Pharmacology and Massage Therapy: Beta-Blockers

One of the most frequently prescribed class of drugs in the United States are the drugs commonly known as beta blockers. They are prescribed for a great variety of conditions that are approved by the FDA and are used "off label" for any number of other conditions.
Some common beta blockers that you may see on your client's medication list include: propranolol (Inderal), metoprolol (Lopressor) and atenolol (Tenormin).
The drugs block the effects of the Sympathetic Nervous System (SNS) by stopping the effect of epinephrine/norepinephrine at the beta receptors in the heart and sometimes also in the lungs and adrenal glands. The SNS is part of the Autonomic Nervous System that regulates the functions of our bodies in response to internal and external factors. The SNS is the branch that stimulates the body to action and when overstimulated is the source of stress effects on the body. By blocking the effects of the SNS at the receptor sites the drugs decrease blood pressure, decrease the force of heart contractions, slow electrical impulse conduction through the heart, decrease heart output and oxygen demand. In those that affect the lungs, constriction of the broncioles can occur.
Side effects that are related to the blocking of the SNS include fatigue, sleepiness, low blood pressure, slow heart rate, fainting, fluid retention, wheezing, irregular heartbeat, edema, Raynaud's syndrome, gas, and nausea and vomiting.
Beta blockers are generally used to treat high blood pressure, irregular heart rhythms and long-term prevention of angina (chest pain) and heart attack. They are also used for such diverse conditions as migraines, anxiety, essential tremors, glaucoma, PMS and perimenopausal symptoms.
As a massage therapist recognize that the body may relax more quickly and deeply for the client taking these meds and that gentle stimulation at the end of the massage may be needed. A drop in blood pressure can also occur with massage, so care in getting the client on and off the table is needed. Other changes to how massage is applied may be required related to the client condition, severity of cardiac disease etc.
References: http://www.mayoclinic.com/health/beta-blockers/HI00059 , http://www.medicinenet.com/beta_blockers/article.htm
Jean Wible, RN, BSN, LMT, NCTMB, HTCP Author of "Pharmacology for Massage Therapy" and "Drug Handbook for Massage Therapists"

Pathology and Massage: Scleroderma by Jean Wible

Scleroderma is an autoimmune disease that affects women 4 times more than men. While its cause is unclear, its symptoms are due to an overproduction of collogen and hardening (sclerosis) of the tissues of the body. Scleroderma can manifest in many ways. It can be local or systemic. It can affect the skin, blood vessels and organs. The most common symptom is changes in the color of the skin and tightening and thickening of the skin.
In localized scleroderma two types of lesions can occur; morphea, which shows as oval patches on the trunk, face and extremities that start as dry, thickened skin and progress to pale centers with purple edges, or linear, where a discolored line or band on arms, legs or forehead appear resembling a scar from a long cut. Localized scleroderma is usually self-limiting and may resolve over time.
Systemic scleroderma is a more serious form of the disease that can involve skin, blood vessels, and organs especially the heart, kidneys, lungs and digestive tract. There are 3 forms; limited systemic scleroderma which has a slow onset and progression but can eventually affect the organs, diffuse scleroderma which has a sudden onset and more rapidly involves the organs, and sine scleroderma which only involves the organs and doesn't manifest in the skin at all.
CREST is the acronym for the common symptoms of scleroderma and stands for Calcinosis, calcium deposits in the skin especially in the fingers, Raynaud's phenomenon, impaired circulation and vascular spasm in the extremities, Esophageal dysmotility or sluggish digestion with reflux, Sclerodactyly, which is hardening of the fingers, and Telangiectasia or discoloration of the skin.
Systemic scleroderma can cause major health problems as it progresses. Ulcerations of the skin can lead to infection and gangrene while fibrosis of lungs, kidney and heart can lead to failure of these organs. While most often a long term, chronic disease systemic scleroderma can be fatal.
Treatment is supportive with immunosuppressant drugs, corticosteroids, pain relievers, and other drugs depending on the symptoms. Physical and occupational therapy are also utilized to help maintain movement and flexibility of the joints as long as possible.
Massage therapy will need to be adjusted depending on the type of scleroderma, the individual symptoms and the severity of the disease. Myofascial techniques will generally be ineffective due to changes in the tissue itself. Deep tissue may be cautioned or contraindicated if skin hardening is severe and circulation compromised. Gentle relaxation massage that is firm and rhythmic can help improve circulation and be soothing to tight tissues as well as help the client to deal with the stress and pain of a chronic disease. Passive and active movement of the joints can also be of help but should be gentle and never forced beyond the physiologic barriers. Energy work and breath work are some of the other modalities that may be used even when massage may be contraindicated.
Further information on this topic can be found at http://www.mayoclinic.com/health/scleroderma/DS00362 , http://www.scleroderma.org/ , or http://www.niams.nih.gov/Health_Info/Scleroderma/default.asp
Jean Wible is a Registerd Nurse, Nationally Certified and Licensed Massage Therapist and Healing Touch Certified Practitioner. Author of "Pharmacology for Massage Therapy" and "Drug Handbook for Massage Therapists" and faculty at the Associate Degree Program in Massage Therapy at The Community College of Baltimore County.

