Monday, 17 May 2010

Sample case study

CASE STUDY :

Personal Information:

Name: Mr. U
Occupation: Full time student of law and worked part time in Waitrose.
Age: 26
Contact details: To be produced if requested
Reason for attendance: Mr. U was a friend of mine. He rang me up complaining of a neck pain which he started experiencing after writing an assignment for long.
Support and family: He was a single 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. U was an above six feet tall well built endomorphic person. A full time student of law, he was a single and lived in a rented five bedroom accommodation which he shared with 4 other students. He was an extremely friendly person and popular among his friends. He was medically fit. The pain in the neck was recent and was predominantly due to him bending in an incorrect position while working on his assignments. The pain kept on reappearing every time he tried to turn his neck towards the right and it didn’t seem to go away even after three days of him first noticing it.
Though he wasn’t emotionally highly disturbed due to it but the pain it self was nagging and troubled him in his every day activities especially as he couldn’t study in a seated position with his neck even slightly bent. This was making him worried as he had to prepare for his exams.

Medical History:

Mr. U was a healthy individual with no past medical condition that needed consideration for the treatment to be done. He had an operation six years back in his right leg due to a fractured shin bone from a motorcycle accident. The injury had healed completely and he needed no attention to be paid to that.
His present condition was an acute pain in neck primarily related to postural anomaly.

Emotional health:

Mr. U was my friend and I had known him for quiet a long time. He was a very friendly person who loved to make people laugh sometimes by playing pranks on himself, but at the same time he was very well spoken and straight forward. He was popular among all his friends and was loved by his parents for being a good son and a brilliant student as well. He always faced stressful situations with a positive attitude. The current pain in neck made him slightly worried because of his inability to study but he was confident in the fact that he would be well soon with my assistance both in aromatherapy and exercise.

Life Style:

Exercise: Occasional jogging but not regular.
Brisk walks every day.
Diet: Healthy overall, junk foods very rarely.
Bowel habits: Regular.
Smoking: Occasional.
Social life: Was popular among his friends and family.
Alcohol consumption: Socially only.
Recreational drugs: None.
Daily routines: Mr. Uddin was a full time student of law. He worked at Waitrose at weekends. He went for mild jogging about three times a week with his friends and a few brisk walks every now and then. His sleep times were regular other than exam weeks when he would study till late at nights.

Current presenting problems:

His recent problem was an acute pain in neck due to improper sitting posture while doing assignments. He was slightly worried about it since it didn’t seem to go off but was confident in himself and my assistance as a personal trainer and a student aroma-therapist. He had no other problems either mental or physical that he was aware of.

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 pain in neck. 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.

Type of treatment and massage sequence:

We both agreed to five neck and shoulder massage sessions two on the first day, the next one the immediate next day, and the next two every two days. The order was as follows:
D1: morning, evening.
D2: afternoon.
D3: none.
D4: none.
D5: afternoon.
D6: none.
D7: none.
D8: afternoon.

Treatment 1:

This session was done at around 9 ’o’clock in the morning.
Massage to be done was neck and shoulders.

Essential oils used were:

Black pepper (Piper Nigrum)
Peppermint (Mentha Piperita)
Rosemary (Rosmarinus Officinalis)

Career oil used was grape seed oil.

Rationale for choice of oils:

Black pepper (Piper Nigrum) is an analgesic and tonic in action. So it aids in circulation, and has a tonic effect on muscles, besides being an analgesic thus making it useful in treating muscular aches and pains.

Peppermint (Mentha Piperita) is an analgesic, anti-inflammatory, antiphlogistic and nervine and hence could be used in treating muscle pains effectively.

Rosemary (Rosmarinus Officinalis) is an analgesic, antioxidant, cordial, restorative, stimulant and tonic in actions. Thus it could be used to dissolve lactic acid and ease tired, overworked muscles.

Grape seed oil is available only in pure form and could be used safely as the client didn’t have any condition that would contraindicate its use.
(Clarke, 2009)
(Lawless, 2002)
(Price, 1998)
Dilution and measurements:

The synergistic blend:
1 drop of black pepper
1 drop of peppermint
1 drop of rosemary

Career oil:
15ml grape seed oil

The massage was done with emphasis laid on effleurage, petrissage, friction movements and some draining movements. Stretching movements were employed to the warmed muscles to ease muscular tension.

Client was advised additional intake of water to promote a healthy metabolism, and inclusion of healthy oils preferably sea fish (Ω3 oils, EPA, DHA and vitamin E) in diet to rule out diet related deficiencies.

