Archive for February, 2010

Disease awareness and infection control

February 26, 2010

Review of Mosby’s Pathology for Massage Therapists, by Salvo and Anderson.

As a massage therapists we are accountable to providing safe and ethical care to the public in accordance with the standards of our profession. It is our responsibility to ensure that our infection control practices are current and meet professional requirements which include the application of evidence based measures and the use of professional judgment. Because of our type of work human-to-human contact we have to use precautions which include for example mandatory hand washing, cleaning and disinfecting massage equipment and being in a good health to perform treatment.

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Endocrine pathologies

February 23, 2010

Review of Mosby’s Pathology for Massage Therapists, by Salvo and Anderson.

Chapter 6–This chapter was about endocrine pathologies. The endocrine system works with the nervous system in order to “coordinate all body systems” (page 173). The difference between the endocrine and the nervous system is that the nervous system uses nerve impulses to communicate while the endocrine system uses hormones and chemical messengers. There are two different types of glands from which hormones are released. The first is an exocrine and the second is a endocrine. In addition, the chapter pairs each hormone with the gland it comes with along with the function on pages 174-175 (Table 6-1). This was very informational and helpful in understanding the different pathologies to follow throughout the rest of the chapter. For example, when there is something wrong with the pituitary gland it can cause a variety of related diseases such as acromegaly, diabetes insipidus, hypopititarism, and hyperpituitarism. This is the same with all of the pathologies listed starting on page 176 to page 185. As in the last chapters, massage considerations were discussed. For a lot of the disorders clearance needed to be obtained from the primary physician before carrying out any massage treatment plan. One exception was in the case of the goiter. I was surprised to find that if a goiter was present on a patient it can be massaged. Goiters are sometimes found in people with graves disease. One thing I learned from this chapter was that seasonal affective disorder is placed with the endocrine pathologies. I assumed it would be with depression and bipolar disorders in the neurological chapter.

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Musculoskeletal pathologies

February 23, 2010

Review of Mosby’s Pathology for Massage Therapists, by Salvo and Anderson.

Chapter 4– This chapter was about musculoskeletal pathologies. The chapter started with a muscular system overview. This was a really nice review, since there is a lot to know regarding this system. It included material about different muscle types, the difference between voluntary and involuntary, and the different functions (movement, stabilization etc). It even goes into how a muscle fiber contracts (figure 4-4 and page 101). The beginning of this chapter also reviews bones, joints, and a little about connective tissues. The chapter goes on to talk about musculoskeletal diseases. Pages 110-135 describe different types of diseases regarding this system. Similarly to the last chapter it briefly describes the issue and then follows up with how massage therapists should treat the issue (massage consideration). In the previous chapter, the pathologic skin was usually not touched. However, in this chapter most of conditions allow for the therapist to massage the affected area. However, if the pathology caused the patient pain the therapist was advised to keep this in mind when determining the treatment plan. The text usually recommended that the therapist ask the client how painful or sensitive the area is before they proceed. Often if there was extreme inflammation, massage was discouraged until some of the swelling subsided. One of the most interesting portions of this chapter was on page 119 (figure 4-34) regarding the different types of fractures. The diagram was very informational and will help me remember all the different types of fractures in the future. All of the pictures were once again very helpful in understanding the pathology being discussed.

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Dermatological Pathologies

February 23, 2010

Review of Mosby’s Pathology for Massage Therapists, by Salvo and Anderson.

Chapter 3– This chapter is about dermatological pathologies. The whole chapter is about diseases/pathologies that occur on/under the skin. This is important to a massage therapist because it helps them determine how to go about their treatment plan. Most of the skin diseases make it so the therapist cannot massage or palpitate the affected area. This means the therapist may have to adjust his/her treatment plan. Some of the pathologies discussed include acne, athlete’s foot, a bruise, burns, cellulitis, chickenpox, contact dermatitis, corn/callus, decubitus ulcer, eczema, folliculitis, furuncle, german measles, herpes simplex, hives, ichthyosis vulgaris, impetigo, jock itch, lice, measles, onychomycosis, open wounds, paronychia, petechiae, psoriasis, ringworm, rosacea, scabies, scars, scleroderma, sebaceous cyst, seborrheic dermatitis, seborrheic keratosis, shingles, skin tags, stretch marks, thrust, wart, and xerosis. I had heard of almost all of these diseases but I learned a little more about each in this chapter. The pictures were also very helpful in understanding the disease a little more. The Chapter also distinguishes the difference between skin lesions. Some of the different kinds are macule, papule, patch, plaque, wheal, nodule and etc (found on pages 62-68). The last part of the chapter talks about different skin pigmentation issues. The ones discusses were age spots, albinism, birthmarks, chloasma, freckle, and vitiligo. I really enjoyed learning about Ichthyosis vulgaris in this chapter. In fact, I was so fascinated by this particular disease I researched it further. I also learned about the progression from a freckle to a malignant melanoma found on page 91 (figure 3-63).

