Category Archives: CAMTC Certified

Migraine Journey Part 3: Update Feeling A Bit Better!

February was a challenge

The weather was unusual for Southern California, a lot of rain and overcast skies that often cause me a lot of light sensitivity and headaches.

My last entry detailed many of the ongoing days of struggle with the migraines and it was a bit chaotic but I decided to leave the entry exactly as it is because that is how my mind was working at the time.

I have been on the 100 mgs of Topamax for over a month now and using CBD oil daily along with Turmeric with Black Pepper and some Vitamin D (since I already know I am low on that) and drinking water.

I am trying to manage my migraines using as little over the counter or prescription pain relivers as possible due to the potential for rebound or over use headaches, this is a very real problem for many migraine sufferers.

Rebound or Overuse Headaches

Medication Overuse Headache

Medication overuse headaches have previously been termed “rebound headaches,” or drug-inducedheadache and medication misuse headaches. Medication overuse headaches are experienced more than 15 days a month for at least three months and have developed or markedly worsened during medication overuse.
And that brings us to the conundrum of the doctor saying “take this pill as soon as you feel the migraine coming on for full effectiveness.” If I were to take something every time I feel a migraine coming on I would run the risk of over use because there is not a day that goes by that my head is not threatening to turn on me, sometimes I can convince it to stay calm and work with me, but all it takes is a flash of light or a can of Axe deodorant spray and its on and popping!

I Promised You An Update….

So, I didn’t think the MRI would show up with anything strange, but you never know, so to rule things out before proceeding with treatment options it was best to have a look in there. Everything appears normal.

And since I have tried several Triptan’s I can be referred for the next treatment option after I try one more (because they have to say I at least gave them all a try) and then we can try Botox. The Doctor says many of his patients have good results with the Botox treatment.

As for March and my headaches, so far Zero ocular migraines and I have only turned to medication (not including the daily Topamax) three times this month, I have been able to manage it with the CBD oil most of the time… or, maybe the migraines have lessened due to the daily Topamax? That is very possible.

What Has Worsened? Photophobia! Oh Joy!

I am blessed to work in a dim lit environment, right? Well that has its disadvantages too! Coming out of the dim lighting and into the brighter hallway and then looking onto the computer screens for information on my next client can be painfully blinding, but not only that I have developed a new and even more entertaining migraine side effect, PHOTOPHOBIA!

I was fully aware that the light sensitivity and the way the headlights of oncoming cars and even the street lights and stop lights flare and hurt my eyes was a form of photophobia but now I have gotten to a point where the cell phone and computer screen are also painfully bright to me as well.

Walking down the hallway at work after coming out of a dark room I am now seeing the trim boards move like waves as I walk past them and returning to the dim lit room I now see not one but two massage tables briefly. I am able to adjust to the lighting in a few minutes with some time to focus but I feel as if I am becoming a vampire, suddenly preferring to come out of the building once the sun has completely set.

So, my obvious next step will be to see an optometrist, which is something I had been putting off since the migraines tend to effect my vision and it can change from day to day based on the migraine attacks. I will look into that this coming week.

In a Nut Shell

What seems to be working, the CBD oil and the Topamax, what does not seem to be working for me, the Triptans seem to help with the headaches about 50% of the time but really make me feel terrible, muscle pain and weakness and just an overall feeling that I do not like at all.

Another simple thing that I found on migraine forums is that in the UK the first line of treatment is 900 to 1,000mg of Aspirin taken with a Sugar Cola (sugar, not fructose corn syrup, so something like a Jones Soda or a Mexican Coke) and I have tried that twice now and both times it has stopped a migraine in its tracks.

I have since looked up the studies on Aspirin for migraines and there have been several peer reviewed studies where they compared 900 to 1,000 mgs of Aspirin to the Triptans and Placebo and found the Aspirin to be as effective as the Triptans, my Neurologist disagrees with that but the many studies shows this to be the case.

Last night I tried another in the Triptan family, within 30 minutes I felt my body get weak, I began to feel sick to my stomach, the pain in my head did not go away, in fact it got worse. I took some CBD oil and went to bed. I felt better this morning, but if the pain continues today I will simply use the Aspirin because I do need to function at work, I do not need to have my muscles effected by a my migraine medication.

I do hope that something along the way here may be of help to someone else that may be going through this or even to my daughter who is struggling with the migraines along with me. It turns out that there is indeed a genetic component to the condition and it unfortunately effects more women than men.

Most migraine studies have been largely conducted on men in the past but that trend is changing and I look forward to more research studies being done on women and more specifically on the hormonal triggers as that is often a very common trigger for many women.

Yours Always, In Health and Wellness!

Kristeen Anne Smart (formerly Kish)

CAMTC Certified Massage Therapist

 

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Migraine Journey Part 2 Its Been A Long February

Today I am Feeling a lot Better

It has taken me several days and a lot of trial and error to get to this point. Rewind to Tuesday’s last blog post, I went in for my brain scan with a migraine hiding behind my sunglasses.

The scan went well, I managed to hold still the entire time, they got my message about being unable to lay on my back without support under my knees and had everything ready when I got there.  The entire procedure only took about 15 minutes once they got my head and shoulders stabilized in whatever contraption they use to make sure you do not move around while they do the imaging.

The process was made more bearable by some head phones playing  old school 80s radio, I would have preferred  relaxing meditative instrumentals or ocean waves but some Phil Collins was not a bad way to set my mind at ease.

When the procedure was done I decided to head to the pharmacy to see if they had ever heard back on the dosage for the Maxalt for the migraine pain, they called the doctor again.

