Wednesday, August 31, 2011

Certification v. Licensure

Q: I recently learned that Darya just got her national massage certification. I've been going to her for years now and had no idea she was not certified. I'm very concerned because I assumed someone in a professional establishment like yours would be appropriately licensed. Do the rest of your therapists have licenses?

A: This is a great question--thank you for asking. I'd like to start off by assuring you that all of our practitioners and instructors are appropriately credentialed. But I would also like to explain the difference between certification and licensure, which may help eliminate the confusion. The two main levels of credentialing in our society are licenses and certifications. 

First, licensure is a status granted by an individual state. For example, driving licenses are regulated at the state level. Similarly, states can choose to regulate other activities, such as hunting, fishing, or even careers by regulating specific professions. Being able to practice medicine or psychology is almost always regulated through the granting of licenses at the state level. Typically, professions where significant harm could be done to a client if the professional is not appropriately trained are regulated by licenses. In these cases, states determine what requirements they have for licensure, and an individual is not allowed to practice in that state without a license. 

However, there are many fields that fall under a gray area and so it varies from state to state--clients could be harmed if the professional is not properly trained, but the risk of harm is minimal or the state does not want to regulate it for some other reason. This is the case with massage therapy in Vermont. Although there is a great deal of science connected with the practice of massage therapy, and although a massage therapist could do some damage to a client if not properly trained, this is not a profession that Vermont has chosen to regulate at this time. Therefore, anyone can practice massage in Vermont without a license because Vermont massage licenses do not exist.

In contrast to state licensure, professionals can also be certified. Certifications come from a specific organization. For example, the Pyramid certifies students in massage therapy, Reiki, and fitness instruction. Certifications can be extremely localized, or they can be more nationally focused. A certification simply means that some person or organization has reviewed and/or provided a professional's education and/or work experience and certifies that it meets a minimum standard. 

In the field of massage therapy, it is generally accepted in Vermont that a localized professional certification is enough; however, some practitioners choose to increase their level of certification by adding additional training or testing. This is the case with both Darya McNolty and Tammy Brown. Darya had already received her massage training certificate from the Santa Monica School of Massage, and she worked for ten years as a massage therapist. However, in the field of massage, there is no national standard from state to state but the national board for massage therapy and bodywork (the NCBTMB) offers what they call a national certification, and that just means that the massage therapist meets one of the highest levels of certification in the United States. Darya recently successfully took their national exam which now gives her the additional certification, which, by the way, very few massage therapists in Vermont have. Tammy Brown has also recently completed an additional Yoga teaching certification; although she had completed her Yoga teacher training years ago, she recently completed education for another level of certification.

So I want to assure you that all of our practitioners and instructors have appropriate credentials--either licensure or certification status--and they are all actively working on improving their skills, so be sure to watch for more announcements of additional certifications coming soon and always!

William D. Kelley, Ph.D.
Pyramid Holistic Wellness Center
Pyramid Fitness and Oxygen Bar
120 and 79 Merchants Row
Rutland, VT 05701

Monday, July 25, 2011

Thai Yoga Massage

A couple of weeks ago I wrote about how ironic and sad it is that I work at the Pyramid and hardly ever get to take a class from another instructor. Equally ironic and sad is that I am constantly surrounded by excellent massage therapists, and I am almost never able to receive a massage. So it was especially valuable to me last Wednesday when I was able to receive a Thai Yoga Massage (TYM) from local Yoga instructor and TYM therapist Tammy Brown.

There is no question that Tammy's reputation as a Yoga instructor preceeds her everywhere she goes, but many people do not realize that she also offers TYM. Although I had seen it demonstrated at various wellness fairs throughout the country, my first TYM experience was with Tammy just a few years ago. Soon after I officially met her, she let  me know that she was going through training in TYM and needed guinea pigs. Wait--stop--twist my arm! So I was lucky enough to be one of her first "clients."

Fast forward to 2011 and I am committed to my own plan of self-care more than ever. That plan includes the things you might expect from someone at the Pyramid--daily exercise, healthy eating, meditation, and plenty of sleep. But working at the Pyramid, I also have access to an almost limitless array of other services--the Salt Cave, the Halotherapy Room, the Oxygen Bar, the Nautilus circuit, the inversion table, and over 40 different instructors and practitioners. So part of my plan includes partaking in as many of these offerings as I can, as often as I can. So when the opportunity to receive another TYM from Tammy presented itself, I could not refuse.

