Monday, August 30, 2010

Case Study

(s) My client is a 55 year old female. She's in good shape and eats healthy. She's suffering from migraines and bouts of insomnia. She also claims to get very anxious at times. Her right rhomboid is sore as well as the right shoulder. She thinks she has frozen shoulder and tendonitis on that side. Her main goal is to relieve shoulder pain, stress relief, better sleep, and general relaxation.

(o) My client relaxes easily, partly due to her being comfortable with me and partly because she is looking forward to some quiet time. Her traps, neck, rhomboids and levetor scapulae are constantly tight and dense- these muscles include teres minor, supraspinatus, infraspinatus, and subscapularis. The erector spinae group of muscles down the back always seemed to have knots in them. This was more so on the low back. Biceps in the arms felt a bit more tense in the right arm. The IT band was problematic and tight. Rectus Femoris also tight with knots/ "speed" bumps. I could not do a deep clearing stroke on the legs. Throughout the massages I noticed the right shoulder gained more range of motion and flexibility. The IT band also let up over time. She was seemingly happier and more relaxed. She didnt slouch or slump her shoulders as much as she was before. She also said she felt more energized, pain reduction in the shoulder, and could sleep better at night. It took about 3 sessions to really notice a significant difference in how she felt.

(a) Throughout out time together I made sure to move very slow through the head/scalp massage to relax my client. I taught her 3 centered meditation for during the massages and to use outside of our sessions. On days that her anxiety level was high I would do a nice foot massage first and do some energy work to draw the energy down. When she experienced headaches I would work the pain path in the arms, including points LI 11,10,9, and 4. I also incorporated the S.I points 11 and 12 and L.I 16 all located around the shoulder to help with the shoulder pain. Energy work in the arms to draw the energy out through the fingertips and open up the pathway for the pain to travel out. Lung 1 and 2 were also included into the treatment plan, more towards the end. I used the LV/GB grasping down the legs to open up the meridians. This will help wood imbalance, manifested in the nails being ridged. The upper back got extra attention around the rhomboids and made sure to work S.I 10 on the scapula. Deeper pressure was often applied the erector spinae and focused more on the low back. When shoulder pain and headaches were at a high i would focus more on the arms, shoulders, neck, and back, and skip the legs completely besides compression. All these teqniques seemed to work for my client over time with pain relief and over all sense of well being.

(p) I plan to keep working with this person for as long as I can. I would like to assign and teach some Qi Gong movements to help her low back, which would include: Reaching for heaven and earth, accept the moon qi, and painting the world. Rowing on the lake would also be good for range of motion in the shoulders. I would also like to use the 9 points to revive the yang for depression issues and to restore energy. I would like to draw up a 5 element chart and map out imbalances to help her further. My client is very curious about chinese medicine, and would love to see some more results. I would also like to do a moxa/kidney treatment that we recently learned to help the low back and kidney qi. I will encourage her to use the meditation daily, especially before bed. I would like to practice Smiling Heart Qi Gong with her as well because its my favorite Qi Gong and opens the heart center

In conclusion I would say that I could see a significant different in body tension and some internal changes. Its amazing what a month and a half of consecutive massage can do. I am excited to learn more about Oriental Medicine and use it in the practice. I feel like the things i have learned here at OHAC are beneficial to my practice and make a tremendous difference. They can be life changing and are always positive. I cant wait to see what other positive changes I can make in my life and others.

Monday, August 23, 2010

Chronic Fatigue Findings

Instead of blogging on my case study, I offer this. I found it very interesting. Especially the end comment that this virus was also found in prostate cancer patients.

Makes one think...

