76 more days until my first marathon — the NYC Marathon!
As the mileage builds up and the training runs get longer, the marathon is feeling real and achievable. With regular running, I’ve noticed my body is more relaxed during my long runs – I’m not in a rush to finish, and I take each distance one mile at a time, trying to enjoy the finally cooler morning air. I’m not trying to get a specific time, I’m just training my body to embrace the progressively longer distances. Running is such a mental exercise, and more than half the battle is just convincing yourself you can and will do it.
Of course, running is also physical. Deep vein thrombosis (DVT) is also physical. And the most important thing I wear every day so that I can have a clear mind and focus on my running or anything else in my life is a compression stocking.
It’s been nearly two years since I was diagnosed with DVT, but I still wear my compression stocking daily. All day. Every day. I pretty much only take it off to shower and sleep.
What is a compression stocking?
Compression stockings are a special type of stocking/sock to help promote circulation in your legs after a DVT. The stockings are graduated, which means that they start tighter in the ankle and gradually become less tight as they go up the leg. The stockings apply pressure in such a way that your blood is encouraged (squeezed!) to move out of your leg. Compression helps stop the blood from pooling in your leg, which causes much of the post-DVT swelling and pain.
Why is it important to wear one?
Depending on the severity of your DVT, you may be experiencing varying degrees of swelling, pain and residual clotting/scarring in your veins. DVTs can result in significant trauma to your veins. Arteries bring blood (oxygen) to your legs (and other body parts), and veins bring the blood back to the heart and lungs for oxygenation. Because a DVT damages your veins, and not your arteries, your blood is still able to go into your legs and provide them with oxygen.* The problem comes when your body tries to get that blood back out of your leg, via your veins.
In many cases, people who have experienced a DVT develop something called post-thrombotic syndrome. In a properly functioning leg, your blood moves through your veins through clear clot-free pathways with the help of valves. Valves make sure your blood keeps moving in the right direction. They support the weight of the blood in your veins and keep the blood going forward, instead of leaking backward. Valves are especially important when working against the force of gravity—in your legs, for example.
After a DVT, your veins may be completely or partially blocked off (this may or may not be permanent, depending on the individual)—this makes it difficult for the blood to go through the veins (think of it like a traffic jam for your blood) and out of your leg. Additionally, the DVT causes inflammation of the valves and can permanently damage them. This means that even if your veins become completely clear again, if your valves are damaged, you may experience pain and swelling in your leg.
*If your leg or foot is turning blue/black, you need to see a doctor immediately. This could mean that your DVT is so severe that it is preventing oxygen from getting to your extremities. When I had my DVT (a severe form called phlegmasia cerulea dolens) my foot was turning blue because it was not getting enough oxygen. I’m very lucky I didn’t lose my leg.
So what can you do?
- Elevate your leg. After a long day on your feet (or even sitting in a chair for me), give your legs a break and let gravity help get all that excess blood out of your legs.
- Create new veins! It may seem totally crazy, but your body is a wonderful machine and can create new veins (called collaterals). I create new veins by running regularly and I am still seeing regular improvement in my leg. I hope that one day I won’t even feel a difference between the two legs.
- Wear compression stockings. By wearing compression stockings you are doing two things – (1) You are helping reduce the swelling and pain you feel today. (2) You are reducing the severity of future post-thrombotic syndrome symptoms. Post-thrombotic syndrome can develop up to two years post-DVT. And because the valves are too small to see, it’s really difficult to tell if and how much your valves have been damaged.
How long should I wear one?
All day. Every day. Seriously.
You should wear them for at least two years after your DVT to make sure you don’t develop post-thrombotic syndrome. After that, if you’re no longer experiencing pain and swelling, and you have doctor permission, there’s no need to continue wearing them.
Take them off to sleep and shower, but you’re doing yourself a favor by wearing them as much as possible. Although they can be difficult to put on, it’s really the easiest thing you can do for yourself to help aid in your recovery. Compression stockings will help with pain and swelling, which will allow you to be more active. The more active you are in daily life, and the more you’re able to exercise, and the more veins your body can create. It’s a happy cycle.
Compression stockings may even reduce your risk of developing post-thrombotic syndrome from 49% (without stockings) to 25%. And even if you’re stuck with post-thrombotic syndrome (like me), the stockings will play an enormous role in reducing its severity. I’m even hoping that one day I won’t need them!
No, they’re not incredibly comfortable. Yes, they’re a pain to put on. And yes, they’re unbelievably hot and suffocating when it’s humid and in the middle of summer. But they will MAKE YOU BETTER.
But there are so many! What do I wear?
Take a deep breath. There are a lot of options, but it’s also important you get the right stocking for you.
