Hello all,
I have recently consulted on a pediatric patient who is 11 years old
with bilateral below knee primary lymphedema. The lymphedema in the dorsum of
feet and toes is limiting shoe options. I have not seen a lot of
pediatric/primary lymphedema cases. I wanted to reach out to see if anyone has
suggestions or best practices when it comes to compression garments for growing
children, make sure I am not missing something.
The patient was seeing a CLT more local to where she lives, but that CLT is no
longer able to see her. The patient has had a growth spurt in the last year and
grew out of her Juzo day time compression garments. Mom tried wrapping while
they work on getting new garments but is having difficulty with
learning/implementing compression wrapping and the patient is self-conscious
with wearing wrapping at school. She also needing a night time compression
garment, so I am thinking a reduction kit/trim to fit type garment with a toe
cap. And since the patient still has a smaller kid-size feet length, focusing
education on how to wrap the foot. Does anyone has a preference for the
reduction kit over trim to fit for peds or vice versa or other suggestion? I
am leaning toward the reduction kit and leave it a little longer to allow for
another potential growth spurt in the next year before she is able to order
another garment. I'm thinking this could be a backup as well if the patient
grows out of her day time garments again.
For day time she fits into Juzo's day time ready to wear garments petite
length. I'm also going to talk with mom about Active massage ankle socks from
Solidea to consider for use intermittently during the warmer months here in
Virginia.
Is there a shoe brand that is better fit for pediatric lymphedema? We've
talked about elastic shoe laces for now and I am hoping to get the volume of
her feet down with consistent wrapping of the feet/toes.
Thank you for any/all suggestions!
Best,
Sara Yoder, PT, DPT, CLT
UVA Health
