CASE STUDY 4:
Personal Information:
Name: Mr. K
Occupation: Full time student of law and worked part time in a mental health nursing home.
Age: 32
Contact details: To be produced if requested
Reason for attendance: Mr. K was a friend of mine. He rang me up complaining of a cramp in his right calf.
Support and family: He was married with no children and lived in a rented accommodation.
Client consent: The entire treatment was done with his permission and no doctor was consulted as his problem was minor.
Client Profile:
Mr. K was a short statured person and morphologically inclined towards the endomorphic type. A full time student of law, he was married and lived in a rented five bedroom accommodation which he shared with his partner. He was a friendly person but was extremely sober and polite who would take part in a discussion by listening rather than talking. His right hand was slightly deformed but it didn’t prevent him from doing any of his daily activities. He was declared medically fit by his GP. The cramp in his right calf was perhaps due to him working overtime in a ward, where he had to walk for extended hours. This was perhaps the direct cause along with the underlying cause of his usual consumption of a rich diet which was deficient in B vitamins because of avoidance of whole grains. He had to work in mental hospital in the weekends about which he was worried.
Medical History:
Mr. K was a healthy individual. His right hand was slightly deformed but did not prevent him from doing any of his daily activities. He was declared fit by his GP when he had been for a work related medical test.
His present condition was an acute pain in the right calf due to a cramp in the muscle primarily related to over use. A diet deficient in vitamins and minerals could have been an underlying cause.
Emotional health:
Mr. K was my friend and I had known him for quiet a long time. He was a friendly person but was very sober in nature. He was extremely polite and would rather take part in a discussion quietly listening rather than actively talking. Though he didn’t lack confidence but he was slightly soft natured and would get scared and shocked at little things which would perhaps be normal for his partner. The cramp in his right calf had almost left him crying. The added stress of his weekend work worried him even more.
Life Style:
Exercise: None other than the little walking he had to do at the nursing home where he worked.
Diet: Spicy food regularly cooked with excess oil.
Bowel habits: Regular.
Smoking: Very rarely (could be once in two months).
Social life: Was popular among his friends and family. His sober nature was always talked of.
Alcohol consumption: Socially only.
Recreational drugs: None.
Daily routines: Mr. K was a full time student of law. He worked at a mental health nursing home at weekends. He would occasionally call his friends over to his place and have evening chats which he enjoyed taking part passively as a listener. Her sleep times were regular other than exam weeks when he would study till late at nights.
Current presenting problems:
His recent problem was a cramp in his right calf due to over-use while working. He was almost left to cry due to his pain being the usual soft natured person he was. He had no other problems either mental or physical that he was aware of, other than the deformity in his right hand, which he never counted as a problem either.
Contraindications/precautions:
Existing medical conditions: None.
Skin sensitivity: None.
Dermatitis: None.
Allergies: None.
Asthma: None.
No serious medical condition was present; neither was he taking any prescription or recreational drug, which could have a contraindication with the aromatherapy therapy treatment to be done.
There was no sign of inflammation at the sight of pain.
Treatment Plan:
Client’s problem was a cramp in his right calf. He was otherwise a healthy individual with no special medical needs.
There was no inflammation at the site of pain to contraindicate a massage treatment.
We both agreed to two leg and foot massage sessions in the following order:
D1: evening (when he called me)
D2: none
D3: none
D4: evening
We also agreed follow ups would be done if needed.
Treatment 1:
Leg and foot massage was done that evening.
Essential oils used were:
Black pepper (Piper Nigrum)
Sweet Marjoram (Origanum Marjorana)
True Lavender (Lavandula Angustifolia)
Career oil used was grape seed oil.
Rationale for choice of oils:
Black pepper (Piper Nigrum) is an analgesic, circulatory stimulant and tonic in action thus making it useful in treating muscular aches and pains.
Sweet Marjoram (Origanum Marjorana) is an analgesic, antioxidant, hypo-tensor, sedative, tonic and vasodilator making it useful in treating muscular cramps and aches in when the sessions are in the later part of the day.
True lavender (Lavandula Angustifolia) is an analgesic, ant-rheumatic, antitoxic, hypo-tensor, sedative, stimulant and tonic.
Hence it could be used to treat his muscle pain yet at the same time it’s calming, relaxing, hypotensive and sedative properties could facilitate in him a sense of ease and relaxation.
Grape seed oil was used as career oil as it high percentage Vitamin E and is also one of the few oils which are cholesterol free and easily digested. It has no known contraindications and is non-toxic.
