This chapter describes the pads which may be ordered in Spencer Supports to help relieve various conditions. It explains their use, the supports with which they may be used, and all other essential information.
The Abdominal Spring, Ptosis, Supra Pubic, Sacroiliac and Lumbosacral Pads are attached to the support with which they are ordered when they are sent from Banbury. All other pads are sent detached, in order that they may be carefully fitted by the Retailer-Fitter in their correct position when the support is properly adjusted on the client. When the correct location has been determined by the Fitter, it is a simple matter for her to sew the pads in place.
When pads of irregular shape or size are needed, a paper pattern attached to the order will be helpful to the technicians. If a pad of irregular thickness is being ordered, the pattern should be marked to indicate the thickness required in various parts.
Two types of pads have been developed especially to care for the thin patient whose abdomen is flat or concave and who is suffering from ptosis, movable kidney, or other conditions requiring the use of such pads. The pads extend across the lower front part of the support to which they are attached. When the abdomen is full, such pads are not ordinarily needed.
These pads are called the Abdominal Spring Pad and the Ptosis Pad.
Either of these pads is used to best advantage in a Spensupport and other Spencer Supports made with Straps and Slides Fastening and Curve Out Over Groin. Either pad can also be used with satisfaction in the Spencer Abdominal Supporting Belt, the Abdominal Supporting Corset and the Spencerflex.
To obtain best results, patient should lie down with hips well elevated for final adjustment.
When the Abdominal Spring Pad or Ptosis Pad is used in a Spencer Abdominal Supporting Corset or Belt ; Spensupport ; or Spencer Corset with Curve Out Over Groin and Straps and Slides Fastening ; an Extra Straight Strap will usually be supplied (see page 216). This Extra Straight Strap helps to increase the effectiveness of the pad.
It is important that these pads always remain centred on the abdomen. If the support is ordered with Straps and Slides Fastening, the pad is attached to one side of the front. Any increase in size of figure will require relocation of pad.
The Abdominal Spring Pad (Fig. 149) may be ordered for the thin patient whose abdomen is flat or concave and who is suffering from ptosis, movable kidney, or angina pectoris. It may also be ordered for the patient whose doctor prescribes a support for postural hypotension (see page 179).
For patients whose abdominal muscles have become weakened or paralyzed, such as polio patients, the Abdominal Spring Pad made two inches higher than usual supplies uplift and support as well as spring action to help compensate for damaged muscles (see also page 158 for Junior Supports).
Attachment of Abdominal
Spring Pad to Spencerform
It is thin, light, and so constructed, shaped and located in the lower abdominal area of a Spencer Support that it will when the support is adjusted-act as a resilient visceral elevator. The pad is attached to the support (as shown in Fig. 150) at top and bottom, at points " A " and " B." This permits the spring action which could not take place if the sides of the pad were attached to the support.
The side of the pad worn against the body is covered with plush. Several wide, closely spaced spring steels are placed horizontally in the pad. These spring steels are curved inwardly at the centre and give the pad an arched shape. The arch is deeper at the bottom than at the top.
When the support with the Abdominal Spring Pad is adjusted on the wearer, the pressure of the support against the ends of the spring steels in the pad presses the curved portion of the pad against the abdomen directly above the pubic bone.
The resilient pressure and spring action of this thin pad follow the movements of the abdomen. It lifts and holds the organs in the abdominal cavity in a more nearly normal position than can be maintained by a felt pad.
Each time the wearer inhales, there is a slight flattening of the steels in the Abdominal Spring Pad. Each time the wearer exhales, the mild spring pressure against the lower abdomen creates an action that favours better circulation. This action is similar to the natural action of strong abdominal muscles. Therefore the Abdominal Spring Pad is especially helpful to patients suffering from postural hypotension, angina pectoris and functional disorders that may be relieved by improved circulation in the abdominal area.
The Abdominal Spring Pad may be used in place of felt Ptosis Pads of various thicknesses. The pad is shaped in Banbury to supply normal uplift. When more or less uplift is necessary, you can easily increase or decrease the curve on the steels to get the desired results.
To Order. Check space on order form.
