HillRom Monarch Vest Review

It has been a month since I received my Monarch vest and I have racked up just under 40 hours of use. I feel like I have used it enough to give it a fair review. Considering how many hours I have spent on my Monarch I bet you can guess how I feel about it. (This is long...brace yourself)

I will start by telling you all the things I have done while vesting in the Monarch over the past month because I think that alone speaks volumes. In the past week I have done my Monarch while cooking, cleaning the house, doing laundry, playing soccer with my daughter, harvesting produce from my garden, getting ready for bed/day, getting my daughter ready for bed/school, watching tv, and riding in a car (probably not safe and maybe illegal so I wouldn't recommend it, but it was still awesome). This has been a life changer!

I wasn't sure how much more convenient the Monarch would be because I do not have a portable nebulizer. Here's the thing though,  I do my vest SO much more often. Recently, my doctors told me to up my treatments from 2 times a day to 3 times a day because mucus plugging has been such a big issue. My whole life felt like it was stuck sitting in my living room Vesting. With the monarch I often do my Vest 4 times a day or I will do it for over an hour at a time. If I am stuck over the stove making dinner I just throw on the Monarch. If I need to do easy house chores…why not Monarch at the same time? It just is so easy to go above and beyond being compliant which is pretty amazing!

The other life changing aspect to Monarch is that it is quiet! You know how if anyone wants to watch tv and you come in to vest there is a collective groan and everyone evacuates because the vest is so darn loud you have to break your tv speaker to hear over the humming? Not with Monarch!! In fact, we watched a movie as a family...all in the same room, with my monarch ON! What?? It felt like a miracle!!

These are the two aspects that made me fall in love with Monarch, but it isn't all sunshine and rainbows so on to the nitty gritty details comparing the two.

Putting the Monarch on the first time I immediately wanted to take it off because it was uncomfortable. It is stiff and hard and feels like armor which is vastly different from the soft fabric of a deflated Vest. And the first few days I found it pretty uncomfortable, but manageable. The one thing to keep in mind is that I have had several people (RTs, Nurses and CF Drs) say that they tried using the (original deflectable) vest and found it so uncomfortable they needed to take it off. So likely the older vest was uncomfortable the first time we tried it too, but through the years we got used to it. This was the biggest reason that I kept pushing forward with Monarch. I am happy to report by the first week I was 100% used to the feel of the Monarch and although it isn't comfortable per se I would never consider it uncomfortable anymore. The old inflatable vest and the monarch are probably a tie in comfort in my opinion, neither feels like a cozy pair of pajamas, but nothing to complain about either..

The percussion felt so much more harsh than the vibrations of the vest and this was a huge improvement for me, but I could see some people not liking the feel. It felt so much more like manual CPT vs a gentle vibration (old vest), but this was a huge plus in my opinion. The percussion of the Monarch actually made me cough...a lot! I coughed the whole first week nonstop all day even after treatments. It was equally annoying and miraculous. Was this because the percussion was better or was it because it was something my lungs hadn't grown accustom to? I am not sure, but I was happy that I was moving mucus. In fact, after the first week I stopped the incessant all day coughing and started coughing out old nasty plugs. I have been coughing them out almost daily for the last month which tells me that for me and my body the Monarch is SO much more effective!!

There are a few downsides to the Monarch. First, the battery doesn't last as long as I would like and I find my Monarch warning me that my battery is low often. But I also use my Monarch a lot so this may not be an issue if you use it for the typical twice a day. I find the Monarch uncomfortable when my port is accessed. The gave me foam to put around my needle (it can be used even when your port isn't accessed, but now that I am used to the feel of the Monarch I don't feel the need to use the foam when not accessed), but it still just wasn't as comfortable as I would have liked. This is especially troublesome because when we are on IVs it is even more important to do extra treatments. My port is dead center of one of the pods so depending on your port placement or how long your needle is it may not be an issue. It is the one aspect that is a bit disappointing considering the majority of CF adults (Monarch is only available to adults) have ports. I feel like this should have been addressed during development, but I still feel the good outweighs that bad significantly.

The only other downside may be if you are a very small person it may feel heavy. It is 13lbs which is a bit of weight to have sitting on your shoulders. I think this may have been partially why I found the Monarch uncomfortable at first, but again I got used to it and the weight isn't an issue anymore.

I was a bit nervous to make the switch because I have heard such mixed results. However for me, the Monarch is more convenient, more effective, and overall a much better product.

