Feel like I am too cautious sometimes

[duck]

I had a lady come in who is in the process of getting tests done to check for heart disease. I told her I would need a written release from her cardiologist. She came in, but without a release and said that the doctor basically laughed at her when she asked the question if she could receive a massage. I told her I was not comfortable giving one to her until she is diagnosed next week. Am I being too cautious?

 

[Lenieye_Moon]

I don't think you're being too cautious. It's really what you are comforitable doing.
You never know what could happen!

 

[Disabled Vietnam Veteran]

Feel like I am too cautious sometimes

I had a lady come in who is in the process of getting tests done to check for heart disease.

One possible way of handling this would have been to do the massage but in order to err on the side of caution, assume that the tests were going to be positive and do the treatment as if she did have heart disease going with those particular contraindications (for example no excessive heat.)

Angie

 

[SNFcj (Back on my grind)]

Her doctor laughed at her? And wouldn't give her an answer? And she didn't chew him/her out and take her business elsewhere?

 

[royalmeddy]

Her doctor laughed at her? And wouldn't give her an answer? And she didn't chew him/her out and take her business elsewhere?

Not that uncommon. Many (most?) doctors will get a little chuckle out of a patient asking for a release for massage. They simply aren't trained in the effects that MT can have on various pathologies, and see it as "harmless pampering."

 

[katiet93]

Before I went into massage school 2months to be exact.. I wound up having a PE (blood clot in lung) for a surgery gone very bad.Well, I started the program & I had explained to the teachers about my situation & they too wanted a Dr's note saying it was ok for me to receive massages. My Pulmonologist did the same thing, laughed.. I did have massages with caution. I just don't get it @ times..

 

[Pompal 09.]

I think I saw somewhere a "note" to give to your doctor explaining how massage affects various systems in the body, and why they are being asked to approve the patient/client to receive massage therapy.
If only I knew where that was...

Maybe we could write one up here?

 

[Derrick]

I had a client with some issues and her doctor was impressed that I wouldn't do a massage at the time due to her condition. He will be releasing her soon, I think, as she really wants to continue getting massage.

 

[zangmo315]

I think I saw somewhere a "note" to give to your doctor explaining how massage affects various systems in the body, and why they are being asked to approve the patient/client to receive massage therapy.
If only I knew where that was...

Maybe we could write one up here?

My physicians release form gives the doctor a little info about massage increasing circulation/affecting some pathologies & medication absorption, but I don't go into ANY details....just asking that they approve the client's request for massage and give me any restrictions, if any, and saying a non-circulatory massage can be done per doctor's orders if an increase in circulation is contraindicated. It's really very short. I reworded what our school told us to use because that was more negative, and I had doctors refusing to "order" massage, when I wasn't asking for an order. Now I state the the client has CHOSEN to receive massage and ask the doctor to stipulate or sign saying there are no stipulations.

 

[misskelleygirl]

I think I saw somewhere a "note" to give to your doctor explaining how massage affects various systems in the body, and why they are being asked to approve the patient/client to receive massage therapy.
If only I knew where that was...

Maybe we could write one up here?

My physicians release form gives the doctor a little info about massage increasing circulation/affecting some pathologies & medication absorption, but I don't go into ANY details....just asking that they approve the client's request for massage and give me any restrictions, if any, and saying a non-circulatory massage can be done per doctor's orders if an increase in circulation is contraindicated. It's really very short. I reworded what our school told us to use because that was more negative, and I had doctors refusing to "order" massage, when I wasn't asking for an order. Now I state the the client has CHOSEN to receive massage and ask the doctor to stipulate or sign saying there are no stipulations.

Would you mind posting your form here?

 

[JerseyGirl]

Sure. I don't know why I didn't just look it up last night! :

Rose of Sharon Therapeutic Massage
Physician Release

Dear Physician;

Your client, _________________________has chosen to receive massage therapy.

Therapeutic Massage can affect all the body‘s systems. Because we understand that each client presents a unique health history with different health conditions, restrictions, precautions and recovery potential, we sometimes request a written instructions before providing any type of therapeutic massage that would increase the circulation or affect a post-surgical site. Please help us ensure that appropriate care is given to your patient by completing the release at the bottom of this page. A non-circulatory massage, Shiatsu, which is compressions along the fascial lines at a pressure enjoyed by the client, may be provided in the event that circulatory massage is medically contraindicated.

