Mary’s Spinning Explained: A Story of Aging and Vertigo, Part 3 – Final

Mary’s tests showed that her vestibular system was declining due to age. Presbyequilibrium is a result of the reduction in the gelatinous substance in the otoconial mass, causing the inability to sense gravity and linear acceleration. Aging also contributes to a loss of the sensory hair cells in the vestibular organs. Because of macular degeneration, Mary’s vision was failing which also contributed to her vertigo. With no cure for her vestibular function loss, she came home with a list of balance exercises and began to use a walker to steady herself.

Even though I no longer massage Mary, I still pop into her room to visit. Mary can’t remember my name, but does recognize me. Amazingly, she can remember the names of my children whom she has never met, having only listened to my stories of them. She told me the nurses don’t want her to leave her easy chair without someone in her room. She no longer has the strength or balance to walk unassisted. She’s not very happy about this and jokingly threatens to stand in her doorway and put one toe out in the hallway just to show that she can.

Because of Mary, I’ve continued my studies in neurobiology and brain function to better understand the neurobiological challenges that my geriatric clients face. I have applied my learning to the issues of balance, vertigo, memory loss, peripheral neuropathy, and muscle weakness that affect my clients. Now I understand working memory and why a resident can’t remember my name, yet can relate stories from their childhood. The loss of memory, hearing, balance and vision, and chronic pain can be part of aging. I recognize the anxiety felt when one’s perceived world is shrinking because input to the brain and the brain itself is failing.  Facing this unpredictable decline is a harsh reality that I hope to mitigate somewhat with my increased neurobiological understanding and caring touch.

 

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Dizziness in the Elderly: A Story of Aging and Vertigo, Part 2

Chronic dizziness in those 65 and older is fairly common and presents symptoms such as lightheadedness, vertigo, disequilibrium, spinning, and faintness.[1]  Because Mary’s dizziness was increasing, she made an appointment with her doctor. Dizziness in the elderly can be caused by multiple health issues, vision problems, over the counter medications, ototoxic effects of some drugs, hearing loss, cervical arthritis, anemia, or a combination of these.[2] After examination, her doctor referred her for vestibular function testing.

The vestibular system, located in the inner ear, enables us to maintain our balance and keep our gaze steady. It consists of the semicircular canals that sense angular acceleration on three planes: pitch, yaw, and roll. When the head begins to rotate, the endolymph in the affected canal places pressure on the cupula, which is a membrane packed with hair cell bundles called steriocillia. As the motion of the steriocillia moves toward or away from the tallest hair cell, the kinocillium, the tip links open or close ion channels to send nerve impulses via the vestibulocochlear nerve to the brain.  Located beneath the semicircular canals in the common vestibule are the ottoconial masses that detect gravity and linear acceleration in the vertical and horizontal planes. The otolith organs are groupings of hair cells covered with a gelatinous substance. Movement of the head or body causes small particles called otoliths to bend hair fibers (steriocillia and kinocillium) sending signals to the brain interpreted as motion. The brain compares the incoming signals from the vestibular system with input from the eyes and proprioceptors to interpret where the head and body are oriented in space.

[1] Aman Nanda, MD, CMD, “Chronic Dizziness in Older Persons,” Geriatrics for the Practicing Physician Volume 90 (Sept 2007): 291.

[2] Aman Nanda, MD, CMD, 291-292.

 

Next:                                                                                                                                                   Mary’s Spinning Explained: A Story of Aging and Vertigo, Part 3

 

 

 

 

 

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Meet Mary: A Story of Aging and Vertigo, Part 1

I am the massage therapist for a retirement community ranging in age from late sixties to late nineties. Working with this group is challenging because of the many age related conditions that can develop with advancing years. One of my clients has been experiencing dizziness for a number of years and it has been getting worse. This is the story of Mary* and her loss of vestibular sense.

Mary is 85 years old and lives on the skilled nursing floor. She has been a client of mine for seven years and received massage twice a month until about a year ago. Five years ago she started commenting on a mild dizziness that seemed to come and go both in duration and intensity. She was still quite active and self-sufficient.

