All Parts are Equal or are They?

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When a person has back surgery or has had a limb amputated, it is standard for them to go through a rehabilitation process, including physical therapy or massage therapy to be prescribed. However, if a woman has breast surgery, rehabilitation (massage or physical therapy) is not automatically ordered and often not even suggested.
When a woman chooses to have her breasts removed, reconstructed, increased or reduced, it’s important that she understands not only the benefits of the procedures, but the risks as well. Chronic pain and postural problems can appear years later if rehabilitation is not completed following breast surgery.

Breasts are composed of mammary glands, connective tissue, blood vessels, nerves, and lymph vessels. Breast tissue can extend from the border of the breastbone near the center of the chest all the way to the armpit, and overlies the second to sixth ribs. The breast has an axillary tail, which is a tail of tissue that extends up into the armpit region. The breast lies on top of the pectoralis major muscle.
Breast tissue is part of the fascial web of connective tissue, which runs continuously throughout the body from head to foot and superficial to deep without interruption. Any alteration, even the slightest damage to the fascial network has major ramifications.
The body’s balance and symmetry can be significantly altered after a mastectomy, augmentation or reduction. This is something many women aren’t informed of or prepared for. Scar tissue is also a very important fact which women need to be aware of and prepared for. Unpredictable development of scar tissue is quite common after any surgery and can have long-term effects on the body.
Early intervention following breast surgery by a massage or physical therapist can play a pivotal roll in helping women heal and regain full function.
After mastectomy surgery a woman may experience tightness or pulling originating from her incision, which spreads across her body. This is caused by scar tissue, which is the body’s way of healing from surgery. The result can be very dense tissue under the incision, which is painful and which can restrict the arm’s range of motion (ROM). The restricted ROM puts women at risk for a painful condition known as frozen shoulder. Scars can range in size after a breast-conserving lumpectomy or a mastectomy procedure that removes the entire breast. Either way, most breast cancer patients are left with some sort of surgical scar as a by-product of their quest to heal.
In order to rebuild the breast, tissue is taken from another area of the body. It can be taken from several different locations. One host area is the Latissimus Dorsi. In the picture below you can see how much of the body is affected by this location.
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The TUG procedure uses skin and fat from the inner portion of the upper thigh; the incision scar will be hidden near the crease of the groin. The flap is named for the transverse upper gracilis muscle to which the skin and fat are connected. Muscle may be removed as part of the TUG flap.

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Radiation treatment for Breast Cancer has its own list of complications. This type of therapy not only changes tissue characteristics by making it more susceptible to breakdown, it continues to make tissues tighter for 2 to 5 years following treatment.

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It can also lead to:
Skin tightening;
Limited arm and shoulder mobility;
Chest expansion limitations;
Restrictions in and around the area of treatment.
Breast reduction surgery is still largely considered to be a cosmetic surgical procedure. However, it is most often performed to relieve significant physical and emotional problems resulting from overly large and/or heavy breasts. Surgeries are classified as “cosmetic” if it is an elective procedure that insurance does not cover. If it is a procedure that is restoring form or function, it’s referred to as “reconstructive”. Reconstructive procedures are often covered by insurance. The same procedure may be classified as cosmetic or reconstructive depending on how it impacts an individual. Public opinion still sees it as cosmetic but 9.5 times out of ten it is being performed to reduce pain or to alter the overall structure.

 

According to the American Society of Aesthetic Plastic Surgery, 112,964 breast reductions were performed in 2011. Breast reduction surgery leaves permanent scarring.

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The operation using the anchor technique leaves three scars:
One around the nipple (areola);
One from the nipple to the crease below the breast (this is the worst scar as it takes the most tension);
One from the breast bone to the armpit along the crease below the breast.

The severity of scarring largely depends on the individual. Most women are completely unaware of how the scar tissue is affecting them.

 

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Kelly Bowers, a massage therapist from Washington, DC states:
“I had breast reduction surgery in 1992. By 2012 I rarely thought of it and certainly didn’t think the scars were an issue any more. They were barely visible! Then I had scar release work. I was stunned at how far I felt the effects of the work. I felt it from my shoulder to my hip! I’m delighted I had a chance to experience this work and finally take care of these scars as they deserved to be taken care of.”
The American Society for Aesthetic Plastic Surgery also reported that breast augmentation is the most popular surgical cosmetic procedure for women, with more than 316,000 procedures performed in 2011. Yes, augmentation is an elective cosmetic surgery, but it is still a surgery that alters the body. Rehabilitative therapy is necessary after any surgery.

Women who have breast augmentation frequently experience:
Limited upper extremity mobility (range of motion);
Arm weakness and swelling;
Fatigue;
Shoulder dysfunction;
Back pain;
Chest pain.

 
Scar tissue can occur at any time after the augmentation has been performed, not just within the first few months. Capsular contracture is the term used to describe scar tissue that can form around breast implants which may cause the breasts to harden, look or feel different, and may cause some discomfort from the tightening of the capsule. Capsular contracture is an unpredictable complication, but it is also the most common complication following breast augmentation.

 
Scars left by breast augmentation surgery are usually hidden in the crease beneath the breast (inframammary fold incision), around the nipple (peri-areolar incision) or in the armpit (transaxillary incision). Rehabilitation/therapy and physical activity are integral to recovery and to reduce post-breast surgery side effects such as:
Scar tissue/soft tissue immobility;
Flexibility limitations;
Limited range of motion;
Decreased strength.

 
Even if a woman does not actually develop pain or limited function directly after the procedure, at some point pain and disability will become present if scar tissue is not addressed in a timely and proper fashion.