So I waited, in the corner hidden behind my sunglasses until someone at the pharmacy started suggesting to me that perhaps I should try contacting the doctor myself, he continued talking to me while my head was pounding and all I wanted to do was just get some Extra Strength Excedrin, some chocolate, and go to nice dark quiet place, so I did just that and left.

Later that afternoon the pharmacy texted that my med was ready, head was still pounding so I sent my daughter to pick it up for me, an hour after taking that I was still in pain, that evening I took two more Extra Strength Excedrin. The following morning I took another Maxalt and went to work suffering in pain.

At work I asked the manager on duty to put me down for a wellness massage as soon as possible, she not only did that she helped clear my schedule and get me off the clock so that I could go rest because by that time I was experiencing vertigo and nausea as well as the excruciating head pain.

The Massage focus was on head, neck, shoulders and back, a lot of neck and scalp specific work and believe me the muscles of the scalp were painful to the touch, especially the temporalis muscles and I was definitely feeling those areas of tension throughout the evening after the massage.

The pain continued though and by the next day I had given up on the meds aside from the daily preventative Topamax and changed course and started taking large amounts of Turmeric, Vitamin D3, B6, B12, Magnesium, and lots of water along with hemp CBD oil by the dropper as needed all day long.

By the following day I was able to use far less of it, I can still feel that I am not fully out of the woods yet, the pain is sill subtly throbbing in there, but the CBD seems to be making life far more bearable right now, so much so that I was able to pick up another shift at work today to make up for clearing my shift the other day.

Anyhow, This was just a quick update while the events of this week are still all to fresh in my mind… and a little timeline of events in case I forget them later:

Feb 7 met the neuro had visual migraine that evening

Feb 9 had migraine (have had pressure by right orbital bone since last visual migraine)

Feb 18 had irritability, sound and light sensitivity (I knew it was coming)

Feb19 woke with the migraine was MRI day, finally got the Maxalt (did Excedrin twice that day as well)

Feb 20 ouch still going Tried Maxalt again and Excedrin, got massage, most painful night ever! sound sensitive, light sensitive.

Feb 21 gave up on the Maxalt and Excedrin and used CBD and supplements, started feeling a little better, still dizzy.

Feb 22 still doing CBD and supplements, still mild headache, a bit off balance, some visual difficulty, light sensitive.

Feb 23 good morning Firday… how do I feel right now? my eye has been doing that twitching thing for so long that I totally forgot to mention it, its almost become such a daily thing that its not even a thing, so there is that, my eyelid has been twitching for the better part of this month, thank goodness no one seems to have noticed little lefty winky… I feel drained, there is still a feeling as if someone has a finger over the orbital bone by my right eye and there is a slight pain throbbing on the left side of my head. I also feel like there is a veil over my head, cant describe it better than that really.

I feel much better than I have all week and that is saying a lot, but I am not leaving for work without my CBD oil and I have ordered more, I am now realizing why I waited so long to seek treatment for my migraines, because I have done this in the past with similar results, what I was seeking this time is treatment options, not simply more pills. I will continue to update you if I do find out anything that works, so far CBD helps.

(Editing to add the events of the weekend)

Feb 24 Sunday evening at work the head pain continued mildly, growing in intensity with any activity, I was able to keep it under control with some deep breathing and closing my eyes whenever possible but I was still having visual disturbances in the form of tracers and seeing movement in the corners of my eyes.

It is now Monday Feb 25th and I have a new Dr P product being delivered today that I am excited to give a try later, a combination of CBD and Hops for anti-inflammatory properties, believe me at this point I am willing to give anything a try.

As for how I am feeling today, I feel like crap, this has been going on too long, my stomach aches, my head aches, it hurts to look at my cell phone, my computer, the outside world where the beautiful sun is shining, any white paper, any website with a dark background and yellow font, and website with a white background and black font, and that’s pretty much every website lol! Sound hurts, especially high pitched sounds like flutes or children’s squeals.

My vision is not terribly out of focus today, at least for the moment, it honesty changes from moment to moment. There is a constant pressure in my head, it gets more bearable if I sit totally still and do nothing at all, meditation or sleeping is preferable to anything else at this point. Bending down to pick something up makes it worse, movement, exercise, any exertion of energy seems to aggravate the headache, so its just best to be still and calm.

People have been asking me about the results of my brain scan, I do not have any answers because my next neuro appointment is not until the end of next month, its very difficult to get in to see the neurologist, which is why it is very difficult for migraine sufferers to find someone who specializes in this condition, there are very few and they are fully booked out for several weeks in advance. I will keep you posted as I find anything out!

In case you are wondering, the CBD I am currently using is Dr P’s Dark Chocolate Mint CBD Oil

Dr. P’s Dark Chocolate Mint CBD Oil

I trust both Barefut’s products and Dr P’s products so it was an easy choice for me, full spectrum, co2 extracted, no solvent, pure CBD.

Yours in Health and Wellness,

Kristeen Anne Smart (formerly Kristeen Anne Kish)

CAMTC Certified Massage Therapist

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Migraine Journey Part 1

One Week In Treatment

Lets start with the fact that I usually avoid doctors like the plague, yes I do, they terrify me more than going to the dentist and that’s saying a lot, but the migraines have increased in frequency.

As you may know I treat people with migraines and headaches in my massage practices all the time, there are a few tricks I have learned a long the way, but it is very difficult to practice on myself because I cant lay still on the table and work on myself, not for lack of trying.

