Honesty is Always the Best Policy... Your Therapist Deserves It

Oct 9, 11:01 PM

by Katharine Koeppen, RA

I've had a few days of the same incidents happening over and over again, so I'm just going to let loose with a rant: DO NOT withhold personal health information from your massage therapist or aromatherapist!

Your therapist uses the health information you provide, along with their professional expertise, to design safe, effective treatment protocols for you. Presumably, that is what you are paying them for. When your therapist asks a question regarding something on your health profile that is unclear, omitted or partially explained, don't insult them by snapping, "Well, I don't think it's any of your damn business!"

That was the response I got this weekend when I asked a new client for details on why she had checked "cancer" on her intake form with no further explanation. It turned out "cancer" meant 3 previous bouts with breast cancer, cervical cancer and thyroid cancer, and included a double radical mastectomy. She had arrived expecting a deep tissue aromatherapy massage with a focus on her upper body.

Several red alarm bells went off for me. As someone who is trained in both clinical aromatherapy and oncology massage, I knew a whole list of essential oils was contraindicated for a history of hormone-positive cancers due to their potential to stimulate estrogen production. Deep tissue massage was out of the question due to the possibilty of causing lymphedema of the upper extremities (a permanent, debilitating condition) because of her mastectomies. In fact, once I got my hands on the client, it became obvious that she could not handle anything more than very light massage without reddening the tissue and overstimulating her lymphatics. Although the need to modify her session was explained in detail, she was still very leery and remained so until the close of her session, when she finally admitted, "You seem to really know what you're doing." Double duh.

I had a similar experience the day after. A young woman came in who had checked "surgery" on her intake and was extremely reticent to give any further explanation, stating, "I don't see what the problem is, I've had plenty of massages since my last surgery." After asking her a few questions, it turned out she'd had a double radical mastectomy with reconstructive surgeries, a history of multiple blood clots including pulmonary embolism, and complete fusions of both the cervical and lumbar spine. She also had uncontrollable high blood pressure with medication. None of this was disclosed in her health profile. The same contraindications existed for her as for my previous client, plus a few more: I could not perform deep massage anywhere on her body, could not perform spinal traction, and needed to be vigilant for any areas of redness or swelling accompanied by heat. When I explained why I needed to modify my approach, she was nice about it and understood the necessity of full disclosure to any future bodyworkers.

Not so with my next client, an older man who had mutiple bandaids on his back. "I had a few little growths removed at the dermatologist 5 days ago, no big deal, just be careful around the bandages. It's healed up nicely by now." OK, easily done. However, I was horrified when he turned over to reveal a heavily bruised, 6" incision on his anterior thigh and a huge crater the size of my hand on his chest. Both incisions were still oozing and had bled all over the sheets. He did not want to hear that he should have disclosed the presence of these incisions and rescheduled his massage for a later date, and did not care that he'd exposed me to body fluids. "It's not a big deal, I just had a couple melanomas removed." He remained unfazed as I told him he was far too close to removal of a rapidly spreading, burrowing form of cancer to safely receive any massage therapy. He is no longer welcome in my practice; I don't want that kind of liability and will not put up with that kind of overt disrespect.

Never worry about trusting your therapist with personal health information, as they are ethically bound to protect your privacy. Additionally, they are bound by the same HIPAA law as any other medical professional, and they cannot disclose your information to others without your explicit permission. If you want them to treat you with honesty, be honest with them. (In case you're wondering, some of my clients' details have been changed in this blog post to protect their privacy.)

No bodyworker or aromatherapist ever wants to cause injury to a client, but it can happen if the client withholds crucial health information. Worse yet, injuries can occur when an inexperienced or poorly trained therapist doesn't understand or ignores absolute or local contraindications. If you have serious health issues, past or present, make sure to seek out a therapist who is knowledgable, experienced, well-trained, and willing to explain any modifications in treatment protocols. Accept those modifications without arguments or insults. A good therapist always has your continued health in mind, but cannot adequately and safely help you if you will not work in mutually respectful partnership with her.


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