Monday August 23, 2010

Chronic Fatigue Linked to Mouse Virus in U.S. Government StudyAugust 23, 2010, 3:13 PM EDT

By Michelle Fay Cortez
Aug. 23 (Bloomberg) -- Almost 90 percent of patients with chronic fatigue syndrome showed signs of infection with a novel mouse virus in a U.S. government study, raising fresh questions about the cause and treatment of the debilitating condition.
Researchers from the Food and Drug Administration, the National Institutes of Health, and Harvard Medical School found the virus in blood samples taken from 32 of 37 patients with the syndrome, bolstering a finding with a related virus last year. The new infectious agent was also found in three of 44 samples from healthy blood donors, according to the study published today in the Proceedings of the National Academy of Sciences.
It was the first time the mouse virus has been found in people or in the blood supply, deepening the mystery surrounding CFS, a condition that affects more than 1 million Americans, mainly women ages 30 to 50. A report from the U.S. Centers for Disease Control and Prevention had said there was no sign of the virus in a similar study earlier this year. Those results were confirmed by the current FDA researchers, who analyzed some the CDC’s samples using their own laboratory methods.
“The study doesn’t prove these viruses are the cause of chronic fatigue syndrome,” said Celia Witten, director of the FDA’s Office of Cellular, Tissue and Gene Therapies, who oversees the lab where the research was conducted. “More research is needed.”
Testing Drugs
Antiviral drugs, including Merck & Co.’s Isentress and Gilead Sciences Inc.’s Viread, should be used to treat the patients to see if it gives them any respite, French and Canadian researchers wrote in an editorial accompanying the study.
While there isn’t sufficient proof that the mouse viruses cause chronic fatigue syndrome, a study showing whether antiviral drugs are an effective treatment could help confirm the hypothesis, said the doctors led by Valerie Courgnaud, from the University of Montpellier in France.
There is no evidence that the viruses are transmitted by blood transfusions or that they lead to any type of human disease or illness, Witten said in a telephone interview.
There are no specific tools to pinpoint chronic fatigue syndrome, which is typically diagnosed after patients experience extreme fatigue for at least six months. The condition is marked by a relapse of symptoms after mental or physical exertion, sleep that doesn’t refresh, and joint and muscle pain.
The link between chronic fatigue and the retroviruses was identified previously by a team led by Vincent Lombardi of the Whittemore Peterson Institute for Neuro-Immune Disease, in Reno, Nevada, and published in October in the journal Science. The researchers analyzed the genes in tissue samples collected from 101 patients with chronic fatigue, and in 68 the scientists found evidence of a related virus known as XMRV. The virus was also identified in some prostate-cancer patients.
--Editors: Donna Alvarado, Jeffrey Tannenbaum
To contact the reporter on this story: Michelle Fay Cortez in Minneapolis at
To contact the editor responsible for this story: Reg Gale at

©2010 Bloomberg L.P. All Rights Reserved.

Friday, August 20, 2010

Case Study

My case study included six massages spread out over a period of nine weeks. Ideally, I would have liked to have seen my client at least once a week, but because of our different schedules and time constraints it took nine weeks to complete all six massages.

My client was a 42 year old female. During the first intake the client told me that she was on blood thinners (Coumadin). In January of 2009 she was experiencing pain in her legs, sever fatigue and dizziness. She ended up in the emergency room and it was discovered that she had many blood clots in her left leg. She was admitted to the hospital and stayed for a week under close supervision until she was stable enough to go into surgery where the Doctors placed a filter in her Vena Cava. The filter was put in place to help catch the clots so they would not go through her heart, into her lungs and cause a possible pulmonary embolism.During this time she was also placed on blood thinners, namely Coumadin, to help prevent further clotting. Her leg gets achy when she is on her feet all day and she has been told to elevate it at the end of the day. She now takes blood thinners daily and sometimes hydrocodone for the pain in her legs. The Dr.’s say she will probably have to be on Coumadin for the rest of her life. Because of the blood thinners she tends to bruise easily. She used to go in for lymphatic drainage massage (usually only the axillary and clavicle area) twice a month but doesn’t do this anymore. She has been cleared by her Dr. for regular massage therapy.

During her time in the hospital she also drastically lost weight. Since then she has had low energy and no regular physical exercise plan and has put on a lot of weight. This makes her upset and sometimes sad and frustrated about her lack of energy. She experiences swelling in her legs after extended periods of being on her feet (walking, standing, ect..) and has had difficulty staying active because of this and stress with kids, work, and everyday life. She has said that when she can fit in regular exercise her leg feels less achy and she sleeps better.
Also during the intake she indicated that she has a medium stress level and holds her stress in her shoulders and low back. She also tends to get very bad headaches when she gets very stressed out. Works in an office and has for most of her professional life.

