Friday, 6 April 2018

Review: Sigvaris Doff n Donner.


[Image: Photo of the Sigvaris Doff n Donner. To the left of the photo is the fluid-filled and corrugated beige Doff n Donner 'doughnut'. To the right is the taller black and red cone part of the device. Photo source.]

This is not a sponsored post. I purchased my Sigvaris Doff n Donner from my local Access Rehabilitation Equipment store last year. They can be purchased directly from Sigvaris stores and online from most of the larger compression stocking retailers.

I would strongly suggest anyone interested in the device ask their local distributor to get one in for them to try. If possible get a Sigvaris rep familiar with the product and proficient in its use to give you a demo and instruct you on how to use it with your personal stocking. 

And to get the laughs out of the way. Yes, it looks phallic. And yes it looks suss putting the stocking on. My youngest son was giggling hysterically when he accompanied me to trial the product.




Putting on compression stockings is difficult. There is no pretending otherwise. The higher the compression the more the difficulty increases. If you have poor dexterity, weakened hands, joints that sublax or dislocate, a bad back or a host of other medical issues getting compressions stockings on and off can be problematic and exhausting.

On a personal level, I have popped finger joints, punched myself in the face, and grunted and groaned while writhing on my bed trying to put them on. I've tried various techniques and used various donners, but still somedays popping them on is simply beyond me. On occasion, my husband, Mr Grumpy, helps but as my weakened legs frequently offer little resistance it ends up more hapless Mr Bean skit as he applies a little pressure and instead of applying the stocking my whole leg moves backwards or bends up again and again, than actual effective donning.

At the end of the day I am faced with the problem of removal. While I can get the top of my thing highs rolled down to about an inch above my knee the rest frequently remains beyond me. I often hassle Mr Grumpy back into action to help in their removal while I try and grip onto something so as to not slide forward as he attempts to pull them off my legs. Yet another Mr Bean skit in the making as I move in unison with the stockings thus falling off the bed or lounge.

I spotted the Sigvaris Doff n Donner in an advertisement last year and was intrigued by the design and apparent ease of use. My local rehabilitation store ordered in the Doff n Donner for me to try out (something I recommend as it is a substantial financial investment). After a demonstration and trial, I decided to purchase the Doff n Donner and brought it home. I've had it for about 6 months now so thought it was a great time to review not only it's ease of use, but it's usefulness over time.

Product:

The Sigvaris Doff n Donner comes in two parts that can be purchased separately: A cone and the Doff n Donner (DND) itself.

The cone is made of smooth black plastic, flaring at the base and has a suction cup that allows it to fix onto a flat clean surface with a silver lever to lock it in place. There are two red strips of material extending down the cone to provide some grip to hold the stocking.

The (DND) is a squishy fluid-filled silicone "doughnut". The stocking is rolled onto the DND to both don and remove stItsngs. It's texture reminds me of some of my children's old squishy and wobbly toys.

It is suitable with "calf stockings and A-G thigh high stockings with/without grip top in all sizes and compression classes as well as open or closed toe" (Source)

Trial:

I tried the product in the store with the help and instruction of the assistant, again with a Sigvaris rep who came to the rehabilitation store and here at home now for approximately 6 months.

Results:
In Sigvaris branded products I wear a Small Long, closed toe, thigh high, in 20-30mmHg, and equivalent in other brands. It was in using these that I base my opinion regarding the product. If you use a different sized stocking or compression level you may have another experience, although as mentioned above neither size nor compression should matter.

Technique is everything with this product and will make or break its usefulness. There are a number of videos from both Sigvaris and various sellers as well as a small instructional leaflet and none of them really give enough information for the average user. Having used the product for months now all I can think is that the stockings used in the videos are of a larger size and lighter compression than what I use and/or the demonstrators have no level of disability or reduced functioning, as it is yet to be as easy as is shown in the videos.

There is simply no way that the stockings I use can be easily lifted over the DND as shown in the video below. Neither the assistant in the store nor my husband were able to manoeuvre the stocking as shown, though using a larger stocking the Sigvaris rep was more successful. The rep did give me some alternative tips which I have been using but are not covered in any of the official videos.



