Taming the Tube

It had been a particularly busy Saturday, with lots of clients coming in for massage therapy at my office. After work, tired though I was, honey and I went over to the local promenade for dinner and walked along the cement boardwalk for quite a ways looking at the crowds and shops.
         

Usually we stop for a few moments to listen to the street musicians. This time I wanted to stop at the benches by the flamenco guitarist. We found a spot. Honey asked me what was wrong.

         

“My quad(ricep)s are numb,” I said. “It seems to go away when I sit down.”

       

After a few minutes we resumed walking. Again, the front of my legs above the knee went numb.

         

“What’s going on?” Sweetie asked.

        

“I don’t know, but I am going to find out,” I said.

        

We walked back to the car pretty slowly, my legs complaining the whole way back.

        

As massage therapists we are used to people having symptoms of things that might be a bit worse than just sore muscles. I know I have. It is easy to tell a client to go have it checked out. But do we forget how hard that can be?

      

My doctor wanted to know what was going on right away. He recommended a lumbar X-ray series and a lumbar MRI. The X-rays, no problem. I walked in to the offices of the local. The MRI?

        

Oh heavens. I’d had one years ago for my neck and shoulders, and I remembered being able to handle it as long as I kept my eyes shut. Starting in the hall outside the machine. I put the test off for a few days.

        

My doctor called to find out if I had the MRI yet. The X-rays showed suspected spinal stenosis. I needed to get in ASAP.

         

Spinal stenosis? I did what everyone else does. I looked it up on WebMD. By the way, never do that. By the time I went in for the MRI, I was convinced I would be disabled for life.

        

MRIs have not changed much, but I have. This time my arms hit the side of the tube, making me feel like I was being held. I couldn’t do the time in the machine. Two tries later I was sweating and resigned. I went to the local “open” MRI. Much better. Except for the train-wreck sounds. The tech had insisted I listen to some spa music. Thank heavens. It gave me something to focus on besides the noise of the MRI.

        

I was pretty tense when I went in for a consult with a neurosurgeon. The lady in the waiting room was about 30, in a wheelchair. She smiled at me. I thought about whether they have to measure you for a tongue stick. You know, the kind you use to paint watercolors because you are in a wheelchair for life.

In the exam room, I had high blood pressure for the first time in my life. “White coat syndrome?” the assistant asked.

Seeing a neurosurgeon. Egads. The assistant loaded the MRI onto a computer. I stared at the image. What was that? Lobster tail?

The discs and all were fine, but I do have spinal stenosis and a pinched nerve at the L4-L5 foramen. The doctor smiled at me and recommended a cortisone shot. “You should be fine,” he said. “That should take care of your symptoms. You need to strengthen your psoas and spinal erectors.”

Hmm. That last part sounded like what I find with many massage clients. I thought I could feel my blood pressure drop back to normal.

I took a breath, perhaps my first of the day. “I’m sorry. I have been pretty freaked out about this,” I said.

Time for a massage.

Frequent Fliers and Massage Therapy

Folks who travel for vacations complain the most about the plane ride home – they are tired, often sunburned and a bit depressed that the dream vacation is over.

Many clients book massages during their vacations, but forget about dealing with the stress and fatigue of the trip home.

That’s why I have recommended people get a jet lag massage post-vacation.

We book it in advance for the day after they return, (air travel isn’t always timely these days) and I plan on spending a lot of the massage time trying to relax the nervous system and flush the lymphatic system.

           

The post-vacation massage seems to be helpful in getting rid of the blues and trip tiredness. I also enjoy hearing a bit about the vacation, as most of my clients `take much more exciting trips than I do.

           

Clients are often surprised by how much better they feel. It helps them get enough energy together to unpack, clean up and get ready for work again.

So I suggest more massage therapists offer the post-travel massage. It is a wonderful way to reconnect with clients and serves their needs well.

Wrapped Up in Fibromyalgia Massage

A recent study showed hyper nerve endings under the skin of people with fibromyalgia – the first “objective” sign that people with fibro are not just whining about their pain.

         

Well, we massage therapists are different from others in the treatment community who have doubted the clinical basis of fibromyalgia. The difference is fairly simple – when people tell us they hurt and where they hurt, we believe them.