Of course, I have had the pleasure of many Thai Yoga massages from Tammy over the years, but schedules had gotten in the way and Tammy and I had not been able to connect for a while. This particular day was a day that I definitely was in need of some work, and Tammy's session was exactly what I needed.

One of the things I respect the most about Tammy is her precision. Whereas my Yoga training and interest have been mostly in the philosophy of Yoga, Tammy is clearly also an expert on alignment. Her attention to detail and form in the classroom is equally present in her massage sessions, and from the moment it begins, you know that Tammy is going to make sure that you are in proper form, that you get the most benefit from the massage, and that you do not injure yourself during it.

Those not familiar with TYM may not understand these references; although there are some traditional massage techniques used in TYM, a TYM session is so much more than a traditional massage. This type of treatment allows the recipient to remain rather passive as the therapist actively moves him or her through a series of postures designed to stretch and release the muscles. Some might liken TYM to a Yoga class where the instructor moves your body for you. Because it is an assisted process, often the therapist will help you get a deeper stretch while supporting your body for an intensity that you cannot safely get on your own.

Beyond her clinical precision, though, there is just something special about Tammy. Do not let her quiet presence fool you...she is a powerhouse of wellness expertise. She will greet you at the start of your session, ask some questions to get a sense of how to create a safe, positive experience, and then she will go to work with a smile. I'll admit--sometimes I like to open my eyes during a session sneak a peek at her working, because she is in her bliss when she is able to do TYM. Everything...her music choice, the way she prepares the massage room, and her soothing touch all work together with her expertise to create a special experience like none other.

During the massage I also find myself opening my eyes to see how she is doing what I am feeling, because sometimes the feel of it defies logic and I cannot picture what bizarre things she must be having to do so it can feel like that to me. I am often in awe at the workout that she must get during a TYM session, because in any given moment, she could be crouching over your back, pressing her foot into your hamstring, squeezing the back of your neck with her palms, or some combination of these and more. It definitely takes skill to provide a Thai Yoga Massage.

As she works, I find myself in my own state of bliss. No one can deny the benefit of human touch, and Tammy's calming, Reiki-infused touch is incredible. I immediately feel my heart rate slow down, my blood pressure relax, and my muscles melt down into the floor. For this one hour, I do not have to think...I just have to allow and breathe. I trust Tammy to move my body through the session, and by the end, I feel completely relaxed and ready to move on to the rest of my day. By the end of my session on Wednesday, I found myself wondering why I do not do this more often. Oh, yeah--schedules, money, time. And in those post-TYM bliss moments, I tell myself that there is nothing more important than my wellness, and I need to make time and budget for it accordingly.

Thai Yoga Massage with Tammy Brown: $70/session
TYM Benefits: blissfully priceless

If you would like to try a TYM session, please call us at 802-775-8080.

Thanks, Tammy, for an amazing session, and for being part of the Pyramid team!

William Kelley
Pyramid Holistic Wellness Center

Friday, July 1, 2011

A little piece of Heaven...for $6!!!

It's kind of embarrassing to say but although I work at the Pyramid and am surrounded by wonderful instructors all day long, I almost never get to take a class from another instructor because I am almost always teaching my own classes. But last night the stars lined up and I was able to take Darlene Kepner's Upbeat Yoga class.

Once I recovered from the shock of being able to actually take a class (and I think once Darlene was able to recover from the shock, too!) I spread out my mat and water, turned off my cell phone, and sat down on the floor with the other students. I had honestly never sat on the floor facing that direction, and I was pleasantly surprised to see the mountain view and feel the cooling breeze entering through the third floor windows. In those few minutes, I enjoyed the scene--Darlene happily preparing for her class, checking in with new students and setting the mood with her excellent taste in music. I wasn't sure what to expect for the music from an "upbeat" class, but I soon fell into the rhythmic world music, enjoying the change from the usual new age class music. My breathing slowed down and I found myself slipping into a familiar state of peace.

Darlene has a voice that is so easy to hear and follow. Even her instructions were calming. I felt reassured, because her confidence in her teaching and herself came through. I knew I was in good hands when she started inviting us into her interpretation of the practice of Yoga.

