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Frequently Asked Questions | Portable Oxygen Concentrator Information | Medical Equipment Qualifications | Medical equipment Medicare Guidelines

Have questions about your product, disease, qualifications or rental process? Don't understand the Medicare process or what they are thinking? Maybe we can help.______________________________________________________________

Portable Oxygen Concentrators
Learn about how portable oxygen concentrators work and learn if portable oxygen concentrators paid for by Medicare. Which portable oxygen concentrator is the best one for you and why?

Diabetes Management
Learn about how Diabetes and how diabetic supplies work. Can Diabetic shoes help your feet? What other diabetic supplies exist to help me? Which Diabetic Shoes are the best ones for you and why?
Vienna Medical does not guarantee any of this information and all patients should consult their physician prior to commencing any of these practices or instituting any advice regarding diabetes.

Lymphedema Pumps & Coverage
Learn about how lymphedema pumps work and are compression lymphedema pumps covered by Medicare and insurance. What is compression therapy for edema or other conditions of the limbs. What are the best ones for you and why?

Medicare/Medicaid/Insurance Guidelines
Learn about how Medicare determines if you qualify for oxygen and medical supplies. Medicare guidelines have changed and new competitive bidding has been instituted for certain areas regarding Durable Medical EQuipment. Medicare offers some great benefits for beneferaries but you must have correct documentation.

POC pic portable oxygen concentrators on sale

Call our Oxygen Experts Today! We rent and sell POC's for airline, cruise & train travel.

Call or click here for rental and sales information.

Customer Care Department 1-800-489-8165

 


Portable Oxygen Concentrators (Generators)


What is a portable oxygen concentrator machine and how do they work?

Portable oxygen concentrators (or POC's) are a portable device used to provide oxygen therapy to a patient at substantially higher concentrations than the levels of ambient air. It is very similar to a home oxygen concentrator, but it smaller in size and more mobile. The portable oxygen concentrator makes it easy for patients to travel freely; they are small enough to fit in a car and most of the major concentrators are now FAA-approved.

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How do I know which portable oxygen concentrator (poc) machine is best for me?

It depends on your liter flow and your overall need for continuous oxygen. The Eclipse, Invacare Solo, Devilbiss IGO and Oxlife will provide someone with a continuous flow during sleep and when needed on exertion. In contrast, but while smaller and lighter, the Lifechoice, Invacare XPO2, Inogen One G2, Precision EasyPulse and Drive Oxus Reliability provide the patient a pulse dose or on-demand flow when the patient inhales. These "portable oxygen concentrators" are the newest generation of concentrators steming from the home stationary concentrator. Yes, the big bulky one in the corner. So, which poc is best for you?

The best POC for you is the one that fits your needs. What will you be doing when you use it? Where will you be? Do you need it just for exertion or walking? Do you need it for sleep? The answers to these questions will narrow your choices down to just a few.

For sleep or to use in conjuction with a cpap machine you need, most likely, a continuous flow unit however, the lifechoice does offer a "sleep mode" which enables the unit to be 10 times more sensitvie and is FDA approved for sleep and the only one I might add. Now with that said you should consult your physician before making your choice especially if it has to do with sleeping on a pulse dose maching like the Lifechoice.

For exertion only patients you can get away with a lighter, smaller more nimble "pulse dose" POC such as the Lifechoice, Invacare XPO2, Inogen One G2, Precision EasyPulse or Drive Oxus Reliability.

If you are looking to fly with the unit then you need to make sure that the one you want is FAA Approved although most of them are. If you don't know you can look at our FAA regulations page or just give us a call. In addition, the FAA requires that you have 150% of your flight time in battery life. You can find the battery life of each unit at specific liter flows on the product specific pages. Just use the links above or visit our portable oxygen concentrator page here.


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Will insurance or Medicare pay for a portable oxygen concentrator machine?

Yes and No. The complete answer is lengthy. Medicare and insurance do have billable codes for POC's however the supplier or oxygen provider is the one you have to convince. DME companies or oxygen suppliers are not required to give Medicare beneficeraries a POC only what is necessary to maintian the patient on oxygen and abide by the 21 Medicare standards.
Now if you have a private insurance company or Medicare replacement plan I would certainly recommend calling them and asking if they would pay for one.