So I made an appointment to see a Neurologist because if I am going to see a doctor I would prefer it be the correct doctor for the problem at hand.

The First Visit

Filled out the paperwork, met the tall elderly gentleman who is my new doctor, I thought to myself “good, he is older” I prefer an older doctor as they have been around and have seen many conditions and know that not everyone will respond the same to treatments.

He did some basic nerve tests, poked me with a pin, my nerves are all working well, which is a very good thing given my history with my back surgery over 13 years ago, and then he suggests a brain scan just to rule out any possible damage or other conditions and wrote me a script for medications.

Two prescriptions, one for a preventative, a generic form of Topomax and Maxalt, trouble was he didn’t put down a dosage on the prescription for the Maxalt so the pharmacy was unable to fill the Maxalt prescription so I was only able to fill the preventative.

That evening I went into a full blown visual migraine, I call it a visual migraine but they call it a “migraine with aura.” I find it funny they call that thing an “aura” as to me the term aura sounds so peaceful, what I see is anything but peaceful, it is sharp and jagged, a visual and sensory assault that wipes me out.

They put in a call to his office for clarification on the other prescription but to this day no return call has been made about the other medication. I have been taking the preventative for just over one week, as I am writing this today I have had one migraine with aura the evening I filled the prescription, one regular migraine two days following, and one at this moment.

I will bet you are wondering how it is that I am typing this right now with a migraine, well, because I can still see, and because I took some CBD oil which seems to be taking the edge off for the moment and I want to take a moment to share this with you because today is important.

Today I Go For A Brain Scan

This afternoon I go for a brain scan in Huntington Beach, I am actually glad that I am experiencing the migraine today because I would prefer that my brain be doing whatever it is that it does when they do the scan so that whatever is happening will be evident, if it be some sort of swelling or pressure or whatever it may be.

This is why I am actually considering todays migraine to be a bit timely. Maybe we can get some answers? Maybe this isn’t just hormones, or environmental triggers, or some hidden allergic reaction to something I ate or was exposed to, maybe it has nothing to do with the lighting on the computer monitor, or the sunlight, or driving without sunglasses.

I will keep you posted if I learn anything new on this journey or anything new about migraine treatments, what works, what doesn’t, what helps me, what doesn’t help me… and by the way, so far at 100 milligrams of generic Topamax at just over one week I am still having migraines.

Yours in Health and Wellness,

Kristeen Smart (Formerly Kish)

CAMTC Certified Massage Therapist

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What is Firm Swedish?

The other night at work an Esthetician asked me “What is Firm Swedish?”

One of my massage therapist coworkers was in the break room with us at the time and turned to hear my response…

I began to try and explain that it is a Swedish Massage with a firmer pressure, then I said “ok, realistically it is a gentle  Deep Tissue because Deep Tissues by definition is accessing the deeper layers of the muscles instead of just the superficial ones and I have no idea why we even bother muddying the waters with all the various terms we use.”

My coworkers eyes widened and she said “You are right, Swedish is gentle and relaxing, its not supposed to be firm pressure.”

Firm Swedish is for people wanting more of a Deep Tissue therapeutic effect without the pain or discomfort often associated with Deep Tissue massage

In all honestly there is not a lot of difference between the stokes, moves, and methods that I would use during a Firm Swedish Massage and the ones that I would use for someone asking for Deep Tissue.

In fact many of the Firm Swedish massages that I do end up being Deep Tissue work and some of the Deep Tissue work that I do ends up being more of a Firm Swedish depending on the need and tolerance level of my client.

Pressure is subjective!

We then discussed how all these words “Firm” “Deep” “Light” and “Medium”  are all subjective and vary widely  from not only the clients but the therapists as well.

One client’s idea of medium pressure is another client’s idea of deep, some say light when they really want medium, and some say light when they want feather light pressure.

My idea of light may be too light for some or too heavy handed for others, each persons perception of pressure is different and each therapists idea of pressure is different.

I find its easier if the client says something like “I want results but I don’t want to be put in pain” or “really go to town on those shoulders” or “please no elbows” to give me a better idea of what it is they are seeking. Communication is always the key to getting the massage experience that you desire.

Deep Tissue Massage Does not have to be painful!

If you search the internet about Deep Tissue massage you will find that page after page all state “Deep Tissue does not have to be painful to be effective.”

Unfortunately many people believe in the “no pain no gain” concept, this includes many Massage Therapists.

The idea that you have to tolerate a painful session because “you really need this” is not correct. If you are wincing, flinching, or tensing up then your muscles are not going to be able to relax and it may be counter productive to the goal of getting your muscles to loosen up.

Of course there will be people who will argue that point and say that the muscles will feel better after two or three days because of the painful deep pressure, that too is valid in the fact that eventually the muscle will tire and weaken and the result will be less tension due to the muscle exhaustion.

That being said there have been cases of injuries from Deep Tissue massage, there is a point where too much is too much. There is  also a condition called Rhabdomyolysis or Rhabdo for short that can result from muscle crush injuries.

Muscles store myoglobin, when too much myoglobin is released into the body it can become toxic when it reaches the kidneys. This is one of the main reasons why you should drink plenty of water following a massage to help flush that away.

Release of Myoglobin from massage has been found in a study to reduce the pain and discomfort of myofascial pain syndromes with surprisingly positive results:

https://www.ncbi.nlm.nih.gov/pubmed/3462906

A positive correlation was found between the degree of muscle tension and pain, and the increase in plasma myoglobin concentration. After repeated massage treatment a gradual decline in the increase in plasma myoglobin concentration could be demonstrated parallel to a reduction in the muscle tension and pain.

