The confused client and her hard-headed doctor

[Thegustaffa]

I have been seeing this lady as a client of mine for about three months now. She was referred to me from another massage therapist, who worked on her for several months before me.

As I work on my client, I always feel these large masses on her thighs right above the back of her knees. I also feel these masses in her upper arms and on the front of her lower legs, but those areas are not as large. When I discussed these problems with the other massage therapist, she ventured to think that the client had fibromyalgia, which was a concern in the back of my mind as well.

Eventually I coaxed the client to get tested for fibromyalgia, but her doctor brushes her requests off like she doesn't know what she's talking about. And to make matters worse, the client's own daughter, who is half her age, was just diagnosed with fibromyalgia last year!!! My client also suffers from arthritis really bad in her knees and shoulders and has vericose veins in her legs which prevents me from doing most deep-tissue work. But the client isn't satisified with the massage unless she feels pain; in her mind, she has to feel pain in order to be relieved of her stresses.

I am at a complete and total loss as to how to help this woman, especially if her doctor won't confirm our belief. Do any of you have any suggestions as to what I could do to make her massage a more beneficial and enjoyable one? Any suggestions would be irrefutably appreciated. :?

 

[ikbatters]

My only thought is she needs to see a new doctor. Any doctor who does not listen to his patient is almost worthless as a physician. I know insurance can make it difficult, but it can be done. No harm would be done by testing her for fibro, so there is no reason for refusing to confirm or rule it out.

 

[Ghapy]

My sentiments exactly! But how do you tastefully suggest to someone that they should seek an entirely different doctor? I brought the idea of seeking a second opinion up, but she's content with her doctor's diagnosis.

***THE MOST DIFFICULT CLIENT IN THE WORLD***!!!!!!!! Makes you just wanna SHAKE something!!!!
(And I say that with love)

 

[[killer]kelli.(:]

Well, that certainly makes it more difficult!! I guess there isn't much you can do. I think I would concentrate on relaxation massage, explaining all the health benefits and how simply reducing stress and increasing circulation can have a huge positive effect on her overall health. Improving the overall health has no drawbacks.

 

[HenryVIII]

I'm with Sharon. Unfortunately, if this client wants to live in pain without so much as a second opinion, that's her choice It's hard for us to watch clients in pain that simply won't do anything about it that you KNOW could help, but whaddaya do besides helping her relax and giving her the best care you can. You can lead a horse to water, etc.

But, on another note, a VERY qualified and knowledgeable massage instructor of ours told us that often, Fibromyalgia is what she called a "wastebasket diagnosis". In other words, "we can't find what's wrong with you but we're going to slap an impressive-sounding label on your symptoms." Often, this instructor said, the real cause is trigger points. She mentioned that in a fibromyalgia test, they test a set number of benchmark areas to see which ones are painful and if over a certain number of them are, poof: you have fibromyalgia. Never mind that this person may have been in a car wreck or be on some drug that screws with the neurological/musculoskeletal system(s) and that the patient might be in pain from THAT and it MAY have nothing to do with actual fibromyalgia, which, I believe, STILL hasn't been nailed down to any particular cause yet. It's what most other conditions are in the medical world: forget the cause, create a list of symptoms that we can drug and bill for (at least that's true for some).

Anyway, good luck with your client, and hopefully someday she will "see the light"

Peace,
~Jyoti

 

[cheyenne]

I'm so discouraged, I almost want to stop seeing her as a client. I hate not being to help people, but I know I can't help everybody. I kinda want her to have fibromyalgia, just so I can say "I told you so", so she could say "Yes, you were right" and sue her doctor. :twisted:

 

[Tracer]

The confused client and her hard-headed doctor

the client's own daughter, who is half her age, was just diagnosed with fibromyalgia last year!!!

Maybe suggest she sees her daughter's doctor? If the daughter is seeing the same doctor, not sure what you could suggest.


I'm thinking cold stones (with hot stones to keep the body warm). The alternating temps will do great things. She probably won't like the temp, the no pain no gain attitude might be good here

Aromatherapy http://www.holistic-online.com/remedies/cfs/fib_aromatherapy.htm Only use the junpier if there are no kidney isses and only use the rosemary if there are no blood pressure issues. If there are no liver issues, I'd include carrot seed oil. If her liver is not good, it will make her feel like she has a hangover the next morning, it can stimulate quite a liver detox. With her no pain no gain attitude, she might like feeling rotten the next day.

 

[carlos]

You know, she actually likes the heat therapies I give her, she says it works wonders for her arthritic knees. Maybe I should just run her a hot bath and charge her... :

 

[Sikenflossy]

I brought the idea of seeking a second opinion up, but she's content with her doctor's diagnosis.

