Friday, October 21, 2005

The Flexitouch Device for Lymphedema

THE FLEXITOUCH DEVICE – INITIAL OBSERVATIONS

Pat O’Connor

Lymphedema People

October 17, 2005

Preface:

The information contained herein is not meant to be an endorsement of the Flexitouch Device and in designed to be an educational advisory to lymphedema patients. Also, I have received no compensation for this article and in fact, I was not asked by Tactile Systems to write this.

My opposition to use the use compression pumps for the treatment of lower limb lymphedema is well known. Due to the well documented incredibly high risk of genital lymphedema, I personally just don’t feel they should be used.

Upon my review of the Flexitouch device, it seemed to be such a radical departure from the products we are familiar with, that I felt further investigation was warranted.

I also want it noted that I went into this demonstration with a cynical attitude and looking for any reason to not like the device.

Our Problem:

The biggest challenge those of us with lower limb lymphedema is perhaps how to maintain the reduction of swelling achieved after decongestive therapy treatments. We all know the importance of patient compliance in the maintenance phase of lymphedema management. However, with leg lymphedema that is easier said then done.

First, self massage therapy (simple decongestive therapy) is all but impossible without the assistance of another individual. Secondly, the compression hosiery has been for me a nightmare. I stopped using them decades ago because of complications involved. A couple years ago I tried again, hoping there had been an improvement in the product design. What I found was the same complications. Severe bunching and cutting off of circulation at the groin, knee and ankle caused me to once again discard the idea.

My Concerns:

My concerns about the product were three fold. First, basically does the device work towards the reduction of swelling. Secondly, with the pressure used, what is the risk of damaging the delicate superficial lymphatics. Third, what would be the possible risk of genital lymphedema as a result of using the device.

After treatment I was very careful to pay extremely close attention to any scrotal edema and to watch for any residual discomfort in any treated area. This included watching for discomfort in any nodal regions that had been treated.

On that I am able to report there was absolutely no change in scrotal size and not even a hint of residual pain of any type.

The Company:

I will say that I was favorably impressed and pleased that the representative from Tactile was also a registered nurse instead of simply a salesperson hawking a product. The rep also answered each and every question I had in a thorough and knowledgeable manner.

In review the company staff, I was also impressed with the number of medically trained people in the company.

They also have a complete appeals section staff that will do all the work necessary should your insurance company deny coverage.

Also, I want to emphasize, the company is marketing this and makes a very clear point of saying the device is not in any way meant to replace the all important decongestive therapy that we all should have. Instead, they stress that this is an adjunctive tool to be used at home in a maintenance program after you go through your prescribe treatment protocol with a therapist.

The Garment:

The garment used was a soft fabric and is wrapped around the leg and abdomen. It is held in place by Velcro, which means it can be adjusted specific to the individual needs of the patient. For the purpose of the test, I chose the firmest fit.It is also composed of 32 separate chambers and provides a very gentle ripple effect versus the “squeeze” effect used by pumps.

Preparation Phase:

One of the claims of the company is that the device follows the same preparation protocol used by lymphedema therapists. I found this to be accurate. You go through an initial thirty minute preparation phase where at first the abdominal lymphatics are cleared and then subsequent preparation of the leg. The pressure used was extremely light and did in fact follow exactly the lymph flow patterns that a therapist would use.

Treatment Phase:

Once the prep stage was completed, a thirty minute treatment phase began. The experience was one of a gentle ripple effect that went from toes to abdomen. The pressure again was gentle and light.

The Experience:

I must say that overall the experience was extremely comfortable and even relaxing as it felt much like a massage. There was absolutely no pain or discomfort and not once did the thought come to mind that “I can’t wait for this to be over.”

The result:

Before we began treatment, the leg was marked and measured. Afterwards, using the same mark, there was a 2 centimeter decrease in limb size.

Contraindications for Usage:

There are of course, contraindications for the usage of the device as would be common with pumps or actual hands on therapy by a therapist. I would add two more relevant ones.

First, I am still too uncomfortable with possible complications to suggest anyone try any device and/or pump is you already experience any type of genital lymphedema. This would be true for male and/or female.

Secondly, and this is strictly individual, is that if you have any extent of pleural effusions (lung fluid), you should not use it.

As the device cleared the abdomen, the fluid was moved upward. In my personal situation with lymphoma being spread throughout the lymph system and with the extensive pleural effusions I have, I experienced a serious problem with breathing.

This did clear up after I had been up again, and I have no residual problems today.Drawbacks:The central drawback may be in the price.

Conclusions:

First, I want to say that I am very pleased that the pressure on the machine is preset at the factory and can not be changed. This eliminates the risk that we have sometimes thinking if some pressure if good, more pressure is more effective. That means the device is safe from patients causing self injury by the miss use of the strength of the pressure.Also, due to the light pressure used and the very gentle rippling effect of the therapy, in my personal opinion, I don’t see how this device could possible cause damage to the superficial lymphatics.

Second, what is still needed is a study on the possible risk of genital lymphedema. Without such a study it is not possible to say emphatically that the device will not cause that complication. However, having said that I would be extremely surprised if the device did cause it. This is a result of the preparation phase, clearing of the abdominal lymphatics and the gentleness of the ripple pressure used.

Finally, for many years I have wondered why a pneumatic device could not be invented that was safe, effective and that mimicked hands on decongestive therapy. Clearly, the Flexitouch is the closest device to that I have seen and I must candidly admit, I am excited about the potential here.

I am not a medical professional, nor have had formal medical training. The opinions expressed herein are my own personal opinion based up a personal review, test treatment session, my experience with lymphedema and knowledge of the lymphatic system.

© 2005 Pat O’Connor, Lymphedema People. Written authorization must be obtained before the reprint, reuse or republishing of this article or any part therein.

2 comments:

Help Meet in the Making said...

Hi,
I am so glad to hear your wonderful comments about the Flexitouch system. I am just starting a side job as a Flexitouch systems trainer for new patients and I'm very excited about this product and the wonderful reviews it has received.

Caspurr said...

4/25/12

I received the flexitouch system about two months ago to use on my right leg. I had a large, hard, "bowling ball" size lump right above my knee and it was getting very difficult to even walk. After using Flexitouch, my leg is so much better.

I so agree with your statements above. My insurance rejected paying for the Flexitouch twice, and with the help of the wonderful staff at Tactile Systems helped me appeal their decision, until they said they would pay for it.

It's a life saver!