So  there is definitely benefit to getting Deep Tissue massage for people with muscle pain, the same can be said for Firm Swedish which is simply another form of Deep Tissue therapy.

We can honestly only go so deep

There are times when we get a client who wants the deepest, hardest, and most painful massage that we can possibly give them.

For whatever reason that client feels the need to have it hurt, whether it is because they believe it will be more effective or because they cannot quite feel how much pressure is actually being given I am not sure.

When a client is clearly seeking a sensation of pain we do our best to try and use pressure points to provide them the sensation they seek without causing damage to the muscles  tissues and bony structure, however, there are times when we simply cannot go any harder or any deeper.

In closing, to sum things up…

Firm Swedish is simply a more gentle form of Deep Tissue Massage. Deep Tissue Massage does not have to be painful to be effective.  Areas that are more tense may be a bit painful but it should be a “good hurt” and not a “bad hurt” or overly painful experience.

Whatever it is you are seeking from your massage experience it is best to communicate your needs, concerns, and areas that you want to address as well as areas that are more sensitive to you so that we can offer you the massage experience and effect that you are seeking.

Yours in Health and Wellness,

Kristeen Smart aka Kristeen Kish

CAMTC Certified Massage Therapist

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A Little About Myself… Setting the Record Straight

Who is Kristeen Smart? aka Kristeen Kish aka Kristeen Narlock?

Hello, some of you already know me and know many things about me and about my life and have followed my journey from Nursing Assistant to Massage Therapist.

Due to an ongoing cyber stalking and harassment situation I feel the need to share a bit more about myself and state for the record my qualifications and address the lies that have been posted publicly about me.

I grew up in a small town in Washington State

I was born in a Naval Hospital and grew up not far from the Navy Base in a small town on the Bay over looking the mothball fleet of ships in the Puget Sound.

My birth name is Kristeen Anne Smart.

I am a beach bum at heart and spending hours searching the shores for trinkets and treasures of shells and rocks was my passion from an early age.

At a young age I was a member of the Medical Explorers Post on base where I was first introduced to health care and medicine as well as instructed in the use of CPR and First Aid.

As an adult my passion for helping others led me to become a Nursing Assistant in 1992 in Washington State, 1993 in the state of Wisconsin, and 1998 in the state of Oregon until the year 2012 when I allowed my license to expire after moving to California to peruse my career as a Massage Therapist.

Names I held licenses under as a Nursing Assistant  were Kristeen Anne Narlock (1st husbands last name) in the states of Washington and Wisconsin and in the state of Oregon Kristeen Anne Narlock until my second marriage when I became Kristeen Anne Kish. In 2017 I legally resumed the use of my maiden name Kristeen Anne Smart following my divorce.

During those years I worked in Nursing Homes, Assisted Living Facilities, a Group Home for Children with Developmental Disabilities, An Independent Living Apartment for Quadriplegics, a Senior Day Center, and Home Health Care.

Over the years I have had extensive background checks and have been fingerprinted, licensed and bonded in several states. I am currently on live scan.

I held Nurse Delegations as a Medication Aide in two Assisted Living Facilities, one Day Center, a Group Home, one Independent Living Apartment, and Home Health from the year 2000 until I left the state of Oregon in October of 2011.

My delegations included medication administration, medical records and documentation, diabetic testing and injections, epotin injections, wound care, catheter care including insertion and removal, bowel care, trach care and suction, and tube feedings.

My licenses and certifications are as follows:

1992 and 1993 Nursing Assistant Registered Washington State

1993 to 1999 Certified Nursing Assistant State of Wisconsin

1998 to 2012 Certified Nursing Assistant State of Oregon

2010 to 2012 Certified Chiropractic Assistant State of Oregon

2010 to 2012 Licensed Massage Therapists State of Oregon

2012 to Current California Certified Massage Therapist

My Stalker claims that I am unlicensed and uninsured, as you can see I am licensed and all of this can be verified. I have also maintained professional liability insurance since becoming a Massage Therapist with no lapse in coverage since graduating college in February 2010.

In 2009 I made the decision to go to school for Massage Therapy

In many of my jobs as a Nursing Assistant I worked in co-operation with Physical and Occupational Therapy departments where I was trained in Range of Motion Therapies and Ambulation to assist in recovery.

I enjoyed that aspect of helping others so much that I decided to peruse a career in Massage Therapy. It has always been my goal to remain in a field of health and wellness where I can continue to help others.

From 2010 to 2012 I held three licenses in the state of Oregon, Certified Nursing Assistant, Certified Chiropractic Assistant, and Licensed Massage Therapist.

From 2012 to current I have held and maintained Massage Therapy Certification through the California Massage Therapy Council in good standing.

In my many years in the field of Massage Therapy I have had the opportunity to work with people suffering from chronic pain disorders, skeletal defect, auto accidents, and work related injuries.

To me there is no greater satisfaction than helping others and the experiences that I have had both as a Nursing Assistant and as a Massage Therapist have been priceless to me.

As for the allegations being posted about me online…

First one must consider the source, a spiteful woman who poses as an “activist” online and has nothing but time on her hands.

My stalker has a history or court actions revolving around her ongoing stalking and harassing of people whom she has met on social media and has a list of victims of her harassment in several states across this nation and far more who have not come forward.

She once publicly announced on a talk radio show that she was being “stalked and harassed by 20 woman on facebook” when in reality she was the one who was stalking and harassing at least 20 women on facebook. I have court documents supporting this.

