Lana - re fibrotic cysts ( - another anatomy lesson)

[Guest guest]

Lana wrote:

Oh my gosh, Mike, I had no idea on this!! Can you tell me about

Nebraska's laws?

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(1) That's why I post these things; because not enough people know

about them, including primary care providers.

(2) As for Nebraska's laws, I don't know any specifics other than

Nebraska does have a state license requirement for massage and the

hours of training are the highest in the country, tied at 1000 with

New York. Because of that, I would assume there would be no legal

problem in Nebraska. Generally, the higher the license requirements,

the broader the scope of practice. Where you are apt to run into a

problem is those states with no state-wide license requirement

because massage tends to fall under the vice laws in those

jurisdictions. And that problem has been one of the main driving

factors in the push for licensing across the country in the last few

years - to shed the " massage parlor front for prostitution " stigma

and get therapeutic massage recognized for what it is - a legitimate

part of the health care field.

(3) I don't have any idea how common fibrotic cysts are, but they

are certainly no rarity. I also don't have any idea if they are

more common among EDSers than the general population, although I

would not be surprised if that were the case. Doesn't matter. My

point here is that women are told and told and told about the

importance of doing their own breast self-examinations on a regular

basis. My personal opinion is that they should also be taught at

the same time to do lymphatic breast drainage on themselves. That,

unfortunately, is not a realistic expectation since their doctor

probably doesn't know anything about it him/herself either.

(4) The biggest problem is finding someone qualified to perform the

procedure. I checked the Upledger site for Omaha. There are 18

total listings. Fifteen of them are for level I only. There are two

for levels I and II (both LMTs) and one for advanced training in LDT

(and other things as well) and he is a PT. Since you don't learn

lymphatic breast care until level II, that means there are three

practitioners in Omaha trained in this. If you want more details on

any of them, let me know.

(5) The most difficult aspect of learning how to do it on yourself

is developing the proper touch – how much pressure to apply without

going too deep into the tissue. The superficial lymphatic system

runs at a depth just below the skin and just above the muscle. If

you press too hard or too deep, you are engaging the muscle and not

the lymph and are not accomplishing what you want. By the same

token, how difficult is it to develop the necessary palpation

sensitivity to detect lumps and cysts?

(6) The analogy that is used with ALL lymphatic drainage systems

(LDT, MLD, Vodder) is the " ferry car " approach. If your car is at

the back end of the ferry, you aren't going anywhere until the first

car gets off. You have to open the pathways from the front end back

toward the blockage before you work on the specific problem area.

Let's say I am treating someone with a sprained wrist. I have to

first " stimulate " the clavicular and axillary nodes, then drain the

neck, top of the shoulder, upper arm and forearm before getting to

the wrist. Same thing for a sprained ankle. I have to first

stimulate the deep abdominal nodes, the inguinal nodes in the groin,

the secondary nodes in the thigh and the popliteal nodes in the back

of the knee, and then drain starting with the abdomen, the upper

thigh, lower thigh, and calf before getting to the ankle.

(7) The same concept applies for lymphatic breast work. You start

by opening or stimulating the clavicular and axillary nodes. You

then do a short neck drainage and all areas surrounding the breast,

specifically along the clavicles and into the armpits. As for

working on the breast itself, lymphatic flow of the breast is

divided into four quadrants: upper lateral, upper medial, lower

lateral and lower medial. Upper is obviously the top half of the

breast and lower is the bottom half. Lateral means toward the

shoulder area and medial means toward the sternum. Upper and lower

lateral drain toward the armpit. Upper medial drains toward the

clavicle. Lower medial drains toward the bottom of the sternum.

Both upper and lower medial flow is into the secondary intercostals

nodes. Both lateral flows are into the major axillary nodes. Each

quadrant is superficially drained in sequence with from 3-7

light " pumping " strokes. This is followed by a deeper drainage of

the actual glands in the breast by " pumping " with one hand over the

medial half of the breast toward the other hand on the lateral half,

which then pumps in sequence toward the armpit. The procedure

finishes by rinsing from the axillary nodes back along the

clavicular pathway.

(8) The above sounds far more complicated than it is. And no, there

is not enough detail information in # 7 for someone to take it and

run with it. You need to also know where the actual nodes are and

the proper technique to stimulate them. It was not intended as a how-

to set of instructions. It was intended as a general overview of

what is involved. And even if it does sound a bit complicated when

reading it, the actual doing of it isn't. It is just a matter of

learning locations and proper touch.