Although the class started gently, it did not take long for me to work up a sweat. Downward dog...chair posture...planks. My type of class! And yet Darlene did a wonderful job of showing alternatives for every level. I watched as even the beginners in the class could follow and enjoy her non-judgmental style. The more advanced participants were also challenged. That is the joy of taking classes in Vermont for me--in more urban areas, there are so many people taking classes that they can split them up by level, so you would choose to attend a beginner, intermediate, or advanced class. But in Vermont, because we do not have the popularion, all levels are usually combined. I enjoy this especially because although I have been practicing Yoga for 20 years and teaching it for over ten, there are days when I want a gentler class...there are times when my body feels like it needs a beginner level. And then there are days when I really want to bust it out and use my practice to release serious stress and build strength. A mixed level class allows you to work at your own pace without feeling pressure to conform to the level of those around you. And although I consider myself a more advanced Yoga student, I wasn't created with the typical "Yoga body" so it is often more work for me than the average person to get into the asanas. In a mixed level class, it is always nice to be reminded of the basic cues, and it is great to see how others challenge themselves. In short, a mixed level class allows you to grow in ways that one might not imagine--and I was definitely not disppointed in Darlene's class.

I have to admit that the class went by quickly. I don't know whether I was just in a zone or I was so craving the experience of taking someone else's class that I was in what positive psychologists call "flow" and the experience of time was dramatically sped up for me. Either way, I watched and learned from Darlene's expert teaching style and had a wonderful time.

As we moved into the final few moments of class, I checked in with my body. I forgot how good it feels to just follow along with someone else leading, and especially when the instructor is as wonderful as Darlene. I felt awesome--energized and relaxed at the same I had just taken a mini-vacation. I looked around at the other students and imagined that they were feeling the same way I was. For a moment, I felt connected to everything and everyone. While that is definitely one of the goals of Yoga practice, I realized how easy it is in this life to feel disconnected. In that moment I realized that too much lately I have felt disconnected. Like many, I've felt more in the flow of work than the flow of the universe. Even instructors can fall into this pattern. As I rested in corpse pose, I felt a disconnected sadness that I had never experienced in my practice before, and I knew that I have to make some changes.

To say that this experience was intense is an understatement. It was one that came just at the right time that I needed it. It would not be an exaggeration to say that this class positively changed my life. And when I think of the small investment that I made--an hour of my time and $6--I feel so blessed to be surrounded by the tools to truly make a difference in my own life and the lives of those around me. Experiencing this class reminded me of why I wanted to keep our class prices at $6 in the first place--because I do not believe that the practice of Yoga should be reserved for the world's elite. Everyone should have access to a class like I took last night. I have so much respect and gratitude for our instructors who have also committed to this mission of affordable instruction.

With Darlene's smile and soothing encouragement, with the energy of the other students, the music, and the beautiful atmosphere of the ballroom studio at the Pyramid, it was easy to see why so many people take classes. And it was easy for me to recommit to myself to make sure that I take classes as often as I can. 

Of course there will always be things that come up--board meetings, emergency clients, facilities issues, and more--but aren't we all worth taking the time to invest in ourselves? 

I cannot wait for my next awesome class with Darlene--and the other wonderful Pyramid instructors. 

Darlene currently teaches Upbeat Yoga on Thursdays at 7 PM, Sun Salutation Sunday on Sundays at 10:30 AM, and Gentle Yoga on Mondays at 4 PM. For the full Pyramid class schedule, please visit our website:

Thank you, Darlene, and thanks to everyone!

William Kelley
Pyramid Holistic Wellness Center and
Pyramid Fitness

Tuesday, June 28, 2011

Why Nautilus?

As a child, I remember reading in the newspaper that our local YMCA had purchased a line of Nautilus equipment. I remember thinking how scary the equipment looked---and in my head, it was associated with serious body building. I never imagined that someday I would fall in love with Nautilus equipment...I never imagined that I would be someone who would use Nautilus...and I certainly never imagined that I would someday own a fitness center that featured a Nautilus circuit.

Until I was in college, I never fully realized that muscular strength is a huge part of the wellness puzzle. Strong muscules keep us healthy, and even though I especially should do strength training because of my weak genetics, I thought that I would feel totally out of place if I tried to go to a gym. In my head, I had imaginative reasons for not going--I thought that big body builders would make fun of me if I tried to lift weights. But what I did not realize was that Nautilus equipment was designed exactly for me, and everyone else as well!