Control With an Abdominal Spring Pad. When an Abdominal Spring Pad is to be worn with a support, the following method of control is recommended for best results :
Before attaching front panel as in Step 4, page 27, have client lie down with hips elevated as shown in Booklet No. 515.
Mould the Abdominal Spring Pad sufficiently to fill in space between hipbones, then put the pad in place inside of front sections. Put the front panel in position and tighten straps of Control Support to prevent the organs in the abdominal cavity from slipping down. Have client stand and complete control. Take measurements as usual.
The Ptosis Pad is thick at the bottom and becomes gradually thinner until, about half or two-thirds of the way up toward the top of the pad, there is very slight thickness. When the adjusting straps are drawn tightly, this pad reaches into the abdomen above pubic bone and between hipbones and provides the necessary uplift.
Ptosis Pads are made ¾, 1½, 2¼ inches thick, or in additional units of ¾ of an inch if necessary.
Ptosis Pads must be shaped to fit the lower front edge of the support with which they are to be worn. Therefore, if you order a pad for a support that is already made up, send an order on Order Form 137. Attach the duplicate of the original order, or a paper pattern showing the exact size and shape of the pad needed.
Figure 151 shows a Ptosis Pad.
To Order. Check space on the order form and give thickness if other than ¾ inch is wanted.
Control when Ptosis Pad is to be Used. Before attaching front panel as in Step 4, page 27, have client lie down with hips elevated as shown in Booklet No. 515.
Fill in space between the hipbones with sample Ptosis Pad (or other padding) placed inside of front sections. Put the front panel in position and tighten straps of the Control Support to prevent the organs in the abdominal cavity from slipping down. Have client stand. Complete control and take measurements as usual.
When the doctor asks you to decide on thickness of Ptosis Pad to be ordered, this can be easily determined by the thickness of padding used for control.
In most cases pads are not needed to protect scars. However, when an incision from a recent operation extends down the muscular wall and over the pubic bone, a pad may be necessary to prevent the lower edge of the support from cutting into the scar. A Ptosis Pad with an inverted " V " shape cut-out is made as shown in Figure 152. This allows the padding to rest on the body on either side of the scar, but there is no pressure on the scar itself.
When ordering such a pad, check " Ptosis Pad " on the order form, give thickness if other than ¾ inch is desired, describe location of the scar, and specify that the pad is to be cut out.
This pad may be used with an Abdominal Supporting Corset, Spencer Belt, Spencerflex, Spensupport, and other Spencer Supports made with Straps and Slides Fastening and Curve Out Over Groin.
A large client's very soft flesh will sometimes slide out from under the bottom edge of the abdominal supporting section. This condition can be controlled with a Supra Pubic Pad. This is a narrow pad, thick at the bottom, and tapering off sharply at the top (see Fig. 153). It is placed along the bottom of the abdominal supporting section.
Unless a special thickness is specified on the order form, a pad ¾ inch thick will be supplied.
The Supra Pubic Pad may be worn with the Abdominal Supporting Corset or Spencer Belt.
To Order. Check space on order form.
Distress from movable kidney may be relieved, usually, by use of an Abdominal Spring Pad or a Ptosis Pad. In certain cases, at the direction of the doctor, a Kidney Pad (see Fig. 154) may also be used to give local pressure at a point in front of and somewhat below the kidney.
The Kidney Pad is about 2 inches by 5 inches in size and should be sewn in place so the top end is on a line with and about 1½inches to the side of the navel. When used in the Abdominal Supporting Corset, the top of this pad may extend slightly above the top edge of the abdominal supporting section. The Kidney Pad should be placed diagonally as shown in Figure 155.
The Kidney Pad may be used with the Abdominal Supporting Corset, De Luxe or Regular Belt, Spensupport, other Spencer Supports made with Straps and Slides Fastening and Curve Out Over Groin, and the Spencerflex.
Laparotomy Pads (Fig. 156) are used to cover a scar following an abdominal operation. Ordinarily such a pad is not needed with a Spencer Support because the support itself gives needed protection. However, if either doctor or client desires a pad, we supply two kinds. The one most commonly used is a soft pad ¼ inch thick, 4 inches wide and 6½ inches long, covered with a suitable material. To order, check " Laparotomy " on the order form, and cross off "Hard."