Due to Medicare oxygen regulations being what they are suppliers have to be very frugal and careful with which peices of equipment they give to which patients. Let me explain, for a Medicare patient; The way an oxygen supplier is paid is if, of course the patient qualifies for oxygen first, but next comes how we get paid. Medicare pays oxygen suppliers a rental fee for 36 months and then a maintenance fee for the 24 months following that. The "maintenance" fee is basically no more than a couple hundred dollars but yet are expected to supply oxygen to that beneficerary for 2 years for almost no money. So, basically the first thing suppliers look at with an oxygen patient is how many "paying" months are left within that patients 36 months or are they a new oxygen patient where the 36months of payment is just beginning. As an example, if a patient has been on oxygen for 2 years and they want to move to another company the new supplier would only have 12 months of payment remaining and then the "maintenance fee" for 24 months. So there is no incentive to accept this new patient and provide them with the new state of the art equipment as the cost of POC's can far outway the return from Medicare payments. With this said, oxygen suppliers are always looking for new patients or those patients who have been on oxygen for 5 years and their new 5 years is starting over. Yes, Medicare considers the life of the equipment to be 5 years therefore they will start the payment process over again and this requires the provider to replace the old equipment with new equipment and this is where you will have you best chance at obtaining a POC from your supplier.

How do you now how long you have been on oxygen or how many months you are into your 5 years? Call you local supplier to find out. Then make your decisions accordingly.

To complicate all of this Medicare has now implemented "competitive bidding" for suppliers of oxygen in most large metropolitan areas. This means that the rates suppliers will get paid will be reduced even more and you will only have a handful of oxygen suppliers to choose from as without a winning contract most will go out of business. So there continues to be less and less financial motivation for suppliers to give POC's. To read more about "competitive bidding" and what you can do as concerned citizen please visit the link below and do what you can as America's Medicare beneferaries have no idea what is about to happen to them. It is the opinion of most in the industry that competitive bidding will strip the rights of patients and hurt there ability to receive quality equipment and good service. http://www.aahomecare.org/displaycommon.cfm?an=1&subarticlenbr=495

In conclusion, more and more patients are just buying the equipment as the benefits of POC's generally far outways the liability of the cost. They provide so much more freedom for patients to be independent and have a better quality of life.

Vienna Medical does supply POC's to select patients where the business decision is a good one and the patient is a good candidate for it. If you are a local oxygen patient please contact us for more information.

For more information on purchasing a unit click here

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Where can I find the online rental form?

The online rental form can be found on the Portable Oxygen Page or downloaded directly by clicking here.

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How do I know if my airline approves of the machine I am renting?

Follow this link to the FAA Regulations Page

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What is my first step?

The first step is to determine which portable oxygen concentrator will best suite your needs. This is sometimes done with your physician but most of our patients call us first to discuss their needs with one of our respiratory specialists. They are great at asking the right questions and determining which of the 12 different machines we carry would be best for you. 1-800-489-8165

You may click here to get product comparisons.

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I am not very good at new things. How hard is it to operate one of these?


Most of the machines are relatively easy to operate. We strive to provide a seamless understanding for you by providing instruction when you open the box. In addition, most of the manufacturers provide an instructional video that comes with all of our rental and purchases. We also have video's for most of the POC's on the product specific page. Basically, you need to know how to turn it on, set your liter flow, how to change the battery, how to charge the unit and what to do if you have an alarm. Most of the time the alarms patients here with POC's is due to the patient not briething through their nose and therefore the POC is telling you that "hey your not doing this correctly" which is a good thing. Most patients get use to their portable oxygen concentrator and understand how it likes to operate.

You also need to make sure you know how long you will require battery life during a given time period such as a flight. Upon your reservation, we can assist you with batteries and how many you might need. Each unit comes with a "how to start up guide" and we are always available 24 hours a day for technical response and support. If you are having trouble or would like to see our technical support page and/or user manuals click here and scroll to your product.

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How do I get the machine and how do I get it back to you when renting?

If you are renting, upon your reservation, we will determine the date you need to receive the unit and make sure you receive it in plenty of time. Then the unit is shipped to you 1-2 days prior to your departure or need and when you are finished with it, you simply put it back in the same box and use the prepaid call tag to send it back.

