(This is Jade, from the Juzo soft Winter range.
More green in really life, but as you can see goes well with my girly floral dress from ASOS.
You'd never know they are actually medical grade compression stockings.)
One of the most common recommendations to help manage Dysautonomia is to use compression garments, in particular compression stockings. As a woman in her 30s having to wear something that is more associated with the elderly is rather disheartening. It is even more disheartening when you start looking for a pair and find that the majority are rather unattractive shades of beige. Oh, you can get your hands on white or black and occasionally a navy, but that is about it for the majority of brands on the market.
Why do so many of these companies think that a) only the elderly or post surgical patients wear these products and b) that if you require them you must automatically lose all fashion sense? Even as a granny I'd want to rock some sexy legs. Illness and infirmity are bad enough without adding dowdy to the mix.
Luckily a few companies are now starting to realise that there is a huge untapped market of patients who want to feel attractive as well as prevent cankles and pooling. Whilst the market is improving there are still few companies who provide even a semblance of fashion sense for higher strength compression hosiery.
But before you get to purchasing your compression stockings there are a few things you need to consider.
1. What length do you need?
Compression garments come in a variety of lengths. At their most basic these are: waist high, thigh high and knee high socks. Waist high is most commonly recommended and what I started with. (Waist high ones do have the added bonus of working like Spanx and give you a perky bum and smooth out your saddle bags.) However, if like me you have chronic gastric issues and permanent abdominal pain, waist high stockings can be incredibly uncomfortable. I now choose thigh highs simply for the comfort factor and find that they still make a discernible improvement in my ability to function and remain upright.
You can also find toeless and footless compression stockings. Great if you want to wear thongs (flip flops for my US readers) in Summer. My only word of caution would be if like me, you have significant pooling issues and poor vascular flow, you can end up with very fat, very purple toes hanging out the bottom of your stockings. Not the most attractive look, or the healthiest option for your toes.
If you choose thigh highs or other non-full length options be aware that the band that holds up the stocking can be made from a range of products including silicon and latex. If you have allergies this may need to be taken into account.
Whilst this post is specifically about compression stockings it should be noted that there are also abdominal binders and a range of upper limb garments (love the fashionable range of full sleeves and gauntlets from LympheDivas and wish they did stockings as well, plus they now have an Australian distributor) which may be useful if your pooling extends to the upper body, and full body compression suits, similar to the G suits favoured by pilots.
2. What strength compression do you require?
Depending on your level of pooling you may require different levels of compression. Your treating doctor will be able to best advise you on the strength you require based upon your particular medical situation.
Compression levels are measured in mmHg which refers to millimetres of mercury. (One millimeter of mercury is approximately 1 torr, which is 1/760 of standard atmospheric pressure.)
For some, sports compression garments such as Skins may suffice. These are easily accessible both in store and online and may be a good starting point for those tossing up whether or not, compression garments may be for them. One thing to consider with these type of garments are the multiple seams in the structure of the garment. Whilst for many this may not be an issue, if your vascular flow is particularly poor or your skin is sensitive, these seams can leave bruises and sore spots, something I found out the hard way.
If you only need a small amount of compression (eg 15-20mmHg) there are more options available. For example, the UK company Happy Healthy Legs offer a range of lower strength fashionable compression stockings in the 15-20mmHg range. Other companies such as Rejuvahealth and Juzo also offer fashionable compression hosiery in this range.
Moderate strength (20-30mmHg) fashion options are available from both Rejuvahealth and Juzo. This is really the minimum strength recommended for Dysautonomia management.
Juzo were the only brand I came across that had higher strength (30-40mmHg) colourful compression stockings. Whilst there are even higher strength compression stockings available I haven't been able to find any that come in either bright colours or patterning.
If you want to compare a wide range of brands (more than I can cover in one post) and stocking types Compression Stockings.com is definitely a great starting point. I use them and it is also the company that I've heard the most positive feedback about from fellow patients.
Every brand has their own sizing. Check out their sites for instructions particular to each brand. If possible get someone else to measure for you. When I purchased my first pair of waist high Jobst stockings the pharmacist did the measurements. I had no idea how many they needed to take for accuracy. The tips I took from that early experience are: measure both legs separately (some people have one legs that is significantly different from the other) and measure twice or even more. I've also found that if your measurements cross over two sizings it pays to get the smaller size. With time and frequent use there will be some stretching.