Therapist observation and client feedback:

After the session was over client himself informed being relaxed and warmed and signs of immediate relief.

The effectiveness of the first treatment session brought more confidence in us both and we agreed to carry on with our initial treatment plan without changing it.

Treatment 2:

This session was done at around 8’o’ clock in the evening.
Massage to be done was neck and shoulders.

Essential oils used were:

Sweet Marjoram (Origanum Marjorana)
German Chamomile (Matricaria Recutita)

Career oil used was grape seed oil.

Rationale for choice:

Sweet Marjoram (Origanum Marjorana) is an analgesic, antioxidant, hypo-tensor, sedative, tonic and vasodilator making it useful in treating muscular aches and stiffness when the sessions are in the later part of the day.

German chamomile (Matricaria Recutita) is an analgesic, anti-inflammatory, antiphlogistic and nerve sedative making it very useful in treating muscular pain without disturbing sleep especially when sessions are in the evening.

Grape seed oil is available only in pure form and could be used safely as the client didn’t have any condition that would contraindicate its use.
(CLARKE, 2009)
(Lawless, 2002)
(Price, 1998)
Dilution and measurements:

The synergistic blend:
1 drop of sweet marjoram
1 drop of German chamomile

Career oil:
15ml grape seed oil


Massage techniques were similar to the ones used in the morning session.

Therapist observation and client feedback:

After the session was over client looked relaxed and relieved. He himself wanted to take a short nap and thanked for the session.

The second treatment session also went quite well and the outcomes were as desired.

Treatment 3:

This session was done at around 2 ’o’clock in the afternoon the next day.

Blend chosen was exactly the same as that in treatment 1.

Effectiveness of treatment 1 and the warm feeling that it brought convinced both of us to use it.

The entire session was similar to treatment 1.

Client informed feeling very warm and relieved but had to leave for an appointment after a short rest.

I was convinced the treatments were working perfectly and hence prepared for the next session with even more confidence.




Treatment 4:

This session was done at around 2 ’o’clock in the afternoon two days later as was previously planned.

Essential oil used was only peppermint (Mentha Piperita) with the simple rationale being the fact that I didn’t want to overdose on the oils yet reap the beneficial effects of them.

Peppermint (Mentha Piperita) is an analgesic, anti-inflammatory, antiphlogistic and nervine and hence could be used in treating muscle pains effectively, yet at the same time it is nontoxic, non irritant making it more sensible to use for the follow-up treatments.
(Lawless, 2002)
Concentration used was:

2 drops of peppermint

In

15ml grape seed oil

Massage techniques were similar to the ones used in the previous treatments.

Client informed a relaxed and refreshed feeling after the session. To my surprise he felt the fourth session was more relaxing yet uplifting than the third session which actually had a more complex blend of oils. This taught me some times simple approaches could be better than complex ones.

The success of the fourth session made us both agree to use the same composition in the fifth and final session which would be at a similar time after two days.
(CLARKE, 2009)

Treatment 5:

Treatment 5 was exactly as planned two days back.

Client looked like he had no pain in his neck at all, and in fact invited me for dinner for the amazing relief I had provided him. The rationale behind noting this in the case study was the confidence boost and sense of achievement that I had when he said that.

Treatment 5 went exactly as planned.

Analysis:

From all the data collected by questioning Mr. U and by carefully observing his non verbal cues I concluded my treatment was successful.

I’ll admit I was scared of having the treatment sessions so close and the fear of overdosing on the essential oils were always there in me. Over the top the client being a friend of mine added to the fear since he would trust me blindly so I had my responsibilities as a friend as well along side that of a therapist. I chose the oils carefully after going through as many books and directories as possible to check their effects and side effects and also adopted the minimum concentrations I could find.
Treatments did work however the fact that client liked session 4 and 5 more than 3 taught me I should have perhaps used the same simple composition in session 3 as well as I did in 4 and 5.

This how ever did not guarantee me to be an expert in all future case studies as all clients would be different and so would be their cases. But reflecting on my experience would definitely help me learn from my experience and place me in a better chance.




Reference:

CLARKE, S. (2009) Essential Chemistry for Aromatherapy 2nd Edition London: Churchill Livingstone
LAWLESS, J. (2002) Complete Illustrated Guide to Aromatherapy: A Practical Approach to the Use of Essential Oils for Health and Well-being
Element Books

PRICE, S. (1998) Aromatherapy Workbook: Understanding Essential Oils from Plant to Bottle Thorsons