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What Liter flow do the machines go up to?

All of the machines are a little different and this is one of the facts you need to get before making a decision on which one is best for you. This is a prime example of why Vienna Medical offers all of the different kinds of portable oxygen units.

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What documents or paper work will my airline require for a portable oxygen concentrator?

You need to communicate with your airline as they all have their own set of rules and regulations. Most of them have online instructions and requirements. Please use our FAA regulations page to find this information. Scroll down to Airline consent forms and you will find active links to all of the airlines.

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What happens if my machine malfunctions when I am on my trip?


First it is always highly recommended that you have a backup plan for oxygen. We can help you if something goes wrong with one of the machines but having a plan B in place to begin with is never a bad thing.

Most malfunctions are easily fixed. It is usually the machine trying to tell you something. However, there are times when machines have their own agenda. For this we have worked very hard to create a backup situation for you. First, you would call our customer care department who would run through a troubleshooting process. Second, If this does not work or we can't determine the problem, we also belong to a nationwide respiratory network of providers that can quickly provide you with backup oxygen. Third, all transport carriers have emergency oxygen on board if you have a malfunction during the transport. This can be used until we can provide the troubleshooting or the backup. For reference you may look at our technical support page.

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Can I sleep with my machine?

Yes you can, but you do need to speak with your physician prior to rental to determine your nocturnal needs. Most patients on oxygen are on a continuous flow when sleeping at home. The Eclipse, Invacare Solo, Devilbiss IGO and Oxlife provide a continuous flow while the other pulse dose POC's only provide on demand conserver technology. However, sometimes the physician may say it is ok for you to sleep with the conserver for a week or so. You must consult your physician on this as we cannot be responsible for you making the wrong choice but will help to guide you as much as possible.

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Where can I purchase a portable oxygen concentrator?

From us! The great news is that you all already here and we offer all POC's on the market. Vienna Medical sells new and used POC units. Visit our portable oxygen concentrator page for sale items. For specific questions on different products for sale, call our customer care department.

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I don't understand how to use the machine.

You can reference your instructions that came with the unit, you may call our customer care department or visit our online support page by clicking here.

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How quickly can I get one?

Vienna Medical understands there are certain situations where our clients need immediate help. Your in the right place, just call us as soon as you can and we will expedite your order and ship overnight. Please have your information ready when calling.

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How long will the battery last?

The units can last up to 4.4 hours depending on your settings, such as pulse or continuous flow in combinations with your liters per minute usage. Generaly, a lower liter flow setting will offer longer battery life. For further details for each type of unit visit the products page by clicking here. Keep in mind that if your battery does go down you may plug the POC's into a cigarette lighter in a car using the DC adapter or into any wall outlet using the AC adapter to use and recharge the batteries.

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Can I get the equipment insured?

You can ask your travel agent about travel insurance that may cover this item.

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Diabetes Management

Information compiled from the American Diabetes Association. Please check with your physician before utilizing any information. Shenk Enterprises L.L.C. and Vienna Medical not responsible for any misprints or misinformation. Read and apply at your own risk. (THE BELOW LINKS ARE NOT FUNCTIONING YET PLEASE SCROLL DOWN.

What is Diabetes? Statistics
How is Diabetes treated?
Why do I need to see a Dietitian?
Can I eat foods with sugar in them?
Why does losing weight help my diabetes?
How can I cut the fat in my diet?
Are some fats better than others?
What foods can I eat a lot of?
What can I do if I overeat over the holidays?
Can I use low calorie sweeteners?
How much weight should I lose each week?
Can I drink alcohol?
Isn't glucose control easier if I eat the same things every day?
What vitamins will help my diabetes?
Are there herbs that will help my diabetes?
How can Diabetic shoes help me?
Tips on Foot Care
Foot Problems associated with Diabetes
Choosing your footwear
How do I qualify through Medicare for Diabetic Shoes?
How to measure for Diabetic Shoes



What is Diabetes? Statistics

Diabetes mellitus is a chronic disease that affects the lives of about 16 million people in the United States, 5.4 million of whom are unaware that they even have the disease. Every day, 2,200 new cases of diabetes are diagnosed, and an estimated 780,000 new cases are identified each year. The disease is marked by the inability to manufacture or properly use insulin, and impairs the body's ability to convert sugars, starches, and other foods into energy. The long-term effects of elevated blood sugar (hyperglycemia) are damage to the eyes, heart, feet, kidneys, nerves, and blood vessels.