I have already faced this person and her wild accusations in a court of law and proved by “preponderance of the evidence” (as stated by the judge) that her allegations have absolutely no merit, yet she continues over a year later to make her accusations.

She claims that I lied about being CPR and AED certified

In the state of California it is not required of a Massage Therapist to obtain nor maintain their CPR certification, I do it because I want to and because it leaves open the possibility of working at other jobs that may require it.

In the state of Oregon it is a requirement for massage therapists, and while working in Oregon I always maintained my CPR/AED/ and First Aid certifications.

Recently an opportunity to take not only the CPR and AED certification but also First Aid literally fell into my lap through a city program for disaster readiness at a remarkable price, and it just happened to be on one of my rare days off! How could I possibly let that pass me by? So once again I am CPR/AED/First Aid Certified.

She claims I lied about my credentials

Now this one is seriously grasping at straws! In 2016 my cyber stalker found a listing online that erroneously listed my qualifications as a “nurse and nurse practitioner” (see link below.) This content was compiled without my knowledge or approval and had images and information obtained from my linkedin profile.

I have never professed to be either a Nurse or a Nurse Practitioner either online or in person and have always been honest about my credentials, licenses, certifications and professional delegations, once again all of my licenses can be verified by the issuing states.

40 Licensed Massage Therapists in Santa Ana, CA Directory

As you can see from the others listed there many have strangely exceptional credentials including Lawyers, Chiropractors, and Investment Bankers. Apparently we have some highly over qualified Massage Therapists in the area! All joking aside that listing is from a Radaris based search engine that takes information from your Linkedin profile and compiles it into a listing that you have absolutely no knowledge of or control over.

Not to mention the simple fact that no one in their right mind would be searching for a “Nurse” or “Nurse Practitioner” on a list of MASSAGE THERAPISTS, just stating the obvious here!

The listing about me stated my credentials as:

Massage Therapist Wellness and Fitness Licensed Massage Therapist Massage Therapy Nurse Nurse Practitioner Independent Contractor Contractor Independent Business Owners

Once again, just to be clear, this content was not created nor sanctioned by me in any way.

This woman then contacted my employer repeatedly in emails and via telephone claiming that I was advertising myself as a Nurse and Nurse Practitioner based on that listing and demanding that they fire me and threatening them with complaints to the better business bureau. They did not fire me so she then followed up with several phone calls harassing the company. This is exactly why I no longer state where I work anywhere online.

I contacted Radaris to have the listing removed. The profile in the listing has been removed at my request but the preview remains, they do not or will not remove the preview but they did as I requested and removed the profile in the link. Click on it and you can see for yourself the big bold words that read “NOT FOUND.”

Since then she has used this as her sole basis for all of her claims that I am passing myself off as a Nurse and Nurse Practitioner and she also claims that my participation in a Q&A site online called Quara is “practicing medicine without a license.”

Quoras Terms of Service CLEARLY state the following:

Content posted by Medical Contributors is not intended to be medical advice or instructions for medical diagnosis or treatment, and no physician-patient relationship is, or is intended to be, created by Content provided by Medical Contributors.

I hope that this clears up any misinformation being spread about me the internet. If you have any questions feel free to contact me!

Yours in Health and Wellness,

Kristeen Anne Smart aka Kristeen Kish

CMATC Certified Massage Therapist

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How To Get The Perfect Massage

Getting the perfect massage begins with communication

A good establishment will want to put the client with the right therapist. Every client has different needs and expectations and every therapist has a different specialty or approach to their massage style.

The receptionists get a lot of feed back from the clients and are happy to recommend the therapist who may be the best fit for you based on the information that you provide them about what you are seeking in your session.

Let them know if there are things you prefer, such as Deep Tissue, Stretching, Trigger Point Therapy, or a Gentle Relaxing Swedish Massage, or anywhere in between.

If you had a favorite therapist who has left the establishment or moved away feel free to ask if there is another therapist with a similar style.

The staff wants you to have the best possible experience and will do their best to match you with the therapist who’s skills seem closest to what you are seeking in a massage therapy session.

When you meet your therapist

Usually the Massage therapist will ask you a few questions before the session, I usually ask if there are any areas that you want to focus on and what type of pressure you usually prefer.

This is a good time to briefly explain any areas that have been bothering you, areas to avoid such as face and scalp, and any areas that you particularly enjoy having extra focus on such as the feet or head and scalp.

It is also a good time to discuss any injuries, surgeries, or areas of muscle tension or concerns.

Feel free to ask questions, also if you prefer no talking during the session let your therapist know that and they will try to keep the session as quiet as possible other than to check in with you about the pressure.

Sometimes we find something that we want to discuss with you such as ways to minimize the discomfort or some self help tips that you can do at home, but we can discuss our findings with you at the end of the session if you would prefer not to be disturbed during the session.

Many clients enjoy learning ways that they can manage their own areas of concern and we are always happy to give you after care and home care suggestions.

Some complaints that I sometimes see in online reviews:

  1. “The Therapist didn’t massage my face”
  2. “The massage was too hard and painful”
  3. “Therapist was too chatty”
  4. “Not enough time spent on my problem areas”
  5. “I wasn’t offered a robe or hair tie”
  6. “I asked for LIGHT pressure not therapeutic massage”
  7. “Paid for two hours and only got an hour and forty minutes”

The above quotes are a few of the more common complaints that I see in online reviews of various establishments.

I looked at reviews from several local spas both high end and chain establishments to find some examples where communication seems to be the biggest problem, so lets go through these individually….

