Cumadin

[Pompal 09.]

I am curious as to how others handle clients who are on Cumadin (blood thinner/anti-coagulant). I had a client who came in yesterday, referred by her physician for a wicked knot in her shoulder. Her appointment was an hour and a half, and she told me she is on Cumadin, has varicose veins, and is recovering from a stroke (3 years ago).

Needless to say, I used very light pressure for the whole session, and addressed the knot in the only way I felt comfortable - some light (LIGHT!) compression and energy work. Her lower legs just got an application of oil due to the varicose veins.

Even though she said her doctor had sent her, I didn't feel that deep work would be safe at all.

Does anyone feel differently about this or did I do the right thing?

The client LOVED her massage, by the way, and rebooked for next month. I talked her down to an hour since she was light-headed after an hour and a half and I had to help her off the table (more like help her not try to get up too fast!).

Thanks,

Emily

 

[Amanda :D]

Coumadin = NO MASSAGE!!! Big contraindication!!! This is a heavy duty blood thinner, even from light touch she can bruise, and it will not coagulate...

 

[jazzmaster]

Thanks for replying Pandora.

In school we were taught to be very careful in working with folks on this medication, but that it can be done. I've also seen other research that says you can massage. Couldn't tell you where now (I'll have to look). I know at least a few MT's who massage folks that are on cumadin, but they say to use a very light touch. Which I did.

The thing about the medical field is that the research always seems to be changing. This woman massages herself daily, and she was referred to me by the same physician who prescribed the blood thinner - to work out a knot (go fig). Usually "working out knots" indicates deep work.

Has anyone heard any other side of the story?

Thanks,

Em

 

[Zeb]

I guess what I mean to ask is Why The HECK would a Doc send a woman on Cumadin in for deep work????

LOL.

 

[iluvaaron<3]

I have clients on coumadin, but they have been on long enough to be stabilized - the dose has been adjusted enough and they have been watched by their doctor long enough that they are no longer bruising. If they bruise that easily after having been on it awhile, they are taking too much and their doctor is not doing his/her job.

The pressure definitely cannot be very deep. TP's need to be eased out very slowly and gently. Coax it out, don't work it out.

Having the doctor give written instructions with his signature regarding depth/pressure is my preference.

 

[Office Monkey]

I have had an MD and a PT give okays for their patients to receive massage.

 

[Victoria M]

I've posted a response in Private DIscussion.

 

[Cat Litter Man]

Thanks everyone for your replies. I was able to talk to my mentor as well and he, after asking me about my client's lifestyle and health, told me to go light and let the client and my hands lead me. I like what Rose said about coaxing out the knots instead of working them out. That's what it felt like I was doing but I couldn't put it into words as well as that. It was more about intention than actual technique, if that makes any sense.

Emily

 

[funwithsharpthings]

Hi Emily, I have several clients on blood thinners and I agree with the "coaxing".
I have a Doctor's permission slip for all of them and feel very comfortable working on them.
I particularily like RoS's advise to get a specific Rx from the Dr regarding depth of pressure and techniques to avoid.

 

[JDB]

Hi Em, I know this is an old post. I am just curious to what texts your school used? I have never seen any printed info anywhere in texts where it says it is o.k. to massage on coumadin. I am just curious. Thanks.

 

[ano]

It was something that was verbally relayed to us. I have it in my notes from class, I'm sure. The other research was on internet searches, but I couldn't tell you where now. Sorry . I just did a quick search and looked through some different articles.

The lady who I worked on adored her session and felt wonderful afterwards. She had no bruising at all and enjoyed a two-week vacation in Italy just after.

Emily