The Continuing Quest for Knowledge

Leave a Comment

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….

Leave a Comment

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.

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

Leave a Comment

Essential Oils or Vitamin E for Healing Scar Tissue

Whether it’s acne pockmarks, 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. From natural at-home remedies to mass-produced and mass-marketed products, we are flooded with options that claim to help with scars. In this series of blogs, I will shed some light on natural and medical scar treatments.

What Should You Do to Heal Scar Tissue?

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 directly 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 the 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 the 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 contact dermatitis to the vitamin E. Therefore it was concluded that the 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!

Hope this helps with your scar healing.

Check out the second post of the series: Do’s and Don’t’s of Healing Scar Tissue – Tip #2

》A B O U T   M A R J O R I E   B R O O K

marjorie brook lmt author headshotMarjorie Brook, LMT is a massage therapist, author and international educator. For over 21 years, she has specialized in scar tissue release and massage therapy. She works from the fundamental belief that your body is intuitively aligned with the thoughts you think, the emotions that you feel and the things that you do. She founded Brooks Seminars in 2007 after working as a decade as a nationally recognized massage therapist with a private practice on Long Island. She is the creator of the Scar Tissue Release and Integrated Therapies (S.T.R.A.I.T Method™) and offers continuing education courses on this method all over the world. Her articles have appeared in magazines such as Massage Today, American Fitness and Massage World. She’s approved by the National Certification Board for Therapeutic Massage and Bodywork, the Massage Therapy Association of Alberta and the College of Massage Therapists of British Columbia.

Mandatory Gratuities -Oxymoron

Leave a Comment

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.

Wide Band Narrow View

Leave a Comment

A_HAD_1p_P36Should we stretch? Does it help or does it cause harm? This is a very popular debate. One that usually ends in “Well… there is no evidence that proves it is good… but everyone does feels better afterwards.” or “It is a waste of time that can only lead to loss of strength.”

When we think about stretching we tend to think only about the muscles and static holds. These narrow views are what gives stretching a bad reputation and where all of the misunderstandings occur. We should be stretching the whole body, which is primarily made of fascia, in line with the way it was designed to move, dynamically.

For example let’s look at the knee. Usually when there is an knee issue most look to stretching the Quadriceps or Hamstrings muscles. body_worlds_knee When the IT Band comes to the knee joint it binds into a large network of connective tissue or Fascia. This fascial network comes across the front of the knee depending on the direction of force and it connects down into the shins. The IT Band fascially connects into the Peronals & Tibialis Anterior. The knee cap is embedded in fascia. When we have Knee injuries such as patella tracking, meniscus tears, ACL we often focus our view on the Hamstrings and Quadriceps addressing only half the possibilities of causation. Perhaps the fasica is inflamed. A common complaints of knee pain is a sweeping type of pain across the knee and under the knee cap. For it to be sweeping across it must be the fibrous attachments across the knee. This is not the type of pain a Quadricep or Hamstring would be causing.

So by opening up our point of view to encompass all of tissues involved, while recognizing the patterns in which it is connected and functions leads to a productive pain reducing, fascial lengthening, muscle educating and recovering stretching session.