My Experience with the Flexitouch Pneumatic Pump for Lymphedema

To pump or not to pump…that is a question that I hear in the lymphedema community. When I developed secondary lymphedema from breast cancer treatment in 2010 I asked my therapist about compression pumps. She explained that compression pumps force air into sleeves with multiple chambers. The chambers take turns filling up with air with the goal of moving excess fluid out of the affected limb and returning it to the cardiovascular system. My therapist wasn’t very keen on the use of these pumps and stated that they can sometimes hinder rather than help lymphedema. She advocated instead for daily manual lymphatic drainage and the wearing of compression garments. I met other therapists here and there and all of them preferred manual lymphatic drainage, MLD, over the use of pumps.

So for almost every night for the next seven years I sat down and performed MLD on my left arm. Then one evening last fall when I was arriving at a SWELL lymphedema support meeting I heard a buzz in the air. Words like “new kind of pump”, “different than the old types”, “favorable studies”, and “Dr. Rockson” floated to my ears. I knew Dr. Stanley Rockson of Stanford University was performing a drug trial with a medication called Uberimex for the treatment of lymphedema so I was keenly interested in learning what he said about this new pump.

The pump is called the Flexitouch® System by Tactile Medical. I subsequently found out that Flexitouch had actually been around for several years but a new study had brought awareness to this pneumatic compression device or lymphedema pump. The study, published in October 2015 and authored by Pinar Karaca-Mandic, PhD, Alan T. Hirsch, MD, Stanley Rockson, MD, and Sheila Ridner, PhD, RN, showed promising results when a patient used the Flexitouch System for one year.

According to the Journal of American Medical Association (JAMA), In the 12 months following the receipt of the Flexitouch APCD: Cancer-related lymphedema patients demonstrated a: 79% decline in the rate of cellulitis, 29% reduction in the rate of out-patient hospital visits, a 30% reduction in rate of physical therapy, and a 37% reduction in lymphedema-related costs. Non-cancer related lymphedema patients demonstrated a: 75% decline in the rate of cellulitis, a 40% reduction in the rate of out-patient hospital visits, a 34% reduction in rate of physical therapy visits, and a 36% reduction in lymphedema-related costs.

https://www.tactilemedical.com/wp-content//uploads/2018/03/500266-002-RevC-JAMA-Clinical-Highlight.pdf

My interest in pumps suddenly skyrocketed! I’ve always been diligent about caring for my lymphedema but if there was a product that could further the health of my left arm, I was going to investigate. A friend who was using the Flexitouch for lymphedema in her legs directed me to Alexis, the sales representative for Flexitouch. In my home, Alexis helped me slip into a padded bolero type jacket with a long sleeve for my left arm.  Another set of pads enveloped my left thigh and trunk. I was rather startled at how wrapped up I was. Michelin Man came to mind as I stretched out on the couch. For an hour, the air chambers inflated and deflated sequentially, creating a wave-like motion. The whole process, though limiting my ambulation, was comfortable and relaxing.

I didn’t make a decision to purchase a pump that day. I wanted to talk to some people who had actually used the pump. I chatted with a woman from Tacoma and another from Idaho. Prior to using a Flexitouch, the Tacoma woman had at least two to three bouts of cellulitis a year, some requiring hospitalization. Since using the Flexitouch for almost a year, she had not experienced cellulitis. The woman from Idaho said her arm was softer and found the machine easy to use.

My insurance company required me to use a different brand of compression pump and experience failure before they would consider covering the cost of a Flexitouch. I decided to purchase one without insurance. Buying a reconditioned machine saved me some money. The warranty was the same as a new machine.

I’ve had my Flexitouch for almost five months. I use it every evening. If I’m out late, I use it in the morning and then resume again in the evening. I always start with the one hour full arm and core setting. Since my trouble spot is below my elbow, several times a week I use the 22 minute forearm and hand setting. Reading or watching TV are the activities I’m able to do while I’m being treated.  It’s also a relief not to manually MLD my arm every night. As one Flexitouch woman put it, it’s like finally getting a dishwasher to do your dishes.

What do I think about my Flexitouch, or spacesuit as my husband and I affectionately call it? I’m  glad I have it. I did a baseline measurement of my left arm before treatment and three weeks after using the pump. Except for my wrist, all my measurements showed reduction. Most significantly was the reduction in my forearm. Surprisingly, my therapist’s measurements showed minimal difference with previous measurements. I can’t explain that but I can visually see a difference.  Out of my sleeve, my 3/4 length sleeves aren’t as tight. My skin appears more like the skin on my right arm. Also, when I am out of my sleeve for special occasions, the knuckles of my hand are still showing after a few hours. This all proves to me that my Flexitouch is moving lymphatic fluid out of my lymphedema affected areas.

Managing my lymphedema requires attention and an assortment of tools. I’m diligent in taking care of myself because I want to continue to pursue activities that enrich my life. Adding the Flexitouch compression pump to my daily lymphedema care regime has helped me attain that goal.

Karen Gillespie

(Note: There are other well regarded pumps on the market. This is not an advertisement for Flexitouch.)

 

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