  1. Client expected that all massage sessions include face massage. Personally I usually do not do face massage unless it is requested because not everyone likes or wants their face massaged. Some do not want the oils or lotions to clog their pores, or they have make up on, or simply do not want their face touched. If face or scalp is something you enjoy and expect in your session be sure to mention it to the therapist, your therapist will be happy to add that to your individual session.
  2. The massage being too hard and painful, first of all you do NOT have to grin and bear it, if it is too painful tell your therapist, if the therapist continues despite your wishes it is your right to end the session. You are always in control of your massage session.
  3. The “chatty” therapist, this one is more complicated because there are several different scenarios: The therapist may be sensing that you are uncomfortable and trying to engage in small talk because he or she is trying to put you at ease. The therapist is asking questions such as “What do you do for a living?” or “Do you work out?” to better understand your muscular condition to give you the best treatment and advice for after care. Or the therapist is simply friendly and outgoing and does not seem to understand that you simply want a nice quiet session. Communication in this case begins with saying “Can we discuss this after the session?” or “I just want quiet during my massage thank you.
  4. Not enough time spent on area of focus. Again this could be for a number of reasons such as the therapist has found that other areas are effecting the area of focus, such as muscles of the opposing side pulling on that area. Not enough time for everything, an example of this is the client who’s areas of focus are “stiff neck, tight shoulders, sciatic down right leg, tight hamstrings and calves.” That’s an entire laundry list of things to try and adequately effect in a short period of time. The communicative solution to this would be to focus on the main areas and skip the full body or certain parts such as arms and feet, however, if you feel that your therapist is simply not listening to you then bring this to the attention of the reception staff, they  will be more than happy to accommodate you and suggest a therapist who is more suited to your needs.
  5. Was not offered a robe or a hair tie, I assume when I see such things in reviews that the person writing the review is used to high end spas where you wear a robe because you will be leaving from one area to another before and after your session, in a day spa setting that is only done when you are going to be having dual services in different rooms that day, otherwise you will be alone in a private room where you can dress and undress in private, a robe is not necessary in such settings. The hair tie, yes high end spas usually have those and sometimes in day spas the therapist will provide them as well, but it is often best if you bring you own, but if you forgot to bring one we can always place a towel over your hair to protect it from the oils and lotions.
  6. Asked for LIGHT pressure but got therapeutic, the main problem here is that light, medium, and deep are all very subjective words. One persons idea of light is another persons idea of medium or firm. As for therapeutic, all massage is therapeutic in some way, that being said some therapists (myself included) cannot always control what your body is telling our hands to do and the impulse to give you what you need. It is best to speak up and remind the therapist that you asked for a light pressure and simply want to relax, I had a client who once said to me “I know I have knots but today I want you to ignore them and just pamper me.” I think that’s the best way to respond when you feel that your therapist is getting too focused on problem areas.
  7. THIS is the biggest complaint that I see, this is a miscommunication that is typical in most spa settings “I paid for an hour and only got 50 minutes.” “I was shorted 10 minutes on my massage.” “I paid for two hours and only got an hour and forty minutes.“In a typical spa setting both high end and day spa its is common that an hour session is 50 minutes hands on and 5 minutes before and after for you to dress and undress as well as the brief intake in the room. The two hour sessions can vary from establishment to establishment, in the case of the one I quoted above some of these spas bill a two hour as two fifty minute sessions making your session a 100 minute session, some places are careful to call it what it really is a 100 minute session, a 50 minute session or an 80 minute session. This miscommunication in my opinion falls squarely on the establishment for not being clear to the client about the real time length of the massage. These times are set in respect to time billed as well as to give the therapist time to clean and change the room over for the next client.

The Key to the Perfect Massage is Communication

From the moment that you set up your appointment to the moment you check out the key to the perfect massage is communication to get the therapist that is the best fit for your needs and the massage session that you prefer.

Yours in Health and Wellness,

Kristeen Smart aka Kristeen Kish

CAMTC Certified Massage Therapist

 

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Your Massage Session, What to Expect

  1. Arrive early to fill out intake paperwork if this is your first visit. Intake paperwork may include a full medical history.
  2. Please call if you are going to be late or not able to make it as soon as possible. Make sure you are aware of the cancellation policy, many places request you call a day ahead of time if you cannot make it to avoid cancellation fees.
  3. Silence your phone when you arrive. The session is your time away from everything, we do not want that interrupted from outside forces.
  4. Let your therapist know about any conditions you may have that could be adversely effected by massage, such as bruising easily, past surgeries and injuries, pregnancy, osteoporosis, or high blood pressure.
  5. If you need special assistance such as help getting on or off of the table please discuss this with your therapist at the start of the session, we are more than happy to accommodate your needs.
  6. Do let us know if there are any areas of concern to be focused on or if there are areas you do or do not want massaged (IE: you love or hate scalp massage.)
  7. Please wait until we leave the room to disrobe.
  8. Let us know if you need any accommodations such as a pillow or breast cushion.
  9. Dress down to your level of comfort unless instructed to leave clothing on. Some therapists may request that you leave your underwear on while others may do massages fully clothed.
  10. Get between the sheets, not on top of them, and cover your body before your therapist returns.
  11. If you wish to talk during the session please keep your voice down so as not to disturb others in adjacent rooms.
  12. If you wish for no talking during the session tell the therapist at the beginning, let them know you just want to relax undisturbed and that any suggestions can be discussed at the end of the session.
  13. Feel free to speak up if the pressure is too much or too little, you are in control of your massage.
  14. Relax and enjoy your session, if you fall asleep that is fine, if you snore we don’t mind at all.
  15. If at any point in the massage you feel uncomfortable for any reason you can end the session. If your therapist has made you feel uncomfortable do bring this to the attention of the management right away.
  16. At the end of the session please wait until the therapist has left the room to get off of the table and get dressed.
  17. Be careful when first getting off of the table as people sometimes feel light headed following a massage.
  18. Your therapist may offer your some fresh water and after care instructions when you come out of the room. Those instructions may include some stretches or suggestions for heat or ice following the massage as well as suggestions for future sessions to meet your needs.