         

For something to be so simple it is also hugely significant for people with fibro. They are often battered, doubted, maligned and otherwise felt to be somehow less legit than someone who has an X-ray proven injury such as a broken leg.

         

I have had clients who have been “fired” by therapists in other modalities because they can’t stick to exercise programs. Even though within a few weeks, even a few hours, exercise programs make fibro folks feel worse.

         

A recent client pointed it out to me in bright flashing lights. She does not look like she has fibro. She is young, thin, and fairly flexible and has no apparent history of trauma other than a car accident 5 years ago.

Several times she has tried to comply with strengthening programs only to have her head and neck pain increase – and her disability from fibro go wild. When she complained of increasing problems, her complaints are dismissed.

Figuring that the definition of insanity was proving true – Crazy is doing the same thing over and over and expecting a different result - she decided to do her own research.

She stumbled across some articles about trigger points and fibro and decided to try massage. I’m happy to say she is feeling much better.

Reminding us all that it never hurts a massage therapist to believe people when they report symptoms, nor does it hurt to use our skills to relieve those symptoms. It is our strength.    

Look! No Hands!

It being the crack of summer and my massage practice being filled to the seams, I decided to take 10 days off. Daring, I know, for anyone in private practice, but it was great.

For 10 days, no massages, no excess use of my hands and now, heading back to the office for another full slate, I am doing my back exercises in hopes I can keep it all working just right when I head back in.

Taking time for a vacation can be a big guilt trip for therapists. It can take years to build a decent practice, and sometimes it entails working through your weekends – a massage here and there on Sunday or Mondays off to keep the books full.

In my first five years of practice, I worked four days a week at a spa and spent my “off” days serving private clients. Trouble was, if the spa called me and I could fit it in, I would also work extra shifts. I was being a team player, of course, helping the manager avoid canceling massage appointments because of someone calling in sick on a weekend.

After 30 days with no days off, I took the daring step of saying no to some extra shifts. They managed to live without me, and I saw the error of my ways.

Then I took vacations fairly regularly, a week here and there, and used my time off to do massage related things such as attend conventions. I loved the classes, and I came back recharged.

As time passed, however, I felt less like immersing myself in c.e.u. classes on my time off. The true massage-less vacations began and I enjoy them.

A good friend in practice for more years than I explained the math to me: If you do too many massages in a week or a month, maybe that is fine. But let’s say you do too many massages in a quarter or half-year or a year?

My friend was seeing 35 clients a week. After a few months, he woke up one morning with no energy for anything. He dropped two of his side jobs and went with his own practice clients exclusively. It took him a year to recover.

Frying out is a danger to all massage therapists. Every person has their own personal limits, and before you reach them you may have no clue as to what those limits are.

As I teetered along the edge of burnout for a few years, I began to see no-work vacations as a blessing. Yes, leave a message that you are gone. It will be OK.

When clients come in, they notice you are fresh. And it is a great compliment when they admit two-timing you while you were off, and coming back because the massage elsewhere wasn’t that good.

Covering the Cradle

Some things about being a massage therapist are all about the details – the atmosphere, noise level, lighting, and yes the table linens.

         

Face cradle covers have always been problematic for massage therapists. The disposable covers are scratchy – and although no client has ever complained about them I have heard clients complain about other therapists who use them.

          

One fellow observed that he stopped using a therapist because of the scratchy covers. A comment I took note of.

           

Spas that have to worry about mounds of laundry at the end of the day – and costs – often use cotton hand towels. I have always found that kind of scratchy, too. I used pillowcases at first, and moved to soft paper/cotton towels for a time.

           

The fitted covers that come with sheet sets seem to be ill fitting for the larger, softer face cushions. After wrestling with the underwear-like elastic gathers on those cradle covers I finally threw in the towel.

          

Now I use a compromise on all fronts – soft, cotton flannel, flat cradle covers. These can slip around a bit but they do not have any seams to leave lines on the face and they are easier to fit over a face cushion. Less wrangling.

           

The cotton flats avoid the too-snug fit of elastic-edged covers and overcome the scratchy thing of disposables. At $5.99 apiece, the thought of stocking all flats has made me queasy, especially so because I suspect they will not be as durable as the undie-fit covers.

