVE SE (403) 255-2288 0000050451 002
CANMORE
MEDIC COMFORTS 1-1302 BOW VALLEY TR (403) 678-3002 0000344827 001
NANTON
NANTON MEDICAL SUPPLIES 2212 20 ST PO BOX 302 (403) 646-2168 0000045612 001
FOR current updated lists of authorized vendors:
Call the AADL office: 310-0000, then (780) 427-0731 when prompted, OR check out their website:
http://www.seniors.gov.ab.ca/aadl/av/manual/index.asp
Vendor List: Compression Garments (Ready Made) Calgary Health Region
AIRDRIE
PHARMASAVE #338 209 CENTRE AVE W (403) 948-0010 0000043698 001
CALGARY
ABILITY MEDICAL SUPPLIES LTD 3439 26 AVE NE (403) 263-9994 0000300601 001
ALBERTA ARTIFICIAL LIMB INC DEERFOOT COURT 105-1144 29 AVE NE (403) 244-2029 0000254394 001
BLAIN MACLEAN PHARMACY (1990) LTD 3407 26 AVE SW (403) 249-7515 0000049249 001
CALMEDI & SURGICAL SUPPLIES INC 160-4411 16 AVE NW (403) 663-8777 0000298843 001
HEALTHCARE & REHAB SPECIALTIES 629 1 AVE NE (403) 262-7595 0000096829 002
HOME CARE MEDICAL SUPPLY CENTRE 9309 MACLEOD TR SW (403) 252-2266 0000096196 001
KENRON PHARMACY 100-1620 29 ST NW (403) 289-7224 0000011365 001
MEDICHAIR CALGARY SOUTH 7413 MACLEOD TR SW (403) 252-5366 0000023360 001
MEDICINE SHOPPE #212 2905 17 AVE SE (403) 235-0888 0000347026 001
PHARMACY PLUS LTD 5066 68 ST NE (403) 568-0005 0000264830 001
RON'S PHARMACY AND HOME HEALTH CARE @ GLENMORE LANDING D167-1600 90 AVE SW (403) 255-4200 0000042928 001
SHOPPERS DRUG MART #354 1231-3800 MEMORIAL DR NE (403) 272-2848 0000042941 001
SHOPPERS DRUG MART #358 24-6455 MACLEOD TR SW (403) 253-2424 0000013637 001
SHOPPERS HOME HEALTH CARE #8301 STADIUM MALL 21-1941 UXBRIDGE DR NW (403) 662-2211 0000050451 003
SHOPPERS HOME HEALTH CARE #8302 25A-180 94 AVE SE (403) 255-2288 0000050451 002
CANMORE
GOURLAY'S CANMORE PHARMACY 120-1151 SIDNEY ST (403) 678-5288 0000042983 001
FOR current updated lists of authorized vendors:
Call the AADL office: 310-0000, then (780) 427-0731 when prompted, OR check out their website:
http://www.seniors.gov.ab.ca/aadl/av/manual/index.asp
Q: Can I utilize both my private Extended Health Insurance and AADL benefit?
A: Yes. Many of our client's will use a combination of their extended health benefits along with AADL benefits. Please discuss this option with your therapist while in program.
Q: What type of compression garment should I have?
A: The most effective compression garment is one that you are able to wear, and helps to effectively manage the condition! The type of compression garment you need depends on several factors. Your therapist will make a recommendation based on:
- the amount and severity of Lymphedema,
- your medical issues,
- your daily living activities,
- Input from you.
You are the most important person in this process! Compression products become part of your daily wear and serve a vital role in long-term management of Lymphedema. The garments need to meet your medical needs and be suitable to your lifestyle. Remember that your needs may change over time. Also, products continue to improve, and new products are being offered every year. Your therapist will discuss any garment recommendations with you. We want to hear your thoughts as well!
Q: What is the difference between a Custom garment and a Standard garment? Which one do I need?
A: Standard garments are made by companies to fit using pre-established measuring points. If your affected extremity fits within the range on all measurement points, you may be a candidate to wear a standard-sized sleeve. If you have a mild, or negligible Lymphedema, a standard size sleeve may be adequate to fit your needs.
In comparison, a custom-sized garment is a made-to-measure product to meet the specifications of your affected extremity. A custom garment will provide a best-fit for your extremity, and will provide a more consistent level of graduated compression support. Custom garments are more expensive, and you will wait longer for a custom sleeve to be made, and shipped to you.
Q: How long will I have to wait for a compression garment?
A: Most of the garments are made in either the U.S. or Europe, and are shipped on order to Calgary. Standard size, or off the shelf sleeves are pre-fabricated, and can often be shipped within days. In our past experience, custom sleeves from the United States arrive approximately 2 business weeks from date of order. Custom sleeves ordered from Europe will take approximately 2-4 weeks. THESE ARE ESTIMATES ONLY. Fortunately, many of the custom sleeves are now being fabricated in the United States. CLRCS does stock several off the shelf garments which can be fitted while you are at the clinic. The manufacturers or distributors DO NOT guarantee a date of delivery.
Q: How do I manage my Lymphedema while waiting for the garment to arrive?