Considerations for your therapist:

  1. Arrive clean and ready for a massage.
  2. Avoid wearing heavy perfumes.
  3. If you have athletes foot or other contagious conditions please let your therapist know so they can avoid that area during the massage. Foot massage can be done through the sheet if needed.
  4. Please find a baby sitter for your children, the massage rooms are small and as much as we adore your children they can get in the way while we are trying to massage you.
  5. Please do not ask your therapist for services that are out of their scope of practice such as chiropractic adjustments.
  6. If you are sick please reschedule your appointment.

Communication is key to getting the massage experience that you are seeking.

When you communicate with the therapist before and even during the session as to pressure and preference you can get the prefect massage tailored to your individual needs.

Enjoy your service!

Yours in Health and Wellness,

Kristeen Smart aka Kristeen Kish

CAMTC Certified Massage Therapist

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When in Doubt Refer Them Out

At the college that I attended it was impressed upon us not to be afraid to refer a client to a doctor.

We are not allowed to diagnose, even if we know exactly what it is we are seeing it is out of our scope of practice to tell them what we suspect, but we are well within our scope to suggest or even encourage them to see a doctor or specialist.

Years ago I had a co-worker who told me she would never refer or suggest that someone should see a doctor

She did not believe that referring clients to a doctor is our responsibility as Massage Therapists, I said to her “but we are in a unique position to see areas of their body that they cannot see and conditions they may not be aware they have.” We have a responsibility to our clients to make them aware when something needs to be addressed by a doctor.

Depending on the situation or condition I might say something to the effect of  “you should have a dermatologist check this out” or “it might not be a bad idea to have a doctor take a look at that.”  They may ask you what you suspect or why you have made that suggestion, be careful not to cross the line into diagnosis, try not to sound alarming while at the same time let them know that it is a good idea to have it looked at to rule out any issues.

If it is something so concerning that you do not feel comfortable massaging the area or continuing the session then explain to them that you do not feel comfortable working on that area until it has been seen by a doctor, this could be anything from a suspicious rash to a suspected muscle tear or injury. You are well within your scope of practice to refuse to treat any area that you believe may cause further damage or injury to the client.

What if it ends up being nothing serious?

Well great! Both you and your client will feel better knowing that it was nothing serious, but what if you said nothing and it was?

The other night a client that I last saw a few months ago came in for a massage and said to me:
“I wanted to thank you, you saved me!” he said “You suggested I should see a dermatologist, and you saved me, it was stage one aggressive malignant melanoma”

They were able to diagnose and remove the cancer before it had a chance to spread and he is now being monitored regularly to make sure that it does not return.

This was not the first time someone thanked me for suggesting they should see their doctor or specialist, but it is the one that will forever reinforce my position on referring clients to a doctor or specialist.

We are in a unique position to help others

That is what we do, it is who we are! Don’t be afraid to speak up if you feel that your client should see a doctor, if you are wrong then you both gain peace of mind, and if you are correct you might just save a life!

 

Yours in Health and Wellness,
Kristeen Smart AKA Kristeen Kish
CAMTC Certified Massage Therapist
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Massage Tools and Liability Insurance

A cautionary post for fellow Massage Therapists and Student

I research things as I become curious about certain subjects, one of my recent curiosities was about a product which got me searching for more information on tools and liability insurance because I know that not all tools are covered by all liability companies and I usually search mine to find out what is excluded, but new products raise the question of what actually is included.

Personally my advice to anyone using any tools or exotic modalities would be to contact your liability insurance and ask about coverage just to make sure. I know that some insurance companies do not cover hot stones while others do not cover cupping, and many insurance companies strictly exclude T-bar use.

In my opinion we need to be diligent in making sure that what we utilize in our practice is covered. That being said I did find this post and thought to share it with you.

https://www.ctha.com/Forums/?b=21206

Massage Tools and Insurance

Hi Everybody!

Do you use any supplemental tools when massaging and do your insurers know this? If so, what are their requirements for insuring you to use that tool: an accredited course, confirmation of reading all the instructional material, paying an extra ‘tool-use’ supplment or something else?

I have been asked to write an article about this relevant topic as an ‘expert’ on massage tools (I designed and sell a massage tool called ‘The Kneader’ for both general public and professional therapist use).

Recently, I gave a workshop on our new venture, which is Kneader On-Site Massage. Only Level 3 on-site therapists attended, as it was to gauge if they liked On-Site Massage with the Kneader as much as we do. Thankfully, they did and they all bought 1-2 Kneaders in preparation for our Kneader On-site Massage course, which is hopefully going to be this summer.

One of the therapists contacted her insurers at CThA to make sure she was covered to use the Kneader, in the meantime, as a supplemental tool. They said she was not insured until she took an accredited course on how to use the Kneader (again, even as a supplemental tool during a standard massage treatment). This was not good news as lots of therapists have been buying and using the Kneader as a supplemental tool for several years now! What ensued was nearly two months of deliberation on the Kneader – my argument being that the product comes with a comprehensive manual and DVD and there are loads of clips and instructional material on our website and YouTube.