(Clarke, 2009)
(Ernst et al 2008)
(TISSERAND, 1988)
(Lawless, 2002)
Dilution and measurements:
The synergistic blend:
1 drops of black pepper
1 drop of sweet marjoram
1 drop of lavender
Career oil:
15ml grape seed oil
The massage was done with emphasis laid on effleurage, petrissage, friction movements and some draining movements.
Client was advised additional intake of water to promote a healthy metabolism and promote excretion of toxins from the body. Stretching exercises (including static, dynamic and PNF) were all shown and recommended especially after work which would lead to relaxation and removal of toxins from the muscles which would already be in a warmed up state after work. Regular intake of Vitamin C (@500mg per day) and B vitamin Complex tablet (1 a day RDA) was advised as these two are water soluble vitamins and would not be easily overdosed especially coupled with the additional water intake and hence could be safely taken. Healthy diet was advised, but occasional rich food was permitted.
Therapist observation and client feedback:
The massage session took an extremely long period as the movements had to be slow first and then deep to facilitate further relaxation and circulation. Dynamic Stretching techniques were applied at the end to the warmed up muscles. Client was first cautious of any chance of pain inflicted due to the massage but later informed a profuse sense of relaxation.
Next session would be carried on as planned.
Treatment 2:
Leg and calf massage was to be done this evening as previously planned.
Essential oils used were:
Sweet Marjoram (Origanum Marjorana)
True Lavender (Lavandula Angustifolia)
Black pepper (Piper Nigrum) was removed from the blend this time due to a possible chance of over dosing as the sessions were close enough.
Career oil used was grape seed oil.
(Clarke, 2009)
(Lawless, 2002)
(Price, 1998)
Dilution and measurements:
The synergistic blend:
1 drop of sweet marjoram
1 drop of true lavender
Career oil:
15ml grape seed oil
Massage techniques were similar to session 1.
Therapist observation and client feedback:
Client informed a sense of relaxation after the session. He even said the pain had gone away and he could extend and contract his calf muscles with out any sense of pain. On being enquired about his regular stretching workouts which he was advised to do he replied in affirmative.
It was after this session that he requested a few full body massage sessions after he would return from work in the weekends.
We both agreed to a full body massage session on the next three Sunday evenings.
So the extended treatment plan would be
1 full body massage session every Sunday evening.
Treatment 3:
Full body massage was to be done this evening as was planned.
Essential oil used was:
True Lavender (Lavandula Angustifolia)
Career oil was grape seed oil.
The simple rationale being the fact that true lavender has been almost used as an all purpose oil with minimum side effects and hence made maximum sense for the follow up sessions when pain had subsided entirely.
Also it would help him relax after his work.
(Clarke, 2009)
(TISSERAND, 1988)
(Lawless, 2002)
(Price, 1998)
Concentration used was:
3 drops of lavender
In
50ml grape seed oil
Full body massage was done with the sequence-
Back - back of legs - front of legs – feet – hands -chest - neck and shoulders.
Slow movements were used to emphasise relaxation.
Lymph drainage techniques were employed where ever needed.
Client fell asleep during the massage session.
No questioning was done that day as that would be very disturbing and counterproductive to a relaxation treatment. But the fat that he fell asleep it self proved how well the treatment worked as it was intended to.
Treatments 4 and 5:
Sessions 4 and 5 were exact replicas of session 3.
Analysis:
Client was regularly asked about his diet, vitamin, and water intake. His diet was similar to the one that he was on before treatment; he didn’t stop eating rich foods, but started exercising regularly and went for brisk walks with his partner when ever they were free.
I always analysed data collected by me from his verbal and non verbal cues and this time I felt both me and my client were satisfied by the way the treatment sessions went.
I believe my competency as a therapist increased every time I treated a client, and each treatment brought me up to a next level in terms of confidence and knowledge.
References:
CLARKE, S. (2009) Essential Chemistry for Aromatherapy 2nd Edition London: Churchill Livingstone
ERNST, E., PITTLER, M., WIDER, B. And BODDY, K. (2008) Oxford Handbook of Complementary Medicine Oxford: Oxford University Press
LAWLESS, J. (2002) Complete Illustrated Guide to Aromatherapy: A Practical Approach to the Use of Essential Oils for Health and Well-being
Element Books
LAWLESS, J. (2002) Encyclopedia of Essential Oils: The Complete Guide to the Use of Aromatic Oils in Aromatherapy, Herbalism, Health and Well Being Thorsons
PRICE, S. (1998) Aromatherapy Workbook: Understanding Essential Oils from Plant to Bottle Thorsons
TISSERAND, R. (1988) Lavender Beats Benzodiazepines. International Journal of Aromatherapy, 1 (2) 1-2