Respectfully,

Sharon Baker, Nationally Certified Massage Practitioner


Physician Release
Client Name____________________________________________________

Client Signature_________________________________________________

Rose of Sharon Therapeutic Massage has my permission to provide massage to this patient, with the following restrictions or precautions:
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________

Physician’s Name:_______________________________________________
(Please Print)

Physician’s Signature:____________________________________________

Date Signed:__________________________

(contact info/address included at the bottom)

 

[binksbailey2000]

circulatory nonsense

What's the problem with giving a massage to someone "heart disease"?
I do not see any physiological reason (the same goes for high blood pressure) for caution, unless edema is present due to CHF.
Then the problem is edema.

Of course, giving a massage to someone prone to thrombii in the veins - use light pressure on the posterior calves.

Millions of Americans have atherosclerosis within their coronary arteries. 75 million have primary HBP. Thousands of these individuals get massage everyday, with no negative effect.

Many say we need to be cautious because we increase circulation. We don't, and so what if we did.

Massage does not increase overall circulation (the total blood moving through the heart per minute). That can only occur with an increase in either heart rate, or stroke volume. Laying down decreases both. Getting a relaxing massage further decreases heart rate, stroke and blood pressure. Thus, circulation decreases during massage.

Think about it logically: although some severely affected individuals may be on doctors orders to reduce physical activity, most with HBP, or on the high end of cardiovascular risk factors, are told to engage in moderate exercise.
What does exercise do? Increase - heart rate, blood pressure, and stroke volume.

It's true, Doctors can be nitwits, but many of our massage texts continue to repeat nonsense about circulation, high blood pressure, the effects of massage on meds, etc.

 

[Bluey]

palpateit - I agree with you regarding actual risk. However, because of the legal climate, the fact that our training requires we learn specific contraindications requires us to behave as though we cannot do massage in some instances without doctor's instructions. It's a CYA thing, rather than a true risk, in many instances. Sad.....but some of those nitwit doctors who don't know much about how massage can (or how they will NOT) affect pathologies would have NO qualms about blaming the MT if something goes wrong. And we have AMTA putting out ads to terrify the masses about getting a massage from a non-AMTA member. :roll:

 

[Pompal 09.]

And we have AMTA putting out ads to terrify the masses about getting a massage from a non-AMTA member. :roll:

Worth remembering when choosing a professional association...

 

[Sea Of Love]

And we have AMTA putting out ads to terrify the masses about getting a massage from a non-AMTA member. :roll:

Worth remembering when choosing a professional association...

I switched - left AMTA - over that! I tried engaging them in a conversation about it and got a "line" over and over.

 

[moi]

And we have AMTA putting out ads to terrify the masses about getting a massage from a non-AMTA member. :roll:

Worth remembering when choosing a professional association...

I switched - left AMTA - over that! I tried engaging them in a conversation about it and got a "line" over and over.

I just switched over to ABMP last month

 

[rainbow lover]

I switched - left AMTA - over that! I tried engaging them in a conversation about it and got a "line" over and over.

Ditto. I will generally run far away from anything that proclaims itself the "ONLY RIGHT WAY."

 

[dmx87]

Personally, I appreciate that AMTA is advertising the massage therapy profession and their referral service for qualified professionals. I don't perceive them as being pushy, or even as claiming that they are the ONLY qualified professional association for MTs, they just happen to be spending a heck of alot more on advertising. I've considered switching to ABMP because I find them more supportive of other forms of bodywork, such as Thai, but frankly I would rather my dues money be put to better use like the massive advertising campaigns of AMTA.

 

[agent4927]

Personally, I appreciate that AMTA is advertising the massage therapy profession and their referral service for qualified professionals. I don't perceive them as being pushy, or even as claiming that they are the ONLY qualified professional association for MTs, they just happen to be spending a heck of alot more on advertising. I've considered switching to ABMP because I find them more supportive of other forms of bodywork, such as Thai, but frankly I would rather my dues money be put to better use like the massive advertising campaigns of AMTA.

I understand, and I agree to a point - that point being the specific ads that say, "use an AMTA MT or *this* HORRIBLE THING could happen!!! You are in DANGER with anyone but an AMTA member!" :roll:

Honestly, though, I don't mind others disagreeing with me and I'm not on a mission to shut them down. I did go on a minor mission to ask them to be HONEST....honesty is a part of OUR code of ethics!! But when they said no, I said okay. And goodbye. I have friends and former classmates who disagree with me, and that is okay too.

 

[..l0VEx3..]

Oh, I appreciate and respect your point of view too. I would also have been upset if I got the response you did. I guess I haven't seen any of those ads you mention.