The people at Nautilus knew that modern Americans were more out of shape than ever due to sedentary lifestyles and unlimited access to low-quality, low-nutrient foods. They also knew that many Americans were like me and afraid of strength training equipment. And most importantly, they knew that Americans had less and less time to dedicate to working out, so they needed to create equipment that would be very efficient, and that is exactly what they did.

The Nautilus circuit is made up of selectorized strength training equipment--that is, pieces of equipment that are geared towards strengthening one part of the body. In a typical circuit of eight to twelve pieces of equipment, the human "machine" works all muscle groups. The circuit is also designed to be completed in around twenty minutes, making it a time-saving workout meant to be done every other day. Basically, in an hour a week, people can reach their fitness goals. Beyond the time benefits, there are other benefits as well:

- Safety--it is nearly impossible to injure yourself on a Nautilus machine
- No need for a "spotter"
- Easy to adjust the machine to your body type
- Easy to quickly and effortlessly change the amount of weight
- Easy to learn and the machine will usually not allow you to use it incorrectly
- Many of the machines offer multiple exercises and work overlapping muscle groups, allowing for a very flexible workout
- Increases shape, size, strength, and endurance of the muscles
- Improves immune system performance
- Increases self-esteem
- Supports body fat loss by speeding up the metabolism, as stronger muscles require more calories to function than weaker muscles
- With Nautilus, you see almost immediate results
- Very little waiting around time, so people are not watching you while you exercise
- Most people find doing Nautilus fun and rewarding

Yet many people, like I used to be, are afraid to try Nautilus. They may fear the size and weight of the equipment, exercising in front of other people, or injuring themselves. They may also think they do not have time to get a real workout.

Serious body builders often believe that Nautilus is for lesser athletes; however, even elite athletes in the professional world use Nautilus because of its versatility.

Whether you are an elite athlete or someone knew to Nautilus, you are sure to get benefit from a genuine Nautilus circuit. At Pyramid Fitness, we have the Nautilus Nitro line, which is the latest generation Nautilus equipment, going through several upgrades since that line that my childhood YMCA purchased.

Come check it out today and you will not be disappointed!

Sunday, April 24, 2011

The Scientific Research on the use of Himalayan Salt

It wasn't long after the press release went out about Dr. Margaret Smiechowski's Himalayan salt cave opening in Pennsylvania that we started getting bombarded with requests for information from a self-appointed "watchdog" organization in that area whose members were concerned that the use of Himalayan salt in salt caves was a scam. Among other things, these people ridiculed the notion that salt could provide any real benefit, ridiculed Dr. Margaret's "foreign" education, and claimed that no scientific evidence exists to support the use of Himalayan salt. Further, they challenged us to produce even one study that shows beyond a reasonable doubt that there are statistically significant benefits to using the salt. 

The truth is that there are literally dozens of scientific studies that have been conducted over decades that show without any question that there are medical benefits to using Himalayan salt. If this is true, one might wonder why these organizations waste their time trying to discredit speleotherapy and halotherapy?

The answer to this question is fairly complicated. The main reason is because most of these studies were conducted in Europe and Asia and were published in scholarly journals in languages other than English. They are not translated into English and discussed in the US because in general we are putting our research dollars into more traditional, pharmaceutical-based research. Truthfully, Americans do not care about the research of salt. Those who have experienced its benefits do not need to see the multitude of studies that exist--they just know and believe. And those who will not believe no matter what do not want to see the studies. For those who are on the fence, we created this blog entry so you can see what research actually does exist.

Most of the dozens of clinical trials thus far, mainly reported in Russian-language journals, have focused on the use of speleotherapy or halotherapy as a treatment for asthma, chronic bronchitis, a range of respiratory conditions and potentially against systemic diseases. Clinical studies have also been published in the New England Journal of Medicine (2006) demonstrating that the inhalation of saline produces sustained mucus clearance and improved lung function in patients with Cistic Fibrosis. In 1995 the Journal of Aerosol Medicine reported significant improvements in patients with various types of respiratory diseases (bronchial asthma, chronic obstructive and non-obstructive bronchitis, bronchiectasis, cystic fibrosis) who were treated with halotherapy in a placebo-controlled clinical trial. Here is a small sample of some of the other relevant studies:

Chernenkov RA, Chernenkova EA, Zhukov GV.
The use of an artificial microclimate chamber (salt cave) in the treatment of patients with chronic obstructive lung diseases
Vopr Kurortol Fizioter Lech Fiz Kult. 1997 Jul-Aug ;( 4):19-21. (Article in Russian)
PMID: 9424823

Chervinskaya AV, Zilber NA.
Halotherapy for treatment of respiratory diseases
J Aerosol Med. 1995 Fall;8(3):221-32.
PMID: 10161255

Gorbenko PP, Adamova IV, Sinitsyna TM.
Bronchial hyperreactivity to the inhalation of hypo- and hyperosmolar aerosols and its correction by halotherapy
Ter Arkh. 1996; 68(8):24-8. (Article in Russian)
PMID: 9019826

Grinshtein IuI, Shestovitskii VA, Kuligina-Maksimova AV.
Clinical significance of cytological characteristics of bronchial inflammation in obstructive pulmonary diseases
Ter Arkh. 2004; 76(3):36-9. (Article in Russian)
PMID: 15108456

Grigor'eva NV.
Halotherapy in combined non-puncture therapy of patients with acute purulent maxillary sinusitis
Vestn Otorinolaringol. 2003;(4):42-4. (Article in Russian)
PMID: 13677023

Abdrakhmanova LM, Farkhutdinov UR, Farkhutdinov RR.
Effectiveness of halotherapy of chronic bronchitis patients
Vopr Kurortol Fizioter Lech Fiz Kult. 2000 Nov-Dec ;( 6):21-4. (Article in Russian)
PMID: 11197648

Maev EZ, Vinogradov NV.
Halotherapy in the combined treatment of chronic bronchitis patients
Voen Med Zh. 1999 Jun; 320(6):34-7, 96. (Article in Russian)
PMID: 10439712

Chervinskaia AV.
The scientific validation and outlook for the practical use of halo-aerosol therapy
Vopr Kurortol Fizioter Lech Fiz Kult. 2000 Jan-Feb ;( 1):21-4. (Article in Russian)
PMID: 11094875

Farkhutdinov UR, Abdrakhmanova LM, Farkhutdinov RR.
Effects of halotherapy on free radical oxidation in patients with chronic bronchitis
Klin Med ( Moscow ). 2000;78(12):37-40. (Article in Russian)
PMID: 11210350

Borisenko LV, et al
The use of halotherapy for the rehabilitation of patients with acute bronchitis and a protracted and recurrent course
Vopr Kurortol Fizioter Lech Fiz Kult. 1995 Jan-Feb ;( 1):11-5. (Article in Russian)
PMID: 7785211

Roslaia NA, Likhacheva EI, Shchekoldin PI.
Efficacy of therapeutic use of ultrasound and sinusoidal modulated currents combined with halotherapy in patients with occupational toxic-dust bronchitis
Vopr Kurortol Fizioter Lech Fiz Kult. 2001 Jan-Feb ;( 1):26-7. (Article in Russian)
PMID: 11530404

Maliavin AG, Filiaeva IuA, Umakhanova MM, Chervinskaia AV.
Halotherapy-a new treatment for bacterial vaginosis
Vopr Kurortol Fizioter Lech Fiz Kult. 2004 May-Jun ;( 3):35-7. (Article in Russian)
PMID: 15216790

Wark, P.A.B. and V. McDonald (2004), "Nebulised Hypertonic Saline for Cystic Fibrosis," Cochrane Review (abstract), (as of August 3, 2004).

In case these thirteen clinical studies are not enough, the following websites offer additional support:

Tano, L Tano
Salt mine rehabilitation center

If you are still reading, here is something else that might be of interest from Dr. Smiechowski about the mines at Wieliczka:

In 2004, the Wieliczka Salt Mine Underground Rehabilitation and Treatment Centre received the International ISO 9001:2000 Certificate in the Quality Management in health care in the field of treatment of the respiratory system and allergic conditions in adults and children. [Surely this is not granted to institutions using non-scientific methods or quackery?]

Thanks to the agreement signed between the Wieliczka Salt Mine, the Jagiellonian University Collegium Medicum and the Academy of Physical Education on co-operation in teaching, research and scientific activities, the Centre is a venue of research on the influence of the special microclimate of the Wieliczka Mine on the human body.