The hard laparotomy pad, similar in construction, is reinforced with a stiff backing, and any pressure or blow that reaches the part covered is taken up by the whole of the pad. To order, check " Laparotomy Hard " on the order form, and cross off " soft."
When ordering a Laparotomy Pad, please give the length of the scar if it is more than 5½ inches, long.
The Laparotomy Pad may be used with an Abdominal Supporting Corset, De Luxe or Regular Belt, Spensupport, other Spencer Supports made with Straps and Slides Fastening and Curve Out Over Groin, and with the Spencerflex. It should be fastened inside the support to cover the scar.
See information under Spencer Lumbosacral Corset on pages 110 and 153.
See information under Sacroiliac Corset on pages 100 and 152.
Special pads are designed for use when the hipbones are so prominent that the slightest pressure is a source of annoyance. These pads are con- structed with a depression in the centre and should be attached so that this depression comes directly over the sharp hipbone, leaving the padding on each side. The padding takes the pressure of the support and forms a bridge over the sensitive part (see Fig. 157).
Sensitive-Hip Pads may be worn with any Spencer Support.
To Order. Write " Sensitive-Hip Pads " under Additional Instructions.
The pad used for control of umbilical or ventral hernia is circular in shape, fiat on one side and rounded on the side that is placed next to the body. It is about 1½ inches thick at centre and about 3½ inches in diameter (see Fig. 158). Pads may be ordered in different sizes at the doctor's recommendation.
Pads are seldom needed to control umbilical hernia or ventral hernia occurring in that part of the muscular wall of the abdomen which can be covered by the abdominal supporting section. They should be ordered only on the advice of a doctor who will instruct the client in the technique of reducing the hernia.
Umbilical and Ventral Hernia Pads may be used with the Ab- dominal Supporting Corset, Spencer Belt and Spencerflex. They should be attached to the support so that when the client reduces the hernia, the greatest pressure comes at the place where the hernia disappears back through the muscles.
To Order. Check space on order form.
Pads must be used to control inguinal and femoral hernias. These pads are egg-shaped, with one side flat, and are usually 12 inches thick, 2 inches wide, and 3 inches long (see Fig. 159). Pads may be ordered in different sizes at the doctor's recommendation.
Femoral and Inguinal Hernia Pads are made of special felt which is firm in texture and yet not hard. The coverings are made of a soft material.
To Order. Check space on order form.
Hernia Tabs. Femoral or Inguinal Hernia Pads can be used only in conjunction with tabs attached to the lower edge of the abdominal supporting section of the Spencer Belt (see Fig. 160). As a continuation of the tabs, adjustable straps pass between the legs and fasten to the back of the support.
To locate the exact place to attach the pad, have the client adjust all straps except those attached to the tabs. She should then lie on her back to reduce the hernia while you hold the straps out of the way. Then, place the pad with the rounded edge against the body, the thin end at the top, and the thick end directly over the spot where the hernia disappeared. The pad should not be vertical on the body, but should slant outward slightly at the upper thin end. Place the tab over the pad. Draw on the strap to make certain that the tab holds the pad in place. Mark the position of the pad on the tab. Remove the support and sew the pad in place.
There is an extra charge (see Price List) for Hernia Tabs on Belts for women. There is no extra charge for Hernia Tabs when ordered on Belts for men.
To Order. Check space on order form.
The Spencer Breast Form provides an excellent substitute for the natural break.
It is designed of a light, porous material to provide soft, natural contours and is concave on the inner surface to prevent any possi- bility of uncomfortable pressure when worn. When the breast support is laundered, the Breast Form may be quickly and easily removed.
The Spencer Breast Form is used :
1. To provide normal appearance in cases of mastectomy, when one or both breasts have been removed (see Fig. 161).
2. To increase apparent size of under-developed breasts (see Fig. 162).
For Mastectomy Cases. When ordered because one or both breasts have been removed, the Breast Form should be ordered with the 140 or 160 Long or Short Breast Support, the 150, or the Spencer-All. The Breast Form will be especially designed to fit the breast pocket of the support and the client will be assured of normal appearance and comfort.
NOTE. In the following pages where breast supports are mentioned in connection with Breast Forms, the information also applies to Spencer-Alls. As there are no spaces to check for Breast Forms on the Spencer-All Order Form, this information must be written under Additional Instructions.