My client’s main goal for her massage was relaxation. I could tell by the way she spoke and the concerns she had that her thoughts seemed hurried and rushed. Her eyes looked tired and tended to sigh often while she talked. Her skin was healthy and soft, well tanned. Although she had not been doing regular exercise and had gained some weight, her muscle tone was still good and her energy felt strong but tired. She had lots of tension in her neck and upper traps, with a large knot in the left occipitals. She was very sensitive in the neck area. Small bump on palmar side of right forearm (says it has been there since she was young) that could be a possible ganglion cyst. Her left leg was noticeably more swollen than her right from the iliac crest to her ankle, seemed to be more so around thigh area. Edema but not pitting. Feet were both cold and limited ROM in hip area. Some tension in low back and erector spinae and knots in L levator scapulae and R rhomboids. All shu points on back felt good except for small pluckable knot in R LV shu point.

Because of the clients blood thinner medication I used only light/moderate pressure with lots of soothing strokes. She was sensitive in certain places, liker her neck, but liked a little more pressure on her back and so I adjusted accordingly. I spent a good amount of time on face and head massage to open up and relieve tension in that area to help with headaches. I did more detailed work on her neck and upper traps to help loosen and break up stagnant energy. On her arms I emphasized strokes toward the body to help with lymph drainage and included Li 11, 10, 9 &4 to open up arms and give stagnant energy a place to go. She did not want abdominal work during the first few massages but during the last two sessions I did do some work through the sheet. On days when she had a head ache I was sure to include grasping down the GB meridian and lots of scalp massage, Li 4. Strokes on her legs were all towards the body to help with lymph drainage and I always gave a very nice foot massage to help soothe and relax. Points in her feet and legs included following Ki merdian from Ki 1, 2, 3 & 7 (8x). Lv 2-3 (50x). and St 36 (8x). On her back I used a little more pressure. Mostly long gliding strokes with focus on knots in levator scapulae and rhomboids. Sacral roll on low back and grasping. All shu points were included and stimulated 24x. On our last session I did reviving the yang to help with her low energy level (Ki1, Ki3, Sp6, St36, Cv12 Pc8, Li4, Gv15)

Over the course of the 9 weeks of treatment I saw some alleviation of tension in the neck, specifically the knot in L occipitals released. Tension also decreased in shoulders and rhomboids. When massages were weekly I noticed that her left leg was not as swollen most likely due to lymph drainage and increased circulation to that area. Her headaches were not as frequent and were always gone by the end of a massage. She really enjoyed all massages and felt very relaxed and rested. She and I plan on continuing to work together once our schedules settle into a regular routine. Now that I have learned the 64-point acupressure foot massage I would like to include that into the massage for her left foot/leg. Also, I would recommend a longer session with time at the beginning for a QiGong. She is open and interested in QiGong and I was hoping to start showing her the Dragon QiGong, which is good for weight loss and tonifying the meridians.

Thursday, August 19, 2010

Arthritis Case Study

Nearly one in five Americans have arthritis or chronic joint symptoms. So not surprisingly there are two people in my household with some form of arthritis. With so many people having an issue with arthritis I chose it as my topic to research in pathology class so I would be more knowledgeable when I need to help a client with arthritis and so I could learn to better help the people close to me.

The person I chose for my case study has arthritis in her hands and ankles, a degenerative disk in her low back, and had recent surgery for a bowel obstruction. In the five elements of TCM arthritis would fall into the wood element, the low back pain would be influenced by the water element, and small intestine issues are part of the fire element.

For her six weeks of weekly massages I started out with the general one-hour relaxation pattern with some extra attention to her hands, ankles, and knees. I taught her the Small Intestines qigong for the dragon qigong we do in class to help with her digestion, but also because the movement rotates the wrist and arm up to the shoulder blade where she holds a lot of her tension. After two weeks with that qigong I showed her the Painting the World qigong to give some range of motion movements to her low back and also to massage the abdomen. I showed her yin-yang palms to get her wrists moving and the blood flowing. I told her how to massage her own abdomen with oil in a clockwise motion to help her heal from the surgery and to get her bowels moving.