The Continuing Quest for Knowledge

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imagesZO3BUDV6Continuing Education is offered in every profession.  Some have specific requirements and others leave it up to the professional to improve their knowledge of their chosen field. Seminars and workshops are offered from one extreme to the other and at all levels. These courses also range from the good to the bad to the ugly.

The healthcare profession, like most, is flooded with numerous courses.  So much so that choosing where to spend your money and time is a huge concern.  In an effort to ease the decision making process several course review sites and forums have be created to provide open and honest reviews of the various courses.  These forums usually represent the professionals needs and concerns and I thought it would benefit everyone to see the world of continuing education from the perspective of the providers.

Here are some basic questions that providers have to answer, literally on a daily basis.

1- “This course was nothing like I expected it to be.”

Please research a course and it’s instructor before you register. Make sure the content is something you are interested in and the instructor has a good reputation before committing your money and time. Do not trust or rely on the website as no one is going to list that they are a lousy instructor and their course a marketing scam. And please, unless you know the person, do not trust someone’s opinion who is “overly” dedicated to a particular technique or instructor.  Find someone who can give you an objective well rounded opinion.

2- “What do you mean it is canceled?  I really want to take this class.”

Once you have decided to attend do not wait until the last minute to register.  Especially if the instructor is not local.  If minimum attendance is not meet by the early bird date the traveling instructor will be FORCED to cancel class. FYI- the main reason for the early bird rate is to insure enough of an attendance for the instructor to arrange for travel (in the past you could make flight changes or cancel a flight with minor penalties.  Not so today- instructors can lose hundreds of dollars for last minute flight cancelations or changes) and so that the host will not lose their deposit on the hall or conference center.

Now, life happens and if you do have to wait until the last minute to sign up and find the class canceled please do not blame the instructor or host. Seriously, we want to hold the courses but we have bills to pay as well and can not make a financial commitment if you do not.

3- “When are you going to offer a course in my area?” 

Traveling to attend a course is expensive.  Trust us we know this.  What you need to recognize is that scheduling a course is not as easy as it sounds.  There is a lot of work, time and money that goes into organizing/hosting a seminar/workshop.  If you truly want the course in your area then you need to be proactive by contacting local schools and organizations, let them know you and your fellow therapists would like to have this course brought in and most importantly that you are all committed to attending .

3a-“I had no idea you were in my area last month.” 

If you are interested in attending a course then sign-up for the newsletter and more importantly, periodically check the websites for course listings. I have had to cancel courses only to have a number of people contact me/post a few weeks/months later complaining that I never come to their area.

3b- “Can you let me know when you are in my area?”

Sorry, but no, we would love to attend to you personally but that is just not possible.  Again, please if you are interested in attending then just periodically check the website and watch for local advertising.

4- “What do you mean I am not signed-up?”

Calling to inquire about a class does not mean you are registered or that a spot is now reserved for you.  Emailing to inquire about the course does mean you are registered or that a spot is now reserved for you . Posting that you are attending a course does not mean you are registered or that a spot is now reserved.

Actually registering and paying for the class means you are registered and have a spot reserved in the course.

5- “Do I need to take Level 1 to sign up for Level 2?”

If a course has a pre-requisite(s) you should not call with the following questions:  “I am really only interested in level 2,  so can I just skip the level 1?” or  “I am trained in another technique so can I skip the pre- requisites?”.  The answer is and will always be no.

6- “So when are you ending the class?” or ” Are we going to get out early?” If  you sign up for a 16 hour course then arrange/plan your travel, day etc for a 16 hour course.  Do not walk in the door and ask if there is any chance the class can get out early.  If you cannot, for whatever reason life hands you, stay for the full length of the course then inform the instructor and take it upon yourself to quietly and respectfully leave.  Do not ask/expect the instructor to speed things up or deprive other students of the education they paid for.

6a- “I have to leave early but I still get full credit right? I need it to fill my requirement.”

If you do leave a class early or show up late please understand that you are forfeiting the CEU time you missed. I.e. if you leave an hour early because you wanted to catch an earlier flight then you are entitled to 15 out of the 16 CE contact hours for the course.  This is the rule which the Instructor is required to implement to maintain their certification as an approved provider.

6b – Lunch does not count as a CE contact hour. 

You learned how to eat a sandwich in kindergarten. In other words, if it is an 8 CE contact hours class plan on being there for 9 hours.

7- “I have this client so how do I treat them?”

An instructor is always happy to give some advice and answer questions. But please do not expect complete treatment plans and/or instructions on how to treat your clients or yourself.  Remember we can only give suggestions since we have never actually met your client.  If you have extensive questions or would like help creating a treatment plan then please respect the instructor’s time & knowledge and book a consultation.

8- Could you just look at my back? I have had this problem forever.”

Always attend a class looking to gain new insight on how to treat your clients or your own issues.  Do not, however, come to a class expecting free treatments (from instructor or fellow classmates), or to be cured/fixed.  If you are in need then inquire (before seminar if at all possible) if the instructor is seeing clients and schedule an appointment .

9- “I really won’t use any of this I just needed the credit.”

If you are taking a course simply to meet your state requirements please remember the instructor is there to share a topic or technique that they love and that the rest of your classmates want to learn.  Respect that.

10-“Well this is how I do it.”

When in class leave your personal techniques (not your knowledge) at the door.  It is very disrespectful during practice session to perform your own work.  You and your practice partner came to learn and experience the work being taught, period.  And a little side note, the instructor’s insurance does not cover you treating in their classroom.

11-Speak up and make a difference

If the course/instructor turned out not to be to your liking please fill out the review sheet and give a comprehensive, professional and polite statement as to why and how you would suggest the course can be improved.  Do not just circle number 5 for all of the questions and then later complain on Face Book. Or worse say nothing to anyone and let others have the same bad experience you did.

You will not hurt the instructor’s feelings, yes we do take all comments into account and yes, we do try to improve our classes each and every time we teach. Your feedback matters.