The scientific research conducted at the Centre is supervised by Professor Krystyna Obtułowicz - the head of the UJ Collegium Medicum Allergology department, as the Plenipotentiary of Collegiom's Vice-chancellor for of Co-operation with the Mine.

So you see, much research does exist. 

Do people really think we would waste our time, money, and other resources (not to mention risk our professional reputations) on something that was a scam? While Dr. Margaret had the benefit of growing up in Poland where no one would even think of questioning the benefits of salt, I did not--so when she approached me to build a salt cave at the Pyramid, you better believe I did my research. Although I do not speak Russian, Dr. Margaret was able to summarize the studies for me and it did not take long for me to realize that things like the Salt Cave and Halotherapy Room hold the potential for incredible wellness benefits. I've done the research myself, so I know that even though we must say that these treatments are just for relaxation, I know that they are so much more. People living near salt therapy options in general do not understand the potential they hold, and so we find ourselves trying hard to raise awarenes without violating the rules of the FDA. The other complaint that the watchdog members had was that if these studies exist, why are they not on our Pyramid website? The answer to this is quite simple; because of FDA regulations, we cannot make any medical claims about salt, so it would be wrong for us to advertise it as anything except a relaxation technique. Why would we point to studies on our website that is designed to give people information about what we have to offer that would suggest that salt could be used as a medical treatment?

Of course, it is hard enough in this world to get people to try new things, especially in this economy when you must charge for the service. The watchdog organization members claimed that we were ripping off the public and probably making a lot of money off this scam. At $10 per session, we are hardly getting rich off the Salt Cave. Most days we do not even cover our own expenses to run the cave, but we continue to offer it and other similar treatments because we believe in them, we see them work, and we want to provide people with effective tools to manage their own wellness.

The bottom line is that it is not our job to convince people that they need Himalayan salt. The research is out there if someone wants to take the time to look. The benefits are there if someone wants to take the time to experience it. We actually invited the members of this organization to come have a session on us. They declined.

As I watched them ridicule everything I believe in, I learned some very valuable lessons. There are people out there who are just plain miserable and want to attack others via the Internet for the fun of it and the power that it must make them feel. They do not feel empowered to be well, so they do not want to see anyone else feel empowered, either. And they would rather put their lives in the hands of medical doctors because it is easier to turn that responsibility over to someone else instead of accepting that they have some ability to treat themselves as a complement to regular medicine.

Although I was sad to see this incredibly healing treatment attacked, it was a great opportunity for me to return to the original research that convinced me. Now more than ever, I feel strongly that speleotherapy and halotherapy are two ways that we have as humans to use the power of salt crystals from the earth itself to help us stay well.

Thank you for reading.
Be well!
William Kelley, Ph.D.
Pyramid Holistic Wellness Center

Wednesday, February 23, 2011


So you are getting a massage for the first time. And you probably have many questions to ask the massage therapist. In this first supplement of “Massage at your fingertips” Kathleen will be able to answer some of your questions even before you have your first appointment.

1.) What time should I arrive for my appointment?

Being on time is important! Arrive about 10 minutes prior to your appointment. This will give you time to use the rest room and to change into a robe and slippers (if they are provided).Should you arrive late, your treatment will end as scheduled as a courtesy to our other guest and to the therapist. If there is a front desk receptionist, be sure to “check in” so that they can tell your therapist that you have arrived.

2.) When will I meet my massage therapist?

At the time of your appointment, the massage therapist will come and get you and call you by name. They will introduce themselves. “My name is Kathleen and I am your massage therapist.” Expect to shake hands. At this point, the therapist will bring you into a treatment room.

3.) Once I get into the massage room, does the massage “just start”?

Most of the time, your massage therapist wants to get to know you. Plan on about a 5-10 minute consultation in regards your health. You may even have a health information form to fill out and a signed release “to treat” agreement.

4.) What types of question will they ask me?

Questions such as: Have you ever had a massage? If so, when was your last massage?

Do you have high blood pressure, diabetes, heart problems or could you be pregnant?

Do you have any allergies? Have you had a recent accident, injury, illness or surgery?

5.) It seems like they ask a lot of personal health questions, why is that?

With massage therapy being one of the most hands on professions in health care, massage therapists need to make sure that each person they treat will receive they best care possible. And the best way this can be done is to ask many questions about your health.

6.) So I am about ready to have my massage, now what?

