Head Cold Case Study

Read the following case study and answer the questions. Submit your answers in the Comments section. (Click on "Comments" below the blog. Type in your answer under "Leave your Comments". Be sure to include your initials and student number as part of your text. Click on Anonymous under "Choose an Identity", and then click on "Publish your comments").

It’s about 11am on Wednesday morning. The phone rings. Betty White would like to schedule a massage. She’d love to get in this afternoon if you can squeeze her in as she feels “achy all over.” One pm is available – that time works for her.

Betty enters your office with a facial tissue in hand. When you question her about it, she says that she began sneezing and having a runny nose yesterday – it must be allergies, but she doesn’t have a history of allergies, so she is unsure.

Looking at Betty’s face, her eyes were watery and she is so congested that she is breathing through her mouth. Prone position is off the table; Betty is already having trouble breathing normally, so you elect to massage her in a semi-reclining supine and side lying positions.

You begin asking Betty about other symptoms and she mentions a sore throat. After getting permission to palpate her neck for swollen lymph nodes (which you must avoid), you place your hands just beneath her ears and slide them under her jaw.

Betty’s skin feels warm. You suspect a slight fever. After explaining to Betty that it in her best interest to postpone massage, she seems upset and irritated.

1. Are there other modalities you can offer Betty rather that Swedish or therapeutic massage? If so, which ones?


2. Why are some massage modalities more appropriate than others in these cases? Be specific.


3. When is Betty safe to receive a Swedish massage?


4. Should she be referred to her doctor in the meantime?


5. What are some home care suggestions to help her address her achiness, if any?

Anatomy in Braille

"Focus on your client. Keep your strokes
fluid and consistent. Be present and in the moment."

Sounds easy, doesn't it? Well, throw in a couple distractions such as a room full of people, questions asked by a teacher, discussion between the giver and the receiver about pressure, and a fellow classmate walking to the rest room a student’s focus flies right out the window.

Bring in brightly colored bandanas and cashmere scarves, and we have the tools of the trade for today's massage therapy class. Blindfold Massage is on the agenda, and the students look, well..., let's say --- apprehensive. They attempt to hide this with nervous laughter, but don't be fooled. And then comes the questions... "Where will I put the massage cream?" "What if the cream falls to the floor?" "How will I know if I am draping properly?" The teacher calmly explains that these are all wonderful questions and they will be answered later -- after the experience. As the students picked their partners for the trade, the receivers gently, but firmly, blindfolded the givers. It was amusing to watch the blindfolded therapists with outstretched arms as if reaching out for help. As the blindfolded students took baby steps towards their massage tables (and their clients), I watched to see what would happen next.

The connection between therapist and client was immediate. These students were relying completely on touch. Visually, there were no distractions for them. Audible disruptions were ignored in favor of staying close to their massage table. As a result, their body mechanics were quickly evolving into textbook perfection right before my eyes. About 15 minutes into the massage, I walked in front of the room to observe the class as a whole. The therapists were fluidly performing massage without breaking contact with their client. The blindfolded student's hands were open and relaxed, giving firm and focused pressure. They were present and in the moment. By my observation, and their fellow student's feedback, it was their best massage to date.

The students on the massage table were eager to take their turn as the blindfolded therapists, and the mood of the class remained positive and energetic for the rest of that day. Some of you may laugh out loud at the photographs of these incredibly talented students performing massage with blinders on. To me, they've never looked better.


-Kristi Nelson

Student's Perpective on Massage

Preamble: Students are required to give and receive massage both in and out of class. Here is one student's experience.

I have a friend who is a massage therapist. This therapist has a client diagnosed with Parkinson disease. She asked if I could practice on him. I jumped at the opportunity. How lucky I was to be asked. Unfamiliar with the disease, I did my research on how to massage a person with Parkinson disease and set off to his house.

What a beautiful house it was. His home was built in 1904 and had a 200 year old live oak tree in the front yard. Ironically, I have driven by this beautiful house many times and pointed it out to my family. I remember wishing I could meet who lived there and walk inside. Now, as fate would have it, I was standing at the doorway about to get my wish.

My client was a gentleman in his mid sixties stricken with a severe case of Parkinson disease. As I help him on my massage table, I began worrying… “Was I ready for this?” Perhaps sensing my apprehension, his wife joined us in the room. She told me about what my friend, the massage therapist, had done. This information was both interesting and valuable. The man’s speech was affected by his disease, so his wife translated so I could understand what he was saying.