Massage Therapy Week in the News

Massage Therapy Week at CCBC was a celebration of wellness and an appreciation of how Therapeutic Massage can improve your quality of life. Thanks to everyone who stopped by for a massage or to learn more about the Associate's Degree program in Massage Therapy at the Community College of Baltimore County.

Read the article in The Avenue

Yumm, Pumpkin Pie!

I love pumpkin pie! I have played with many recipes and concocted a few winners myself, so I was intrigued by this offering from Dr. Fuhrman and had to try it. Many pumpkin pie recipes are too heavy, this one doesn't make that mistake. And the cashew cream is amazingly good. Go ahead, try it!

Guilt Free Pumkin Pie

Eat well, be well!

Worst Massage Ever!

When I started talking to other Massage Therapists about the worst massage I'd ever received, everyone had a story to tell. "Oh, do you mean the one that was so light and fluffy it was annoying, or the one who left you with bruises?"

Well, yes, those too. The light and fluffy one tells me that poor therapist never learned the first thing about body mechanics and doesn't know how to apply appropriate pressure; it is sooo annoying, like a gnat I just want to swat away. Don't waste my time.

Then there is the steam roller who believes in applying deep pressure at 90 mile an hour - this person is clueless about "listening" to the client and never learned the secret to great deep tissue . . . the sloooow sink, the take all the time in the world, oh yes, that feels good sort of relief that knotted muscles are begging for. Is it any mystery why many people don't like Deep Tissue Massage? Slow down, breath, pay attention. The really bad Deep Tissue massage that I had was even more memorable because this guy worked out of his house . . . okay, nothing wrong with that, but there was the smelly dog, the music that wasn't at all massage music, and the fact that this guy wouldn't shut up and when I asked him to slow down, he told me that I wasn't the first person to tell him that. Well, Duh? And to make matters worse, this therapist had 17 years of experience. How can one have 17 years of experience and be so unskilled?

The worst massage I've had lately is one that I received while attending a National Convention. It was a text book case of all the things not to do in a massage. The room was cluttered and unappealing, the therapist talked too much, he alternated between too deep and too light, really did not appear to be paying attention, and he was really unprofessional with the draping. It seemed that he hadn't heard a word I said when I explained where I was tight and where I wanted him to focus. To add insult to injury he cut the massage short. Well, considering how bad the massage was, he may have done me a favor. My first thought was that this guy was really inexperienced - then on second thought I realized he may have been experienced but was just unskilled! I have had a number of very good massages at our student clinic by student therapists who are inexperienced, but surprisingly skilled.

What was your worst massage experience? And how do you find a good therapist when you are traveling?

Massage Therapy Awareness Week a Big Hit on Campus!

October 25th through October 31st was National Massage Therapy Awareness Week. The Massage Therapy Program at CCBC promoted Massage Therapy through several community functions and open houses during the week.
The CCBC Women's Soccer Team visited with faculty and students in our on site Massage Clinic at the Essex Campus for seated massage on Monday.
On Tuesday, a Meet and Greet saw the faculty and students of the School of Health Professions joining in the fun with the Massage Therapy faculty and students in our bodywork lab. There were hand massages, seated massage, refreshments and more! We had a great time!
On Wednesday, we held an Open House on the Essex Campus to which all were invited! We had visitors from on campus and from the general community. We even had family of some of our massage students visiting. Tours, question and answer, refreshments and seated massage were enjoyed by all.
If you would like more information on what Massage Therapy can do for you or on becoming a Massage Therapist, contact us at 443-840-1069 or 443-840-1431.
You can also e-mail us at massagetherapysc@ccbcmd.edu

Saving Money on Electric Utilities

Saving Money has never been a better idea - especially when you can save on something as mundane but necessary as electric utilities. A friend (who happens to work at BGE) told me about changing your electric supplier . . . in years past, businesses could do this, but not residential customers. Now, we can take advantage of savings by selecting an alternate supplier as residential customers as well.

You still get your bill from BGE, but you are actually purchasing the power from a cheaper source. It is as good as it sounds! It is easy, and the savings are significant.

Last June I changed my supplier from BGE to Washington Gas Energy Services, and I have been consistently pleased with the savings on my bill every month!

The process is easy. I went to the WGES website, called the 800 number, gave them my BGE account information, and they hooked me up with a cheaper rate.

I love saving money! Check out the alternatives. You'll love saving money, too!

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