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Malignancy

February 15, 2010

Review of Mosby’s Pathology for Massage Therapists, by Salvo and Anderson.

In today’s society, everyone knows someone who has been directly or indirectly affected by at least one type of cancer- the uncontrollable growth of abnormal cells that form a tumor. It is the second highest cause of death in the United States, second to heart disease. Incidences of different kinds of cancer vary by age, gender, ethnicity and location (Salvo, 312).

Page 324 discussed the general guidelines for massage therapists when working with cancer patients. Although many of us are familiar with cancer, there are certain precautions and considerations that need to be taken into account when working with a client with cancer. I feel that one of the most important points was the idea of being educated about the type of cancer and the treatments which the client is undergoing. Overall, discussing the client’s needs and level of comfort with the massage is crucial for an effective treatment plan. “The massage therapist needs to ask the client exactly what symptoms and quality of those symptoms the client is experiencing each time the client receives a massage treatment so that the massage therapist can tailor the treatment based on the client’s needs.” Also of importance is accepting the client’s appearance and remaining professional and considerate, as this is respectful to the client and what he/she is going through. These considerations remain true for all of the various cancers presented, and thus I felt were the most pertinent part of the chapter.

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Reproductive Conditions

February 15, 2010

Massage can be a highly effective method of relief for premenstrual syndrome, endometriosis, and dysmenorrhea, as long as the therapist is careful to first ask the client about the location and severity of the pain. Different positions can provide more comfort during massage, and these various positions should be tried with the client depending on their pain level and location. Gentle massage can help a client who is experiencing these conditions relax.

Also, with the prevalence of sexually transmitted diseases, it is important that massage therapists are aware of the various pathologies of the reproductive system. Some can be contagious and also cause pain for the client during massage. Massage can be contraindicated until the client has fully recovered, but some conditions can also be life-threatening. Also, some pathologies only affect the reproductive system, while others can have consequences on the entire body and other systems. This is why, although not directly affected by massage, therapists must know and understand the reproductive system.

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Nervous System Pathology

February 15, 2010

Review of Mosby’s Pathology for Massage Therapists, by Salvo and Anderson.

Chapter 5– This chapter was about nervous pathologies. The beginning of the chapter started with an overview of the nervous system. This was a nice review. It broke the nervous system down into three basic functions: Sensory, integrative, and motor. It mentioned that the spinal chord and brain make up the central nervous system and that all the remaining nervous tissue outside of that is part of the Central nervous system. The review section also discusses the autonomic nervous system and the parasympathetic nervous system. On page 146 the text talks about some of general manifestations of nervous system diseases. Some example include, dizziness, tremors, and loss of coordination. Then the chapter includes many pathologies from pages 147 -168. This chapter touches on disorders such as multiple sclerosis, cerebal palsy as well as mood disorders such as depression. For many of the diseases massage could be done and was often recommended depending on the pathology being discussed. Sometimes the massage therapist needed to obtain clearance from the primary health provider prior to performing any treatment. The one disease I learned the most about was shingles. I did not realize this is neurological. It didn’t touch on in much in chapter 5, but referred me back to chapter 3. After doing additional research I learned how it was neurological and how it "hibernates" for years.

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Assessment

February 15, 2010

Review of Mosby’s Pathology for Massage Therapists, by Salvo and Anderson.

There was a lot of information in this chapter on client intake and health assessment. The first portion talks about documentation, informed consent forms charting, and assessing the patient’s treatment. I found this portion very interesting because when I’ve done some shadowing in the field I want to enter (occupational therapy), the therapists all used the documentation detailed here. It was nice to see some of the questions that a massage therapists would ask a client prior to the massage (pages 30-35). I learned the importance of subjective and objective data when assessing a client. A large part of this chapter was actually looking at objective data a massage therapist might collect from looking at a patient. For example, looking at skin color, skin condition, and skin pigmentation would be part of an objective exam. Nail condition, breathing, posture and body structure are also important things to look at before a therapist determines how to proceed with their course of treatment. The chapter goes on to talk about many additional things to consider from skin turgor to gait. The last part of the chapter describes how to set up a treatment plan. This includes maybe setting up short-term massage goals along with long term ones for example. The therapist will be sure to assess the client’s needs while coming up with a treatment plan. I learned a lot from this chapter. I feel that treatment plans are a big part of occupational therapy as well as massage therapy! I didn’t know the two were similar in this regard.

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Infection Control

February 15, 2010

Review of Mosby’s Pathology for Massage Therapists, by Salvo and Anderson.