- Length. Stockings come in different lengths: (1) knee high, (2) thigh high, and (3) pantyhose (both legs). Definitely consult your doctor first to figure out which length is best for you. If your DVT was small and in your calf only, you might only need knee high. Because my DVT was so severe, I need to wear a stocking that goes all the way to the top of my thigh. Perhaps if you had DVT in both legs, you would be best suited to wear pantyhose (both legs).
- Compression. Compression stockings won’t work unless they’re tight on your leg. They should be difficult to put on and feel extremely tight. Before you purchase your first compression stockings, you should consult a doctor to make sure you are properly fitted. The stockings should have a compression pressure of 35 mmHG.
- Colors. Compression stockings are offered in a variety of colors ranging from white, different shades of nude, brown and black. Although they will not match your skin color exactly, you can get pretty close.
- Open and Closed Toe. This is more a matter of preference and comfort level. I have a variety of both, depending on the situation (more below).
- Brand. Again, this is personal preference. When you first order compression stockings, you should purchase from several different brands. Some will fit better, be more comfortable, stand up to wear and tear longer, or match your skin tone better.
- *Compression stockings are also not the same thing as the white anti-embolism stockings you will be given in the hospital. I made this mistake for a month—these stocks are given to patients and have light compression to help with blood flow to help prevent blood clots, but are not what you will need to help get over your DVT.
How often should I replace them?
Every 3-6 months. Over time, the stockings lose their elasticity and ability to compress. It’s important to replace them, or there’s no point in wearing them at all. I notice that my leg tends to ache more when the stockings start to get old.
I realize this can potentially add up to be a lot of money, but look into whether your insurance will cover them. Many do.
For those of you wearing thigh high compression stockings, you can also recycle them for your good leg (see below).
But they’re so ugly!
Yes and no. When I was first told I would need to wear compression stockings for a minimum of TWO YEARS, possibly for the rest of my life, I was pretty upset. I was convinced I would look completely ridiculous and everyone would stare at me and wonder who the weird girl with the one stocking was. As a twenty-something year old girl in New York City, it’s hard not to be a little vain and self-conscious sometimes.
But I wanted to get better, and at the end of the day my health was and is more important than any feelings of embarrassment I might have.
And you know what?
It doesn’t matter. No one cares. In fact, most people don’t even notice. And even if they do notice, they still don’t care. It’s just a sock.
But I do have some practical advice for making stockings work for you:
- Daily life: Most of the time, I wear a simple nude compression stocking. I prefer the open toe stocking, and pull it up over my ankle so that my leg is covered, but most of my foot is exposed. I can wear sandals and flip flops, get a manicure, walk around barefoot, all with no problem because my feet are out in the open.
- Winter: If I’m wearing a skirt or a dress in the winter, I will typically wear closed toe black compression stockings. Although they are thicker and tighter than stockings you might buy for cheap at any store, no one else can tell by looking at them. I did find that it was difficult to find a “regular” stocking that would match the exact color for my good/right leg, and so I’ve started recycling my old stockings. Because compression socks are only good for 3-6 months, I will use the looser, older black closed toe stockings for my right leg.
- Adding some color: Unfortunately there’s not a whole lot of fun color variety in the world of compression stockings. However, if you wear an open-toe nude stocking, your regular fun and colorful tights will go on top and no one will know the better.
- Pants and jeans: I’ll wear open toe compression stockings with pants so that if I take my shoes or regular socks off, you’ll see a little bit of compression stocking sticking out from the bottom of my jeans, but nothing more.
- Working out: When I work out and run, my feet like room to breathe. Closed toe compression stockings can get a little tight and make my feet uncomfortable, so I always wear open toe stockings when I work out.
- Swimming: This is probably when I feel the most self-conscious. I wear the nude compression stocking and it’s definitely much more visible than normal because the top of the stock is visible. I’ll either wear shorts to cover up, or just rock the sock. I’m with my friends or family, and they don’t care.
At the end of the day—my drawers are filled with two types of socks (1) thigh high nude open toe and (2) thigh high black closed toe.
Where can I buy them?
You can buy your stockings from a variety of places, including online and in the store. The major compression stocking companies are:
I don’t endorse any brand or site over another, but I get my socks at compressionsale.com because I find they are the cheapest.
I’m still on the lookout for other sites and brands, so I’m happy to take more recommendations. I’m also interested in trying knee high compression running socks while training (over my regular thigh high), but I’m still looking into that as well.
First, you can get sunburnt through them. The stocking provides some sun protection, but I definitely was badly burned on my last beach vacation because I incorrectly thought I was safe.
And lastly, this is one of the easiest ways you can protect yourself and get better! Rock the one legged sock all the time and you can live a happier and healthier life. 🙂