Monarch Vest by HillRom

I am in utter shock! Why, you ask? Because somehow my insurance approved the new portable Monarch Vest by Hillrom. I just received it yesterday and it is totally embarrassing how excited I was to get a piece of medical equipment. I feel like I haven't had it long enough to give a thorough review of the product because I have only used it 5 times and it is soooo different than the old vest. It feels so different on my body, it feels different to put on, it feels different in the way it percusses. It really feels like it doesn't even belong in the category of the old vest, a completely different beast. After using the old style Vest for 20 years I feel like I need too give it at least a week before I can give a fair review. But I will be back with a review!

I did want to give some info on how to get a new vest for yourself. This is just information that was very helpful to me and I wanted to pass it on.  Hillrom doesn't even know I wrote this so this isn't sponsored (but hey hillrom feel free to cut me a check for this ;) ). I knew about the portable vest, but I wrote it off as something only people with amazing insurance could get so I never even bothered mentioning it at clinic. I think this had to do with my past experiences trying to upgrade from the 50lb original Vest to the much smaller and lighter 105 model years ago. Every time I tried to upgrade, my insurance said they already issued a Vest to me and so I should be happy with what I have. It took me 14 years to upgrade to the 105 so you can imagine I wasn't hopeful in getting an even newer Vest in a shorter span of time.

Here is the good news. Apparently, most insurance companies used to see the Vest as a lifelong machine and therefore many companies were not willing to upgrade. The only way I got a new Vest was that my insurance company changed so the never issued my once in a lifetime machine, hence the upgrade. But things have changed and now most insurance companies see the Vest as a 7 year investment. This means that if your Vest is 7 years old (which most of us adult CFers have had our Vests at least that long, but many of us have had them much much longer) there is a decent chance that you can get a new vest. I wish I had known that when the Monarch (or even afflovest) first came out because I would have gotten one as fast as possible. The best part is that if your insurance paid off your old vest you get to keep your old Vest too. How amazing is it to have a backup Vest?

Of course, insurance may not cover the whole thing and it is super expensive even when broken down into monthly payments.  But it is totally worth asking your clinic and seeing if/what your insurance will cover and then figuring out if it makes financial sense. It is good to know that the majority of insurance companies won't downright say, "no" if it has been 7+ years.

Quality Control

I got my first vest at the age of 14. That obnoxiously large Vest shook my chest walls throughout my teens and followed me to multiple dorm rooms, apartments, and even saw the first few years of my marriage. At 28 I finally got an upgraded Vest, not because it was broken (although the timer no longer worked and the peddle sometimes needed a little encouragement to get the thing to start), but because my insurance finally approved it. The new Vest came when I was heavily pregnant, but even with a Vest that couldn't be fully snapped, I was delighted with the much smaller, lighter and programmable Vest.

And then within two years it broke. Just stopped working. So I got a new one. This time with locking hoses (!!!) so that less time was spent popping tubing back into the machine. Although the tubes did wiggle their way out of the machine from time to time I was still excited to get an upgraded version that would make my Vesting experience more enjoyable... err..as enjoyable as sitting in a Vest that violently shakes your chest for 30 minutes can be.

And then with only 200 hours clocked on the machine the new and improved locking hose broke. A little over 6 months and the tube is completely useless. As I wrote "call the Vest company" on my Monday to-do list I couldn't help but think about the old, loud, HEAVY vest that lasted 14 years without a problem which seems to be 12-13 years longer than I can get the newer model to last!

Baby Hates The Vest

I think my baby officially hates the Vest. It always wakes her up and she usually starts stretching wildly. She is currently kinda transverse. Her head is by my left hip and her feet are on my right side above my belly button, but not all the way to the ribs. She pushes her little legs out as far as she can (against my side) when I vest. I am not sure if she is squished and trying to make more room or what. This morning she was stretching so hard it was hurting. I placed my fingers against the pain and I could feel her little feet!!! I have felt her feet kick before or briefly push by, but these little feet were not moving. I tried to apply a little (as in a minuscule) amount of pressure to get her to move, but she would not budge. Seriously, the coolest feeling ever. At the same time I felt horrible because I sensed that she wasn't the happiest camper since it seemed as if she was trying to avoid the vibrations by shimmying down my torso and stretching out as far as she could in her cramped corridors.