In type 1 diabetes, the pancreas cannot produce enough insulin. Therefore, insulin therapy is needed. In type 2 diabetes, patients produce insulin, but cells throughout the body do not respond normally to the insulin. Nevertheless, insulin also may be used in type 2 diabetes to overcome the resistance of the cells to insulin. By increasing the uptake of glucose by cells and reducing the concentration of glucose in the blood, insulin prevents or reduces the long-term complications of diabetes, including damage to the blood vessels, eyes, kidneys, and nerves.

Symptoms of hyperglycemia may include frequent urination, excessive thirst, extreme hunger, unexplained weight loss, tingling or numbness of the feet or hands, blurred vision, fatigue, slow-to-heal wounds, and susceptibility to certain infections. People who have any of these symptoms and have not been tested for diabetes are putting themselves at considerable risk and should see a physician without delay.

Part of keeping your diabetes in control is testing your blood sugar often. Ask your doctor how often you should test, and what your blood sugar levels should be. Testing your blood and then treating high blood sugar early will help you to prevent complications.

The socioeconomic costs of diabetes are enormous. The dollar costs have been estimated at $98 billion annually, about $44 billion of which are direct costs from the disease with $54 billion indirectly related. Diabetes is the sixth-leading cause of death by disease in the United States, and individuals with diabetes are two to four times as likely to experience heart disease and stroke.

The growth of the disease worldwide is especially alarming. The World Health Organization (WHO) expects the number of new diabetes cases to double in the next 25 years from 135 million to nearly 300 million. Much of this growth will occur in developing countries where aging, unhealthy diets, obesity, and sedentary lifestyles will contribute to the onset of the disease.

According to a recent survey, about 86,000 lower limbs are amputated annually due to complications from diabetes. Diabetes is the leading cause of end-stage kidney disease, accounting for about 40 percent of new cases. Diabetes is the leading cause of new cases of blindness among adults, age 20 to 74.

While there is currently no cure for diabetes, there is hope. With a proper diet, exercise, medical care, and careful management at home, a person with diabetes can keep the most serious of the consequences at bay and enjoy a long, full life.

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How is Diabetes treated?

The major goal in treating diabetes is to minimize any elevation of blood sugar (glucose) without causing abnormally low levels of blood sugar. Type 1 diabetes is treated with insulin, exercise, and a diabetic diet. Type 2 diabetes is treated first with weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugars, oral medications are used. If oral medications are still insufficient, treatment with insulin is considered.

Adherence to a diabetic diet is an important aspect of controlling elevated blood sugar in patients with diabetes. The American Diabetes Association (ADA) has provided guidelines for a diabetic diet. The ADA diet is a balanced, nutritious diet that is low in fat, cholesterol, and simple sugars. The total daily calories are evenly divided into three meals. In the past two years, the ADA has lifted the absolute ban on simple sugars. Small amounts of simple sugars are allowed when consumed with a complex meal. For more, please read the Diabetic Diet article.

Weight reduction and exercise are important treatments for diabetes. Weight reduction and exercise increase the body's sensitivity to insulin, thus helping to control blood sugar elevations. For more, please read the Weight Loss and Fitness articles.

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Why do I need to see a dietitian?

Registered dietitians (RDs) have training and expertise in how the body uses food. RDs who understand diabetes can teach you how the food you eat changes your blood glucose level and how to coordinate your diabetes medications and eating. Do you know how many calories you should eat each day? How to cut down on the fat in your meals? How to make eating time more interesting? An RD can help you learn the answers to these, and lots of other questions. Your dietitian will work with you to create a healthy eating plan that includes your favorite foods.

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Can I eat foods with sugar in them?