At this point, the massage therapist will explain that they will be leaving the room for a moment or two so “that you will have time to undress down to your comfort.” Meaning, “your may leave on your undershorts or take them off”. They will also tell you to either get on the massage table by being face up or face down in the face cradle. Once you are undressed, you will get on the massage table between the two sheets. After a moment or two, the therapist will knock on the door and come back into the room and then your massage will begin.

7.) I just found out I am pregnant, can I make an appointment for a pregnancy massage?

Many massage therapists will ask you what trimester or how many weeks along you are. If you are less than 12 weeks or 3 months from the last day of your last menstrual period, chances are you will be unable to be treated at that time. Many therapists will refuse to offer massage to a woman who is still in her first trimester because of the increased statistics for miscarriage associated with the first 12 weeks of pregnancy. However after 3 months, be sure to discuss massage options with your OB/BYN or midwife. Contraindications for pregnancy massage are as followed: Hypertension (high blood pressure) with preeclampsia, previous preterm labor, severe headache or swelling or questionable vaginal bleeding. Also do not be surprised if the massage therapist tells you that they will not be massaging your feet. Trained prenatal or pregnancy massage therapists are aware of pressure points on the ankles and wrists that can gently stimulate pelvic muscles, including the uterus. Certified prenatal massage therapists are trained to avoid very specific and intentional pressure to these areas during pregnancy. Any woman who has experienced pre-term contractions or consistent Braxton-Hicks contractions should alert her therapist to that fact so that pressure points can be avoided completely.

8). I just had a car accident, can I still have a massage?

Consult with the doctor that is treating you with your injuries. Request a referral to a clinical massage therapist. Most clinical massage therapists have experience with how to treat those who have been injured in an accident. The therapist will be able to file with insurances, work with physicians and lawyers.

Please feel free to e-mail me at with any question that you may have in regards to massage. I welcome questions from massage therapists, patients, those considering treatment and massage students.

Ask Dr. Margaret: Hot Flashes

Q: I thought I was too young, but I am finding myself starting menopause. This is of course bringing up all sorts of emotional issues that I am working through with my counselor. But the physical symptoms are really stressful for me—especially the hot flashes. I used to think my grandmother and mother were just teasing me, but I am finding out for myself now that they can be really bad and really impact my life. What causes hot flashes? And what do you recommend for treating them?

A: Thank you for this question. The following article may be of interest to you:

Hot Flash Relief.

What is the most common symptom of menopause experienced by 75% of women at some point? Hot flashes. This pesky problem is attributed to estrogen withdrawal. As of the year 2000 there were approximately 37.5 million women reaching menopause; with the aging baby boomer population this number is only growing. With such a common symptom affecting such a large percentage of the world's population, it's no wonder research continues to focus on ways to gain relief.

Recent research into the efficacy of escitalopram (Lexapro), suggests it may cut the number of hot flashes experienced by postmenopausal women in half. Lexapro, a selective serotonin reuptake inhibitor (SSRI), was originally developed as a pharmaceutical treatment option for depression. This is not the first SSRI researched for hot flash relief, even so, the exact way in which Lexapro works to relieve hot flashes is not completely understood. It's pricy though. Women choosing this pharmaceutical for hot flash relief can expect a lofty price tag as the treatment runs approximately $110 per month.

During the menopausal transition, hot flashes are associated with a rise in the body's core temperature and a narrowing of the body's thermoneutral zone, with a decrease of the sweating threshold and an increase of the shivering threshold. Simply put, peri and menopausal women tend to run a bit warmer than pre-menopausal women with an increased tolerance for cold and a decreased tolerance for heat. These changes in the body's temperature regulation are associated with multiple fluctuations in hormones and the neurotransmitters that accompany menopause, including changes in estrogen, norepinephrine and serotonin.

So what is the connection? Well, in the brain, estrogen increases serotonin's ability to activate its receptors. Estrogen withdrawal during menopause causes decreased serotonin receptor sensitivity, resulting in multiple physiological changes including the temperature regulation changes that contribute to menopausal hot flashes. Although the use of an SSRI does not address the decreased serotonin receptor sensitivity associated with estrogen withdrawal, it does maintain higher levels of serotonin available for use by the receptors.

