Topic: Flexitouch system?
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Joined: Apr 2006
Posts: 387
Posts: 387
- Posted on: Feb 8, 2007 06:33 am
I know someone was talking about this before but I could not find the thread.
Has anyone used this and does it work?
Is this something I can buy for in my home (how much is it?) or is it only used in the doctors offices?
Thanks!
Cathy
Has anyone used this and does it work?
Is this something I can buy for in my home (how much is it?) or is it only used in the doctors offices?
Thanks!
Cathy
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LindaLou53 Joined: Jan 2006 Posts: 292 |
Feb 8, 2007 12:20 pm
LindaLou53 wrote:
Flexitouch is a compression pump system manufactured by Tactile Systems. Check out their website at http://www.tactilesystems.com/ It is different from other pump systems because it attempts to follow the same process used in MLD. It starts with a preparation phase of 30 min duration which gently stimulates the groin and abdomen, chest and arm (for Upper Extremity LE)in order to prepare the primary nodal areas. It then performs a drainage phase of 30 min duration which starts at the distal end of the affected extremity (finger tips)and gradually works the massage up the extremity, to the chest and truncal area and ends up at the abdomen and groin to help stimulate lymph flow. I tried out the Flexitouch at my therapists clinic after doing alot of research on it. I have now owned my own unit at home for 2 weeks. I have used it every day, usually right before bedtime. I just had a regular scheduled MLD visit today with my therapist and she examined and measured my arm. I have lost on average about 1.0 cm at all measurement points on my affected arm except right at the top of my shoulder where fluid tends to accumulate more on me. I also have stage 2 LE with alot of thick, firm fibrotic tissue which has begun to soften up noticeable after using the Flexitouch. The pump is NOT a substitution for other LE maintenance steps. I still wear my Elvarex compression sleeve and glove through out the day. I wear a Jovi Pak night time sleeve and I use Kinesio Taping on my arm underneath it all. I am still seeing my therapist at least once a week for MLD and range of motion exercises since I have alot of scar tissue from the surgery and radiation. The Flexitouch pump is EXTREMELY comfortable and relaxing, and I look forward to the hour long sessions each day just for the restful benefit. It takes only 1 or 2 sessions to get used to fitting the garments snugly to fit your body, after that you can more easily slip them off and on without starting from scratch each time. The pump itself seems to be very well made and durable. It is quiet and easy to operate. I have found the staff at Tactile systems to be very helpful, polite and not high pressure at all. The pump system is certainly NOT cheap however and you will need to verify that your insurance will pay for the bulk of the cost. Generally the retail cost of the system is between $9500 - $10,000 which would be out of reach for almost anybody doing self pay. However, if your insurance has Tactile Systems listed as one of their contracted providers and you have the medical necessity letter filled out by your therapist and signed by your doctor you may find it is much more affordable. My BC/BS insurance agreed to approve $6500 of the retail price and because Tactile Systems is a contracted provider for BC/BS they agreed to accept the approved amount. I have a 90/10 plan so my responsibility is 10%. Flexitouch guaranteed me my portion would not be more than $650. They do all the legwork talking to and verifying insurance coverage. They shipped my Flexi system to me after all the medical forms were complete and I have not had to pay a dime until after they receive the insurance payment. So far I am very pleased with the performance of the unit and the customer support. Only time will tell how much benefit the pump will be for my LE. Of course everyones LE is different and someone else may get different results. They do have several clinical studies on the website for review and I have read several positive anectdotal testimonies. Hope this helps 
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Gator Joined: Jul 2006 Posts: 13 |
Feb 8, 2007 12:41 pm Gator wrote: Great response! I don't have much to add except that I have been using my flexitouch since July and I love it. It is such a relaxing hour and really helps with the lymphedema, especially in my hand which is my problem area. My insurance paid the full amount since I had already met my total deductible because of a couple of hospital visits. They are a very easy company to work with and were very helpful. When I received my unit someone came to my home to teach me the proper way to use the machine and fitted it for me. Hopefully this helps you. Joy |
