Ep 133 – Happy Birthday to . . . Us! “I Have a Client Who . . .” Pathology Conversations with Ruth Werner

0:00:00.0 Speaker 1: Ruth Werner's best-selling book, A Massage Therapist's Guide to Pathology, is a highly regarded, comprehensive resource that sets the standard for pathology education. Written for massage therapy students and practitioners, this ground-breaking resource serves up a comprehensive review of the pathophysiology, signs, symptoms and treatment, of more than 500 diseases and disorders. Learn more at booksofdiscovery.com.

0:00:32.4 Speaker 2: Anatomy Trains is happy to announce our return to the dissection lab in person, January 10th to the 14th, 2022, at the Laboratory of Anatomical Enlightenment, in Boulder, Colorado. We are thrilled to be back in the lab with Anatomy Trains author, Tom Myers, and master dissector, Todd Garcia. Join students from around the world and from all types of manual, movement, and fitness professions to explore the real human form, not the images you get from books. This is an exclusive invitation. Email info@anatomytrains.com, if you'd like to join us in the lab.

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0:01:17.3 Ruth Werner: Hi, and welcome to, I Have A Client Who, pathology conversations with Ruth Werner, the podcast where I will discuss your real life stories about clients with conditions that are perplexing or confusing. I'm Ruth Werner, author of, A Massage Therapist's Guide to Pathology, and I have spent decades, studying, writing about and teaching about where massage therapy intersects with diseases and conditions, that might limit our client's health.

0:01:46.1 RW: We almost always have something good to offer, even with our most challenged clients. But we need to figure out a way to do that safely, effectively and within our scope of practice, and sometimes, as we have all learned, that is harder than it looks.

0:02:04.3 RW: Happy birthday to you. Happy birthday to you. Happy Birthday, dear, I Have A Client Who. Happy birthday to you. It's hard to believe, but I Have A Client Who, is a year-old, this week. The pilot episode went out on July 24th, 2020, and what a year we have had together. To prepare for today's short celebratory episode, I went back through my records. I keep them stored by title in alphabetical order, rather than by date or body system. That might turn out to be a mistake. But I thought we could do a quick run through of some of the 52 episodes that you and I have made together this year.

0:02:51.3 RW: In the A's, we started with an episode, where a client in a hospital setting, had signs and symptoms of appendicitis but showed up for a massage anyway, and we went through the critical thinking steps that the massage therapist might have to go through, in a situation like that. In the B's, we had a story about someone with brain surgery, who then had debilitating back spasms, and where a massage might fit into that complicated picture, and I had a really simple little episode on bunions, that was really fun. In the C's, we had a complicated episode on corticobasal syndrome, and then in the D's, we had several. A terrific one on dermatomyositis and how it mimic some other autoimmune diseases. And we had several around topics of deep vein thrombosis.

0:03:42.0 RW: In the E's, we had a very touching episode about a client, who lives with an eating disorder, and the response to that was so compassionate and lovely, it was really a high spot for me. And then we had a surprisingly satisfactory episode on a client, who lives with essential tremor. We also talked about eustachian tubes and how they connect with the vestibular system. In the F's, we had two episodes on a procedure called femoral popliteal bypass surgery, and then we talked about window work in the context of a client who just got her flu vaccine. And we finished the F's with a client who had a fractured sternum, and another client who had a frozen shoulder.

0:04:25.3 RW: We had only one in the H's. A client showed up with a knot in his groin, it was a hernia. Infected olecranon bursitis was next on the list, but we also had another olecranon bursitis story that showed up as an occupational hazard for massage therapists who use their elbows a lot. In the K's, we talked about clients who are kidney donors, and a client who has kienbock disease, which is a condition that damages one of the bones in the wrist. We moved on to the L's and we talked about lipedema and liver failure, and logorrhea, which is a situation where a brain problem makes the person have to talk and talk and talk and talk and talk.