You will work with your therapist in developing strategies to help manage the edema independently. You may need to do a combination of:
- a home exercise program,
- self-bandaging,
- self-manual drainage,
- periodic follow-up sessions with your therapist
This period offers a great opportunity to become comfortable developing your skills to manage your Lymphedema independently. Your therapist is available to offer assistance and suggestions to help you in this process.
Q: What if I am coming from outside of Alberta for treatment and want to know about benefits?
A: Each and every province has different benefits and programs to provide coverage for compression garments. If you are a resident from outside Alberta, you will need to follow-up with your local health region administrative office to learn about the process in your own province.
Q: What are other factors I need to consider when getting fitted for a garment?
A: We are fortunate to have choice with the types of compression garments and companies available. Jobst: www.jobst-usa.com; Juzo: www.juzousa.com; Mediven: www.mediusa.com; Sigvaris: www.sigvarisusa.com; and www.venosan.ca are five companies that provide compression garments to vendors in Canada. You are encouraged to discuss your options with both your fitter and therapist. Your therapist will make a recommendation based on past experience with specific products/materials, and service/support provided. Considerations include amount of edema and location, comfort, aesthetics, and personal lifestyle.
Lymphedema compression sleeves are an important part of long-term management of Lymphedema. The sleeves should be replaced every 4-6 months depending on use. You have the option of being fitted with a different type of garment at a later date to see which product best meets your needs. Often it is personal preference that ultimately makes the difference.
Please don't expect surgical garment fitters to provide compression sleeves on an extended trial basis due to potential health concerns.
Q: Why don't I get a compression sleeve prior to starting treatment?
A: Compression garments are a vital part of long-term Lymphedema management. However, compression garments are not designed as an active treatment to reduce a limb(s) that are swollen. A properly fitted compression garment, worn consistently, and replaced as needed, is expected to help our client's maintain a limb's size.
Our clinic recommends assessment and treatment by a licensed therapist trained in Complete decongestive therapy (CDT), to reduce size, volume, improve skin integrity prior to compression garment fitting. After you have been assessed and treated, a compression garment can be fitted to help you manage your Lymphedema.
Working with a therapist will also provide you with other tools to help you manage your Lymphedema independently.
WEARING A COMPRESSION GARMENT ALONE MAY NOT BE ADEQUATE FOR LONG-TERM MANAGEMENT OF YOUR LYMPHEDEMA!
Q: How many sleeves do I need to get? What if the sleeve is not right for me?
A: Calgary Lymphedema Rehabilitation recommends clients start with ordering one compression garment. After being fitted with your first garment, we will provide education, support, and follow-up to ensure your Lymphedema is being well managed.
Questions to ask your self when first wearing the garments are:
- How well is my Lymphedema being managed?
- Does the sleeve feel comfortable? If no, what is bothering me?
- Does the sleeve cause any contraindications that my therapist mentioned during treatment? Pain? Numbness/Tingling? Skin color change?
A follow-up session with your therapist after receiving the garment is strongly recommended. You should try to schedule a follow-up session with your therapist within a couple of weeks of receiving and trialing the garment. If you are having problems or concerns with your garment, you must contact your therapist immediately to help resolve any concerns. Remember, we do not know that you are having problems unless you tell us!!
Garment fitting is a challenging process. We will do our best to ensure you get the best fit, most comfortable garment possible from our manufacturers. Regardless of fit, it takes many of our clients a period to adjust to wearing a garment on a daily basis.
After getting a well-fitted compression garment that meets your needs, we recommend you order a second, identical garment to wear on alternate days. Alternating sleeves may increase the useful life of each garment, and makes it easier to manage with a busy lifestyle. For instance, if you lose or tear one sleeve, you have a back-up available to wear while ordering a replacement.
Q: Do I wear my garment while I sleep?
A: No. Lymphedema compression garments are designed to be worn during waking hours only. Manufacturers have cited potential medical concerns from wearing the garments while sleeping, or extended rest periods. Therefore, garments should be removed, and washed prior to going to bed, and put back on first thing when you wake up.
Q: Are there products available to help me manage my Lymphedema when I rest?
If you need compression therapy during resting hours, Calgary Lymphedema Rehabilitation has access to specialized Night time compression products to meet your needs. Peninsula Medical: www.lymphedema.com; Circaid: www.lymphedema.biz/index.htm; and Jovi-pak: www.jovipak.com; are companies that provide products that can be worn during resting hours to provide Lymphedema management.
Your therapist is available to offer assistance to address evening Lymphedema management including working with you to offer appropriate products. Make sure you take the opportunity to look at some of the demonstration units the clinic has available. These products are available to supplement bandaging at night to assist with management. Self-bandaging should be considered as an option.
Q: How do I care for my sleeve?
New garments usually come with written recommendations for appropriate care of the product. In general, compression garments should be washed daily in a non-bleach detergent. Often, the easiest way to care of the sleeves is to soak the sleeve in mild dish detergent, rinse thoroughly, and hang out to dry overnight. Do not put the garments in a dryer. Garments should be donned and doffed using a pair of rubber gloves to reduce the chance of a tear in the garment. Rubber gloves may be purchased from your fitter. Your fitter should educate you on how to don and doff the garment.
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