Never Stop Learning: An Interview with Linda “Koby” Blanchfield

Never Stop Learning: An Interview with Linda “Koby” Blanchfield

Experience is the best teacher. That’s why WCCMT reaches out for stories from alumni who have graduated to become successful RMT’s. Learning about their Massage Therapy practice is an inspiration, and their advice is priceless. Linda “Koby” Blanchfield, who graduated from WCCMT in 1990, is an example of what dedication and a thirst for knowledge can accomplish.

When she attended school, the campus was located in East Vancouver, the heart of Chinatown at the time. Using public transit, it took her over an hour and 15 minutes one way to commute to school each day. Depending on the weather, it could have taken longer.

The long days were necessary for Koby, since WCCMT was the only Massage school in British Columbia at the time. Due to her growing family, she was unable to make the move to Ontario, and had to make due with the long hours of commute.

But, the hours spent transporting via bus were for a good cause. Koby originally pursued Massage Therapy for a very personal reason.

“I had a motor vehicle accident and physiotherapy, using electricity, was not helping,” Koby told us. “ A friend recommended Massage Therapy, which was then covered by the BC Medical Service Plan. It resolved my musculoskeletal issues. I was impressed, and thought that I would like to be able to help people, like my RMT helped me.”

Her experience left a lasting impression that seeped into her desire to help others through Massage. “It is a wonderful feeling to help folks on the path to wellness with hands on work and education,” she said. “It is gratifying to see the change in physical well being and this often leads to happier patients.”

Koby told us that the initial contact she makes with patients is usually by phone, a necessary step before they can book a treatment. Clients are sent information about some of the conditions they treat at the clinic, so they can work together to develop the treatment plan.

“None of the clients can book online, as the type of work we do must often be planned in advance. This involves collaboration, a great way to encourage adherence to treatment plans.”

When asked about advice for current and new students, Koby suggested to focus on the small things, like punctuality, giving 100% attention to the matter at hand and following through on any commitment made. These simple actions leave a lasting impact on patients and make them feel respected. She said the same applies for school and work, as it will have the same effect on colleagues and teachers.

Her final piece of advice is something that resonates deeply with the WCCMT spirit. Never stop learning – continued education builds a successful practice.

“Passing the Boards is only the start of entry to practice,” said Koby. “Continuing education should not be motivated by a point system, but rather by pursuit of the excellence we can bring to our practice. It never ends.”

Wise words from a valued WCCMT alumnus. Thank you Koby, for sharing your story with us!

Are you interested in a career as a Massage Therapist? Learn more about other students who found their path at WCCMT by checking out our blog and following us on Facebook and Twitter. Want to share your story? Contact Susy at [email protected].

Dealing with Reaction and Aggravation Following Massage Therapy

As an RMT you know better than anyone that every patient is different. In fact, every injury and condition is different and can affect patients in different ways. Because of this you may encounter patients who come back to you following an initial treatment with concerns of pain or sometimes even worse pain than when they arrived. Understanding the difference between aggravation, pain and contraindications is key to making the right decision at their next appointment.

Reaction: No Pain, No Gain

Massage therapy can be one of the most challenging to perform for patients with complaints of pain. Pain management infers that the pain will be alleviated which in some cases is not the first or expected result. Many patients do not realize that when undergoing any form of pain management in certain scenarios the no pain no gain phenomenon actually applies. For example a patient who has complaints of pain and stiffness may feel relief at their first appointment but within a few hours following their appointment begin to feel discomfort again. Although this is a normal “reaction” it can make a negative impression on the patient. In some cases, because their first feeling was relief, when the pain returns they may interpret it to have worsened when in fact it is either the same or slightly lessened. The cause of this reaction is the increase in blood circulation returning to the area. You might liken it to the case of a foot falling asleep that when returned to action tingles and hurts until the circulation is completely returned. Although the pain is unpleasant, once circulation returns the pain is relieved. As with returning mobility and decreasing pain the return of blood circulation is temporarily unpleasant but a necessary reaction to improve the overall condition. Knowing this will make patients less nervous about continuing treatment.

