Thank you for your insight. I have met and spoke with two other closed system specialists and neither of them appear to have the skill and confidence in the closed system as you do. I am glad to hear how you know how and what to do to assist in these matters. One of them told me that If I had anything large to pass they would take me off the speculum and put a bucket under me. How disgusting that sounded. You are on in a few who can care for this type of impaction. Boy I can tell you that fleet enemas did nothing but move about 4" of impacted fecal. My medical doctor had me doing them twice a day and I was getting the clear water out after the first couple days yet I persisted for 3 weeks prior to the colonics. I get a real feel from you that you are special and can help people under these circumstances. So I am glad to know this. I did have massages but they did not seem to be very helpful. the one thing that helped me the most was putting Castor Oil packs on my stomach and going to the hot tub prior to the session. Have you tried that with your patients? I have thought of becoming a colonics specialist. But after checking into the price for the Libbe system I felt discouraged.