For almost every person with diabetes, the answer is yes! Eating a piece of cake made with sugar will raise your blood glucose level. So will eating corn on the cob, a tomato sandwich, or lima beans. The truth is that sugar has gotten a bad reputation. People with diabetes can and do eat sugar. In your body, it becomes glucose, but so do the other foods mentioned above. With sugary foods, the rule is moderation. Eat too much, and 1) you'll send your blood glucose level up higher than you expected; 2) you'll fill up but without the nutrients that come with vegetables and grains; and 3) you'll gain weight. So, don't pass up a slice of birthday cake. Instead, eat a little less bread or potato, and replace it with the cake. Taking a brisk walk to burn some calories is also always helpful.

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Why does losing weight help my diabetes?

Weight loss helps people with diabetes in two important ways. First, it lowers insulin resistance. This allows your natural insulin (in people with type 2 diabetes) to do a better job lowering blood glucose levels. If you take a diabetes medicine, losing weight lowers blood glucose and may allow you to reduce the amount you're taking, or quit taking it altogether. Second, it improves blood fat and blood pressure levels. People with diabetes are about twice as likely to get cardiovascular disease as most people. Lowering blood fats and blood pressure is a way to reduce that risk.

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How can I cut the fat in my diet?

Here are some beginning hints. See a dietitian for more advice. Stir-fry foods in tiny amounts of oil and lots of seasonings. Choose nonfat or low-fat selections, such as nonfat or 1% milk or low-fat cheese. Keep portion sizes on target. Avoid fried foods -- bake, grill, broil, or roast vegetables and meat instead.

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Are some fats better than others?

Yes. Unsaturated fats are the healthiest for your body. This includes both monounsaturated and polyunsaturated fats. You can find these "healthy fats" in foods like nuts, vegetable oils, olives and avocados.

The fats to cut back on are the saturated and trans fats. Saturated fats are found in full-fat dairy products like ice cream, half and half, sour cream, cheese, and meats, chicken skin, bacon and lard. Trans fats are found in margarines and shortening as well as many processed packaged foods and sweets. Trying to cut back on how much saturated and trans fat you eat is important to help reduce your risk of heart attack and stroke.

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What foods can I eat a lot of?

Forget about eating with abandon. The key to healthy living is moderation. Air-popped popcorn may be low in fat, but it still has calories. And calories count. If you can control the portion sizes of the food you eat, you will be able to eat a wider variety of foods, including your favorites, and still keep your blood sugar in your target range.

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What can I do if I overeat over the holidays?

Put on your walking shoes and head for the pavement. Being more active helps lower your blood sugar, blood pressure and cholesterol. Physical activity uses up extra sugar in your blood and helps your insulin work better.

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Can I use low calorie sweeteners?

Low calorie sweeteners are safe for everyone except people with phenylketonuria, who should not use aspartame. Calorie-free sweeteners like aspartame, saccharin, sucralose and acesulfame-K won't increase your blood glucose level. The sugar alcohols -- xylitol, mannitol, and sorbitol -- have some calories and do slightly increase your blood glucose level. Eating too much of any of these can cause gas and diarrhea.

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How much weight should I lose each week?

Limiting your weight loss to 1/2 to 1 pound a week will keep you healthy, and let you enjoy the foods you love in small amounts. A slow steady weight loss is the key to keeping lost weight off.

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Can I drink alcohol?

Yes, in moderation. Moderation is defined as two drinks a day for men and one drink a day for women. A drink is a 5-ounce glass of wine, a 12-ounce light beer, or 1-1/2 ounces of 80-proof distilled spirits. Make sure that your medications don't require avoiding alcohol, and get your doctor's okay.

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Isn't glucose control easier if I eat the same things every day?

Probably, but this method of blood glucose control isn't very nutritious, not to mention boring. One of the keys to nutrition is eating a variety of foods each day. By checking your blood glucose two hours after starting to eat a meal, you can learn how different foods affect you. Over time, you will be able to predict how foods, and combinations of foods, affect your blood glucose level.

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What vitamins will help my diabetes?

If you have a vitamin or mineral deficiency, it could be causing problems with your glucose control. For instance, one study found that taking the trace element chromium improved glucose control in subjects who had a chromium deficiency. More studies need to be done. If you choose a variety of fruits, vegetables, grains, and meat each day, and keep your blood sugar close to your target range, you probably don't need to take vitamin supplements because of diabetes.

