Compression For The Clueless

Doctors insist that POTS patients make many lifestyle changes. One of the easiest lifestyle changes you can make is wearing compression garments. Compression garments work to raise low blood pressure, prevent swelling, and minimize blood pooling. Compression garments aren’t a magic fix, but they help many POTS  patients enough to use them daily.

Myths
Compression garments are uncomfortable
This is often true at first. Finding the best length, pressure, and brand will make a world of difference in your comfort. My favorite, most comfortable tights are JUZO soft. They come in different colors and pressures. Experimenting with different tights can be expensive, but in many cases it is worth it to find ones you are comfortable to wear often.

Compression Garments are ugly
They don’t have to be! Medical white and tan are not your only options. Rejuva health has compression garments that I get compliments on a lot- no one even notices they are for compression. However, my favorite tights are the not from Rejuva Health because I find other brands more comfortable. For example, my favorite (Juzo soft) also come in fun colors (as seen above to the right) and are nice and comfy. Here are some ideas to rock the tights and look fabulous instead of sick.

This is not me- Source

You Have to Wear Compression 24/7
I wear compression tights nearly every single day, but not for everything. When I am going to be up on my feet and standing a lot they are a necessity. However, if I am watching a movie at home I don’t wear them. I can put my legs up and take a break from compression; it feels nice- even when they are comfy. I also do not wear compression to sleep unless I am having severe leg pain. If I want to wear compression constantly, I will wear a lower pressure while relaxing.

You Don’t Have Choices

There are a lot of different options. You can choose the color, length, pressure, open toed vs closed toes, open crotch vs. closed crotch. In fact, all your options can even be overwhelming once you know where to look. Here and here are great places to start.

Tradeoffs
There are some tradeoffs for compression tights that you will have to figure out for yourself what is more important.

Heat vs Compression
In the summer, compression tights become difficult. I am heat intolerant like most POTS patients, because I feel terrible the warmer I am, it is a tradeoff to what will make me feel best. Personally, I have found that 80F degrees and below compression garments are worth it. Beyond that, I get too warm for compression.

EDS vs. Compression
As the pressure increases in the compression garment, it becomes more difficult to put tights on. This can be a problem if you have Ehler’s Danlos as your fingers may subluxate or dislocate. These people may want to stick to a lower pressure or get help putting compression garments on.

Sometimes putting on compression tights is difficult, with or without EDS to deal with. This video shows some methods. Don’t worry, with some practice it gets much easier! 

Levels of Pressure*
There are different levels of pressure in compression gear. More pressure is placed on your body as the number increases. If you are willing to spend some money it is easiest to start at 15-20 mmHg and go up in compression until your legs aren’t swelling or hurting as much. Basically, you are looking for the lowest strength to get the job done. If you are tight on cash consider buying 20-30mmHg because it is most commonly used and works the best for most people. Increasing pressure should be done with a doctor if you still do not get relief at 20-30mmHg.

15-20 mmHg
This is a very minimal pressure that is often found in sports compression garments. This low amount of pressure is perfect for short travels and patients with extremely mild swelling and blood pooling. This compression is also commonly used in pregnant women because it is gentle.

20-30 mmHg
This is the most frequently prescribed compression level. It is perfect for extended travel and moderate swelling. This is the most common pressure I hear recommended for POTS, and the one with the most options for stylish tights.

30-40 mmHg
Do not use without speaking to a doctor; you should not wear this high of compression unless medically necessary. I have heard of some POTS doctors prescribing this level for those with severe blood pooling and swelling. This is the strength I usually wear, but for Post-thrombotic syndrome. Compression tights help with my blood pooling, swelling, and pain.

40-50 mmHg
Do not wear this high of compression unless medically necessary as deemed by a doctor. I have never heard of a doctor recommending this level for POTS patients.

Levels of Coverage
Knee High
If you experience a lot of leg swelling, I would steer clear from this length. The swelling in the legs sometimes gets so bad that the band around your knee area that the compression socks end up cutting off circulation. I started out wearing this length but after seeing how much swelling was happening above and around my knees I was told to steer clear.

Thigh High
Whether you like these or not probably has to do a lot with your body type. If you have slim muscular thighs I have heard of them being comfortable. If you are at all curvy (it doesn’t take much) thigh high compression tights may dig into you, roll down, and look awkward (even with the correct size).

Waist High
This length is my favorite. I feel like I get more compression, and at least for me they are the most comfortable. People wear tights all the time so I don’t feel like I am dressed strangely while wearing them.

Abdominal Binders
In some cases of POTS, blood pooling that can even go up to your abdomen. I just recently started using an abdominal binder- I didn’t think it would work. It actually helps a lot more than expected. You can find a “waist trainer” that does the same thing and is infinitely more attractive.

Arm Compression
Blood pooling also occurs in the arms. It is not as severe and not even a symptom in many POTS patients. Sports shirts with arm compression or compression shirts with sleeves may help you feel even better. The arm compression helps me minimally. I try to buy it in the winter because that is the only time arm compression outweighs my need to stay cool.

Compression garments don’t have to be ugly or uncomfortable. There are plenty of cute outfit ideas all over the internet for tights. Ask your doctor what compression level to start with and don’t be hesitant to experiment with different brands and lengths.

*This is not intended to replace medical advice. Always ask your doctor if you have any medical questions!

Look for even more on compression in my upcoming book!

PillPack Review

Within the past couple months, my Facebook advertisements have been all about Pillpack. I decided to try PillPack out and share my experience. In theory, Pillpack is revolutionary. Pillpack acts as a pharmacy, pre-wrapping each dose of your medicine based on the time of day and sends you all your meds by mail. PillPack is supposed to even work with your pharmacy so you don’t have to play the middle man. It sounds great- no more forgetting if I already took a dose, no more wrestling with pharmacists and insurance companies, no more unorganised pill bottles, and no more standing in long pharmacy lines!

Unfortunately, all I found was in Pillpack was disappointment. I signed up and put all my medicines in, and then waited for PillPack to transfer the prescriptions over. PillPack got one medicine. One medicine doesn’t even begin to cover what I have been prescribed. PillPack filled just one prescription, propranolol- the one that is most important for me to take. PillPack shipped me the propranolol. In the box were 120 small packets each with one single tiny blue pill in them. Suddenly the little packs didn’t seem handy; instead they were a pain to open and not exactly environmentally friendly. Maybe with all my medicines it would be worth it, but with one? Wasteful.

One of the primary reasons I tried PillPac was because I was so sick of pharmacies. Having to deal with both PillPack and a pharmacy was actually making things more difficult for me so I emailed and cancelled PillPack. I received an email acknowledging my cancellation.However, PillPack ignored my cancellation. Instead, they shipped out my Propranolol to the wrong address. I didn’t bother changing my address after I moved with PillPack because I cancelled their services- why would I?

I went without propranolol for a good part of the weekend. Now that I tracked down where my package went, I have to drive across town to hopefully get my medicine. There is a good possibility that they have returned the package since I don’t live there. Worst of all, my regular pharmacy cannot fill my prescription (or my insurance won’t cover it) because PillPack sent out this order without my approval. PillPack did not succeed in simplifying my health care- it complicated it.

I do not recommend using PillPack. I can see how the PillPack system may work in others. Some people may have more success, such as those without a pain doctor or those whose medicine and dosage is constant. Pain doctors write new scripts when you come into the office each month. Some pain specialists do this for even non-narcotic medicines. PillPack isn’t well equipped for the kind of care that changed each month. PillPack is most helpful in people with a few medications that are not being changed, experimented with, or adjusted. If you are, like me, still trying to figure out what medicines and doses work the best- avoid PillPack.