I let my hands follow my heart and started the massage. I used a light to medium pressure and lots of long gliding strokes. Throughout the experience, I heard the voices of my instructors in my head. I am thankful for them and their wisdom. Many times they assured me and my classmates; they had faith in us -- we could do the work. My client drifted in and out of restful sleep as his wife and I chatted. She stayed with us for the entire massage, telling me stories about their family and their life together.

Turning over was a challenge. He was very stiff and did not move easily. It took a few minutes for him to become supine. But once there, all was good. I worked on his neck doing some light stretching and pressure points. He told me that he felt much better and that he enjoyed my touch. It was at that moment that I saw the look in his loving wife's eyes. That look of love she had for her husband - that deep, from her soul, with everything she had, kind of love. The experience blew me away.

He asked me how long I'd been married. “Only 19 years,” I said. With a small tear in his eye, he told me that next month he and his wife will celebrate 50 years of marriage. He reached out for her hand and she stood there and held it for the rest of the massage. The love, compassion, and gratitude I saw exchanged between them were amazing. They not only loved each other, but respected and honored each other unconditionally. One rarely witnesses this kind of love anymore. At that moment, I realized that was the luckiest person in the world; massage had allowed me to be there in that moment. To see such love was a gift.

I know that being a massage therapist will be more than just a job; it will be a way of life. Massage is a gift and it is an honor to be able to help people -- to share a client’s joy and pain – to help heal the body and spirit. I feel grateful for my life’s path and for this school. The knowledge, support, and confidence all the instructors have shown for me and my fellow students is unbelievable. It propels us to be better therapists and better people. I'm sure that massage therapy will open many doors for me.

To feel is to know…

to know is to be.

-Lisa B.

Entire Class of Massage Students ABDUCTED!! Alien spaceship seen over massage school!

Sunday. October 19th. 7:30 pm. The last day of student clinic was winding to a close. The clinic had been successful one and the students were proud of themselves. The clients had come in the door tense and left relaxed. I thought everything was going well.....until the next day, that is.

Monday. October 20th. 9:12 am. No one had shown up for class yet. It wasn't like them to be late, except for Little Red. He burst in the door. "They've ....... all ....... been ...... TAKEN!" he stammered between labored breaths.

"What? Who? Who's been taken?", I asked.

Again the answer came between ragged breaths, "My ...... classmates ......... and ......... they ........ almost ........ got ........ me."

Monday. October 20th. 9:16 am. I turned it over and over in my head. Who could have abducted an entire class of massage students? The Mafia? Aliens? The FBI? The NSA? The military? The Real Housewives of Beverly Hills?

"NO!!!!!" Screamed Little Red, catching his breath at last after the long run across the parking lot, "it was the ..... the ..... the ..... CLIENTS!!!"

Oh my, I had heard comments all last week from clients stating that they wanted to take their student therapists home with them, but I did not think it would lead to this.

I called 911 and waited for what seemed like an eternity when the black and white pulled up with two of Lake Charles' finest. "Good morning, ma'am, what seems to be the problem?"

"An entire class of students has been abducted by their clients from last week's student clinic," I explained. The two officers exchanged nervous glances. "Why would anyone kidnap an entire class of massage students? What motive could they possibly have?" the taller officer asked.

"Obviously, you two have never had a massage. Little Red, give the officers a quick chair massage." Twenty minutes later, the officers had a better understanding of the situation. "Ms. Salvo, we're taking Mr. Red down to the station for further ....... uh ...... questioning. We'll get back to you when we finish our investigation." I never heard from Little Red again, but crime in our town is down 20% and our city's police officers look more refreshed than ever.

I guess abduction (alien or not) is just one of the everyday job hazards in our line of work.

Martha Stewart - are you ready for a sheet folding THROWDOWN?

TWO CHAMPIONS IN THEIR FIELDS - Domestic Diva Martha Stewart, takes on challenger Susan Salvo in the ULTIMATE SHEET FOLDING THROWDOWN! We go now to the challenger's dressing room for a special interview.

"While I may not cook like Bobby Flay, the star of Food Network's show Throwdown, I can outdo anyone in the laundry room." says Salvo.

Salvo continues, "During student massage clinic, we average about 3 to 4 overflowing baskets of linens per day. The school uses a linen service for class, but during clinic, more linens are used so I haul them back home to wash."