As time passed, she noticed her dizziness becoming more constant. Some days were better than others, but I could see that she was walking with hesitancy as if she were focusing on her balance and how her feet and body were moving. Mary began to touch a wall or another person when she walked because she said it made her feel steadier.  She would hug me and ask if I could feel her spinning. Sometimes she felt the room moving and other times she felt like she was moving. She developed a fear of falling.

*Name changed to protect identity*

Next:                                                                                                                                             Dizziness in the Elderly: A Story of Aging and Vertigo, Part 2

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Let’s debunk the detox myth.

What does the word “detox” mean? In the case of supplements or diets, it is primarily a marketing term that is backed up by little or no evidence. Often times, no two companies use the same definition. While the claims of toxin removal from the body are not supported by scientific evidence, people claim to feel better during and after the cleanse. Let’s face it: that is anecdotal evidence of the weakest sort. You will either feel better after spending the time and money for a detox program or feel like a fool.

Read Debunking Detox before spending your money on a detox system. Usually the only person who profits is the seller.

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Top Ten Reasons to Believe You Might be a Massage Therapist……

In honor of National Massage Therapy Awareness Week, I’m posting one of my favorite lists pulled together from various sources. We all need a laugh now and again! You’ll know you’re a massage therapist if you laugh or nod your head as you read this list.

(Thanks to everyone who contributed to my list. No, I didn’t think these up on my own.)

10. You call 20 to 30 hours a week “full time”.

 9. Snoring, drooling and farting are all high compliments.

 8. Everyone you know tells you about this knot that they have.

 7. Everyone wants a massage at your family reunions.

 6. You’re the strongest muscle relaxant available without a prescription.

 5. You make A & P jokes.

 4. You notice someone’s posture before their looks or clothes.

 3. You ask for medical books for your birthday.

 2. Someone says Tensor Fasciae Latae and you know it’s not a coffee drink.

 AND the number one reason to believe you’re a massage therapist……..

1. Someone says you’re a pain in the butt and you actually think of the names of the muscles.

 

 

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“Fixing is a form of judgement”

A client of mine passed away several days ago. I suppose this shouldn’t surprise me considering a segment of my massage practice is elderly and in declining health. When I began working in geriatric massage, I knew it was a niche I would find rewarding and fulfilling. I never gave much thought to dealing with death as a part of my practice. Well, here it is staring me right in the face. 

I have massaged this frail yet determined woman every two weeks for the last two years. My biggest question has always been, “Do I make any difference for her?”  She was very ill for those two years and I had to modify the massages to adjust for her changing conditions. These massages weren’t like the deep, muscle unwinding work I was accustomed to doing.  Mindful touch and honoring her fragile body were the best techniques I could muster.

I started looking for answers to my question and the following words of wisdom from author Gayle Macdonald opened my eyes and guided me toward caring for the whole person rather than following a treatment plan:

One of the best ways for therapists to lessen the demand is to let go of any intention to fix the person beneath their hands. When practitioners want to “fix,” that expectation places a demand on the client, a goal that implies success or failure. And, as author Rachel Naomi Remen points out, “There is distance between ourselves and whatever or whomever we are fixing. Fixing is a form of judgment.”

To be present with people is enough —to embrace their bodies and psyches just as they are. People change when they are received in this way.                                         (MacDonald, Gayle, Bodywork for Cancer Patients, the Need for a Less-Demanding Approach, Massage and Bodywork Magazine, June/July 2005)

I know this kind woman suffered. I could see it in her eyes on some days, but she never gave in and always kept partaking of life. So I hope that, yes, I did make a difference in the quality of this woman’s life, if only for a half hour every two weeks. I also learned that being present and focused during a massage session is more valuable and healing than the illusion of fixing.

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I’m not done learning yet….

I heard a massage therapist make a comment the other day that just floored me. We were talking about the time spent in massage school and her opinion was that she had put in her time learning to do a massage and she had no interest in going back, not even for continuing education.

Can you believe that????

