Have been using this cold therapy machine almost 24/7 for the past 3 weeks after a hip replacement. It is VERY quiet. It has made an enormous difference in my comfort levels postop. I use 5 frozen water bottles instead of ice and that's worked perfectly. For the first 10 days or so, we were changing the bottles every 6 hours. I can now go 12 hours. Froze 15 bottles total so I had 3 sets to rotate through. Bought a dishpan at the dollar store to make it easy to carry the bottles between the machine and freezer. I put the ice machine on top of this rolling cart which is the perfect height and so easy to roll between my recovery recliner and bed - this cart has been excellent to keep all my recovery needs (meds, cane, water, books, laptop, blankets, snack, etc) close by: https://smile.amazon.com/gp/product/B07L9F9H29/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1And never thought I'd be happy for a recliner but I'm living in this: https://smile.amazon.com/gp/product/B08GYHMN4D/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1If I was going to be very picky:1) I wish you could detach the hoses at the machine, as they are heavy and it would be way easier to empty the water out that way (but we've only emptied the water about twice a week so no big deal2) I have the hip pad and it's grear, but I think I'd also be fine with the universal pad3) the hoses are very cold so it's best to set up the machine on the same side as the body part you're icing or otherwise wrap the hoses in the blanket you are almost certainly using anyway