           

I found a site that would give me a wholesale discount and got 25 covers for about half. We will see if they measure up. So far, so good. The flats stack a lot neater and smaller. No more grappling in the linen closet for a good one.

Massage Me, Massage My Dog

 Dogs love me, and I love dogs. Cats love me, and I love them too. When this massage therapist does house calls, I suddenly find myself surrounded by four-legged fans.

           

I didn’t mean to, but I have managed to train all of my house clients’ domesticated beasties to expect a mini-massage when I get in the door.

           

It started with golden retrievers, irresistible big dogs with soulful eyes. Now the list includes Siamese, calicoes, mutts and Cairns. I really don’t mind, sort of, because they are such good animals and love to lean on me and get all glossy-eyed.

             

Animals instinctively love massage, which shows their superior tastes and energies as far as I am concerned. Nothing in the world beats a good belly rub, be it a dog or feline. People who don’t like tummy massage should learn from their pets.

            

It struck me by surprise, but I recently learned from a client that she knew I was the one massage therapist for her family when the dog liked me. Apparently dogs and cats are a screening method for more than just boyfriends and future in-laws.

             

Once I have passed the pet-TSA, I get invited to pet-pat, pet-sit and pet-feed. My book is a little too full to take on many of these offers, but I do appreciate them as a sort of badge of acceptance.

             

I have made the occasional exception. A married couple brought in their new foundling, a micro-chihuahua who barely weighs one pound. They hadn’t been able to get to the movies for a few weeks, as the little guy is being dropper-fed and is way too little to leave near their big dogs.

 
They went to the flicks and I got the little carry-bag with the pee pads, special vitamins and puppy-food mix. I put his nibs on my shoulder and the little guy immediately snuggled into my shirt and stayed there. My little implant. 

Last week I asked a client if I could take his cutie-pie terrier home. He looked at me in surprise. 

“Take me instead,” he said. I replied: “Do you roll over and put your hands and feet in the air?”

“I can learn,” he said.

             

Another lesson gleaned from our companions.

Adding New Skills

One of my massage therapist friends had a good bit of extra time on her hands when she first started her practice, so she picked up a Spanish book and taught herself to speak it.

My therapist friend has not used her knowledge of Spanish much in her day spa, but it has come in handy many times when out and about in Southern California, where the number of people more comfortable speaking Spanish than English is fairly significant. Learning another language was a good brain stretch for her.

Spanish is also good to know in a therapeutic setting, especially in medical massage, with many staff therapy aide jobs preferring bilingual.

Thus I had been thinking a bit about trying to learn at least survival Spanish, the kind that can help you find a fire exit or a bathroom. At the hotels where my day spas were located, most of the staff was more comfortable speaking Spanish.

I often sat at the large round table in the cafeteria where the house-workers had lunch, trying to follow as much as I could of the conversation, which went on at about 450 miles per hour. I picked up a few verbs and phrases with a little coaching, and felt a little more confidence in my language abilities.

My motivation was something else as well. During the height of the recession, I decided to limit the amount of time I spent banging my head against the wall trying to book clients. I needed something to stretch my brain, too.

If you have ever watched TV there are about 500 commercials on about 500 channels for a language immersion course on computer. I didn’t do that. I picked instead some cd’s that I could play to and from work in the car. Old-fashioned, yup, that’s me.

Months into my cd experience, I decided to try my Spanish out at the local Mexican restaurant. My mother-in-law orders in perfect New-Mexico Spanish all the time. I thought I would try my luck. The staff at Bahia’s is famously bilingual, slipping from English to Spanish and back to English with ease.

I carefully ordered what I thought would get me a combo with a little cerveza.

Our server looked at me in complete surprise.

Aha! She can tell I am speaking excellent Spanish, I thought.

After a pause, she leaned over the table and looked me right in the eye.

“WHAT?”

My mother-in-law explained, in Spanish, that I was trying to speak Spanish. We all had a good laugh. Me, my folks, the people in the next booth, the entire wait staff and the lady seating customers.

Despite much urging, I declined to repeat my order and pointed at the menu.