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.