Issue link: https://www.massageandbodyworkdigital.com/i/230373
Contraindications and Cautions ■ If you discover nonresponsive cold tissue, or you notice any purplish blotches or breakdown of skin, refer the client to her physician immediately. ■ If a cancer patient discusses the possibility of stopping her chemotherapy because of her irritation with CIPN, advise her to speak to her physician. ■ Keep orange juice and small candy bars handy when treating diabetic patients. ■ Open wounds or sores are contraindications for local massage. ■ A high percentage of cancer patients develop foot fungus as a result of a compromised immune system. This is highly contagious and can be transmitted to the therapist. It is not wise, even if gloved, to work on a toe that is manifesting fungus until the condition is completely cleared up. ■ If the foot has an unusually strong odor, noticeably different from an odor previously noted, this may be a sign of impending gangrene or infection; refer the client to a physician immediately. Doctors are generally reluctant to prescribe medication for CIPN, since it is considered a shortterm condition and the patient is already receiving so much other medical treatment. However, if CIPN persists a year or more after chemotherapy, either Lyrica or Neurontin is usually prescribed. For DPN, the following are often prescribed: • Anticonvulsants, such as gabapentin (Neurontin) and pregabalin (Lyrica). • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Motrin, Advil) and naproxen (Aleve, Anaprox, Naprelan, Naprosyn). • Selective serotonin reuptake inhibitors (SSRIs), such as paroxetine hydrochloride (Paxil) and sertraline hydrochloride (Zoloft). • Selective serotonin-norepinephrine reuptake inhibitors (SNRIs), such as duloxetine (Cymbalta). • Topical creams such as capsaicin. • Tricyclic antidepressants, such as amitriptyline hydrochloride (Apo-Amitriptyline, Endep). • Tricyclic antidepressants, such as imipramine hydrochloride (Tofranil). A potential benefit of the massage protocol described here is decreasing the client's dependence on medication. A MASSAGE THERAPY PROTOCOL THAT WORKS With physician approval, I have used the protocol described here on hundreds of oncology patients at the Beaumont Cancer Institute in Royal Oak, Michigan. The protocol continues to be used for these patients, and I use and teach this protocol across the country. It pays to be ABMP Certified: www.abmp.com/go/certifiedcentral 85