"Loads and loads of linens make their way through the 3 machines - the washer, the dryer, and finally ME, the folding machine. I'm fast. I'm tenacious. I'm totally methodical. And I'm unstoppable." remarks Salvo.

After further questions, Salvo says that the massage table is perfect for the repetitive slinging and stacking of sheets. She adds, "My husband and teenage daughter, Chelsea, don't try to help me with the linens - I don't want them to - they just slow me down. Picture the Tasmanian Devil spinning through a clothesline at 90 miles per hour and leaving a pile of neatly stacked rectangles in his wake. That's me. Dillards and J.C. Penney have offered me jobs in the linen department. Hotels and hospitals want me to give seminars to their housekeeping staff. Dry cleaners are all envious of my extreme folding skills."

Salvo continues, "By early morning, all the linens have been washed, neatly folded, and stacked symmetrically in laundry baskets, which my husband loads into the back of my minivan. And while I'm grateful for his assistance in loading, I'm secretly glad that the neighbors are still asleep and don't see him in all his morning glory - boxer shorts, tousled hair, and bleary eyes. Then it's back to the massage school for another day of student clinic. Needless to say, I gets lots of practice during the four weeks of student clinic."

At the end of the interview, Salvo smiles and states that she hopes Martha Stewart is feeling frisky and she might even "cut Mrs. Stewart some slack and only fold with my left hand."

Increasing Student Success

We all want to succeed. Massage instructors want their students to succeed. Massage schools want their graduates to succeed. Massage school graduates want to succeed, which means passing licensing exams.

The key to learning is repetition. That deserves an encore. The key to learning is repetition. To help students pass their licensing exams, administer practice exams while they are still in school! Start administering these exams about 3 months prior to graduation. Use or compile a question bank (more later) and generate at least 3 practice exams. Administer these exams at regular intervals. Once students receive their scores, give them the correct answer and explain why it’s the correct answer. Then, let them keep their corrected exam as a study guide.

If your school uses my textbooks, a question bank with 400 items is available on the Elsevier’s EVOLVE website. Registration is required to access these and other great resources, but they are free if your school uses Massage Therapy: Principles and Practice or Mosby’s Pathology for Massage Therapists. Both students and instructors can register. Instructors have access to all student resources as well as instructor resources. Here is the URL

https://evolve.elsevier.com/

Please share what has worked for you. This is one area we all need help with!

The Horror of Hurricanes...

I'm not sure what is worse - the physical damage caused by the storms or the emotional upheaval that is the combination of: the media frenzy, the local goverment's overreaction (or underreaction), the preparation work (boarding of windows, removal of possible wind borne projectiles), the evacuation with its inevitable road gridlock, the worry and wonder about property and loved ones during the time away from home, the financial burden caused by evacuation or damage, the exhaustion of riding the storm out, the question of deciding whether to rebuild or relocate, the worry of whether this was just the 100 year storm or result of climate change, the realization that we may have to deal with this every 3 to 5 years from now on, orthe frustration of dealing with FEMA, insurance companies, and government assistance programs.

We were fortunate. Rita devasted southwest Louisiana and southeast Texas in 2005 and yet it has become "the forgotten storm". Eclipsed by Katrina's effect upon New Orleans, our little corner of the state has been all but forgotten. We were impacted by Rita, 14 trees down, 18 holes in the roof, carport, patios, screen porches destroyed. Miraculously, we were functional within 2 weeks! Most of our neighbors were not as fortunate. The storm surge from Rita produced a 3 foot flood of water from the Contraband Bayou along our street. Our home was not affected but others were. THE PHOTOS BELOW ARE FROM RITA IN 2005:

The Hawsey home across the street
One of the 14 trees down on our home

This year, 2008, produced several other hurricane disasters for the Louisiana coast. The first was Hurricane Edouard. Next was Gustav. Then came Ike, the biggest storm to hit the Gulf of Mexico since the 1900.

Our Back Patio Before Ike

Our Back Patio During Ike

Ike pushed a tremendous wall of water that surpassed the flooding of Rita. Our street took 4 foot of water this time and the lake overran the seawall and flooded the downtown area. Fortunately, the trees were all gone and damage from wind was minimal by comparison.

For all of you who have called or emailed, thank you for your concern. My family is doing well. We watch as 12 of our neighbors try to sell their homes or rebuild.