Lymphedema Garments are specially designed to maintain and support the limb, not to reduce its size. Garments must be applied in the morning to prevent gravity from pulling fluid down into the limb. If this happens the garment will trap the fluid and the garment will not fit comfortably. The patient should use rubber gloves to help in the Reqular Pneumatic Appliances of the garment, as these will provide resistance. Garments should be worn daily and removed at night. Lymphedema Garments are available in standard and custom styles Hydroven1 Half Leg Garment. There are several companies to choose from with the final choice usually coming down to cosmetics and cost. Garments usually last about 6 months, at which time it is necessary to be re-fitted. The patient should be re-measured each time a new garment is ordered to account for any changes in the size of the limb, (larger or smaller). The garments are machine washable but seem to last longer when hand washed. The patient will know it is time to get re-fitted when they notice that their limb tends to swell slightly at the end of the day or they notice any signs of stretching in the garment fabric. Recent Medicare rulings require that this type of therapy (custom garments not mandatory) be tried for 30 days and not be be fully effective before pump therapy is approved for use. This is in contrast to the former regulation which listed pump therapy as a last resort.