Issue link: https://www.massageandbodyworkdigital.com/i/329694
I t p a y s t o b e A B M P C e r t i f i e d : w w w. a b m p . c o m / g o / c e r t i f i e d c e n t r a l 93 "I froze when she started having a seizure. What flashed through my mind was, 'She's going to fall off my massage table!' so I threw myself across her body and held on for dear life." That's the summary of a phone call I received from a massage colleague with whom I've waged an ongoing battle over whether massage therapists should ask clients about their medications. This colleague is a very successful relaxation therapist who has maintained for years that she "gets people on the table, makes them feel good, and does no harm." She saw no reason to ask about medications, which she viewed as "beyond our scope" and "nonessential information." After this upsetting experience, she changed her mind. An oversimplification, or rigid interpretation, of the massage therapist's scope of practice might lead therapists to believe that the medications our clients take should not concern us. In the case of my colleague, knowing her client was taking antiseizure medication would have led her to avoid abrupt, overstimulating, or percussive modalities. In a second possible situation, a therapist whose client is taking anticoagulants would decrease the pressure of the massage, knowing the blood-thinning effects of these medications can cause the client to bruise easily. And a client who takes medication to manage blood pressure may need extra care when changing positions on and off the table. In all these cases, knowing a client's medications affords the therapist an opportunity to devise a plan of action in case an adverse reaction occurs. Medication knowledge translates into safe care. AVOID CHASING SYMPTOMS Early in my massage career, I had a client with a lot of medical challenges. Her diagnoses ranged from fibromyalgia to clinical depression, insomnia, polymyalgia, and postpolio syndrome. She was a "doctor-hopper": after becoming disappointed or disillusioned with one doctor, she'd find another, maintaining the prescriptions she had received from each physician. She was taking no less than 23 medications. When I asked her to bring them in so we could make a list, she brought in two huge plastic bags filled with bottles: antidepressants, antipsychotics, muscle relaxants, narcotic pain relievers, sleeping pills, and more, all topped off by huge doses of multivitamins. Even as a new massage therapist, I realized something was seriously wrong with this picture. I made a list of all her medications and, over the following week, compiled a chart with information about each one's purpose and potential side effects. I found exactly what I was looking for: she had come to me for relief from dizziness, muscle soreness, and anxiety, and it turned out those symptoms were all side effects of her daily medication intake! If I continued to see her, I'd only be chasing the symptoms. I was not going to win this battle. I explained what I had found out, saying I'd be glad to see her but I seriously doubted I could offer her much relief. I strongly suggested she take my chart to her doctor for advice about her medication use. She took the chart and I never saw her again. The moral of this story is that you not only want to know the medications your client is taking, you also want to know about possible common side effects. Otherwise, you could be working your heart out to address something that cannot be fixed. A quick glance at the table on the following pages reveals that many medication side effects are similar to common complaints for which clients seek massage therapy—for example, headaches and constipation. As long as the client takes medications that cause these side effects, you will reach no resolution, no matter how stellar your technique. In some situations, of course, temporary relief may be very beneficial and welcome to the client. The key is to be aware and honest about what is possible. CHECK MEDICAL HISTORY DURING INTAKE Learning about your client's medications is easy, and it's essential, whether your practice focuses on