[Video: this instructional video from Sigvaris demonstrates how to use the Doff n Donner for both knee-high and thigh-high compression stockings.]

My stockings cling tightly to the cone and are still tight at the base when stretched over the cone. This makes them difficult to gather onto the DND. Even following the videos and watching the rep demonstrate the product (she was also lovely enough to let me video her so I could rewatch her technique at home) I still have difficulty at times. These days I can mostly get them on, but on days of weakness, or when my finger joints are particularly sublaxy I cannot use this part of the device.

However, when I do get them on the DND properly then it works a treat and it is incredibly easy to both don and remove my stockings.

Donning the stocking

The base of the cone has a suction cup that you lock in place with a small metal arm. Finding a place in my home that worked with the suction cup was difficult. It needs a very clean very smooth table top or bench to adhere properly. I note this having gone to roll the DND up and smacked myself in the face after the whole device came unstuck from my bathroom bench.

Tip: to increase adherence I wipe down the bench with a damp cloth to remove any specks of makeup, toothpaste or dust. The small amount of water also helps increase the suction. 

Placing the stocking on the cone properly is essential. The toe of the stocking needs to be firmly smoothed over the end of the cone. Take the time to smooth down the stocking over the cone, with the extra stocking bunching down around the base.

Tip: Make sure the heel of the stocking is facing you. You need to keep note of this as you roll up the stocking so you can later place it right way down as you don your stocking.

Gather the stocking up around the DND. This part is tricky with a smaller, higher strength stocking. It has taken much trial and error to get this part worked out. The DND is very mobile. This would be less problematic with a larger or low compression stocking, or a knee-high stocking. The length of the cone is perfect for a knee-high stocking, but with a thigh-high, it leaves a lot of material bunched at the base which really needs to be stretched up over the DND to be able to use the DND all the way up the thigh when donning your stocking.

Tip: make sure to tuck the top of your stocking into the inner part of the DND to make it grip as you roll it up the cone. It doesn't need much as the silicon tends to have enough friction to get it to grip with even one small section tucked in.

Once the stocking is rolled onto the DND you need to poke your fingers in push the stocking further to make the toe seam clearly out and visible. This is why it is important to know where the heel is (something I learnt the hard way early on). You should only need a little pressure to get the stocking to begin to roll over the toes and onto the foot. The fluid action of the DND allows it to flow easily over the foot, ankle and up the leg with little pressure required. While I mostly tend to bend over and feed the DND over my foot and leg I have also placed it on the floor (carpeted, you need that grip) once my toes are in and used minimal force to roll the DND over my foot and heel.

Tip: You will still need to smooth the stocking once on to ensure even compression. A pair of washing up gloves works well. Just use gentle upward strokes. Evening out your compression will also make them more comfortable to wear. 

Removing your stocking:

This part of the product is an absolute dream. You simply roll the DND back up your leg, pull down the top of the stocking down over the DND and roll. It moves like a dream down the leg. I do still find the ankle a bit tight, but I simply position my foot so the rolled DND is on the ground and pull my foot back gentle and the stocking rolls right off my foot. The stocking can then be simply unrolled from the DND.

Tip: carpet is again your friend for gripping the DND when it is at your ankle to grip as you pull your foot back. I have used it on tiles with success but carpet is much easier.

Tip: to remove the stocking from the DND I grab the toe of the stocking and shake, letting the weight of the DND help to unroll the stocking.

Tip: make sure your clothing is clear of the DND and stockings as it grabs everything. I have caught my clothes in the DND time and again.



[Video: short video of Michelle sitting at her kitchen table removing her stockings with the Doff n Donner. She wears a green and black dress and her stockings are black and white batik compression stockings from Juzo. She removes the stocking quickly and with little effort. At the end of the video, she jiggles the stocking and Doff n Donner to separate the two.]