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Are there herbs that will help my diabetes?

Many herbs supposedly have glucose-lowering effects, but there are not enough data on any herb to recommend it for use in people with diabetes. Herbs are not considered food by the Food and Drug Administration and are not tested for quality or content. Therefore, products can be promoted as helping health conditions without having to show evidence of this. Discuss the herbal dietary supplements with your doctor or dietitian before trying them. They may interact poorly with your diabetes medication.

Select all of you Medicare Diabetic Products today! We offer Diabetic compression therapy (Lymphedema pumps) Florida, Diabetic shoes, Diabetic socks, Wound care supplies. Deltona, Deland, Orange City, Debary, Daytona, Orlando, Jacksonville, Volusia County, Seminole and Orange County. Elderly Diabetic products? We can help. Diabetic product reviews.

HOW CAN DIABETIC SHOES HELP ME?

Diabetic Shoes are just one of the many tools you can use to fight Diabetes one or two. Many doctors recommend patients purchase shoes specifically designed for diabetics. When looking for a pair of shoes, you want to make sure it has proper ventilation, which allows the feet to reduce dampness and heat. Sweat often is an ideal environment for bacteria and infection to grow. You want to make sure the toe and heal curve slightly, forcing your feet to be in balance when you walk. To prevent injury to susceptible and sensitive toes, the shoe's toe box should be high and durable. The shoe should also be lightweight and seamless to prevent any irritation like calluses, infection or blisters. (Courtesy of Medical Supply guides)

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Here are some tips on foot care that may help relieve discomfort:

With constant care and maintenance, the feet's pain and infection can be minimized.

Wash your feet everyday with mild soap and tepid water.

Carefully trim your toenails or have a podiatrist perform.

Rub and moisturize your feet.

Wear diabetic socks.

Wear diabetic shoes.

Be conscious about your feet and report any sores or infections to your doctor.

At least four times a year, see your doctor for a regular foot checkup.

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Foot problems that may occur in people with diabetes.

Nerve Damage - Neuropathy, can cause a loss of feeling in your feet. When this occurs, you lose the ability to feel when your feet have been injured. You can easily step onto a sharp object, and not know it until you spot blood on your sock. If you don't see any blood, you can worsen the injury by leaving it unattended. Soon an infected foot ulcer may develop.

Poor Circulation - With diabetes arteries can become rigid and blocked, and fail to bring adequate blood, oxygen, nutrients and medications to injured areas of the body. This can significantly delay healing.

Higher risk of infections - When blood sugar frequently goes above 250 mg/dL, your white blood cells, which fight infections, become sluggish. Infections become more difficult to control.

Vision Problems - Cuts and other foot injuries can initially be quite small. It is important that careful checking be done daily. If one's vision is impaired, it is possible to miss potential problems that can become very serious.

Excess Weight - If you have difficulty bending and reaching your feet, checking them carefully can be a problem. It is important to check them diligently so small injuries do not become major ones.

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Choosing your Footwear

Choosing improperly fitting shoes and socks can cause foot trauma. Remember to:

Wear shoes and socks that fit well.

Wear shoes and socks made from natural materials --they allow for healthy air circulation.

Change your shoes at least once each day.

Purchase your shoes in the afternoon, when your feet are at their largest size.

Look for shoes that have a lot of "wiggle room" for your toes. Do not choose shoes that feel tight.

Take time to break in your new shoes. Wear them for 1-2 hours each day to begin with.

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Medicare Therapeutic Shoe Program

In an effort to prevent foot ulcers in people with diabetes who are at risk, Medicare will help pay for therapeutic shoes. For those who qualify, Medicare will pay 80 percent of the allowed amount for one pair of shoes and up to three pairs of molded innersoles per year. (The allowed amount varies depending on the kind of footwear you need.) Most secondary insurers will help pay the other 20 percent.

Who Qualifies?

To qualify, you must be under a comprehensive diabetes treatment plan and have one or more of the following:

history of partial or complete amputation of the foot

history of previous foot ulceration

history of pre-ulcerative callus

peripheral neuropathy with evidence of callus formation

foot deformity

poor circulation

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How do you measure for diabetic shoes and inserts?

