Case Study 6 Benign Tumor in the Pituitary

Results of the research for the poster on the 8th RIEN Conference

Therapist: Débora Armada (Reflexology and TCM student in Centro de Reflexologia da Madeira since 2012)

Patient: female, 44 years old

Pathology: Benign Tumor in the pituitary - incidentaloma (<3mm) 

Diagnosis: 2012, through a routine MRI

Pituitary incidentalomas or Benign Tumor in Pituitary: the natural history of these lesions is not yet fully established. Although typically small (<10mm diameter) and clinically silent, some pituitary incidentalomas may cause mass efects by compressing neighbouring structures. Pituitary incidentalomas are, by definition, detected during the investigation of symptoms seemingly unrelated to pituitary lesion. However, a considerable number of patients have pathological conditionsattibutable to the hypophysis wich had not previously been appreciated mild symptoms, such as headaches, tinnitus, vision loss and paralysis of cranial nerves, as well as research of clinical evidence of hypopituitarism. Pituitary incidentalomas are a heterogeneous group of disorders, and treatment recommendations will vary. According to incidence and endocrine or neurological morbidity related to injury. Anyway, one important aspect that should be considered in all cases aspect is that knowledge of the existance of a mass seal is capable of causing considerable anxiety in patients and may result in reduced quality of life of these individuals.

Symptoms: the symptoms presented by the patient were: headache, dizziness and tinnitus.

Medication: the patient does not use the medication continuously, only when it presents some anxiety. She uses a food supplement (ansioval) containing substances traditionally used to improve sleep, decrease anxiety and reduce stress. Produces a sense of calm , tranquility and restful sleep.

Start of sessions: 05/11/2013

Treatment: 15 integrated reflexology sessions were conducted for a duration of one hour, with the frequency  of 2 times per week. The techniques applied were: Reaxation Tecnhiques, Eunice Ingham Method, Advanced Techniques, Su-jok, Metamorphic Technique, Technique of the vertebrae (C1, C5, C7), Moxibustion and Acupressure. In Acupressure points, L1, L3, SP6, LI4 and B&/ were stimulated. In all sessions were worked with different techniques the reflections Central and Peripheral Nervous System, Endocrine System, Pituitary, Liver, Stomach, Colon, Kidneys and Bladder.

Analysis of Results: throughout the therapeutic process, reflexology techniques were applied preventively and in reduction of symptoms. The techniques that were effective in the patient were the Advanced Techniques, Moxibustion and Acupressure; improvements were feltby the patient during the sessions. It was noted that the symptoms such as headaches an ringing sensation  decreased from the 4th session forward. Consequently the anxiety attacks are becoming less frequent, thus reducing the number of times the same recourse to medication.

Conclusion: it was concluded that reflexology treatments helped the patient to improve her quality of life. She is quite a calmer patient, handles better with her disease and is attentive to its progression.

feet at session 1

feet at session 15

Case Study #5 Panic Disrder

Results of the research for the poster on the 8th RIEN Conference

Therapist: Paula Mão Cheia

Patient: female, 37 years old

Pathology: Panic Disorder

Diagnosis: 2009

Panic Disorder: anxiety disorder characterized by the repeated occurence of panic attacks. These can be defined as acute episodes, self-limiting, extreme apprehension or fear, and sense of imminent danger to the physical or mental integrity, accompanied by vegetative symptoms are as preparing the body for a real threat (sympathetic system) trail. Adrenaline causes physiological changes that prepare the individual to deal with this danger. 

Symptoms: the symptoms reported by the patient during episodes of panic are: dizziness, increased heart rate, feeling of slight shortness of breath, tingling sensation and decreased muscle strenght in the upper and lower limbs ( predominantly on the left side of the body).

Medication: Escitalopram ( anti-depressant used to treat anxiety disturbances) 3mg 4 times a week; Bromazepam (anxiolytic) 10mg in SOS.

Start of sessions: 08/12/2013

Treatment: 15 reflexology sessions were conducted with one-hour duration and frequency of twice a week. Techniques applied: Relaxation techniques, Eunice Ingham method, Advanced techniques, Aromatherapy (essential oil of chamomile), Acupressure, Foot taco (Thay reflexology), Su-jok (use of the ring), VRT (slide and rocking, pituitary pinching), and notions of new medicine.