12- “I would love to attend your classes but they are too expensive.”

Yes there are courses that are over the top when it comes to cost. I, myself, was recently outraged at a Con Ed company.  The course itself was $200 a day, in my opinion a fare and decent price, however they (attempted) to tack on a $200 “city fee” plus the course fee apparently did not include the required texts and demanded an additional $50.  Totally obscene as far as I am concerned and a complete turn off.  However, going to the other extreme, thinking that one can learn a hands on technique from an on-line course or that taking a 3hr mini course at a conference qualifies them to advertise and charge for the technique is just as wrong.

If you did your research as recommended at the beginning of this blog, then you will know if the instructor is experienced and the course quality.  Please do not dismiss all the time and effort the instructors have taken to learn and perfect their work plus all that they have to go through to offer courses by complaining about their prices.

I often hear complaints about having to spend money on continuing education.   The Merriam-Webster dictionary defines a profession as “a calling requiring specialized knowledge and often long and intensive academic preparation.”

First and foremost, professionals are known for their specialized knowledge. They’ve made a deep personal commitment to develop and improve their skills, and, where appropriate, they have the degrees and certifications that serve as the foundation of this knowledge.

Professionals make a serious, thoughtful and sustained effort to master the specialized knowledge needed to succeed in their fields; and that they keep this knowledge up-to-date, so that they can continue to deliver the best work possible.

Understanding that quality education is not only necessary to further ones career but a requirement of being a professional is key.  Unfortunately there are those who view/treat their chosen occupation as a their job not a profession.  Personally, I find this massively disheartening.

So there you have it, a brief look at the other side of the coin. Please consider this information when reading reviews and weighing options.  I hope this insight aids you in the quest for quality continuing education.

Remember CE stands for more than just Credits Earned!

Words can cut like a knife – leaving deep wounds and scars….

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At this past weekend’s Scar Tissue Release, class we were fortunate to have a Registered Nurse volunteer as the demonstration client. She was incredibly generous with her feedback on what she was experiencing during the treatment and answered questions for the students. Two of her scars were from 18 & 20 year old C-sections, respectively. As she told us the stories of the surgeries, the conversation turned to the trauma, both physical and emotional that the events caused.

Apparently, as the surgeons were preparing to cut her open, they were busy discussing their golf game. The surgerical nurse stopped the banter and gave them a what for. Just think how you would feel at that moment, laying on a cold operating table, about to have your abdomen sliced open in order to bring your child into the world, being denied the experience of natural birth. As she told her story, you could see that even after 18 years, she was still very emotional about it.

Since she is a cardiac recovery nurse, I took the opportunity to emphasize a few points I had made during the class lecture. Specifically how “donor” sites, areas where skin or veins are removed in order to repair another injured area of the body, are ignored once they have healed. When I asked her opinion on this matter, she agreed whole heartedly that no further thought is given to these areas; however, she referred to these areas as the “harvest” site.

Everyone in the room took a breath. I knew what they were all thinking as I looked at each of them. The Nurse looked around puzzled, and I explained to her that I refer to the area as a “donor” site. She thought about it for a minute and shook her head. “I never even thought of that, but you are totally right…how horrible.”

How we–doctors, therapists, trainers, family and friends–refer to someone, something, or situation sets the intent. This, in turn, dictates how we regard, and therefore treat or not treat. Most often when we think of harvesting an organ, we think of cadavers. So of course an area that was used for “harvest” does not need further care or concern.

The next day, one of my current clients was among the volunteers for the student practice session. He had burns over 2/3rds of his body from a car fire. He is one of the most balanced and centered people I know. He shared two very important points with the group. First, that he never even considered that there was any kind of restriction, much less a need for therapy, on the areas where they took skin for grafts and that he was blown away by the resulting treatment’s effects all of the areas, grafted and donor. Second, while still recovering in the hospital, a representative of a burn group came by to help him understand and deal with how his life was about to change. “How everyone was going to stare at him and treat him differently…” You can imagine the rest of the conversation. He could not believe this person was there to help him and fortunately he choose not to listen to her doom-and-gloom speech.

I had another client, a massage therapist, who, while filling out her intake form, said to me in regard to the question asking her to list all surgeries, “Well, I did have a C-Section, but I do not really consider that a surgery.” Unbelievably, she was not the first woman to make this statement to me either.

As health care providers we must take care of how we phrase our words, and just as or more importantly, we need pay attention to and assist in altering how our clients refer to themselves. The first step on the road to healing is understanding and awareness.

Innovations, contemplaitions and a light bulb moment.

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This morning I was having a conversation with my client about a History Channel program on the top 101 innovations that changed our lives.  It started because my client is an avid fisherman and two innovations on the list were using fiberglass for fishing poles in place of bamboo and the spin reel.  While a great improvement  for fishermen I did not see how either one changed our lives on a society level.  He of course begged to disagree.

Also on the list was the aerosol spray. It was invented to create bug bomb sprays during the Vietnam war and it turned the tide on the malaria issue. Now my client is a very proud  Vietnam Veteran and we have discussed the war before so I thought nothing of mentioning it. He made a few jokes about how “when you can actually feel a misquote landing on you, then you know you are in trouble.”

My next comment came out without even thinking and received an answer that stunned me.  I said “and of course that bug spray you inhaled was way better for you than the bites.” He snorted and replied “yeah and the agent orange just cleared the foliage with no harmful affect on the soldiers.  It’s only why my brother and both have pace makers now.”

I was silent for a second as he continued to talk about the innovations on the list. Now of course I knew about his pace maker but it never occurred to me that his heart condition was caused by agent orange exposure. Fortunately my client is an amazing person and made peace with his past a long time ago, so my guilt over the casual comment was short lived.  But it was a huge reminder about how much we take our knowledge for granted  as medical professionals.