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Lhunhen Joined: Apr 2006 Posts: 387 |
Feb 8, 2007 01:10 pm
Lhunhen wrote:
Linda, Thank you for your wonderful reply on this. I was searching around and found this and was wondering about it. I am going to a Lymphedema specialist next week (my 2nd one) and hope this one turns out to be good. Even though I'm in a big major city area...it's still hard to find a Lymphedema specialist. I was wondering if maybe some offices have this machine and will ask about it when I go. The video on that site looks really interesting. Cathy |
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LindaLou53 Joined: Jan 2006 Posts: 292 |
Feb 8, 2007 01:27 pm LindaLou53 wrote: Cathy I would ask your new therapist if she is familiar with the Flexitouch or not. She can always contact Tactile Systems and request they setup a date at her clinic where the local Flexitouch Rep can do demo massage sessions with any of her Lymphedema patients who would like to try it out. That is what my therapist did and the Rep just spent the day at the clinic showing interested patients how it all works and letting them get the hour long massage to see how they liked it. The Rep can also drop off folders with info on the clinical studies using Flexitouch and other general information about the system. There are at least 2 or 3 other patients at my therapists clinic who are considering getting one now. |
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Binney4 Joined: Aug 2004 Posts: 3198 |
Feb 8, 2007 03:25 pm
Binney4 wrote:
Hi, Cathy and all, As LindaLou points out, the Flexitouch shares with other pumps the problem of inadequately draining the top of the arm/shoulder. That's one of the major drawbacks of pump use and a primary reason why many therapists are reluctant to use them. When that area is inadequately treated the tissues become fibrotic, and because the location is right there at the top of the arm, it can easily result in damage to tissue further down the arm as well. It's an especially bad place to "dam up." Which is one of the reasons that every pump should be used only with the supervision of an experinced therapist. Pump use is especially helpful for patients who for some reason can't perform self-massage (such as Trixigram, who had a torn rotator cuff in her "good" arm), or conversely for those who won't "comply" with self-care in other forms. While the Flexitouch does have a node-clearing phase that other pumps lack and uses a distal to proximal pumping action, you'll probably notice right away that it doesn't actually follow the MLD massage pattern, in that (for instance) it doesn't move fluid from the underside of the arm to the top for clearing. (Which is probably part of the reason for the tie-up of fluid at the top of the arm.) As for the studies cited on their website, it's important to read any study structure carefully and note the nature of controls and the actual results, and consider the presence or absence of long-term data that would reflect the problems associated with the development of shoulder and upper-arm fibrosis over time. All that just to say that the only safe way to use any pump is with careful supervision by a knowledgeable therapist, preferably for limited periods of time, and with regular additional manual drainage of the upper arm and shoulder. Whew! That said, the Flexitouch is definitely something to watch, and as they continue to develop their product, and as long-term studies by disinterested parties become available, this could be a very promising direction. There's certainly all kinds of room for improvements in the treatment of LE! Binney |
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LindaLou53 Joined: Jan 2006 Posts: 292 |
Feb 8, 2007 06:52 pm
LindaLou53 wrote:
Binney you make valid points. I have not had any experience with other compression pump systems but the Flexitouch. I have been told that other systems do not address the chest or truncal areas but basically "dump" the lymph flow at either the top of the shoulder or at the groin for leg LE patients. I know there have been cases of genital LE and Chest LE developing after use of these types of pump systems and especially ones in which the degree of pressure applied can be altered/increased by the uninformed patient who thinks "if a little is good, alot must be better". When I referenced my problem with excess fluid at the shoulder area, that actually was a long standing problem prior to me ever getting the Flexitouch. I have only had the Flexi now for 2 weeks. I will be the first to agree that the pathway of alternating air chambers which create the massage action on the Flexi do not follow perfectly the recommended MLD pathways to complete accuracy. However they do a pretty good job of proper MLD process compared to any other systems