Love Hate Relationship With My Vest

I don't know if it is just me or the fact that I have an old vest or if this is a common problem, but my Vest can be SO annoying!!!! My number one big problem with the vest are the stupid hoses. The problem with the hoses is that they will not for the life of me stay connected to the stupid machine or the stupid vest for the whole 30 minutes! Now this problem has been happening forever so recently I thought to call the company and get new hoses. My old hoses were 12 years old-Yikes! The company promptly sent over two brand new hoses. I thought my days of annoying hoses was over. I was so very wrong!

I usually get my vest and nebs all set up and grab my computer. I then sit very still and try not to move too much for the next 30 minutes. Despite my best efforts to only allow movement in my finger tips (touch pad on the lap top) and my chest for breathing the stupid hoses pop off the machine or the vest about every 5-7 minutes. I then have to grab the flailing hose and reconnect it which guarantees at least one other connection of the other hose to pop off. My vesting treatment usually includes a lot of cussing and my husband laughing under his breath at how pissed off I get at my stupid vest. I do vest at really high frequencies because personally it feels better and gets more moving, but the higher the frequency the more popping that occurs.

I started trying to get a Vest upgrade when I was 18 and didn't want to lug a 50lb Vest to and from college. 3 insurance companies later and constant applying for an upgrade I still have my old machine and don't see a new machine in sight.

I thought about super gluing the hoses into the machine or heck even duck taping them, but thought I would see if anyone else has this issue and what the heck do you do about it?

The Vest

For those of you new to the blog I am reviewing all of the treatments/meds I use to stay well. I obviously think they are all important because I use them, but some seem to be more effective than other.

Today I am reviewing The Vest...hmmm. I have mixed feeling about it. I do use my vest, but I have to admit that I feel it does very little for me. Most CFers will tell you that The Vest is not a passive treatment (but no CPT is) and that in order for it to be effective you must couple the vest with huff coughing. Okay, but it still produces no more than if I am sitting and watching T.V. and try to huff cough.

Now studies prove over and over again that The Vest is amazing and can do wonders for a CFer, but for me The Flutter works way better. *Flutter review to come soon* In fact I would say most CFers prefer the Vest to other forms of CPT, but I just can't get much up with The Vest. Many people rely on The Vest as their main CPT and I say "Good for you!" because it works for them, but it is just not my thing. When I list my CPT to my docs they always assume my Vest is my primary CPT and the Flutter is my secondary. I always explain that no, it's the other way around. I think they assume that everyone uses The Vest as their primary. But they all agree that it is better to use what works best so Flutter it is.

So why do I use The Vest? Well, good question! I only use it on days I don't exercise or if I feel I am getting sick and I want to take every precaution. I use it while using nebulized albuteral as well as Hyper-tonic Saline. I hope that it may shake loose some mucus and allow these treatments to reach further in my lungs. I also believe that The Vest does shake loose mucus, but for me I need another device (flutter) to help assist the mucus out of my lungs. I would never use The Vest without the Flutter because shaking mucus loose just to resettle in my lungs seems pointless. If the Vest works well for you then I am jealous because I wish I could get more out with The Vest, but it is what it is.

Also, to add to my cons list I find that I must wear only a t-shirt because if any amount of skin is touching the actual vest, it gets very irritated. My skin also itches very badly after I stop The Vest so I give myself a nice scratch down after each treatment. The last con is that it is time consuming and I find I can do very little while using it. It shakes your body so I can't read or type. It is very loud and so it is too hard to watch T.V. or listen to music. I have the old Vest, the HUGE 40lb vest that sounds like a vacuum so the newer models may be quieter. Let me know if you have experience with the newer Vest because I may just ask for an upgrade if it seems worth it.

Pros:
1. Studies show that it helps clear mucus.
2. It is not hard to use.
3. It's nice to have a little boost for the days I don't exercise or am sick.

Cons:
1. I find it does not bring up very much mucus without the assistance of another device (flutter)
2. It is noisy and is hard to do just about anything while using it.
3. It is time consuming 30+ minutes.
4. It is ugly/huge (but I have the old vest) When guests come to my home I always get a "What in tarnation in that?"

Let me know your experiences with The Vest especially if you have a newer model.

**Disclaimer: I am not a Dr and this is just my experience using the Vest. Every CFer is different
and I am not recommending or discouraging any form of treatment, just telling you my experience. Never change your treatment plan without your Drs consent.**