Lets talk about the inserts first. There are two types of inserts. One type of insert is a prefabricated heat-moldable insert. The shoe fitter will actually heat the insert and mold it to the patient's foot. The second type of insert is a custom insert where the shoe fitter will take an impression of the patient's foot, send it to a lab, and the lab will make multi-density plasters of inserts for the patient.

When measuring for diabetic shoes you want the patient standing on a measuring device. The measuring device would measure the length of the foot from the heel to the longest toe and the width at the widest part. Many manufacturers have a single base allowing for different widths and more material around the top. It's very important when fitting the diabetic shoe to make sure to fit it without it being too tight or too loose. If there is any discrepancy, you want to have the ability to try a different size. Diabetic shoes are available in medium wide, extra wide, and in many companies, extra-extra wide.

Typically, a diabetic patient is heavier than an average patient. Department stores may only carry medium width shoes. What we find are patients wearing a regular 10 wide when they actually need an 8 extra-extra wide. There are two or three companies that make custom shoes, because there are some patients with such deformed feet that the regular shoe may not be the best for them. The average person may be off by half a size between the right and left foot. That probably doesn't mean they use two different sizes. When some one been using two vastly different sizes their whole life, we would provide two different sized shoes. If there is a deformity that a normal shoe can't accommodate, the provider may take a cast of the patient's foot so shoes can be custom cut for that patient. Buying diabetic shoes over the internet or by mail order with a fitting kit is really not a very good idea. The most important part of the diabetic program is being fitted by a qualified provider who has experienced fitting diabetic shoes and providing the custom inserts to go along with it.

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Lymphedema Pumps

What is Lymphedema?
What are the benefits of compression therapy?
How do I qualify for a Lymphedema pump through Medicare or insurance?
What is an external compression pump (EPC)?
What is DVT?
What are compression pumps used to treat?
What are acute care DVT pumps?
What are chronic care DVT pumps?
Is there anything I should know before using a compression pump?
Is my compression pump reimbursable by Medicare or Medicaid?
I have compression sleeves from the hospital. Can I use those with my compression pump?
How will I know what size compression pump garments to order?

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What is Lymphedema?

Lymphedema is a condition in which lymph fluid fails to circulate properly, which results in swelling and reduced movement in the arms or legs. It may also result in infection and skin breakdown. Lymphedema can be caused by damaged lymphatics, missing vessels, and by poor venous circulation. Although there is no cure for Lymphedema, the symptoms can be managed by elevating the legs, applying compression hosiery and the use of compression pumps.

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What are the benefits of compression therapy?

There are several benefits to compression therapy including:

Easy to use

Non-invasive

Clinically proven

Relaxing for patients

Few side effects

Medicare reimbursement(if criteria are met)

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How do I qualify for a Lymphedema Pump?

Medicare and major insurance carriers recognize these pumps as safe and effective treatment of:

Primary and secondary Lymphedema

Post Mastectomy/post lumpectomy/post radiation Lymphedema

Venous insufficiency

Venous stasis ulcers

Prevention of thrombosis

Compression pumps are covered for treatment of true Lymphedema as a result of: Primary Lymphedema resulting from a congenital abnormality of lymphatic drainage or Milroy's disease, or

Secondary Lymphedema resulting from the destruction of or damage to formerly functioning lymphatic channels such as:

radical surgical procedures with removal of regional groups of lymph nodes (for example, after radical mastectomy),
post-radiation fibrosis,
spread of malignant tumors to regional lymph nodes with lymphatic obstruction,
or other causes

Before you can be prescribed a pump, your physician must monitor you during a four-week trial period where other treatment options are tried such as medication, limb elevation and compression garments. If, at the end of the trial, there is little or no improvement, a Lymphedema pump can be considered.

The doctor must then document an initial treatment with a pump and establish that the treatment can be tolerated.

- Lymphedema pumps also are covered for the treatment of chronic venus insufficiency (CVI).

Before you can be prescribed a pump for this condition, your physician must monitor you during a six month trial period where other treatment options are tried such as medication, limb elevation and compression garments. If at the end of the trial the stasis ulcers are still present, a Lymphedema pump can be considered.