I'm aware of. I know that the Flexi is addressing my shoulder, underarm area, scapula, down my side and chest area massaging very similarly to standard MLD. One of the debates I hear about how MLD works is whether it is a massage that actually forcefully moves the lymph fluid or if it is more a stimulation technique that encourages normal contractile activity of the existing lymphatic structures. MLD is taught to be a very light, feathery stroke as opposed to a deep tissue massage in order to stimulate lymphatic activity. I do believe, however, from my personal experience receiving professional MLD from my therapist that at times she is actually able to "move" the lymph fluid with very rhythmic and sometimes slightly more pressure at the troublesome fibrotic areas. For this reason I believe the Flexitouch will never be a substitute for professional MLD. I do believe it will do a better job for those of us trying to do self MLD at home though for several reasons. Binney already mentioned persons who have an inability to do adequate self MLD due to other physical problems or to those for whom daily self MLD is just more than they can fit into their lifestyle. I was religiously compliant with my self MLD and daily/nightly wrapping from the onset of my LE and as a result have developed trigger finger, carpal tunnel and early LE symptoms now in my "unaffected" hand from sheer overuse. I also know that try as I might there was no way I could adequately treat my shoulder blade and back area doing self MLD. I just cannot physically reach some of the areas that the Flexitouch can. While the Flexitouch may not be "moving" the fluid as well as MLD might, it definitely is providing a thorough light MLD type massage in a fairly accurate pathway that will stimulate the lymphatics producing better contractility and natural movement of the lymph fluid as a result. I have been in touch with Tactile Systems already making some suggestions about their garment styles because I do believe there can be better coverage of the shoulder, chest and truncal areas. I happen to be 6 ft tall and while they do offer long length arm and leg garments they do not take into account the different lengths in torsos and abd/pelvic areas based on a persons height. I find that my chest garment still leaves a 2-3 inch area below my ribcage and above the truncal garment that is not covered by garment. Their medical consultant, an RN, told me that because they were in fact stimulating lymph flow using the same theory of light rhythmic massage as MLD that it was not necessary for the garments to be totally contiguous with the anatomy and no physical breaks in garment coverage to still have adequate lymph stimulation. That may well be a true statement but I still feel they could do more customization of the chest and truncal garments to take into consideration height differences. They do a good job of accommodating for weight or circumference differences by adding garment extensions to adequately cover a larger body size. I agree that any pump system should be used under the guidance and monitoring of a professional therapist who can reinforce proper technique and check the patients LE status to be sure negative effects are not occurring. No one should just go out and purchase a pump system without professional input. I do believe though that the Flexitouch is extremely user friendly and safe to use. There is no way a person can change the pressure settings to an unsafe level on this system. It comes with a default setting which is already programmed for the patients type of LE ( ie Upper Extremity vs Lower Extremity). It has only one other pressure setting called intense which is to be used based on therapist recommendation for patients with particularly resistant, fibrotic or difficult LE. I have used this setting myself and the difference in pressure is only slightly more noticeable. Certainly not a situation where there is a pressure dial that can be cranked up to any setting desired. Also the criteria that would prevent a person from using any type of pump system holds true for the Flexitouch also. Contraindications are pulmonary edema, thrombophlebitis, congestive heart failure, deep vein thrombosis, episodes of pulmonary embolism, infections and inflammation, acute cancer, and where increased lymphatic return is undesirable. Bottom line is while the Flexitouch is not perfect I believe that it is unique in its function and is able to provide a consistent and thorough MLD that most patients are unlikely to duplicate on their own at home. I would still like to see Tactile Systems improve upon their design and continue to work on some areas of weakness. For me though it is saving more wear and tear on my good hand, has helped already in reducing volume and softening fibrosis, plus I get a great relaxing hour massage to boot!
