Flexitouch

Whew! Good questions -- huge subject!

Flexi IS an improvement over older machines, because it does a more thorough job of imitating a MLD massage. It still requires that you clear your nodes yourself each time before using it (and after is a good idea too). The problem with earlier machines (and possibly with this if you don't do the node clearing) is that they wrung the fluid out of the arm rather than stimulating the lymph vessels in the way MLD does. If the nodes are not first cleared to receive the lymph fluid it will sit around in the area of the axilla and shoulder instead of being processed, and will eventually result in either pushing fluid into the trunk or creating a band of fibrotic tissue at the top of the arm (or both).The Flexi has less of a wringing action than earlier machines, more flowing over the skin in imitation of MLD.

It's time consuming, and you have to lie flat so it's not real easy to watch TV or read while using it. Devoting an hour a day to it is a committment, and it's hard to think realistically about how you're going to fit it in to your day before you actually get it and start using it. It has a "pause" function so you can stop it if something comes up that's important, but it's a major bother to do that and then get back into position. There are dozens of "better" things to do with your time, so many people don't continue to use it once they get it. In fact, though self-MLD is time consuming too, it doesn't generally take me a whole hour to do it, and you can do it anywhere you want.

MLD done by a trained therapist gives them the opportunity to feel what's going on under your skin, note any problems that may be developing, and correct any issues before they become a problem. Therapists can also develop an MLD routine that is personalized based on your own assortment of scars and missing nodes. Even self-MLD gives you the chance to note any changes or problems that may be developing. The pump won't give you any such feedback, so it's no substitute for hands-on therapy by a good therapist.

Because I have bilateral LE I need two sets of garments for my Flexi, and I have to alternate days. I do find that, though the general direction of the Flexi action is downward toward the groin, there is some movement across the chest as well. With bilateral LE that is not acceptable, so I have to modify the way the chest garment fits to avoid it moving in that direction.

So much for the cons. On the positive side, it makes self-MLD possible for women who have range of motion problems, a disability in one arm (such as arthritis, carpal tunnel or rotator cuff injuries), and for people with bilateral LE who just can't do that much manual work on themselves. For me, it's a big help with flares, when the amount of MLD I'm able to do is limited. It also reaches the back in ways I can't do myself. Technically, it's a tool some people use when other self-care measures don't work. And besides all that, when it's all properly adjusted it feels good!

Once you have the garments adjusted you don't have to take them apart all the time. I used a permanent marker to mark where the velcro should go for those pieces I have to undo to get out of it, but the arm stays on the jacket and doesn't need readjustment every time. There is, BTW, a short strap you can order that has velcro on both ends and can be attached over the shoulder if you find the jacket part isn't tight enough at the shoulder (a common problem). You can buy it, but if you need it I'd suggest asking the trainer or area rep to comp you one, as it's part of a proper fit and shouldn't be an extra charge.

The Flexi reps are unusually well-trained and generally extremely helpful. In my experience the trainers who come to help you set up may not be as knowledgeable as the reps, so if you have a problem after set-up, call the rep. This is a pricey machine, so take advantage of the expertise that's available to get the best use from it.

It should not hurt, bind, or create new swelling. Examine your arm and trunk after use and don't get complacent about monitoring your progress. See your therapist at regular intervals for re-measurement and a hands-on evaluation of how it's working for you.

There are other women here who use a Flexi, and I'm sure they'll be along (if they haven't already posted while I've been composing this novel!) Hope this helps. Let us know how it goes!
Binney

I have this machine but haven't got the hang of it.  Also have bilateral.  Trying to get the thing on is a task.  The tech was here and seems much better at it.  Also all those little velcro things hook to other parts and make me crazy.   Tomorrow I am going to work on streamlining the process, has to be an easier way.