Depending on what concerns she had the day of the massage I used some different acupressure points. Large Intestine 20 for her sinus headache along with the Large Intestines pain path down the arms for headaches. I used Stomach 8 to help calm her mind on a day she was noticeably stressed out, and spent some extra time on Stomach 41 for anxiety which I always use in a massage.

After six weeks of weekly massage she told me that she was pain free in her hands for 10 hours after the massage and pain free for 8 hours in her back. She really enjoyed the qigong movements. there was less inflammation in her back, the muscles around that vertebrae were less tense, with less chronic pain overall. she also commented that she felt a huge difference the next day in whether she drank a lot of water or not. Not drinking enough water left her feeling more achy the next morning.

If I was to continue working with this client I would make sure to keep up with the qigong movements, adding more when she felt like she had the ones I taught her memorized. I would make sure to spend extra time round rubbing her joints and low back. Now I know how good it feels to have a lot of time spent on round rubbing, especially rubbing clockwise on the low back, I would make sure to include it in her massage. I would get some Po Sum On oil to use when massaging her hands, Po Sum On oil is warming, helps to relieve pain and aids in circulation.

She loved getting massaged and was a great person to work with. Even with out the changes in her chronic pain she was very happy just to be relaxed after her long hours at work.

Sunday, August 8, 2010

Healing a Dancer

A dancer in my class moves very stiffly and rigidly. Though she tries very hard and loves the class, she keeps getting frustrated over not having the same fluidity in her hips as the others. She would love to see me for a massage session.

The first thing I would check for would be to make sure there is no physical injury or condition that caused stiffness or inhibition of movements.

1. Upon examining her Mu and Shu points I expect that I would see that her kidney points, GB25 and BL23 are depressed to hollow, along with her bladder points, CV23 and BL 28 and her liver points may be a bit harder and blocked, LV 114 and BL 18. There is probably a deficiency in kidney and bladder points as well as an excess in the liver points, there may be some personal issues and discomfort with herself.

2. The major sign I expect to see in her tongue is that it is probably pale and swollen, possibly moist, denoting a deficiency in her yin energy and a definate yang deficiency. I would not be surprised to see redder, scalloped edges, some cracks, or a depression of the kidney area at the root of her tongue.

3. Although I see problems in almost all of her elements, the main one that I see would be a deficiency of her water element, the kidney and the bladder. I see this manifested by her stiffness and lack of sense of where her body is in space. I would also classify some of this stiffness as a problem with her wood element as her core, the spine, is stiff and lacks flexibility. She no doubtedly feels a bit of frustration and this would manifest as some slight excess in the fire side of her being.

As for a massage, I would start off with a nurturing energy, trying to open up the bladder and kidney meridians, wanting her to be comfortable in her body and with the feelings that the dance brings out in her. I think I would spend some time nurturing the liver as I expect there is some anger that is causing some stagnation there. I would want to add some exercises that twist and bend the spine and core. I would want to help her to see her body as it takes up space and be able to visualize it on the different planes in space, right, left, up and down and to be able to visualize how the movements that I try to teach affects how her body moves through space.

Seeing the stiffness is not an uncommon thing. First of all, the fluidity very rarely comes with a new dancer, it is something that comes over time. A woman of western culture frequently has problems with many of the movements if she does not come from a movement background, as we in the west are taught to move in a way foreign to the movments of oriental and eastern dance, using parts of our body that are kept stiff and reigned in with western culture. Often a dancer comes with a past history of abuse or stifling of emotions that takes a while to work through and this can be seen as a stiffness in the body or a lack of ability or awareness of the body as it relates to it's place in space (of course this is barring physical injury, condition or limitation on her movements). In some cases, there may be an excess of heat or fire as there may be a deep seated anger at past treatment or experiences or an inhibition in the sexual power that comes out from feeling comfortable in one's own skin, and it takes time to work through those things until the individual is secure in themselves and ready to surrender to the joy that the movements of dance can bring.

Most of all, I would encourage this dancer to give herself time and love to bring out the beautiful woman and dancer that is hidden inside.