Thankfully, the CThA insurers have been very thorough and accommodating and have now confirmed that all their therapists are insured to use the Kneader as long as they have reviewed the manual and DVD and use the tool in accordance with the product’s instructional material. It’s a start but this is only one insurer of many and they are all of the same view (I’ve checked around) – if you use a tool (any tool), you need to take an accredited course in it to be insured when using it. I have queried about ‘one move’ tools like Bongers, The Knobbler and Omni Ball – if a tool only does one thing, how can you warrant doing a course in it? Massage tool use is on the rise in the industry, because therapists are always looking at ways to improve their treatments and their working lives. Subsequently, how many therapists are using tools to save their hands or enhance their treatments without realising that they are not ensured to do so? It’s a question that I fear a lot of therapists have not even considered and run the risk (however small) of being caught out on.

I would be grateful for any input and will post the article once it is published for your consideration.

In the meantime, all the very best!

Una
Kneads Must

We love to provide our clients with the best that we can offer them but we also need to always remember to protect not only our clients but our practice as well by making sure that our insurance coverage meets our needs when it comes to our services and products.

Yours in Health and Wellness,

Kristeen Smart AKA Kristeen Kish
CAMTC Certified Massage Therapist
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Cortisol, the “Evil” Stress Hormone

Cortisol and weight gain:

The other night I was having a conversation with a client who is struggling to lose weight and she stated that her cortisol levels are too high. This is a common problem for many of us.

As she and I were talking I realized that cortisol has its benefits

I got to thinking about why our cortisol rises, situations in which we might need what that hormone has to offer us. What is it about stress that would cause this need for a hormone that stores fat and keeps us awake at night? SURVIVAL!

I laughed and said to my client “Skinny people do not make it on Survivor” she laughed and agreed, yes that fat storage has its place in times of great physical stress such as famine, drought, and threat to our psychical survival.

Why does our body react to emotional stress the same way it would physical danger?

Our bodies cannot distinguish between a physical threat of harm and an emotional one, to the body it is all the same, your mind perceives ALL STRESS as if you are in danger and must prepare to survive, it really is that simple.

Lets take a look at the Pros and Cons of this “evil” hormone:

The following article has a lot of information on cortisol and its physical effects on the body http://www.fitness4her.com/the-pros-and-cons-of-cortisol-the-key-to-fighting-belly-fight/

Cortisol is a hormone in the body that is secreted by the adrenal glands and provides for the following functions:

  • Proper glucose metabolism

  • Regulation of blood pressure

  • Insulin release for blood sugar maintenance

  • Immune function

  • Inflammatory response

  • A quick burst of energy in times of fight or flight.

  • Heightened memory functions.

  • Boosts the immune system.

  • Lowers sensitivity to pain.

  • Helps to maintain homeostasis in the body.

Often referred to as the stress hormone because of the high levels of cortisol released in the bloodstream when the body is enduring a great amount of stress, too much cortisol can cause problems with your health such as:

  • Increased belly fat which is associated with a greater amount of health problems.

  • Impaired cognitive performance.

  • Suppressed thyroid function.

  • Blood sugar imbalances like hyperglycemia.

  • Decreased bone density.

  • Decreased muscle tissue.

  • High blood pressure.

  • A lowered immune system.

  • Higher levels of cholesterol.

In the first list you will see that it helps to maintain homeostasis, regulates blood sugar, improves immune response and other things that are beneficial to survival. The second list are the unfortunate side effects of cortisol when it is not needed for survival.

So how do we minimize cortisol resulting from stress?

The article goes on to describe several ways to help minimize the negative effects of cortisol:

The key to keeping cortisol production at a healthy level is relaxation.  As a matter of fact, proper rest is vital to the body’s well being. Getting 8 hours of sleep rather than 6 can mean a reduction in cortisol of up to 50%. Other ways of reducing cortisol are:

  1. Meditation and prayer can cut cortisol by as much as 20%.

  2. Listen to some of your favorite music to cut cortisol by nearly 65%. Fill your iPod with some new tunes and take a walk to lower stress and reduce belly fat.

  3. Sip black tea. As it turns out, enjoying an afternoon tea has many health benefits such as reducing cortisol by about 45%.

  4. Attend church or other religious service and reduce cortisol by 25%.

  5. Do something nice for someone to reduce cortisol levels by 20%.

  6. Go for a massage. Let a professional work out the kinks of built up stress and stiffening of the muscles. It can reduce cortisol levels by 30%.

  7. Hang out with a fun loving friend. Someone you can laugh with and enjoy your time with, you’ll reduce cortisol by up to 39%.

  8. Have a romp in the bed with your lover. Increased stress and cortisol can boost your sex drive, so why not take advantage and enjoy some love-making, you’ll reduce stress and cortisol levels, while burning about 70 calories in about 30 minutes.

  9. Exercise regularly. By maintaining your exercise program, you’ll regulate cortisol levels and reduce stress and help to lower blood pressure.

  10. Put stress in its place. Life’s challenges are sure to follow us but we can take charge of how we handle them and not let them control us. Enjoy life and preserve your health and happiness.

In Summary:

Cortisol is necessary for human survival, unfortunately stress can trick the body into believing it is under physical threat causing it to produce more cortisol than is needed. Meditation, massage, exercise, and learning to control your stress can help you to reduce cortisol naturally.

Yours in Health and Wellness,
Kristeen Smart AKA Kristeen Kish
CAMTC Certified Massage Therapist

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