Hi Sara,
To help with cost, I’ve had pediatric patients register with Brylans Feat
Foundation. They help to cover the frequent garments they’ll need as they grow.
Morgan
On Mar 16, 2022, at 2:20 PM, Amy Flinn <dmarc-noreply@xxxxxxxxxxxxx> wrote:
To add to my last email, those ankle length socks were Elvarex or Medi 550
with attached toe caps.
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On Wed, Mar 16, 2022 at 12:18 PM, Amy Flinn
<amyflinnpt@xxxxxxxxx> wrote:
I have treated several kids from 1 or 2 years old through their teens and
into their adult years. I have stayed with Elvarex for them and it has been a
great garment for managing their seelling. As they get older sometimes I
incorporate Medi 550 for some style options. They tend to struggle with toe
swelling, so around age 10 or 11 I incorporate attached toe caps to the day
garments. Both Elvarex and Medi 550 offer that option. I also refer them for
a Flexitouch pump around 10 or 11 which helps them catch up for less
compliant days. These garments generally allow them to stay in usual closed
toe shoes. If they remain uncomfortable showing their garments, I have
sometime added ankle length garments so they can wear ankle socks and their
garments don't show. Not ideal, but since their foot and toe swelling is the
most problematic, it is better than them going without compression for style
reasons. Thankfully in our area Converse are popular even for prom. And yes,
they are all in a Jovi or Tribute night garment which really helps them catch
up overnight. I always start with night garments too long on the foot to
allow them to last longer as they grow (only for the night garments, day
garments are measured to their size).
Fun group to treat
Amy Flinn, PT, CLT-LANA
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On Wed, Mar 16, 2022 at 12:02 PM, Cohn, Joy
<Joy.Cohn@xxxxxxxxxxxxxxxxxxxxxx> wrote:
Sara- I will let the expert pediatric people respond, but have you considered
a Solaris garment for her for night? They have always made kid size
garments- cute colors, sewn on logos, etc. I don’t think they manage toes
well so a loosely measured coarse weave toecap like elvarex could be worn in
conjunction- I have found that a simple light compression bandage layer added
for sleeping is helpful.
Solaris was bought by Lohmann and Rauscher….
I have found the Juzo petite works well with preadolescents as well, but
would a coarser weave custom garment give you better compression in the foot?
OTS garments really don’t provide much foot compression in any iteration- a
sneaker or tie shoe is usually needed over the top.
My peds experience is exhausted- I’ll look for lots of our colleagues to
educate all of us!!
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From: aptaoncology-bounce@xxxxxxxxxxxxx <aptaoncology-bounce@xxxxxxxxxxxxx>
on behalf of Yoder, Sara M *HS <SMY6G@xxxxxxxxxxxxxxxxxxxxxxxx>
Sent: Wednesday, March 16, 2022 2:00:06 PM
To: 'aptaoncology@xxxxxxxxxxxxx' <aptaoncology@xxxxxxxxxxxxx>
Subject: [External] [aptaoncology] Pediatric compression garments
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