When do we get to the point that we know everything there is to know about massage therapy?  I want to be up to date on the latest research in my field. New data changes long-held beliefs and knowledge evolves. I’m constantly reading and yes, I do like to take classes to learn new skills and interact with other therapists.

If you’re looking for a massage therapist in Batesville, Indiana, who is familiar with current research on chronic pain, stress and muscle function, call me. By the way, I give a fantastic massage, too!

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To Retail or Not To Retail…

I have vacillated over selling retail merchandise in my Batesville massage office since I first opened….and I have received differing opinions on the decision.

My massage instructor was a “purist” and saw no reason to be a sales person. She was strictly massage and only worked with clients who had a doctor’s prescription for massage. To her, tipping and retail sales were an insult to our work as health professionals. –  (I’m not getting into the tipping discussion here. That’s another topic in itself!) – She was a huge influence on me as a student because I really valued her experience and knowledge.

Okay, here come the marketing and retail experts telling me that I can make more money in my business without the physical effort of doing massages. Some of these experts I know personally and they are very successful business people. All I need to do is stock product and promote it. Sounds easy and it produces profit.

What to do….what to do???

I use some products that I really believe  in and would like my clients to have access to at home. Of course, they’re not available at your local drug store.

So this is how I’m handling my indecision. I’m asking my clients if they like the products I might stock and would they buy them given the opportunity. I’ve also been giving out samples for home use. The feedback has been positive so far.

Here’s a link to a Facebook page for massage therapists, Retail Mastery,  that I’ll be keeping an eye on for retail advice and ideas as I make my decision and put a plan into action.  

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Oh, the things people say!

I was thinking this morning about things massage therapists say to their clients during a massage session and came up with a couple of gems that have been said to me. 

 Here’s my favorite from way back: “Wow, you’ve got a really boney chest.”  Hey, don’t I know it! Granted, the therapist was new and probably nervous. I think she realized she was babbling.

“Your traps are REALLY tight and your rhomboids, too.  I can’t believe it.” Yup, that’s why I’m here, now work your magic, but please warm up the area before using that bony elbow on my aching shoulders.

Looking back, these were rather funny comments to me, BUT maybe not to another client on the table. Pointing out the obvious on another person’s body just isn’t good form. 

What I took away from these experiences makes me more aware of the fine line between chatting and talking too much during a massage. Saying less and letting my massage do the talking works for me.

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Why I love/hate continuing education.

Massage therapy is not a static art. Like any career/vocation, we need to stay up to date, well-trained and excited about our work. Training doesn’t end with graduation from massage therapy school. In fact, the learning is just beginning with an exciting array of knowledge to be absorbed at continuing education seminars. Keeping our knowledge up to date and maintaining our skills is what separates the good massage therapists from the best massage therapists.

I have a love/hate relationship with my continuing ed requirements. Nothing excites me more or refreshes my dedication to massage therapy than learning new techniques and gathering with other massage therapists. The only down side for me is time, travel and cost. It’s hard to schedule time away from clients and my family. Life is a huge juggling act and keeping all the balls in the air can be a challenge, but like everyone else, I manage to pull it off successfully. 

In February, I’m taking time to become certified in geriatric massage to better serve my elderly clientele. Over the last few years, I’ve discovered that I really enjoy working with seniors but I realize I need more training. Seniors are such a diverse group because overall they don’t categorize as “typical” in a given age range. Some are quite robust while others of the same age can be frail and wheelchair bound. Cognitive abilities can range from alert to dementia and Alzheimer’s. The healing power of massage is amazing in its ability to revitalize and nurture this specialized group.

“Clients of geriatric massage report sleeping better, a reduction in stress, relief from arthritis and chronic pain, increased recovery time from surgeries, better circulation, lower blood pressure and relief from some symptoms of Alzheimer’s disease.” (Sharon Puszko, Geriatric Massage A new face for the future, 2009-2010)

For more information on the benefits of geriatric massage, read this article by Sharon Puszko http://www.massagetherapycanada.com/content/view/1551/ . She is teaching the cont ed class I’ll be attending in February.



Angel Light Therapeutic Massage Batesville IN

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