Aggravation: Pain, No Gain

In the case where a massage causes aggravation this is a pain, no gain scenario. Aggravation can be caused with massage improperly applied. Too much aggression, pressure or too vigorous a massage can work to make the area undergo further trauma and result in unwanted aggravation such as developing trigger points and facet joint subluxation. It is not an intentional occurrence but it shows how important choosing the right technique for each patient is vital to the success of their therapy. Sometimes a patient themselves requests a more aggressive massage which can be misleading to you as an RMT. It might seem they require a deeper massage because the patient is associating the pressure as effective. It is important to consider the patient’s condition and if it is wise to apply further pressure. If it does not make sense it is important to explain to the patient that further pressure or aggression could actually cause damage. Ignoring the basic rules of contraindication will cause aggravation and worse, serious damage to patients.

Further Injury

A common mistake for many massage patients is to feel sudden relief and want to test out their new flexibility. They may reinjure the area without even realizing it and associate the new pain with something that occurred during the massage. It is important to review with each patient how best to treat their improving range of motion and that they must avoid any undue or excessive strain even if they feel better. If they understand that it is possible to strain or sprain the area as a result of their new flexibility they are more likely to continue with their more cautious movements until treatment is completed and they have the thumbs up to return to exercise and activity.

The Importance of Communicating with Patients in Layman’s Terms

Try to remember how you reacted to the first classes you attend in massage school. You probably strained to catch the medical terms and body parts trying to conjure up their meaning without appearing confused. Now you can rhyme them off in everyday conversation without missing a beat. But if you are using these terms to explain treatments and conditions to your patients you can be guaranteed that unless they are in the healthcare profession you’ve lost them with the first mention of Cranial Sacral Therapy. Learning to speak to your patients in layman’s terms will help keep your patients comfortable with the treatment you are recommending and allow them to make informed decisions based on their needs.

Body Language

One of the best ways to communicate with patients about their body is to use their body or yours. When you begin a long and in-depth description about their injuries or intended treatment and how it will affect parts of their body you will lose them if they don’t understand what you are saying. Using their body or your own to point out the body parts you are discussing will allow them to follow along visually making it easier to understand what you are saying. You can choose to use the medical terms while doing this, but do it while pointing to the body parts so they will understand. Indicate where it is located so that they will know what to expect and understand more about their condition.

Medical Text Books Don’t Lie

It may be tempting to quote the terms and modalities you wish to use for treatment because you know the medical text books are accurate in their explanations. As honourable as this might seem, you will definitely do nothing more than confuse your patient. Remember that in the case where you are literally trying to sell them on a recommended treatment to encourage them to return. If they don’t understand the benefits of the treatment they are less likely to spend their money. Think of it as going to an ethnic restaurant where the foods are all named by their ethnic names. If there isn’t a description of the food you will be eating chances are you will want to go to another restaurant where you will recognize the food you will be eating. It is not new flavours that scare you away. It is the unknown that you don’t trust.

Bedside Thesaurus

Keep a thesaurus at your bedside and look for words to replace medical terms. For example, instead of acute you can say sudden, instead of fascia you can say body tissue. Suddenly a sentence that sounds like this: “Deep tissue massage is a modality that reaches structures far beneath the superficial fascia through palpation for efficacious alleviation of chronic muscle problems or injuries to the physiology” becomes this: “Deep tissue massage will offer relief from muscle pain through gentle touch that will relax muscles and improve circulation.” You take the response from “Huh?” to “Ohhhh.”

Learning to communicate with your patients on their terms will help you form stronger bonds. It’s much like the old saying, “Give a man a fish he will eat for a day. Teach a man to fish he will eat for life.” Educating patients in a language they understand will help them trust you and feel comfortable with the treatment you recommend.

Special Considerations When Treating Dementia Patients

Throughout your career you will choose who you wish to treat. You can choose a spa setting where your main focus is providing relaxation and stress relief, work with pregnant moms or sports injury patients or work in a senior care facility. If you choose to provide massage therapy to the elderly there are special rewards you will gain from providing care to those in need of attention and care. You will also face challenges especially when dealing with patients with dementia. Knowing how to deal with the very special needs of dementia patients will help you remain professional while providing the compassion required to work with them successfully.

Communication with Dementia Patients

One of the greatest struggles care givers face is communicating with patients with dementia. Dementia can cause sudden changes in communication which can provide unforeseen road blocks even in mid treatment. As well you might find some patients communicate using non-verbal cues or even through touch. Understanding that human contact is a need we all share will be a good start to remaining patient with dementia patients. It may take a while to learn what communication works best with each patient and it may be difficult when one day your patient is perfectly fine and communicative and completely shut down the next. Learning to expect these changes will make caring for each patient a little easier. As well, when patients are having difficulty communicating sometimes simply stating you are aware they are trying to communicate are not certain what they are trying to say can help validate their feelings. Many people treat patients with dementia less respectively speaking to them like children. Unless your patient responds to this tone and approach it is best to be respectful and treat them as an adult using kind and gentle tones.

