I Really Wanted a Massage

If you have been reading this blog, you may have noticed that I keep mentioning this strange feeling of thoracic tightness.  Seriously, several times each day, I try to pull away the bra that is four sizes too small, to stretch it out or loosen it, only to find that THERE IS NOTHING THERE!

The feeling of tightness is present one hundred percent of the time.  It never goes away.  The occasional stabbing pain is there. The deep zing is in my armpit, but just sometimes.  The skin and fascia at the inferior angles of my ribs are extremely sensitive, like hot spots.  The cutaneous nerves on my thorax are hypersensitive.  I can't sneeze without whimpering.

Four weeks after my surgery, we went out of town and stayed at a lovely golf/beach resort.  I was looking forward to seeing two of my oldest girlfriends, and I noticed that there was a spa on the premisis.  Naturally, I booked a massage.

Well, most of you know that I am a massage therapist.  I do mostly deep tissue/neuromuscular/sports massage, but I have advanced certifications in Manual Lymphatic Drainage for the treatment of lymphedema. What are the chances, right?

I am not one to run out and get a massage at the drop of a hat.  I get somewhere between one and two massages a year.  I guess I never really caught on to the relaxation portion of life, and I certainly can't relax during a massage.  I'm too busy taking notes or internally critiquing their techniques.  Some I like, some I think are absolute BS.

This particular massage experience was going to take place at a point in my life when I needed it the most.  At this point, I had been sleeping on my back for twenty-eight days.  I had never been more uncomfortable, ever.  To reach across my body with either arm (horizontal adduction) was extremely difficult, and I felt super restricted with every breath.  I am not complaining, but this is how I felt.  I wanted nothing more than to have my chest worked on.

Breast massage is a slippery slope, no pun intended.  It is permitted in many states, but only after obtaining express written consent before the treatment commences.  I am trained in breast massage, but I don't perform it.  Like, ever.  I don't care about breast massage on myself per se, but I did want my pectoralis major muscles worked on.  I mean, if we really get down to it, I don't legally have breasts.

During my intake encounter with my male massage therapist, I informed him of the following:

• I am also a LMT.
• I had a bilateral mastectomy with tissue expander reconstruction four weeks prior.
• I have constant chest tightness, and I want my pectoralis major muscles worked on.
• That is really the only thing that I care about.
• I can only lie on my back, so the hour treatment will have to be stretched out with his "front of the body" routine... perhaps there will be more time for my chest?
• My shoulder range of motion is extremely limited.  I physically demonstrated to him that I was only able to raise my arms "this high" (about 95 degrees).
• My chest and rib tissue was very sensitive to the touch, and must be respected.

What happened next is the impetus for this blog and for what is to come for me professionally.  I am not sure where the breakdown occurred... perhaps through my faulty communication?  Doubtful.  Perhaps through his inadequate listening skills?  Perhaps.  Maybe he was afraid of me and what I represented --- cancer?  I suppose he was just unskilled and ill prepared for what had just walked into the spa.

The massage that ensued was horrible, bless his heart.  He had no idea what to do with me.  Regardless of the breast curve ball that I threw him, he should have been able to identify the superior attachments of the pec major.  After I demonstrated my range of motion deficits to him, there was no reason why he should have tried to aggressively stretch my shoulders.  When I told him about my tender inferior ribs, he should have respected my pain and not poked at them while attempting to pull off some sort of abdominal manipulation.  

I know that he was afraid.  I know that he did not know what to do, and I know that his education did not provide him with the skill set required to treat me.  I'm fine with that.  Let's all bless his heart together.  He was probably terrified to touch anything even resembling a breast for legal reasons, and I can certainly emphasize.  A delicate dynamic exists between male therapists and female clients, and I screwed it all up the second I introduced myself and told him what I needed.

I know of almost zero massage therapists, PT's or PTA's who are prepared for a client/patient like me, regarding soft tissue intervention.  Sadly, I am not the only "client like me."  Mastectomies are practically growing on trees these days.  You can't swing a dead cat without hitting a post-mastectomy patient, and they're uncomfortable.

I know beyond the shadow of a doubt that I have gone (and am still going) through this experience for some sort of reason, and I believe it is to educate.  By telling my story, I want to educate the patient, the consumer, the therapist, the daughter, the mother, the friend.  There is no reason why anyone should suffer because their soft tissue professional was inadequately trained.  

I now need to know from you:  I want to hear about your soft tissue experiences and interventions.  Mastectomy without reconstruction?  Nipple sparing?  DIEP flap reconstruction?  Implants?  Expanders then implants?  Tram flap?  Latissimus flap?  Glut flap? Radiation?  Radiation before expanders?  Radiation after implants?  Lymphedema?  Truncal edema?  Please contact me with your story.  I want to know how you feel.  I want to know what made you feel better.  If not you, someone you know?  

Thank you for listening to me.