compression socks - helpful or not?

My 16 year old son has POTS and neuropathy. One doctor has recommended compression socks for his circulation problems while another doctor said the socks will cause his muscles in his legs to atrophy even more. He has been so dizzy lately that he cant stand for more than a few minutes. I am wondering if its ok to wear those socks in bed all day or are they meant for standing and walking only( which he doesnt do much of). Is it ok to put those socks on right he is leaving the house and has to be upright for a while or do you have to wear them from the morning on.

Also, what compression do most people find helpful? We were thinking 30?

[mtgardner]

Welcome to the forum!

I have not been diagnosed for long and have had limited experience with compression stockings.  There are others here who have had a lot and hopefully they will post on this too.

April 28, 2009 we had a lively discussion on this forum about compression stockings.
There was a lot of information presented there including  by members where to buy them cheaper on line and lots of information from some members about sizing.  I am not sure if you can scroll back through messages that far or not.  I know that putting compression stockings in the search engine here did not get me to that spot.

When I was first diagnosed I got an Rx for compression stockings for knee high ones from a doctor who did not know that length is not usually recommended.  They caused
broken blood vessels in my thighs.  I learned from other members that usually thigh high at a minimum are prescribed and some swear by the waist highs only although I am told they are harder to put on.  They evidently are more effective if tolerated. The one thing I was taught was in putting  on compression stockings wear vinyl gloves as it is easier to work with them.  The first time you buy them it helps to go to a specialty store where you are fitted and shown how to put them on.  After that it is easy enough to order them on line.  There are definite minimum compression strengths that are usually on the Rx.

My insurance company allows two pair per six months and I have a co pay.  All insurances are different and some don't cover it.  I know there was some discussion of this on the earlier thread too.  I hope you can access it and that others with more experience answer your other questions here.

It is nice to see you here.  This is a friendly forum and you will find lots of helpful people! Marie

[Heiferly]

I think I found the thread you were looking for and I bumped it up to the front page for everyone:

http://www.medhelp.org/posts/Dysautonomia-Autonomic-Dysfunction/Compression-stockings/show/936330

Let me know if that's not the right one and I'll go fish again.

-H.

[Heiferly]

I've never seen a mention of correlation between compression garments and muscle atrophy and I've read numerous medical textbooks on autonomic dysfunction as well as at least a hundred peer-reviewed medical journal articles on dysautonomia and related topics.  I imagine I would've come across *some* mention of it by this point if it were a respectable theory in the field.  If it's a major concern, ask the doctor who made this claim to provide a reputable source for his claim out of either a medical text or a peer-reviewed journal.  Else, it's nothing more than (ridiculous) speculation.

Moreover, in my personal experience, it was my wearing of compression garments that boosted my orthostatic tolerance and BP sufficiently to enable my participation in cardiac rehabilitation where I was able to work on toning my leg muscles (thus boosting skeletal muscle return of blood to my heart).  Thus, indirectly the compression garments can actually facilitate improvement of muscle tone.  You may want to ask for a Rx for PT or cardiac rehab for your son if he does get compression stockings as this may be a good way to multiply the effectiveness of these non-pharmaceutical treatments, so to speak.  

Wearing them in bed is not ideal, especially at higher levels of compression as are more desireable for increasing orthostatic tolerance, as this can cause blood not to reach the feet properly; this varies from person to person but a significant number of dysauto patients report pain in the feet after staying in the stockings too long when not upright because gravity is no longer working to pull the blood down to the toes.  This may be especially evident in patients on vasoconstrictor medications, but every patient is different.  It is likely optimal to wear them when one is getting out of bed for the day.  

(I personally have narcolepsy and take two rather long—approx. 2 hours each—naps on most days and generally do not run into problems if I keep my stockings on during these naps.  For the past year, I have been wearing 40-50 mmHg custom-fitted thigh-high Mediven stockings.  I will, however, wake up with very bad pain if I fall asleep overnight in the stockings so anything much more than 2 hours without getting up and walking around or at least sitting up is where I tend to run into trouble.  As I said, your mileage may vary.)

You may notice that the people at the Medical Equipment store will emphasize the importance of wearing the stockings from morning to evening.  They are accustomed to fitting these stockings for a different purpose than dysautonomia.  For us, the idea is more to put them on from when you're getting vertical to when you're getting horizontal for the night again.  If you're on the couch until your doc appointment at 1 PM, you can get away with not putting them on until 12:30.  (There may be exceptions for the rare few who have pooling issues in positions other than standing, but you already know who you are, so I'm not going to confuse this discussion with that, LOL.)

[mtgardner]

That is the one and thanks!  Marie

[Heiferly]

Marie,

No problem.  I think something fishy has been going on with the search lately.  I've been having weird problems when I go to find old threads that I *know* are there and used to be able to find with no issues.  I'm going to ask about it and see if tech knows if there's a glitch or something.  At least now I know it's not just me ...

-H.

[bluewind95]

I've been doing okay with compression stockings. I mean, they're not a miracle cure (lol, don't we all want one?) but they do help me. We are all different, of course, but it could maybe be a decent choice to try.

I don't wear them except when I'm expecting to be sitting or standing for long periods of time, though. I'm not sure if they'd be helpful in bed. I think in bed you'd do just as well to just raise his feet. And if his muscles are atrophying from lack of use, mybe he can exercise them a little like that.

While I have not heard anything about compression stockings atrophying muscles, I don't know if it may affect neuropathy. So if you try them out, you may still want to keep a close eye for any changes that may present themselves.