Being a Scar Tissue Practitioner I am well aware of the emotional affects of injuries and surgeries. I am always tactful when inquiring about their history.  I know that a pacemaker is a small device that’s placed in the chest or abdomen to help control abnormal heart rhythms. On his intake form he just put that he had the surgery. We never delved into the exact issue with his heart as his complaint/our treatment focus has always been his arthritis and knee & hip replacements.

One of the great things about working with people is that you learn something every day.  Today, I was reminded not to take anything for granted , how incredible my client is, I need to be even more thorough with my intake and just when you think you know someone you realize there is just so many more layers to them them you ever imagined.

“Life is like an onion: you peel it off one layer at a time, and sometimes you weep.” Carl Sandburg

 

To tired… or is it too weak… to see straight?

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When was the last time you exercised your eyes?  What no idea?  hhhmm…let’s try some easier questions.  When was the last time you used your ipad or tablet? or how about your computer? How long did you spend staring into the tiny lit up phone screen?  Oh, better yet how much television did you watch this week? I bet you had no problem answering those huh?

There has been a dramatic rise in the last decade in the number of people needing glasses due to the increase of use and reliance on electronic devices. And it is only  going to get worse. Bookstores are going the way of the dinosaurs as electronic readers become more and more popular.  Textbooks are being phased out and schools are  issuing ipads. “The dog ate my homework” excuse is no longer plausible as children are now logging onto school websites to do their homework. Leaving the neck and shoulder issues aside for the moment lets literally take a look at the one thing we take for granted -our eyes.

We all assume that as we age we will need eyeglasses. A belief that is coming of age much sooner by our constant computer/TV use. The problem is not really fixed with the glasses either, as your sight will continue to worsen once you start wearing glasses.  We become dependent on the eyeglasses causing stronger and stronger prescriptions to be needed.

Another issue not being recognized is how fashion is also affecting our eyes. Back in the day we wore the Elton John style, large tinted frames (mine where blue to match my eyes) . images (9)These larger frames allowed us to use our eyes normally to see up and down right and left. images (8) The fashion of today have us wearing small Annie Hall style frames. In order to stay within the small frames we are forced to limit our eye movement and move our heads to see in all directions other than straight forward.  Limited movement means muscle, and therefore vision atrophy.

 

Our eyes like any other muscle in the body needs to be exercised.   Practiced faithfully, eye exercises may actually help delay the need for glasses or contacts in some people.

originalIf you regularly experience symptoms such as eyestrain, blurred vision, headaches, increased sensitivity to bright light, tired eyes, or difficulty sustaining attention, eye exercises could very well be the answer.

Side note-exercising eye muscles will not eliminate the most common maladies that necessitate corrective lenses — namely, nearsightedness, farsightedness, astigmatism, and presbyopia (age-related lens stiffening).

 

There are some very simple exercises that take only a few minutes to do.

1. Repeated blinking. This simple action, that we often take for granted, places a vital role in  health and vision– it replenishes the tear film that covers the surface of the eye (the cornea), lubricating it and protecting it against dryness, dust particles and other irritants. Some research shows that when we watch TV or use the computer, we tend to blink less, which dries and irritates the eyes, potentially causing headaches and other types of discomfort. Blinking every three or four seconds for about a minute is thought to help reduce eye strain by clearing the cornea and allowing the eyes to rest.

2. Palming the eyes. This is achieved by lightly pressing three fingers from each hand against the upper eyelids for a couple of seconds, then releasing. Repeating this process at least five times helps relieve tension accumulated in the ciliary muscles of the eye, while also replenishing the eyes’ tear film. Taking a few deep breaths before performing this exercise will improve relaxation.

3. Rolling your eyes, first clockwise, the counter-clockwise. While this may not sound much like an exercise, it is actually one of the most popular do-it-yourself vision therapies, believed to both tone the eye muscles, and improve local blood circulation. It is generally advised to start rolling your eyes slowly, then faster, and to do this about fifteen or twenty times in a row.

4. Focusing on a distant object. This exercise is recommended especially for individuals who suffer from computer vision syndrome, but it can also help relax the eyes after any other strenuous activity. Choose an object that is located six to ten meters away from you, and focus on it for about twenty seconds, without moving your head. Doing so provides rest to the ciliary muscles that we tend to put a lot of stress on when we focus intensely on the computer screen.

5. Zooming in on an object. This simple (and somewhat hilarious) exercise can be performed by holding a pencil in front of you at arm’s length, then slowly moving the arm closer to the nose, while focusing your eyes on the tip of the pencil. The goal is to bring the tip of pencil as close to the nose as possible, until your eyes can’t keep focus. Doing this exercise ten times in a row helps improve eye movement control and strengthens the eye muscles.

Just for irony here is a website with an easy to follow routine. http://eyepitstop.com/

And here is another simple way to exercise your eyes:

The picture in these exercises was developed by Tibetan monks.

tibetan-eye-chart

 

When performed as described below, the exercises are designed to stimulate muscles and optic nerves. Practicing these exercises twice daily, in the morning and evening, may improve vision problems over time. Build up to the 30 seconds twice a day to avoid eye strain.

Copy and  print the snowflake. You can also get the Tibetan Eye Chart as an app. It’s at www.TibetanEyeChartApp.com.

Remove glasses or contacts.

Sit with back straight and the chart centered about one inch directly in front of your face with the center dot at nose level.

Move only the eyes, not your head.

Hold each movement for 30 seconds. It is important to hold for this length of time as this is the time required to break down the protein bridges holding your muscles locked as they are presently.

Begin by relaxing the eyes, closing them gently and cupping with the hands.

