Namaste

When I think of HIV/AIDS red ribbons and African faces flashing across the television screen come to mind.    Words like retroviral, cocktails, discrimination, safe sex, latex condom, get tested, etc. are some of the words I recall, never is the word ‘friend’ associated with the disease.  Yet I have had a few friends who suffered and died from an AIDS-related condition. The most prevalent and distressing symptoms of HIV/AIDS are weight loss, anorexia, fatigue, nausea, vomiting, anxiety, depression, cough, fever, and dyspnoea, which may evolved into a another medical condition from which the client dies. One of my friends who experienced all of the above symptoms (and eventually died from lung failure due to pneumonia) was used as a model during my initial massage therapy training.  One of the main benefits she experienced from the massage treatments was stress relief.  Stress tends to impair logical thinking and can cause a controllable problem to seem like a catastrophe.  The soothing effects of massage provide a safe space in which clients can clear their mind and consider constructive ways of approaching and handing their situation.

Quite often there are many difficult decisions to be made and discussion does not come easy as everything can seem to be a big swirl of chaos that challenges the client to the point where they feel unable to cope.  For my client, this resulted in an abrupt ending of the massage treatments.  She had much to say, but did not know where to start, and opted for shutting me out.  Though I did not understand what she was going through at the time, I never gave up on her.  An assessment of the client helps in creating specific treatment plans for massage therapy, but I was unaware of my client’s condition because a client generally has no obligation to disclose their medical condition, and she may have been fearful of the discrimination that often follows disclosure.  Eventually she opened up to me and treatment resumed.  She explained how difficult it was to receive the bad news of being HIV positive, and listening to the counselor explain her treatment options.  I was asked to participate in broaching the subject to her loved ones, and as she had anticipated, it provoked a crisis.  Emotions were raw, both for her and her children.  Thereon she was able to do most of the communicating, addressing end-of-life issues which led to her mother being assigned power of attorney for health care and well as for her children after her passing.

Massage therapy is also very effective in pain management by activating endorphin and the parasympathetic nervous system.  HIV disease and its treatment are associated with significant pain syndromes causing morbidity, decline in function, and decreased quality of life.  There are some estimates that suggest the prevalence of pain among HIV patients range from 40% to 60% stemming from the extent of disease, the use of older, more toxic first-line Anti-retroviral Therapy (ART) regimens, and limited access to opiates (drugs with morphinelike effects).  Massage also helps help in relieving respiratory congestion by aiding in the removal of excess phlegm.  It helps the liver in toxin removal by increasing the blood and lymph flow and encourage the regeneration of blood cells by increasing oxygen to the affected areas.  This is a big relief as in addition to the general waste that the body produces, it has to process the burden of significant neurotoxicity related to viral load levels.  ART is associated with neuropathic pain syndromes because the reverse transcriptase inhibitors makes the client susceptible to pain in one form or another.  For example, it increase the percentage of acid in the blood, and may degenerate the liver or pancreas (all of which generate some degree of pain) making a massage treatment critical as it efficiently and effectively boosts the circulatory system which in turn causes the body to flush out the waste.

Essential oils can have potent emotional effects and are ideal mood changers. Some oils uplift the spirits while others relax or calm.  Their therapeutic value includes antidepressant, aphrodisiac, antiseptic, antiviral, etc.  Hence the same oil can produce different effects depending upon the emotional state of the individual at the time.  Apart from wellness treatments like aromatherapy massage, clients can be encouraged to seek out nutrition programmes and learn basic hygiene and treatment for common skin infection which may easily occur.  As Therapists it is important for us to remember that our psychological and emotional support are important parts of treatment and appreciate our role in helping to clear up misunderstandings about HIV/AIDS.  HIV/AIDS cannot be spread through any social or affectionate touching which does not involve the exchange of bodily fluids.  Kissing is a very low risk activity.  Sharing the same bedding is perfectly safe.  Both HIV-positive and negative people can share meals together with no risk whatsoever.  However, while sharing the same kitchen utensils cannot transmit HIV, this can transmit Tuberculosis and flu viruses.  Also we need to recognize that HIV/AIDS clients can hope for many things other than the cure of their illness.  For example, they can hope for good control of their symptoms so they can spend meaningful time with family and friends, heal troubled relationships, or create a legacy.  We can help clients to refocus on more attainable goals, thereby reinstating hope into what may be perceived as a hopeless situation.

Massage therapy does help to improve quality of life for people living with HIV/AIDS, particularly in combination with other stress-management modalities such as Yoga, Meditation, etc., which entitles the HIV/AIDS client seek such treatments.  Massage therapy standards of practice require that Therapists adhere to general contraindications.  Doing massages for my friend was no different after my knowledge of her condition.  She had no broken skin so there was not threat of my being in contact with her bodily fluids, apart from sweat.  I was advised that some Therapists use gloves during their massage sessions, but I believe that care should always be taken to ensure that the client does not feel stigmatized during a massage therapy treatment.  Fear of contamination is not sufficient to wear gloves.  Both Therapist and client must be aware of proper justification for using such so that mutual respect is maintained.

In loving memory of Kaley, my friend…my sister.