[Guest guest]

> (4) The biggest problem is finding someone qualified to perform the

> procedure. I checked the Upledger site for Omaha. There are 18

> total listings. Fifteen of them are for level I only. There are

two

> for levels I and II (both LMTs) and one for advanced training in

LDT

> (and other things as well) and he is a PT. Since you don't learn

> lymphatic breast care until level II, that means there are three

> practitioners in Omaha trained in this. If you want more details

on

> any of them, let me know.

>

> (5) The most difficult aspect of learning how to do it on yourself

> is developing the proper touch – how much pressure to apply without

> going too deep into the tissue.

Hmmmm, well, I bet I'm kinda stuck here, as I've had a lot of

Physical Therapy, and only get 60 visits a year, so I have a feeling

the PT guy is out. I will probably need to pay for it myself, so if

you don't mind, would you send me the two LMTs that are trained to do

it, and I'll call and see how much they charge? Things are hitting

us all at once at our house - Mike and his shoulder surgery, Me and

my neck problems, yadda yadda..... but if it's not to expensive, I'll

get this done. If it is, I'll wait until the new calendar year, and

then maybe go to the PT...so I guess that means I'd like all 3 names!

DUH!! Talk about not knowing what the left hand is doing! There's

just too much lately!

Thanks a lot, Mike, for all the info!

Love Lana

[Guest guest]

if you don't mind ...I'd like all 3 names!

----------

Here they are, along with the listing of classes each has taken

through Upledger. None of them have " profiles " so I have no idea

what else any of them might have trained in.

As for expense, you can generally figure that it is going to run

about the same per hour as the going rate for a general session in

either field - massage or PT. In other words, you aren't looking at

anything significantly higher than the standard hourly rates for the

area.

When it comes to setting fee schedules, there is generally a

completely different mind-set with bodywork practitioners compared

to " medical specialists. " The medical specialist mind-set tends to

be " if the GP charges $100 an hour and can't do what I do, I am

going to charge $200 or $300 an hour for my specialty. " Bodyworkers

by comparsion may charge $40-70 an hour, depending on going rates in

their area. When they take advanced training, they don't suddenly

say " ok - I will continue to charge, say $50 an hour for a basic

massage, but $100 an hour if I do something special like LDT or CST

or whatever. " What they do is include that specialty work as part

of their basic structure and use their higher skill level to attract

customers.

Using myself as an example (and I intend no arrogance with this

comment), you are going to be very hard-pressed any place in the

country to find anyone with the degree of cross-training that I

have. My " official " fee schedule isn't based on which modality I am

practicing at the time - it is based on a flat amount per hour,

period. In any given session, particularly longer ones of 90 minutes

or more, I will bounce back and forth and use standard Swedish,

Polarity, Jin Shin Do, LDT, MFR and CST in varying degrees during

that session depending on what is needed. You can expect the same

there in Omaha, especially if you are only talking one or two extra

areas of expertise and if there is competition in the area - which

there is.

Giuseppe Siracusano M.A., P.T.

Omaha, Nebraska 68198-4180 USA

Tel: 402 559-6292

CranioSacral Therapy

Lymph Drainage Therapy

Visceral Manipulation

Classes: ADV AVM AVMII CSI CSII CSP HS1 HS2 HS3 HS4 LDA1

LDT1 LDT2 LDT3 NMT1 NMT2 NMT3 NMT4 PIVM SERI SERII SYMJP

TCSI TCSII TLDT1 VLT VMIA VMIA VMIB VMII VTW VTW2 ZBFF

ZBI

S Putman L.M.T.

Omaha, Nebraska 68135-5330 USA

Tel: 402 592-7686

CranioSacral Therapy

Lymph Drainage Therapy

Classes: CSI CSII LDT1 LDT2

Waniska L.M.T.

Omaha, Nebraska 68137 USA

Tel: 402 669-0427

CranioSacral Therapy

Lymph Drainage Therapy

Visceral Manipulation

Classes: CSI CSI LDT1 LDT1 LDT2 VMIA

[Guest guest]

>

> if you don't mind ...I'd like all 3 names!

>

> ----------

>

> Here they are, along with the listing of classes each has taken

> through Upledger. None of them have " profiles " so I have no idea

> what else any of them might have trained in.

Thanks so very much, Mike! I'm at least going to call and see what

the rates are - it should be interesting! I'll let you know.

Love Lana