Movement #1
Move both eyes clockwise around the outer circle from dot to dot, beginning with 12 o’clock.

Movement #2
Repeat this pattern, moving counterclockwise, again beginning with 12 o’clock.

Movement #3
Move eyes back and forth between dots at 2 o’clock and 8 o’clock positions.

Movement #4
Move eyes back and forth between dots at 4 o’clock and 10 o’clock positions.

End by relaxing eyes and cupping them with your hands.

No part of the body should ever be ignored. Make sure to keep your day bight and in focus and remember to exercise your eyes!

 

 

 

 

 

Do’s & Don’ts of Healing Scar Tissue-Tip #2

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Scars often occur do to improper treating/handling of cuts, scraps and open wounds. Here are few tips to help avoid any unnecessary scarring and infections while caring for the wound.

DO:

images (22)Colloidal Silver- has been around for almost a hundred years since it was first used by physicians and medical experts as a form of antibiotic, capable of fighting a great number of bacteria that thrive in the human body. It was proven potent for killing such infectious organisms, safe without the unfavorable side effects associated with other types of antibiotics.

Colloidal silver is not only a powerful bacteria-fighting agent. Several studies have revealed that colloidal silver is also a great antiseptic that works to heal cuts, abrasions, and wounds. It helps the skin develop its healthiest form without destroying tissue cells. Colloidal silver has wonderful healing properties and helps damaged tissue to regenerate. Major hospital burn units use colloidal silver bandages and ointments.

How it works:
Studies have shown that colloidal silver works to treat scars and stretch marks by simply immobilizing the enzyme that the fungi, bacteria, and viruses use for them to survive. The silver interacts and blends with the blood once applied to the scars and stretch marks and then enter the cells to look for the infectious organisms that need to be destroyed. It destroys the bacteria quickly by suffocating them in less than six minutes. The suffocation takes place right after the initial contact of the silver with the organisms. If the task is successfully done, the colloidal silver is not just capable of restoring the scars and stretch marks, but it also helps to make the immune system more active and strong.

How to apply:
Apply a few drops of the solution placed directly into the affected skin. You can use a cotton bud for the application, and you can also use a band-aid for disinfection purposes.

Precautions:
It is important to note that the colloidal silver should not be overly used for an over dosage of this solution can cause certain complications. You might feel something itchy or sluggish after a few days of application, but this is simply typical for colloidal silver. You can eliminate these symptoms by taking enough amount of water.

Another problem individuals must deal with involves mixing colloidal silver with other drugs you may take on a daily basis. This could be anything from something as small as something to relieve head and body aches to more potent pharmaceuticals that help with osteoporosis and various other disorders and diseases.
colloidal silver blue skin
The most talked side effect is Colloidal argyria. This occurs when you have taken excessive amounts ofcolloidal silver and it begins to look as though it is staining the skin. If you overdo it you take the risk of turning your skin blue.

History:

images (1)Silver has been known for its medicinal and antimicrobial properties for thousands of years. Hippocrates,“Father of Medicine,” used silver for tissue repair & wound healing. The ancient civilizations of Greece and Rome used silver to control bodily infection & prevent food spoilage. The King of Persia used silver containers to carry water to prevent contamination. Throughout the ages, the ‘Metal of the Moon’ as it was known to some of the ancients has been used effectively for numerous medicinal purposes.

Prior to the 1938 colloidal silver was the principle antibiotic treatment in the United States, prescribed by thousands of medical doctors. At that time colloidal silver was considered to be very high-tech. In the last several decades, major colloidal silver technology advancements have been made enhancing safety and efficacy

Don’t:

images (2)Hydrogen peroxide has been touted as the miracle chemical of the century. Its uses include water purification, bleaching of commercial products, and use as a cleaning agent. However, when it comes to its medicinal uses, it has a long history of being abused and misused.

When you pour hydrogen peroxide onto wounded tissue, the wound immediately starts to bubble, a process imagesthat is followed by an intense pain. People used to think that this meant the antiseptic properties of hydrogen peroxide were kicking in. Scientists now know that this is actually an indication that healthy tissue is dying. This slows down the healing process and gives scars a greater chance of forming. Multiple randomized, controlled trials show that hydrogen peroxide does not prevent or treat infections in wounds.

When hydrogen peroxide is applied to the wound, it combines with a natural chemical in human tissue. This combination generates oxygen and water. The concentrated amount of oxygen that is generated can kill off any bacteria that may be contaminating the wound, but it also kills healthy tissue in the body at the same time. The type of killing that is done by the concentrated oxygen is toxic to the human body. It kills anything alive indiscriminately, whether it’s bacteria or healthy human cells. When the body is trying to repair the wound by sending in a microscopic repair crew, these cells can fall victim to the random killing by hydrogen peroxide.

To prevent wound infection, there are many more precise ways to kill the bacteria without hurting the healthy tissues in the body.

History:
Along with its role in infection prevention, hydrogen peroxide has historically been used to get rid of dead tissue in a bad open wound. This has also been proven ineffective, and the majority of medical professionals have halted this practice.
Instead of using hydrogen peroxide, most doctors use a sterile salt water to clean the wound. This salt water is often drawn into a syringe and squirted into the wound to clean out any debris trapped inside the wound.