Additional information about Breast Forms is given on pages 196 to 201.
For Under-Developed Breasts. When the breasts are under-developed, support and the appearance of greater fullness can be obtained through use of Breast Forms. In controlling the figure, the pockets of the Breast Control Support must be padded to give the support and greater fullness desired in the finished support. Small Breast Forms are best for this purpose but other material may be used.
The breast support measurements should be taken in the usual way. No special measurements are required.
The forms are usually made in several pre-determined shapes and sizes. They provide the amount of fullness generally desired by clients with small figures and very small breasts, but do not extend toward the under-arm. They are not regularly made to fit entire pocket of the breast support.
Breast Forms supplied for under-developed breasts are covered with soft material and are not usually attached to the breast support. The covers are not removable.
Breast Forms for under-developed breasts may be ordered with Spencer-Alls or breast supports designed for accentuation.
To Order. Write " Under-developed Breast Forms " under Additional Instructions on Order Form.
Upon request, Breast Forms for under-developed breasts may be made to fit the entire pocket (as in mastectomy cases) and will be built into the support with retainers but no covers. To order for breast supports and Spencer-Alls, write under Additional Instructions on Order Form " Built-in under-developed breast forms to fit entire pocket." The charge in each case will be the same as for mastectomy cases.
Spencer Breast Supports (140 Long and Short ; 150 ; 160 Long or Short) or Spencer-Alls may be designed with Breast Forms for clients who have had one or both breasts removed.
When Only One Breast has been Removed.
Control. When only one breast has been removed, the remaining breast may be controlled as for the ordinary figure (Chapter 4, page 34). Later, the measurements will be taken over this side of the body.
Use small safety pins to take up looseness in other breast pocket, or pad the pocket to fill it out and help hold the Breast Control Support in place. (Sample Breast Form or soft cotton cloth may be used for padding).
Take care that the breast is not crowded and, throughout the time of control and measuring, be certain that the client holds the centre-front of the Breast Control Support exactly in the centre of the body. When the breast has been controlled satisfactorily, outlining may be started.
Outlining. To outline for a breast support when one breast has been removed, proceed as for the ordinary figure (page 50), with these additional steps :
l. Place a pin at the centre of the client's figure at back, and at the Height Above waist at which the Bust Measurement will be taken (" A " in Fig. 163). It is important that this pin be correctly located. Remember, the Breast Control Support may not be exactly centred at the back. Therefore the pin will not necessarily be in the centre of the Breast Control Support at back. It must, however, be exactly at the centre of the client's back.
2. Built-up Shoulders are recommended. (" B " in Fig. 163 is the outline pin marking the point to which the Built-up Shoulders are ordered. The dotted lines represent the outline of the finished breast support ordered with Built-up Shoulders).
3. When the breast support pockets must be made higher than usual to cover scar, or both the pockets and the Breast Form must be made higher than usual to cover an area from which tissue has been removed, place a pin at the top where the outward curve of the remaining breast starts (" A " in Fig. 164) and another pin higher up to indicate the point to which the extension of the breast pocket or the Breast Form is to come above the breast (" B " in Fig. 164).
Measurements. To measure a client for a breast support when one breast has been removed, proceed as for the ordinary figure (page 55), with the exception of the Size Bust. The Bust Measurement is taken halfway around the figure from the centre-front, over the controlled breast, to the pin at centre-back. This measurement should be multiplied by two and placed in the space for Size Bust on the order form (see Figs. 163, 164).
When breast support or Breast Form is to extend above the breast, be sure to start Top to Peak, Top to Under-Bust and Top to Waist Measurements at the uppermost pin (" B " in Fig. 164). In addition, measure from the top of the breast (" A " in Fig. 164) to peak of breast and write this measurement under Additional Instructions— " Start of fullness to peak—inches."
All other measurements are taken as usual and over the remaining breast. Be sure the tape measure is held exactly at centre-front when taking measurements from that point.
Breast supports ordered for this condition will be made higher than usual at centre-front and centre-back only when special heights for these points are listed under Additional Instructions.