I hate not being to help people, but I know I can't help everybody. I kinda want her to have fibromyalgia, just so I can say "I told you so", so she could say "Yes, you were right" and sue her doctor.

My thoughts for what they are worth:

She's content. If she's content, then why push so hard? Let her know that you will do the best with what you have to work with, and it may be that she only gets temporary relief. Suggest a second opinion, if she asks, and then just work as normal. Don't promise anything to her except that if she is not getting relief from your methods, that may be the reason to move on or consider that already mentioned second opinion.

As for "suing". I am not a proponent of even thinking this way.

Just do your best, make the proper suggestions and work with what you have. I have a client right now who is going through the same sort of thing. She has seen other docs she's been referred to and doesn't like the dx of her primary - but continues to go back and do what the primary says. Then she comes to me and continues to be in pain. I can only suggest so much. In the end it is up to that individual if they want to seek other options.

Good luck. I am sure you are helping her in some way and once you are comfortable with doing what you can, without the expectation of "fixing" this lady, I figure you'll be at peace with working on her.



PS:

Fibromyalgia is what she called a "wastebasket diagnosis". In other words, "we can't find what's wrong with you but we're going to slap an impressive-sounding label on your symptoms."

Agreed!

 

[tanaz]

I would also suggest she see a different therapist. If she's dead set on the pain factor when it comes to the massage, and you're not comfortable doing it..then simply don't.

I have no problem telling a client that needs to find a different therapist to do so. If i can't give you what you want and need, then by all means, find someone else who can.



Are these spots you speak of painful? Is she overweight? Could they possibly just be isolated lumps of adipose tissue?

 

[simples]

But the client isn't satisified with the massage unless she feels pain; in her mind, she has to feel pain in order to be relieved of her stresses.

I missed this comment.

Are you saying she needs to feel pain everywhere you touch... or she just likes very deep pressure... and wants to "feel it" in certain areas? For instance, could you go deep in her back and make her happy?

This was a good thread with a lot of input relating to "pain and massage" -
Should a massage hurt?

 

[chick]

Texas-gal wrote:

Are you saying she needs to feel pain everywhere you touch... or she just likes very deep pressure... and wants to "feel it" in certain areas? For instance, could you go deep in her back and make her happy?

No...There is a marked difference between her interpretation of "good firm pressure" and "pain". She likes pressure so deep I'm sure it hurts her at times...She'll just mumble some expletive in her native language like it's all good. I've explained to her on several differemt occassions that good massage DOES NOT equal painful massage, but I may as well be driving a Hummer over her body and I'm sure she'd like it. :twisted:


Spacer wrote:

Are these spots you speak of painful? Is she overweight? Could they possibly just be isolated lumps of adipose tissue?

The spots are painful and hard to the touch, like someone put their hand under her skin...If it is fat, it's hard as H-E-double hockeysticks. She is overweight, but excersizes frequently and eats well. I know she doesn't drink enough water though. I sometimes wonder in the back of my head if she really does exercize and do the homework I ask her to do.

I'm really getting frustrated with this client. I think I'll just continue treating her like normal and try to find someone else, preferably a 300-pound man, to work and twirk her just right.

To IMI ppl: I made an appointment with Irene for her to see this client. I figure if she can't help her, NO ONE CAN! Plus we all know what a masochist Irene is... :wink:

 

[Kebo]

RE: IMI people: Smart move there kid! I'll be curious to hear how it goes with her! IM me and let me know when! :wink:

 

[Kazandra]

The appointment is in two weeks. It would have been today, but she had to cancel. I actually got her on the phone last night with Irene to reschedule because she was giving me such a hard time...When Irene got on the phone, she recoiled like a scared kitty! :twisted: Maaaan, I can't *wait* for this appointment! It's going DOWN!!! :

 

[Navywife0827]

t046

 

[bellz_chick]

I think I wish I knew Irene. :wink:

 

[Tipsy32]

She's an elder Finnish lady who is proud of her craft (and with every right) who has been practicing since she was a poor farm girl of 1930's Finland...Who now has made quite a requtation for herself...Check out her webiste.

But man, I feel for her first-time visitors. I'm sure they leave feeling dazed and confused, but somehow happier... :

 

[the_unluckiest]

I'm getting very confused with the obviously off board discussion comments....

Anyway, Irene sounds like a perfect fit for your client.

 

[Kinomaru]

??? What's confusing? Your opinion would be appreciated too, melb!

 

[Miniver]

I'm getting very confused with the obviously off board discussion comments....

Anyway, Irene sounds like a perfect fit for your client.

Agreed.

The only thing I am a bit concerned about is that you seem to want "Irene" to "hurt" the client.

she recoiled like a scared kitty! Maaaan, I can't *wait* for this appointment! It's going DOWN!!!

I am not quite following... but I hope it all goes according to plan.