In a pinch:

Minor accidents, abrasions and bruises will occur at the most inconvenient of times. It may be useful to know how you can help prevent infection if you don’t have a medical disinfectant like rubbing alcohol handy. Here’s a simple solution you can assemble from household ingredients if you’re in a pinch.
Ingredients:
• Bottled water
• 1 tablespoon salt
• 1 teaspoon vinegar (alternatively, fresh lemon juice)

Steps
• Add bottled water into a glass cup until it is a little more than three-quarters full, making sure that the glass was clean beforehand
• Add salt into water. Salt can be iodized. The salt used for regular cooking will be ideal. Salt is known to contain many bactericidal properties.3
• Mix well until all the salt dissolves in water.
• Add vinegar and mix well. Any kind of vinegar (processed or natural), will do the trick. Vinegar contains a mild acetic acid, which can cleanse and disinfect wounds. If vinegar is unavailable, fresh lemon juice will also suffice.
• Soak into cotton wool and apply to fresh cuts and abrasions on skin. It’s preferable to open a sealed pack of cotton wool.
• After use, dispose of this liquid. It’s not suitable for storage either at room temperature or by refrigeration. Make a fresh preparation each time this procedure needs to be repeated.

Other Natural remedies

download (3)Cayenne pepper: For internal bleeding take one tablespoon of cayenne in a cup of water to stop the bleeding. Cayenne can also be placed directly on an external cut to stop bleeding. You may completely pack the wound if you have enough pepper. Black pepper may be used instead if cayenne is not available. This remedy does not sting like you might imagine and is very important for emergencies.
Plastic Wrap Applying plastic wrap to the skin for three to seven minutes will help clotting and won’t take off the scab when it is removed.

download (2)Sugar: Sugar is an excellent disinfectant. For open wounds or skin ulcerations, sprinkle on granulated sugar to help kill bacteria and speed healing. Smear a ring of petroleum jelly around the edges of the wound to hold the sugar in place, then put a little sugar directly on the wound. Cover the wound with a bandage; change the bandage once or twice a day.

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Tea: Apply a moistened tea bag to the cut to soothe and stop the bleeding.

images (3)Tea tree oil: Derived from the leaves of the native Australian Melaleuca alternifolia tree, tea tree oil contains antiseptic compounds that make it a powerful disinfectant. Use a 10% solution (about 1½ tablespoons to a cup of warm water) to rinse and cleanse wounds.
No matter how you choose to treat an open wound. Always err on the side of caution and if it is a very deep wound or shows any signs of infection contact your doctor immediately.

The children are our future…So how about we pay attention now!

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I received a call the other day from a fellow Massage Therapist. He was
referring one of his clients, a 15 year old male athlete ( lacrosse
goalie and football linebacker) with severe pain in his right knee. The boy’s coach told his mother he needed an MRI and that he most likely tore
something. My friend did not agree and wanted to see what I
thought and if Integrated Therapeutic Stretching would help. He had tryouts in two days and they were concerned about injury.

According to the client he only felt the pain when he was crouching in goalie position. I had him do it for me. He had all of his wait on the outside of his feet which were not wide enough apart to support his weight properly.

I ran him through some quick range of motion & muscle tests as he lay on the table with no resulting pain but revealed very limited ROM throughout the boy’s lower body. As we started to stretch it was quickly discovered that his left glutes were locked up. Hip rotators on both sides were in as bad a shape. IT Band and hamstrings were at 60% ROM and his quadriceps were down to 45%. This is 15 years old folks!

It is terrifying to see the physical shape of children today. Either they are overweight and under exercised or they are over worked, participating in multiple sports where proper strength and flexibility training is nonexistent.

Sports injuries are on the rise in children and teenagers. Each year more than 3.5 million sports-related injuries requiring medical treatment occur in children under age 15. Today, as more and more children and adolescents participate in the same sport year-round, many young athletes are developing overuse injuries. In fact, overuse is responsible for about half of the sports injuries that happen to middle and high school aged students.

We worked together through each stretch, showing him how his body is supposed to move utilizing body proper form and mechanics. He was very eager to learn as was his mother. I assisted and guided him through the stretches focusing especially the ones which really opened his restrictions. Both he and his mother were surprised at how tight he was in the beginning and at speed with which he loosened up.

Now as we were working I observed a deep scar about 1inch in length on his left knee which he claimed was “no big deal” and said it was over a year old. His mother chimed in “the bad one was on his foot”. Three years prior he flayed his right foot open on a fence. There was a huge c shaped scar on the sole of his foot which upon palpation showed to have spread and attached into the arch.

I asked if he wanted to see something cool and then I proceeded to release the scar on his knee. When I asked him to bend his knee his eyes opened wide and said “That’s Sick!”. His knee flexion had increased by 20% . Next with his mother’s permission I went to work on his foot. When I was done I had him stand up. He laughed out loud and said “No Way! Thats Totally Sick! I can feel the bottom of my foot”. His mother , shocked at his reaction said ” I didn’t know you couldn’t feel your foot?!” “Neither did I” was his reply.

We followed this up with gait re-education and proper mechanics required for his respective sports positions (i.e. crouching and squatting). While he still had some minor pain he could see how adjusting his stance took the pressure off his knee. After having him go through the stretches once more I recommend to the mother that if the pain comes back or increases then she should indeed seek their doctor’s advice.

The mother was shocked at how much the scars were affecting her son. I explained to her that scars and adhesions are generally overlooked by health professionals because the extent of physiological affects they can have on the body have never really been acknowledged. The slightest restriction from falling off his bike at 4 could alter how he grows and have major repercussions from one end of his body to the other.

Four days later the duo returned, the tryouts went great and when asked about his knee he said “it still hurts every now and then but whenever I felt it start I shifted around until I felt right and the pain stopped.” I asked if had been stretching and he say before and after the games. (In the four days since I had seen him he had two lacrosse matches and two days of football tryouts). He was also very excited for more scar therapy “It was so weird but I could feel my foot moving better as I played!” His mother than asked if I had any extra time to look at her two scars that have been driving her crazy for years.

During the course of my career I’ve treated many patients whose problems could be traced back to a scar they had forgotten they even had. While not every scar presents a problem, very often they do. Doctors, along with basically everyone else, tend to ignore scar tissue from surgery and accidents especially in children.

