Getting Patients to Wear Compression Stockings
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Help From Plastic Bags
Patients with pigmented purpuric dermatoses on the lower extremities are primarily treated with 20-30 mmHg compression stockings. The same is recommended for stasis dermatitis/ulceration and deep and superficial varicosities. Realistically, many of our patients do not have the strength to put on and take off the snug fitting stockings essential for their treatment.
A possible solution to this dilemma is to first place a thin plastic bag over the foot. Then slide an open-toed compression sock over the foot, around the heel, and up the lower leg. The plastic bag significantly reduces the friction resistance normally encountered when the sock is pulled over bare skin around the heel of the foot. With the sock properly in place, the plastic bag can then be pulled off through to open toe of the sock. I find most patients, or their caregiver, can do this. With proper compression, the patient will now respond better to the prescribed supplemental treatment.
Wayne Fujita, MD | Aiea, HI
5-Fluorouracil Tips
When describing the application of Efudex, explain to the patient that they cannot apply too little. Also, Efudex is toxic to dogs, so make sure to warn patients who have pets that may lick the crusts of treatment areas.
Ronald Vender, MD | Hamilton, Ontario, Canada
In the Loop
There is ample evidence that keep- ing patients in the know with respect to timing and delays is central to the perceived clinic experience. Creating a workflow from check-in to when the patient is in the room to keep them abreast of timing will make even the lengthiest of delays palatable. Throw in some libations or snacks for extra credit!
Adam Friedman, MD | Washington, DC
Wear Your Vegetables
You do not have to eat your vegetables; just wear them. I use frozen peas before and after filler injections to decrease bruising and later for swelling. They can be used after surgery as well. I prefer peas to ice packs as they are softer, conform to the face, and do not get quite as cold as ice. This way you do not need to worry about ice straight on the skin. In addition, I think it makes patients feel like you are taking special care of them and even occasionally gets a laugh.
Jo Herzog, MD | Vestavia Hills, AL
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