Case study 3 **** **** is a twenty-two year old single man who lives at home with his parents and two sisters. He would put his stress levels at home between 5 and 8 out of ten. Recently his grandmother died and this obviously has had an effect on his stress levels.**** works as a mechanic and he would put his stress levels at work at 6. He enjoys his work even though he works long hours.When **** was a child he was very sick and often spent time in hospital. He has however had no serious health problems for the last number of years.His diet is fairly well balanced, although he has a high in-take of sweets and biscuits. He is a non-smoker and doesn’t drink alcohol. He drinks about 4 to 5 pints of water a day.All in all, **** would see himself as fit, healthy and happy.TREATMENT PLANI intend to use a lot of effleurage on **** as his skin comes under a lot of stress from his work. He is often covered in oil and grease. This will help in desquamation and will help improve his circulation.I also intend to use a lot of Petrissage all over his body but particularly on his legs, as I felt that he had a lot of tension in his hamstrings and gastrocnemus muscles. This will help to break down any tension or stiffness that he has from his job. He is fairly active and drinks plenty of water each day so this will also help in the release of any lactic acid that has built upon his muscles.I will also perform some percussion to stimulate the cardiovascular system and help improve his circulation.Session OneI spent a lot of time of doing effleurage all over ****’s body as he comes into contact with a lot of grease and dirt because of his job as a mechanic. This will help with desquamation. I followed this with some petrissage to encourage circulation and to help break down any tension in his muscles. I noticed that he had a good deal of tension in the back of his legs along his ham-strings, more so in his left leg than his right. However this did not continue up through his body as I found that most areas of ****’s body were more or less tension free.I noticed that in places, such as his hands and face, that ****’s skin is very dry and a bit flaky in patches, I put this down to his work.As home care advice, I suggested that even though he comes home from work very tired he should really try to have a shower ever night to wash the grease off his skin. He said that he tries to most nights but sometimes he is just too tired and just goes to sleep and has his shower in the morning. I also suggested that perhaps he should use some sort of moisturiser on his skin to help with it’s dryness.SESSION 2I asked **** how he had gotten on after the last session. He told me that he felt very tired for the rest of the night after the massage and that it was very hard for him to get out of bed the next morning. He also told me that his stomach felt like he had been doing crunches and that he had urinated frequently the night and day after the massage.He also told me that he had tried to use moisturiser but was feeling a bit stupid putting it on thinking about what the boys at work would think of him if they found out. He said that he used the moisture mostly on his hands and had started to use moisturising soap.I went easy and gently over his transverse abdominis, going easy on the large intestine creeping. I did this because he found that his stomach was sore after the last session.I noticed that the tension in his hamstrings was not as pronounced and was moving more freely when I performed some wringing movements.I asked him how he was getting on with his showering at night. He told me that he was able to shower most nights but that one or two nights he was just too tired. I also advised him to cut down on his sweet and biscuit intake as this might be a reason for his tiredness. Sugar and caffeine giving him a quick fix but leaving him more tired in the long term. He said that he would give it ago.SESSION 3 Since the last session ****’s grandmother died and he had been off work. Her funeral was the following day but he decided that he would still attend the session as he needed a break from all the mourning and ritual that surrounds a funeral. He was close to his grandmother and was taking the death very badly. He was also worried about his Mum as it was the second relation of hers that had died recently and she was really taking it bad. He was very worried for her. I decided that for this session that I would do more of a relaxing session than an invigorating one to help **** reduce his stress levels. I did plenty of effleurage and some gentle petrissage . I spent a lot of time on his back, predominately on his trapezius as I found a lot of tension and stiffness there. It was not surprising considering the amount of stress he was under. I performed some wringing, circle of eight and some hacking and cupping on his trapezius to help breakdown the stiffness. For homecare advice, I suggested that he look after himself and make sure that he got to talk about his feelings with someone. I suggested that maybe he should go talk to a counsellor if he felt really bad. I suggested that he spend some time to relax and get away form the whole stress of the funeral, perhaps going for a walk on his own or listening to some relaxing music. SESSION 4 It was two weeks since the last session I asked **** how he was getting on. He told me that he was getting back into the swing of things and that life had more or less returned to normal. He was back at work and back into his routine. He said that his stress levels where getting back to normal and that he was feeling a bit better about his grandmothers death. I asked him if he had continued using the moistureiser on his skin and he told me that he was using it everyday and was noticing that his skin wasn’t as dry. He also said that his stomach had not been as sore as it was after the first session. He had also cut down slightly on his sweet intake but was still eating a lot of junk. I performed a good deal of effleurage over his entire body to try and find the places of tension and stiffness. A lot of his body was tense and I had to perform a lot of petrissage and percussion to try and sort this out. I noticed a lot of tension again around his trapezius. When I was performing some wringing movements I checked in with **** and asked about pressure and he said that it was a bit tender. This was the same around his deltoids. Summary **** has been under a lot of stress recently with the death of his grandmother and his worries about his mum. He is also in a job that is very tireing and he feels exhausted a lot of the time. The oil and grease from his job was having a negative impoact on his skin but with the help of the massage (which helped with desquamation) and the use of skin moistueresers he should be able to get this under control. Although he has a well balanced diet and drinks plenty of water I suggested that he cut down on his sweet and biscuit intake. This could be having an impact on him with regard to his tiredness and also such a high intake of sugar isn’t good for his digestion. **** told me that he enjoyed the sessions and that he would continuing having massages done as he felt that they were very beneficial.
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