Today children are playing more and more sports driven by the need of scholarships and future fame. It is time we start to pay attention to the adverse affects of training and playing so hard so young. We need to make sure that the fall off the bike or the cut from climbing over the fence does not lead to issues later on.

Do’s & Don’ts of Healing Scar Tissue-Tip #1.

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Whether it’s acne pock marks, or the legacy of a burn, wound or surgery, few of us like scars on our skin. And there’s no shortage of remedies that claim to make scars smaller, thinner, less noticeable and heal faster. In this series of blogs I will attempt to shed some light about natural and medical scar treatments.

Do:

download (5)Use Lavender essential oil to treat scars especially burns. Lavender is one of the best all-round essential oil, according to Shirley Price in her book “Aromatherapy for Women.” Lavender oil is gentle, inexpensive and effective. Lavender essential oil can be used to treat acne, scars and most skin conditions; it can be applied direct to the skin, in small quantities.

Lavender essential oil is a very effective antiseptic, antibacterial and antimicrobial that reduces pain, itching and promotes rapid healing. In addition, lavender reduces scarring. When lavender oil is applied to a burn from the onset, the burn may heal with no scarring at all. (For larger burns, put lavender oil onto a gauze or cloth and apply to the burn every few hours.)

How to use it?
• Apply several drops (2-4) on location several times a day
• Directly inhale, diffuse, or
• May be used as a dietary supplement

Safety Considerations With Lavender Essential Oil

Lavender essential oil can sting a little when a wound is still fresh, but once it’s scabbed over and has started healing, lavender essential oil, applied topically, can help minimize scarring while it heals.

Lavender has a relaxation property, often used to fragrance products for bedtime, like lotions and satchels for bedrooms. WebMD warns that lavender essential oil can depress the central nervous system and cause drowsiness and sleepiness (especially good when used properly to treat insomnia and induce relaxation but dangerous when used for other properties and healing in which sleepiness is not a desired effect). You shouldn’t drive or do other dangerous things until you know how lavender will work for you.

rene-maurice-gattefosse
History fact: A French scientist, René Gattefossé, was severely burned in a laboratory accident and immersed his hand in a vat of Lavender for two weeks. Gattefossé found that Lavender oil promoted tissue regeneration quickly and healed the wound with no scarring!

Don’t:

One of the most popular treatments for scarring is vitamin E.
But will vitamin E really help to improve your scar?

can_vitamin_e_h_photoVitamin E, or tocopherol, is a fat-soluble antioxidant. It’s found in capsule or liquid form at drugstores, grocery stores, health food stores, and online. The so called effective remedy consists of opening vitamin E capsules and applying the content on the scar. But this topical use of vitamin E does not result in scar healing. Vitamin E has been shown to penetrate layers of the skin and reduce the formation of free radicals which can interfere with healing. Vitamin E also influences the production of collagen, a structural protein partially responsible for the strength and elasticity of skin. Although many people apply vitamin E oil to their skin to minimize scars and it’s sometimes recommended by physicians after skin surgery, there’s very little evidence that shows it helps.

Vitamin E Research :
Current research does not support vitamin E oil to reduce scar formation.

A study on the effects of topical vitamin E on the cosmetic appearance of scars at the University of Miami that there is no benefit to the cosmetic outcome of scars by applying vitamin E after skin surgery and that the application of topical vitamin E may actually be detrimental to the cosmetic appearance of a scar. In 90% of the cases in this study, topical vitamin E either had no effect on, or actually worsened, the cosmetic appearance of scars. Of the patients studied, 33% developed a contact dermatitis to the vitamin E. Therefore it was concluded that use of topical vitamin E on surgical wounds should be discouraged.

Research by K.C. Wan and J.H. Evans at the Hong Kong Polytechnic University, published in 1999 issue of “Free Radical Biology & Medicine,” found higher amounts of free radicals in hypertrophic scars, which become thicker, redder and more elevated than regular scars. Another study by T.L. Khoo at the Hospital Universiti Sains Malaysia, published in a 2010 issue of the “Journal of Plastic, Reconstructive & Aesthetic Surgery,” concluded that tocotrienols, a vitamin E subfamily, made no significant improvement in scar parameters. Also, a study conducted by Morganroth, Wilmot and Miller in Philadelphia for a 2009 issue of the “Journal of the American Academy of Dermatology” determined that scar products containing vitamin E oil did not support usage for the reduction of postoperative scar formation.

Be on the lookout:
For specific ingredients found in commercial wound ointments and dressings.
Listed below are just a few ingredients present in store bought wound products. Most of these products produce skin irritation, sensitization, and are linked to allergies, cancer and/or immune suppression. Here they are:
• Petrolatum
• Mineral Oil
• Propylene Glycol
• Butylated Hydroxytoluene (BHT)images (19)
• Benzalkonium Chloride
• Yellow #5; FD&C Blue #1
• DMDM Hydantoin

Even many of the natural ointments contain some of these ingredients. Make sure to read the labels and please, test the area for allergic reactions before applying anything to your skin!

Mandatory Gratuities -Oxymoron

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images (18)I was settling up with a new client when she asked “And what is the recommended gratuity?” I explained that “while I appreciate the thought it was not necessary”. She was very surprised and commented that the last few places (both spa and private practice) she went to had a mandatory gratuity policy. This really drives me crazy.

The definition of mandatory is: containing or constituting a command: obligatory
The definition of a gratuity is: something given voluntarily or beyond obligation usually for some service; generally in the form of a tip.

A gratuity is just that. When a person is happy with a service that has been provided for them and wish to show their appreciation. So, would someone please explain to me how demanding a client be grateful for the service they have paid you to perform, whether or not they actually did appreciate it, acceptable? Especially to the point of requiring they give more money on top of the already established fee?

