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