Massage & Bodywork

September/October 2011

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PATHOLOGY PERSPECTIVES Leaky gut syndrome. The theory behind this condition is that a combination of genetics, poor diet, various kinds of imbalances (especially of bacteria and yeasts, but also possibly parasites) and general bad luck have changed the villi of the small intestine so that a person absorbs substances that should not pass through capillary walls. In other words, particles that haven't been appropriately broken about fatigue and general malaise. However, the diagnostic criteria for hypothyroidism assume that every person's "normal range" of hormone secretion is the same. Consequently, a person could have lots of the signs and symptoms of hypothyroidism, but if her blood work indicates that she is in that "normal" range, she may not be considered for treatment. It is important to recognize when symptoms indicate that clients need to consult their primary care provider in addition to their massage therapist. down, or that really should be excreted instead of absorbed, find their way into the bloodstream and stimulate inflammatory reactions elsewhere in the body. Some practitioners consider leaky gut syndrome as a feature in a variety of seemingly disconnected syndromes, including autism spectrum and autoimmune diseases. Hypothyroidism. The thyroid gland is a butterfly shaped gland that wraps around the trachea and secretes a variety of hormones, two of which are dedicated to metabolizing fuel (food) into energy (work). If a person is short on thyroid hormones, the food that she eats is more likely to be stored as fat than used as energy. In the meantime, no matter how pristine her diet is, her digestion is sluggish, she gains weight, and she feels cold and tired all the time. Thyroid function is often one of the first things a conventional medical doctor considers when a patient is concerned Obstructive sleep apnea. In this situation, tissues in the throat collapse and close off the airway during sleep, and breathing temporarily stops. When oxygen levels get low, the person suddenly gasps with a deep snort. This is a little different from typical snoring, during which breathing may be labored, but it doesn't completely stop. A person with obstructive sleep apnea may experience a disruptive oxygen shortage hundreds of times every night, without coming to full wakefulness. Not surprisingly, that person experiences tremendous fatigue in the daytime. This level of fatigue and sleep loss also opens the door to a host of other chronic pain syndromes and disorders. It is important to emphasize that this is just a short list of things to consider when a person reports chronic, low-grade, long-term sense of not feeling good. Other possibilities include anemia, autoimmune diseases, a variety of nutritional deficiencies, multiple chemical sensitivity syndrome, and, of course, depression and anxiety. These are conditions that may or may not be recognized in conventional medical settings, but they can also cause subtle, under-the-radar, quality-of-life-altering symptoms. Wouldn't it be great if there were a short, simple answer for these challenges? If only we could find the right hormone, the perfect vitamin, the missing amino acid, the magic elixir that would set everything else in order, all overnight. Sadly, that almost never happens—in spite of what we might see in the advertisements. Our job as health-care consultants is to be good listeners. It is appropriate to make suggestions with the caveat that those suggestions could be wrong. It is important to recognize when symptoms indicate that clients need to consult their primary care provider in addition to their massage therapist. We can advise patience when our clients are looking for a quick fix. Most of all, we can be cheerleaders for people who are interested enough in their health to do their own research. And we can celebrate that in a situation where serious contraindicating diseases are not a problem, massage is a powerfully positive influence in the life of the person struggling with health. and is approved by the NCTMB as a provider of continuing education. She wrote A Massage Therapist's Guide to Pathology (Lippincott Williams & Wilkins, 2009), now in its fourth edition, which is used in massage schools worldwide. Werner is available at www.ruthwerner.com or wernerworkshops@ruthwerner.com. Ruth Werner is a writer and educator NOTE 1. There is no easy or simple answer to this question. In general, I try to be respectful of people's choices, but I tend to take refuge in research. So when someone comes to me touting a product, I ask for the evidence base. And I particularly look for research that is not conducted by the people who are selling the product. This occasionally makes me look stodgy and closed-minded. I can live with that. tune in to your practice at ABMPtv 105

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