Now I am not saying one should not accept a gratuity. I believe it is a personal choice. It is up to the individual as to whether or not they wish offer a gratuity and to accept one. As I mentioned earlier I always tell my clients it is not necessary but if they insist I will accept because of what the offering means to them. I usually put the tip in a draw and then make a donation somewhere down the road with it, my way of paying it forward. But, again this is my choice there is nothing wrong if another therapist decided to keep the offering. The therapist performed a service to the best of his/her ability and were rewarded for the effort.

I know that there are a few points of view out there in regard to the Massage Profession. The first is we are a service industry and that there is no reason why we should not accept tips. The second is that we are healthcare providers, the same as doctors and physical therapists, and it is unprofessional to accept tips. We are all in service in one way or another from the doctor to therapist to contractors to the waitress at the local dinner. It is always uplifting when one is complimented or thanked for a job well done. Where the distinction falls as to who should or should not receive a gratuity it is commonly left up to proper social etiquette. What most fail to see is that if we follow proper etiquette everyone receives a tip. – hospitals are giving grants, doctors receive the fruit basket or bottle of wine at the holidays. We leave holiday bonuses for the mailman and the garbage collectors. We leave the tip on the table at the end of the meal for the waitress. How much we give, if at all, is a personal choice. While society likes to comment on the end results it is no one else’s business and it is certainly no one else right to demand that their way of doing something be adhered to.

There is also the unwarranted distinction of whether or not the therapist is working for themselves or on staff at a spa. In other words, it is required to tip the therapist at a spa because the house is taking a cut and the therapist makes less. First off the therapist chooses to work for the spa and that alone does not make them worthy of a gratuity. If the client is really pleased with the service then by all means have at it, however, the client should not be required to do so. It is a bad habit of some spas to make gratuities mandatory to make up for the low wages they pay the therapist. So in other words, the Spa is demanding the client not only pay them for the service but also share the cost of paying the salary of the therapist as well. If a spa wants quality staff then pay a decent wage.

A client once told me how she went to a spa where the staff was rude, she waited 20 minutes past her appointment time and the massage was just o.k. In spite of all of this when she paid for her treatment, she included a tip as etiquette required and she was promptly informed out loud “that is not how we do it here your tip is not enough”. She felt so embarrassed she gave them more money and fled. Granted this is not the norm but what is the incentive, for those who need one, to do a good job if they are already guaranteed a bonus no matter how they perform?

As far as not tipping a therapist in private practice because all of the money goes to them- well please, the therapist is paying their own overhead and has bills like everyone else. Either way if the client is pleased with the massage there is no reason not to express their appreciation and it is up to the therapist to choose to accept it. That’s all I am saying.

Law of Averages

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images (17)Who’s goal is it to be average? Average looking, of average intelligence and so forth. When it comes to social acceptance and self image the last thing anyone wants is to be considered average. Except of course when it comes to our health. Being average is actually the goal. Health is often determined or judged according to averages.

Take blood pressure for example, the average range for blood pressure is 120/80 to 110/70. Mine happens to be 90/60, I work out and am in relatively in good shape. During an annual check-up, the nurse taking my blood pressure was alarmed and said that my pressure was low. I had to explain to the nurse that if she would take the time to read my chart she would see that 90/60 is in fact normal pressure for ME. download

What would have happened if I did not know what my personal norm for blood pressure was? I may have been prescribed medication to raise my pressure, which I would most likely have taken without question, because we always listen to the Doctor in the nice white coat, right?

Our health care uses averages as it’s guidelines. Now, do not get me wrong, we need guidelines but that is all they are a guide – not the ultimate answer

images (16)I have a client, 49 year old female, who is very flexible – almost hyper-mobile. During rehab for a knee replacement the PT tested her range of motion (ROM) and noted that she had 90 degrees of hip flexion and told her “wow you have healed really well” and was satisfied with her recovery. For the average person 90 degrees of ROM is considered, sadly, as acceptable and in some cases the goal. Unfortunately for my client, her normal hip flexion ROM prior to surgery was 120 degrees. Trusting that the PT knew what he was talking about she accepted the diagnosis. Meanwhile she did not feel like “she was good to go”, again quoting the PT, and was still experiencing pain and restriction. After increasing her limited ROM and eliminating her back pain she said “I had no idea my pain was related to the knee as they said I was healed. I just thought, well this is what getting old was like”. Again she is only 49 years old. Her ROM prior to surgery should have been documented somewhere. Rehab goals should not be to achieve the average. While a surgery such as a knee replacement will present new limitations it should not be assumed that she is only ever going to be average from here on out.

images (13)Let’s look at this from another perspective. What Doctor should a female go to when the symptoms of Menopause begin? The standard answer is the Gynecologist. But why? – a Gynecologist, for all intense purposes is a plumber. Menopause is not a plumbing issue it is a hormonal one- women should be turning to an Endocrinologist for assistance with the change.
A gynecologist will most likely prescribe estrogen for all of the women who come to him/her. Here is another important time when a woman needs to know what is normal for her. All women should get a full hormonal blood work up every ten years starting when they turn 20 and put the information away until the time occurs. Then she will have a complete history of her hormones. This would be a more appropriate guide for what she personally needs as a supplement, if any, at this point in life.

It is so important that we pay attention to our bodies as well as our instincts when it comes to our health care. We need to when know something is not right for us personally. We should not blindly accept recommendations for surgery, or reasons for continuing/ending treatment. We rarely follow our instincts because we are unsure and uninformed about our own body. The more connected one is with their own body, the better prepared one is to figure out which health options are best suited for us, indidivually. Knowledge is power, combine it with understanding and confidence the result is a uniquely healthier, you. And there is nothing average about that.