Known to be a symptom of low estrogen, a more commonly known treatment option for hot flash relief may be estrogen supplementation. In addition to providing relief from hot flashes, topical bioidentical estrogen supplementation may also be beneficial for optimal bone health. Supplementing estrogen by itself may increase the risk of estrogen-dependent cancers including uterine and breast cancer, thus it's important to balance estrogen therapies with progesterone supplementation. Baseline salivary hormone testing of estrogen and progesterone levels will demonstrate if a woman is deficient in estrogen and determine if she is estrogen dominant. Continued monitoring of her symptoms and hormone levels at regular intervals while participating in a bioidentical hormone supplementation program will ensure she is enjoying her peri and post menopausal years hot flash free.

In short, hot flashes are a normal part of life for women going through menopause. However, there are both traditional and holistic treatments that can help. I do offer one-on-one consultation and together we can talk about your specific case and plan the best treatment for you.


It’s very difficult to express the gratitude I feel…for the wonderful people who choose to work at the Pyramid and to those who use our services, for this growing holistic wellness community we’ve created by coming together, and for the amazing power of living and working within this community that supports mindful living on every level. Every day is a blessing for us, and as we move into our fourth year of business, with tons of new projects and expansion underway, I realize that the greatest achievement of the Pyramid is the assembly of the most diverse, talented team of experts anywhere.

It’s funny…here we are just Margaret, Josh, Tammy, Darlene, Bryn, Mara, Darya, Raven, Alison, Karen, Brad, Jane, Kitty, Tejasinha, Mary, Kammie, Cameron, Gary, Barbara, Scott, Jon, Laurie, Jen, Autumn, etc. But our practitioners and instructors are truly gifted people who are experts in their fields. They are sought after all over the world to present, train, and share their knowledge. They write books and create their own products. They have almost icon status outside of Rutland. And yet in Rutland, they are just regular people who have been drawn to sustaining our mission of providing a quality wellness experience at an affordable price. That is truly amazing to me.

As we prepare to bring yet another internationally known expert to the Pyramid in May (, it occurs to me what a wealth of expertise exists in our area already…of course I am very proud of the Pyramid team, but I am also aware of the expertise that exists around us at other establishments. I don’t know any other area in the United States that boasts so many experts in one place. Per capita, this means great things for the citizens of Vermont.

Unfortunately, however, many Vermonters have to choose between getting a massage or paying their fuel bills. I am sure it is this way all over the country from what I have heard. But given the particularly challenging social and physical environments here, it seems especially difficult for Vermonters.

For those of you new to our newsletter—I want to assure you that the Pyramid is 100% committed to continuing our mission of providing affordable wellness options. Although times are tough, we know that the world would be a much better place if everyone could experience wellness—so we are creating opportunities.

One of my favorite early Pyramid memories was when I taught a Yoga class where a billionaire was sitting next to someone who had picked up quarters from the laundry mat floor to pay for class. Wellness should not be available just to the elite—it should be available to everyone. The reality, of course, is that we have to charge something for our work. But the idea with the Pyramid is that if we keep the costs low, more people will participate—and that is how we can afford to operate. This is how we can afford to offer the same class you would pay double or triple for at other area businesses for only $6. This is how we can offer workshops for $10 that you would literally pay ten times for at other places. And that is how we can offer monthly health club memberships starting at $20, tax included!

Over the next few months, in addition to bringing top notch guest practitioners and lecturers to the Pyramid, we will be highlighting our very own local experts. Sometimes I am in awe at just what the Pyramid team has accomplished collectively and individually. Did you know that we have North America’s foremost expert on Himalayan salt and that she is debuting a new salt technology at Pyramid Fitness? Did you know that you can experience Mindful Movement Therapy, a brand-new offering by the person who invented it? Or receive Ashiatsu Bar Therapy from one of the very few experts trained in it in Vermont, at one of the few facilities with the bars? Did you know that you could learn how to be a massage therapist through the only program in Vermont that combines distance learning with in-person, hands-on training? The list goes on and on. We don’t have enough space to list the accomplishments of all of our team members…but suffice it to say that it is impressive, and we hope you will take some time to get to know the expertise that exists at the Pyramid and beyond in the Rutland area.

If it’s been a while since you’ve been to the Pyramid, we hope you will check out our new offerings. Either way, thank you so much for reading our e-newsletter. Be well!

William D. Kelley, Ph.D.

Pyramid Holistic Wellness Center

120 and 79 Merchants Row

Rutland, VT 05701