0:05:08.3 RW: In the M's, We talked about Marfan syndrome and MRSA, 'cause you can never have too much staph. Am I right? In the N's, we had an episode on nerve irritation and then we went right to the O's, where we had an episode on obesity and pressure adjustments for that situation. That episode also got a lot of attention and really helpful feedback, and I was really happy to put that out into our profession. In the P's, we had an episode on how Parkinson's disease can sometimes be confused with a different issue, called a normal pressure hypertension. That was a new one for me. I'm still waiting for someone to send me an I Have A Client Who story about classic Parkinson's disease, 'cause I love talking about that. So help me out, will you? Also in the P's, one of my very first episodes was on a condition called PFO or patent foramen ovale. This is one of my favorite topics. It was great to have this as an early offering in the podcast world.

0:06:11.0 RW: We've had a few different episodes about pregnancy. One was about a pregnant client who also had carpal tunnel syndrome, one was about a pregnant client who passed out mid-session, and the other was a great interview with Carol Osborn, who knows more about the intersection between massage therapy and pregnancy, than just about anybody. We also had an episode on pseudogout, which is a lot like regular gout, but the chemical profile is different, so it requires different treatment. And we had a podcast on psoriatic arthritis, a really complicated condition, and in this situation, the contributor was the person who had the psoriatic arthritis and his situation was really moving.

0:06:53.4 RW: In the R's, we had a terrific I Have A Client Who story, about an elite soccer player who developed rabdomiolisis, a potentially dangerous medical emergency, where muscle breakdown can damage the kidneys. Also in the R's, I enjoyed talking about restless leg syndrome, which is dear to my heart, because it interrupts sleep, and that's something I care about a lot.

0:07:17.2 RW: In the S's, we heard about a client who was a competitive barrel racer, who had really limiting scoliosis and her massage therapist helped her work out a way to deal with this challenge, to keep active, which demonstrates how amazingly adaptable human bodies are. There was also a fascinating episode about a client with a history of seizures, and a massage therapist who was nervous about what to do if something might happen mid-session. So we laid out some safety precautions and planning guidelines. I had help on that episode, from my son, who is a paramedic. And also in the S's, who can get enough shingles. We had an early episode, where a client had an undiagnosed rash, that turned out to be this very painful condition, and another one more recently, where the question was really about communicability. So I walked through that complicated process. One week, I had no contributors, so I pulled out one of my own, old I Have A Client Who stories, about a client with shoulder pain that did not improve with massage, and it turned out, that's because it wasn't a shoulder problem, it was a referral from her gallbladder.

0:08:26.6 RW: We have looked at massage for clients recovering from spinal fusion surgery, turns out there's a lot we can do there, and in our very first episode, we talked about the prognosis for stroke survivors and the role massage therapy might have there too. One of my favorite episodes so far, was just last week, an interview with Dr. Cynthia Price, about her client who was going through treatment for substance use disorder and how massage is helping her to learn about her body in a positive way.

0:08:58.3 RW: Moving on to the T's, I got to do an episode about a person with Tourette syndrome and someone who has toxic mold syndrome, and that was really fun to dig into. And way at the end of the alphabet, is the episode on vertigo. The person has vertigo and a lot of neck pain, and so the client's awesome doctor recommended massage, and that gave me a chance to do a deep dive on vertigo causes and contributors.

0:09:25.0 RW: So there you have it. From appendicitis to vertigo. This year, you gentle listeners and the kind people at ABMP who gave me this platform, you've all given me the opportunity to interact with the very best of our profession, people who are curious and compassionate and who want the very best for their clients. I have gotten to learn about many conditions that are new to me. Kienbock syndrome, please? Normal pressure hypertension, and I've gotten to deepen my understanding of others. With almost every episode, I provide some reference notes, so that what I can't cover in my 10 minutes of chatter, you can pursue on your own.

0:10:04.0 RW: So, thanks for a great year, I Have A Client Who listeners. Be sure to send me your stories, so we can keep making this resource to share our common wisdom, to enrich our practice. Hey, everybody, thanks for listening to I Have A Client Who, pathology conversations with Ruth Werner. Remember, you can send me your I Have A Client Who stories to, ihaveaclientwho@abmp.com. That's ihaveaclientwho, all one word, all lowercase, @abmp.com. I can't wait to see what you send me, and I'll see you next time.