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November 4, 2010

Oh, The Humanity (Part 4)

I'll never forget the value of the first lessons I learned as a massage therapist about close contact and human smell. I will be sharing some of the lessons that I have learned, some obvious, others not so obvious, about what we can learn about our patients from our nose. Some of these lessons, of course, will require humor, others will yield useful information, but hopefully all will be shared with a gentle respect for our humanness.

My clinical instructor in massage school had a complex about feet. He hated gross feet. He really hated dirty feet. He said one of the things he did with clients who had nasty feet was to massage those and then go straight for the face. Well, that wasn't very professional!!

Feet are an important indicator of a person's health. People with diabetes can have neuropathy, a condition where they cannot feel their feet, or their feet burn with pins and needles sensation. In massage therapy, we are not supposed to massage areas where people have reduced or altered sensation. One of the clues, if patients do not report that they do not have feeling in their feet, is to observe the condition of the skin, of the nails, and the color of the feet. You're doing your diabetic client a favor, because if you observe any sores or calluses on their feet, they need to know about them and get medical attention.

Often, the reason that people have foot odor is because they have nail fungus. I have seen some snaggly, shattered looking nails. Clients with chronically bad looking nails likely have nail fungus and possibly a compromised immune system. This is typically seen in the elderly. Younger people with nail fungus or foot odor may be experiencing http://www.mayoclinic.com/health/athletes-foot/DS00317. Tea tree oil has been touted as beneficial for nail fungus. Massage therapists could add this to their repertoire as a bonus treatment for their clients. Or you could advise them to soak their feet in baking soda water. I had a biology teacher who suggested peeing on your feet in the shower because the ammonia created an unfriendly environment for fungi. Yuck, and yuck again.

Excess moisture is bad for feet. I had a patient who had to wear a plastic orthotic to prevent weakness resulting from foot drop. He was elderly, lived alone, and had limited mobility preventing him from easily attending to his own feet. He would sleep in his orthotic and socks because his feet tended to get cold. Unfortunately, he wore the orthotic for several days at a time causing skin maceration or excess moisture on the skin. Education was paramount to prevent a larger problem from occurring. The problem with this situation, besides being unsanitary is that chronically moist skin leads to tissue breakdown. Upon examining his foot, the skin sloughed off in a paste-like fashion, leading me to believe that someone was already treating the problem. But they weren't, and the smell of that slough was downright cheesy.

Everybody has their "thing" that they cannot stand. Mine is cheesiness. Ugh. Cheesy feet are the worst.

Posted by linda at November 4, 2010 7:02 PM

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