I have had a lot of the content in chapter one in previous classes. However, there are a couple things I learned/relearned. I knew a little about carcinomas but I didn’t know about oncogenes and oncoviruses. It says in the text that oncogenes are, "cancer causing genes"(pg 5). It goes on to explain that scientists aren’t exactly sure how these genes are activated. This part of the text also talks about oncoviruses. These oncoviruses cause cells to divide abnormally. One example that was given in the book was the human papillomavirus. A good deal of the chapter dealt with risk factors and the types of diseases. Some of the types of diseases include: metabolic, infectious, genetic, degenerative, deficiencies, cancer and autoimmune. Some of the risk factors for developing a disease include a person’s age, their genetics, their lifestyle, their environment, stress levels, and their gender. The chapter also noted the different types agents of disease which were bacteria, fungi, protozoa, and viruses. The definition of a pathogen is, "a living biologic agent capable of causing disease." The definitions of each of these are found on pages 8-10. In addition the chapter went on to discuss modes of transmission. Modes of transmission were split into two types: direct physical contact and indirect physical contact. Types of direct physical contact include pathogens entering via mucous membranes, intact skin, or broken skin. Types of indirect physical contact include pathogens entering the body via ingestion, or inhalation. This information can be found on pages 10-11. Another part of this chapter that was really important for massage therapists and the area of the medical field I want to go into is infection control. The text is very specific about proper procedures to follow to keep the therapist safe from the transmission infectious diseases. The basics include washing hands correctly, not wearing jewelry on hands or wrists, hygiene regarding finger nails, the use of clean linens (and how to clean linens), the importance of a clean uniform every day, avoiding cross contamination of lotions and liquids used during a massage session, the use of gloves when the therapist has an injury, not working when the therapist is ill, and not performing massages when the therapist is intoxicated or under the use of other substances. All of these were great reminders for people not only interested in message therapy but all forms of health care. This information was found on pages 13-15.

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Urinary System

February 12, 2010

Review of Mosby’s Pathology for Massage Therapists, by Salvo and Anderson.

The urinary system can be indirectly affected by massage. Of interest to me in this brief chapter was renal dialysis, which aids in artificially cleaning the blood when an individual has kidneys that are no longer functioning properly. This needs to be done several times a week and takes at least 2-3 hours each time. A client may be taking anticoagulants at the time and thus massage should be done gently to prevent bruising. Also, as mentioned on page 282 of the first edition, timing is also very important as clients may feel worse as wastes build up and can be very tired after the dialysis treatment. I feel that this portion was a main element in this chapter because many of the various urinary pathologies mentioned could lead to an improperly functioning kidney or the complete loss of kidney function. Massage therapists need to be aware of these conditions and which techniques are appropriate to use in certain circumstances.

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Gastrointestinal System

February 12, 2010

Review of Mosby’s Pathology for Massage Therapists, by Salvo and Anderson.

As discussed in Chapter 9, understanding the differences among body types is important for massage therapy. Keeping a nonjudgmental attitude is a main component. While people have thoughts and opinions why someone might be overweight, it is important for a therapist to know how to appropriately and professionally massage a larger client. It is possible that the client’s obesity could be attributed to a disorder or disease, making the pre-massage assessment very important. It is also mentioned in chapter 9 the importance of knowing the difference between adipose tissue and muscle tissue in a client who is overweight. If the therapist is not careful, the result could be severe or painful bruising.

The gastrointestinal system can be directly and indirectly impacted by massage therapy. As an individual with Crohn’s Disease, I know firsthand that massage therapy can be effective in reducing stress levels, but abdominal massage could be extremely painful or even dangerous. This is true for other conditions such as gastritis, irritable bowel syndrome, ulcerative colitis, etc. A particular position may be more comfortable, and there may be days when the client is in severe pain versus no pain at all. Discussing the condition with the client is important in order to provide effective treatment.

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Respiratory System

February 12, 2010

Although there is not as strong of a connection between massage and the respiratory system (as is with the musculoskeletal and nervous system), there are still important facets of this system that therapists need to be aware of, especially in terms of respiratory pathologies. Of course the obvious reason is that of contagious respiratory infections or pathologies. However, other conditions can impact the effectiveness or appropriateness of massage therapy treatment.

A good example of this is a client with sleep apnea. The cause of sleep apnea varies from person to person, and thus it is important to know the cause of the apnea before administering massage therapy. Some causes could include: obesity, large tonsils or adenoids, nasal blockage. A client could also have a physical abnormality such as a deviated septum, or the client’s muscles in his/her tongue and throat could relax more easily. Knowing the cause of the apnea is key to deciding appropriate massage techniques. Since the client will generally not be sleeping, and there are not any decisive physical signs to look for, this needs to be predetermined in the pre-massage intake assessment. Information from the client’s physician should also be obtained to determine the course of the treatment plan.

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