First Contact and Appointment

When you have your first appointment with a dementia patient approach them as you would any of your patients and introduce yourself warmly and politely. Always maintain eye contact when possible and explain to them you are there to provide care and a therapeutic massage. It is not uncommon for dementia patients to be unaware of appointments they require or what treatments their doctors have recommended for them. When dealing with any elderly patients it is always a good idea to speak loudly and clearly in case they have hearing issues. Most will have the gumption to tell you to stop shouting if they don’t have hearing problems. Ask them the name they prefer and make a note of this in their chart. This way you will remember to use their preferred name as opposed to general terms such as dear. This is more respectful. If you need to ask them questions speak slowly and clearly and wait for their response. Elderly patients and patients with dementia may take longer to respond than you expect.

Elderly patients are people with the same interests, feelings and emotions as any other patients you will treat. Learning the proper way to deal with your dementia patients will help you maintain a caring, yet professional relationship.

Are There Times When I Shouldn’t Have a Massage?

It’s not a good idea to schedule a massage appointment if you are experiencing any of the following:

  • Have a fever
  • Were recently involved in an accident
  • Are dizzy or nauseated
  • Are bruised or have wounds, rashes, or severe sunburn.

In these cases, it’s important to stabilize your medical condition first. After you have recovered, or the condition is under the management of a medical provider who agrees that massage would be helpful, you can call to schedule an appointment.

In general, medical concerns or conditions might mean the therapist needs to adapt the massage technique or length of session.

What should I do if I have a specific condition?

If you have a temporary or chronic health condition, it is important to select a therapist who demonstrates sensitivity to and an understanding of your conditions or symptoms. Many therapists have advanced massage training on how to provide an effective treatment protocol that will complement other treatments/efforts you are following to reduce or eliminate symptoms.

Before you make an appointment, review the list of medical conditions below and inform your therapist if any of these conditions apply to you. Also be sure to let your therapist know who diagnosed your symptoms/conditions (your physician or primary care provider, a complementary therapy provider, or you, yourself).

It is important to let the therapist know if the conditions/symptoms are ongoing but managed effectively, or new and not managed effectively. To help you identify which is which, read the descriptions below.

Conditions/symptoms are ongoing, but managed effectively if they are:

  • Familiar, you understand what makes condition/symptoms better or worse
  • Under control with medications
  • Managed effectively with supportive activities, such as exercise
  • Successfully stabilized and tested over time or with specific activities

Conditions/symptoms are new and not managed if:

  • You are just beginning to balance medication dosage and daily activities
  • You are just beginning to observe the control or lessening of symptoms
  • Your symptoms seem to be better, but have not been tested by additional daily activities

Tell the therapist if you have these conditions:

Tell your therapist if you have (or in some cases have had) any condition from one of these categories:

  • Contagious skin conditions (boils, warts, or herpes)
  • Other skin conditions (burns, rashes, or sores)
  • Circulatory system issues (high blood pressure, varicose veins, or stroke)
  • Digestive system issues (ulcers, irritable bowel syndrome, or colitis)
  • Edema
  • Endocrine system issues (diabetes or thyroid dysfunction)
  • Musculoskeletal system conditions (carpal tunnel syndrome, fibromyalgia, osteoporosis, rheumatoid arthritis)
  • Lymph/immune system issues (chronic fatigue or HIV/AIDS)
  • Nervous system conditions (herpes or Parkinson’s disease)
  • Respiratory system issues (asthma)
  • Miscellaneous conditions (pregnancy, migraines, cancer)

What are some other cautions?

There are additional conditions where massage therapy could cause adverse effects. Once again, if you have any condition (chronic or acute), or are taking any medications, you should consult with your primary healthcare provider before seeing a massage therapist. In some cases, massage may be appropriate with some changes to the techniques or session.

For example, if you have an open wound or burn, the massage therapist would avoid that area. Or if you have any pins, staples, or artificial joints, the massage therapist may need to alter the techniques as well. Individual decisions must be made according to circumstances and, in many instances, medical advice.

Also, if you are allergic to certain massage oils, creams, cleansers, or disinfectants used on sheets and or tables, you may need to ask the therapist to use different products, or bring your own.

References

Expert Contributor:
Beth Burgan, MA, MFA

Reviewed by:
Dale Healey, DC