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Lhunhen Joined: Apr 2006 Posts: 387 |
Feb 10, 2007 04:56 am
Lhunhen wrote:
Thank you all for your input on this. I think for now I will stick with the MLD and wrappings. For one thing I can't afford this machine in my home. And I'm a little scared to try it at the doctors office if they have one. Cathy |
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phillygirl Joined: Mar 2007 Posts: 17 |
Mar 18, 2007 04:57 pm phillygirl wrote: This is the system I was trying to remember. I tried to get this system two years ago, had Personal Choice, and they would not pay for it. I am considering trying again, but now I have a Keystone HMO and I doubt they'll pay for it either. I appealed and was turned down again. Has anyone fought the ins. co. until they approved this for them? |
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Binney4 Joined: Aug 2004 Posts: 3198 |
Apr 26, 2007 08:31 am Binney4 wrote: to the top |
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Binney4 Joined: Aug 2004 Posts: 3198 |
Jul 15, 2007 07:49 pm Binney4 wrote: Bumping again for Amy |
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bygrace1 Joined: Jun 2006 Posts: 982 |
Jul 18, 2007 04:32 pm
bygrace1 wrote:
Hi Phillygirl, I wanted to reply about the insurance denial for pump. Amazingly enough, me LE therapist went through BioHorizons to get my pump ordered and approved. They did all the contacting of the insurance company--and "fighting" to get it approved. You might want to contact BioHorizons and see if they can help you get the pump you need. I ended up with the Lympha Press Plus, rather than the Flexitouch (but I tried both). My choice was simply due to animal hair--we have two dogs & two cats. Hope this helps. grace
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Binney4 Joined: Aug 2004 Posts: 3198 |
May 13, 2008 05:04 pm
Binney4 wrote:
to the top for Texred Hope everybody's having a swell-free day! |
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txred9876 Joined: Aug 2005 Posts: 557 |
May 14, 2008 10:20 am
txred9876 wrote:
Thank you for all the comments... I am trying the flexitouch today. Mymain issue is the trunk swelling. I have had it from day one I believe. It has just gotten worse and when I had no insurance they just treated the arm with mld and then a sleeve (wrappings at night). I now have bcbs so hopefully they will pay for it. My therapist said she has gotten them approved for several patients. Tina |
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Binney4 Joined: Aug 2004 Posts: 3198 |
Jun 5, 2008 11:02 pm
Binney4 wrote:
To the top for GoodMommy. Hope everyone's having a great evening! Binney |
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Determined1… Joined: Sep 2007 Posts: 650 |
Jun 26, 2008 05:32 pm
Determined1 wrote:
I'm reading this with great interest. I just tried the Flexitouch today at the recommendation of my le therapist. She really seems to think I'm a good candidate for this system for my long term care of le. My question to those who have used this system is this: Does the Flexi do a good job under your arm? My trouble spot is in my armpit (thanks to a Bellisse garment my torso is in good shape, and my arm has gone down 3/4" through religious sleeve use and MLD). But neither the Bellisse, nor the sleeve get to my armpit and I'm not sure the Flexi will, either. Perhaps a combination of using the Flexi, garments and self MLD of my armpit will be the appropriate course for me, but I wanted to check to see what you guys think. Good news is that my insurance will cover 100% of the cost, since I've already met my deductible this year (one benefit of chemo!). Another question: How often does one see a therapist for MLD when using a system like this? Thanks, Ladies. D1 The things that we're afraid of are gonna show us what we're made of in the end.
Dx 8/17/2007, IDC, 1cm, Stage I, Grade 2, 1/7 nodes, ER+/PR+, HER2- |
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rferraris Joined: Jul 2006 Posts: 150 |
Jun 27, 2008 12:06 am
rferraris wrote:
I've been using the Flexitouch for one week now and realized tonight that my legs are tryingn to cramp while I'm using it. I have three pieces (leg/torso, chest & arm). Has anyone else experienced this? Dx 7/13/2006, IDC, 5cm, Stage IIIb, 13/25 nodes, mets, ER+, HER2- |