Here in Australia if you are purchasing stockings for the first time and are unsure, most local chemists will be able to size and order them for you.
Medical compression stockings are expensive. Pay with a kidney or first born son, type of expensive. So you want to work out exactly what you want and get your sizing right. Additionally, when buying certain products eg some of the Juzo soft coloured range, they are dyed for individual purchase and have a no refund or return policy.
Depending on your country of residence and insurance company, you can request a prescription from your doctor for your stockings and claim a set number of pairs under your insurance every year.
For those outside the US or UK you also need to factor in the postage when purchasing stockings online, and this can vary widely. For example, UK company Happy Healthy Legs charges a flat fee of £10 for international purchases, US company Compression Stockings.com which sells multiple brands and is a great starting point (also great customer service from my dealings with them), charge around $5 per item postage to Australia, whilst Rejuvahealth, also from the US charge a highly prohibitive rate of $39 for postage to Australia (I did contact the company about this, but they were adamant they were unable to make postage cheaper).
I would say that cost is indicative of quality when it comes to compression stockings. In the long term it can be more financially sound to buy one pair of the expensive stockings than to buy 10 pairs of cheaper versions that lose their compression quickly or have poor or haphazard compression.
Compression stockings, fashionable or otherwise aren't always comfortable. They are hot, which is one reason I put off wearing them for a long time. When your body temperature is already set at Sahara they can be stifling. Having said that, I do find even going to thigh high did help lessen that somewhat, and they are fine in the cooler months. Sometimes you have to weigh up the heat factor with how much of a difference they can make to your functioning.
They are hard to put on and it can be exhausting, especially when you have weakness and fatigue. There are devices you can buy to help with putting them on, most companies selling compression stockings offer these. There are also multiple how to's on the Internet and YouTube.
Once on I find I don't really notice them anymore. Especially when you are wearing them every day you get used to the feel.
Caring for your compression stockings is easy. You can hand wash them and then leave them in a warm shady spot to drip dry. Or if like me, you have minimal hand strength, simply put them in a lingerie bag and pop them in the washing machine on the delicates/gentle cycle.
To avoid snags when putting them on, remove or cover rings and check for sharp edges on nails.
7. Now to the most important part, fashion options.
Personally, I've been buying the Juzo Soft colour range from Compression Stockings.com. Their range do change based on the Northern Hemisphere seasons, and there is no guarantee that the same colours will be available the next season. If you are purchasing from Australia allow about 3 weeks for delivery of the coloured range eg violet and fuschia. Other traditional colours such as chocolate and shadow, are roughly a week from order to delivery. I now have cranberry and jade (from the Winter range) and chocolate, shadow and violet (from the Summer range) and am really happy with the vibrancy of the colours. They have been really well worn and washed repeatedly, and the colours have maintained their vibrancy and compression remains unchanged. They are a little long in the feet (I have tiny feet and long legs) but with some careful adjusting I can get them to sit and compress properly. This range is also one of the few that goes up to 30-40mmHg.
(Love my new violet stockings from the Juzo soft Summer range.)
(Cranberry, from the Juzo soft Winter range. I wear these all the time.)
(photos from Rejuvahealth)
Or, if it's possible to add some small appliqué to add detail, without messing with the compression?
So there you go. A small starting point to finding some fashionable compression stockings. Hopefully more companies will come to the table and offer more fashionable options, not only in stockings but other devices that the ill or disabled require. We may be unwell but we still want and deserve to look fabulous.
NB: I have also purchased compression stockings from Jobst in regular black and they too are a great quality brand. The have maintained their compression and look good as new even after 2yrs wear.
Update: Juzo Soft now do a fabulous range of tie-dyed stockings with either colour background white pattern or black background coloured pattern. I purchased a scarlet with white pattern earlier this year and must say I love them.
Update: Chic Compressions are now doing Mediven swarovski crystal encrusted compression stockings (highest rating 23-32mmHg) with a choice of 13 and in 3 crystal patterns, Opera, Fanfare and Symphony (shown below). A little on the pricey side but fantastic for that special occasion. So for example if I picked Size I, thigh high with lace top, in vivo, with fanfare crystal embellishment it would cost £117.50 ($209.75 AUD) not including postage. So really only a special occasion eg wedding stocking.
Svigardis also have patterned in higher level compression. For example: Allure Patterned Thigh High 20-30mmHg in Indigo below.
And you can't talk about fashion without a bit of classic David Bowie.