Mastectomy patient before (Fig. 165) and after (Fig. 166) wearing the Spencer Breast Support and Breast Form (Fig. 167; individually designed for her. Notice that this Breast Form has been designed to conceal the removal of tissue above and to the side of the removed breast.
Regular Breast Form
With Above-Breast Extension
With Below-Breast Extension
With Under-Arm Extension
If, because of the scar, it is necessary to have one breast pocket designed higher between shoulder -strap and under-arm, this information should be written in. the space for Additional Instructions " Make (right or left) breast pocket ........................ inches higher than usual between shoulder strap and under-arm."
When both breasts have been removed, it is necessary to pad both pockets with soft cotton cloth or other suitable material. Since there is no natural breast over which to measure, the measure- ments must be taken over the padding. Both breast pockets should be padded very carefully. Keep in mind that it is this padding which you will control into the contours for the client's finished breast support with Breast Forms.
The figure is then controlled, outlined and measured in accordance with the instruction starting on page 34.
When the breast support pockets and Breast Forms must be made higher than usual to cover an area from which tissue has been removed, follow the same instructions given for this subject under " Outlining " for the figure with only one breast removed (pages 196 and 197).
The measurements supplied for the breast support usually make additional measurements for the Breast Form unnecessary. However, when an unusual amount of tissue has been removed above or below the breast, or toward the under-arm, the Breast Form can be designed to conceal this if additional measurements are supplied.
Above the Breast. A Breast Form with above-breast extension (see Fig. 169) will be supplied when " Above-Breast Extension—inches " is filled in on the order form. This measurement is the distance between the top pin (" B " in Fig. 164) and the pin at top of breast (" A " in Fig. 164). See instructions for measuring for above-breast extension on page 197.
Below the Breast. A Breast Form with below-breast extension (see Fig. 170) will be supplied when " Below-Breast Extension inches " is filled in on the order form.
Under-Arm. A Breast Form with under-arm extension (see Fig. 171) will be supplied when " Under-Arm Extension—Peak to End of Form—inches " is filled in on the order form. This measurement should be taken from peak of the controlled natural breast, as far under arm as the Breast Form is to extend.
Foam rubber one-half-inch thick is ordinarily used in these extensions. However, additional thickness will be supplied at extra charge when a thicker extension is ordered.
To Order. Check " Breast Form " and " Right " or " Left " on order Form 648a, and give any special measurements required, as explained above.
For final fitting of the breast support and Breast Form it is sometimes necessary to enlarge or let out the adjustment tucks. Any slight changes in the dimensions of the Breast Form can be made readily as the material is cut easily with scissors.
The only way you can determine exactly what must be done during the final fitting is to put yourself in the position of the client when the breast support and Breast Form are being fitted. Have the client stand facing her mirror. Look over her shoulder into the mirror and you will be able to tell whether any changes must be made to make her breast support and Breast Form absolutely satisfactory.
When one Breast Form is ordered with a breast support, two extra Hold-Down Tabs are supplied. After fitting the breast support, determine the correct position for the tabs and sew them into place. (The eyes, of course, must be sewn on the body support). Extra Hold-Down Tabs are usually placed on the same side of the breast support as the Breast Form, one at the under-arm seam and the other halfway between under-arm and centre-back.
Breast Pad (front)
Breast Pad (back)
The Spencer Breast Pad (see Figs. 172 and 173) consists of a soft material cover filled with a fluffy substance that will not mat. Breast Pads may be worn with Spencer-Alls and Spencer Breast Supports when one or both breasts have been removed.
To measure a mastectomy patient for a Spencer Breast Support and Breast Pad, follow same instructions as given under " Measuring a Mastectomy Patient for Breast Support and Breast Form," starting on page 196.
Breast Pads are intentionally supplied with more filling than is needed ordinarily. Some of this filling may be removed if necessary to reduce the size of the pad.
Breast Pads are not designed as part of breast supports or Spencer-Alls and are not attached to them. They may be ordered with the breast support or Spencer-All (write " Breast Pad " and " Left side " or " Right side " under Additional Instructions) or separately on Order Form 137.
When ordered separately, please give on the order form the Top to Under-Bust Measurement of the support with which the Breast Pad will be worn. Be sure to state whether pad for left or right breast is desired.