The doctor must then document an initial treatment with a pump and establish that the treatment can be tolerated, that there is a caregiver available to assist with the treatment in the home, and then the doctor must prescribe the pressures, frequency, and duration of prescribed use.

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What is an external compression pump (EPC)?

External compression pumps are medical devices that help stimulate blood and fluid movement. They come in a variety of sizes and with several different features. Click here for more information on products.

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What is DVT?

DVT stands for Deep Vein Thrombosis. It is a condition in which there is a blockage in a deep vein, caused by long durations of little or no body movement. Symptoms may vary, although some experience no symptoms at all. DVT can be dangerous since these blockages can travel to the lungs and a life threatening pulmonary emboli.
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What are compression pumps used to treat?

Compression pumps are often used for patients who suffer from venous stasis ulcers, Lymphedema (swelling of the extremities) and also the treatment of blood clots, also known as deep vein thrombosis (DVT). Compression pumps are either used for acute care (in the hospital, temporary) or chronic care (long term, often at home or an extended care facility). These pumps are designed to treat either venous insufficiency, Lymphedema or the treatment of DVTs, and differ in the cycle time of the squeeze. Both augment blood and lymphatic flow. Note: Lymphedema and DVT pumps are not interchangeable, meaning a Lymphedema pump should not be used to treat DVT and vice versa.
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What are acute care DVT pumps?

Acute care DVT pumps are primarily used in the acute hospital setting for the treatment of blood clots. The pump mimics regular walking-like activities by altering leg compression. The standard DVT pump has a cycle time of 12 seconds of inflation and 48 seconds of deflation. The cycle timing provides effective movement of venous blood out of the limb, while allowing adequate time for venous refill prior to the next inflation cycle. The recommended pressure setting is 40 mmHg. The garments extend from the ankle to below the knee or from the ankle to the upper thigh.

The purpose of this pump is to move blood in the veins, thereby preventing venous stasis and stimulating fibrinolytic activity. This aids in the treatment of DVTs and the life-threatening condition of a clot forming and dislodging to the lung, called a pulmonary emboli (PE). This type of pump is most often used in the acute care setting until the patient is fully ambulatory (walking at least five minutes every waking hour). This pump can also be used in the home care setting depending on the needs of the patient. The sleeves or garments used in the hospital for the treatment of DVTs are not interchangeable to treat swelling or lymphedema.
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What are chronic care DVT pumps?

Chronic care compression pumps are primarily used to treat swelling due to venous or lymphatic problems, like venous stasis ulcers and intractable lymphedema. This pump has a much longer cycle time (two to three minutes or greater), with a longer inflation cycle. The longer cycle time is used to assist in the movement of fluid from the interstitial spaces into the venous or lymphatic system for re-circulation and/or elimination. The full leg garment looks and fits like a boot that extends to the groin fold, and the full arm sleeve covers the hand and extends to the axillary (arm pit) region. There are also half leg garments and half arm garments. The pumps' pressure varies depending on the patient's condition, the goal of the therapy, and the patient's response to treatment.
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Is there anything I should know before using a compression pump?

If a compression pump is used to alleviate symptoms of Lymphedema or DVT treatment, care must be taken that infection or metastic disease is not present. In the case of pulmonary edema or phlebitis, extreme caution must be exercised. People with the following conditions should not use an external compression pump:

Pain or numbness of the extremity

Severe peripheral arteriosclerosis or other ischemic diseases

Congestive heart failure/pulmonary edema

Gangrene

Dermatitis

Untreated infected wounds

Recent skin grafts

Known or suspected acute deep vein thrombosis or thrombophlebitis

Please consult your physician to discuss any change in symptoms or treatment before any new therapy is attempted.
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Is my compression pump reimbursable by Medicare or Medicaid?

Consult your insurance plan representative or call us today to find out if you qualify. See How do I qualify for a lympedema pump.

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I have compression sleeves from the hospital. Can I use those with my compression pump?

Compression sleeves given at the hospital are designed for DVT treatment, not Lymphedema. Also, sleeves are specialized to that particular pump. It is not recommended that patients use sleeves other than the ones authorized by the manufacturer.
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How will I know what size of DVT compression pump garments or Lymphedema compression pump garments to order?

Please call.
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