Verdict:

The Sigvaris Doff n Donner is unlike any other donning products on the market and the unique design has many pluses.

It removes stockings like an absolute dream. I love this aspect. It means I can remove my stockings when my husband isn't home to help and anything that increases independence is a plus in my book. Given that by the end of the day my energy levels are pretty much non-existent, I'd say this product is excellent for removing my stockings.

But it also has problems.

The price. A comparison of prices from various outlets is relatively consistent with the $157 I paid here in Australia for both pieces. This is a significant outlay for users who are more likely to be on limited incomes. Like all disability-related products, cost can reduce accessibility.

While the cone is designed to be used with both knee and thigh-high stockings it feels too short for thigh-highs and the bunching of stocking material at the bottom makes it difficult to stretch up adequately onto the DND (especially on a smaller, higher compression stocking). Having also practised with a knee-high I can say that this worked really well in comparison and was far easier, ie worked as advertised. While for storage the compact size is better, perhaps a telescopic option that can extend the cone for a thigh-high might be a consideration for any future design revisions.

The suction cup relies on a completely smooth and clean surface. It doesn't maintain suction on other surfaces. Even my gloss paint coffee table was not sufficient. I was left with my bathroom bench as the only place in my house I could achieve suction, which can be problematic on the days when I am unable to stand.

While I use the DND regularly to remove my stockings, I do find myself not bothering with the cone and DND to don my stockings when it doesn't work the first time around. I simply don't have the energy or patience to try it over and over on the days that I can't get the right grip from the start. The nature of my home is that I am unable to leave the cone set up, meaning I have to get it out and set it up and take it down every time it is used. And while this may seem a very small step, it can be a step too far on a particularly low energy, low strength day.

Even after all this time I have only been able to really position things enough to use the DND to just over my knee after which I simply manoeuver the lower compression material up to its correct position on my thigh (stockings provided graded compression which is strongest at the ankle and decreases as the material goes up the leg). This can be problematic. While getting a stocking over the ankle is frequently the most difficult area, many patients will require the DND to work all the way up the thigh as they are unable to pull the stockings up that far, especially if they wish to don them independently.

Like many disability devices, this product seems more targeted to non-disabled carers and all the instructional or product videos are shown by demonstrators who have no visible disability. It often seems that there is an expectation that those requiring compression garments are more likely to have a carer rather than live independently. Admittedly, the product does say it is for "wearers themselves" but given my experience, and many reviews I have read, I would suggest that you still need to have a significant level of functionality to be able to use the product as demonstrated.


Personally, I want products that increase my independence.  


The Sigvaris Doff n Donner partially meets this brief. 


Since purchase, I have found a number of instructional videos of people who purchase only the DND (both pieces can be purchased separately) and use their arm to roll the stocking onto the device. This works surprisingly well. My only issue with this technique is that I am unable to hold my arm up long enough to do it well or often. But it may be an option for those with better upper arm strength.



[Video: a short demonstration video from Sigvaris using the DND portion of the device on an arm (no cone) to roll up a compression stocking.]

Would I buy the product again?


The DND potion 100% yes, being able to take my stockings off so easily is brilliant. It means I am no longer reliant on my husband to help, especially important when he is working nights and I am home alone to try and manage their removal. Having been caught out by myself with them partially and haphazardly rolled down, causing excessive painful compression, knowing I can now easily remove them by myself is a relief. This part of the product is simple and easy to use. Perfect for increasing independence.

The cone I am unsure. When it works well it is brilliant. When it doesn't it is nothing but frustration. With technique so important especially with smaller and higher compression thigh-highs the available instructional videos are useless. They simply don't reflect the reality. One on one instruction from someone experienced with their use is essential (thank you again to the Sigvaris rep who was very patient and allowed me to video her technique) otherwise the device is simply expensive frustration. I do also think some form of telescopic extension for longer stockings would increase the ease of use.

Have you used the Sigvaris Doff n Donner? I'd love to hear feedback from others.

Michelle

Sarah Vaughan's version of Shiny Stockings feels like the right musical accompaniment.