In all sessions were worked with different techniques reflections of the central and peripheral nervous system, endocrine system (pituitary and adrenal), solar plexus, skeletal and muscular system (cervical spine and shoulders, diaphragm), lungs, digestive system ( liver, gall bladder, stomach, intestine) and urinary system. Acupressure points L3 and K1.

Analysis of Results: The relevant changes face to the patients condition were the feeling of lightness and weel-being after the 1st session and subsequently decrease panic attacks without resorting to SOS medication. In November 2013, before the reflexology treatments, the patient took the SOS medication 5 times. In December 2013, after the beggining of the reflexology treatments, the patient took the SOS medication 5 times. In January 2014, the frequency decreased for one time in the whole month. In the month of February b2014, the patient maintained the frequency an took the SOS medication one time. After the use of Advanced Techniques (3rd session), foot taco and acupressure in L3 and K1 (5th session) points more intensively, the patient reported a great relaxation and lightness at the end of the treatments. Reported greater well-being in the days following the treatments. 

Conclusion: it was concluded that reflexology treatments helped the patient to increase well-being and relaxation, the ability of self-control at the onset of a panic attack, overcoming them without the need for rescue medication and contributed to the effective reduction of the frequency of occurence of panic attacks.

feet at session #1

feet at session #15

Case Study #4 Depression

Results of the research for the poster on the 8th RIEN Conference

Therapist: Noralis Millán

Patient: female, 60 years old

Pathology: depression and anxiety

Diagnosis: 1998

Depression is a mental illness wich is characterized by more pronounced  or prolonged sadness, loss of interest in activities normally experienced as pleasurable and loss of energy or tiredness. Depression is the leading cause of disabilities and the second leading cause of loss of healthy life years among the 107 diseases and health issues most relevant. May be episodic, recurrent or chronic, and leads to substantial decrease of the individuals ability to ensure their daily responsabilities. It can last from a few months to a few years. However, in about 20 percent of the cases it becomes a chronic without remission disease. These cases are due primarily to lack of proper treatment.

Symptomatology: deep sadness, apathy, headache, irritability, constant crying.

Medication: Diazepam (anxiolytics, sedative and hypnotic), Venlafaxine (antidepressant).

Start of sessions: 06/11/2013

Treatment: 15 reflexology sessions were performed with the duration of one hour, with the periodicity of 2 times per week. The techniques applied were: Relaxation Tecniques, Eunice Inghams Method, Advanced Technique, Moxibustion, Foot Taco (Thay Reflexology), Colon Link, Cranial Nerves technique, Vertebrae Techniques, Aromatherapy (lavender, eucalyptus), Acupressure (BP6, F3).

Analysis of results: after the first session, the patient slept all night. At session 5 the headaches disappeared completly and by the end of all 15 sessions the patient says the headaches didn't come back, and therefore, she was less irritable. Is much more calm and relaxes more easily.

Conclusion: The reflexology treatments have helped the patient to be more calm, relaxed and with better quality of life, as one of the symptoms disappeared completly (headache); the treatment also helped to improve the other symptoms not properly linked to depression, such as constipation, elimination, feeling of lightness on her legs after treatments.

feet at session #1

feet in session #15

Case Study #3 Depression

Results of the research for the poster on the 8th RIEN Conference

Therapist: Carolina Millán (Reflexology and TCM student in Centro de Reflexologia da Madeira since 2013)

Patient: male, 22 years old

Pathology: depression and anxiety

Diagnosis: October 2013

Depression is considered a pathology with strong affective disorders, causing the patient the loss of interest or pleasure in usual activities, a feeling of despair or despondency associated with fatigue or decreased energy, decreased concentration, indifference, discouragement, gathering in himself and in addition consequent mental rumination. In general, the individual who suffers so does not want help. May even have suicidal toughts. In direct connection with the nervous system became evident by the changes in the depressed person's brain, particularly with respect to neurotransmitters (serotonin, norepinephrine, and dopamine lesser extent), substances that transmit nerve impulses between cells.

Symptoms: pressure in the chest, insomnia, urge to cry, decreased libido, irregular breathing (causing episodes of asthma), need to be at home, apathy to do any activity, angry outbursts.

Medication: Diazepam (anxiolytic), Montelukast (anti-asthmatics), Loratadinum (allergy), Deflazacort (anti-inflammatory), Fluticasone + salmeterol (bronchodilator and antiasthmatic).

Start of sessions: 02/11/2013

Treatment:15 reflexology sessions were performed with the duration of one hour, with the periodicity of 2 times per week. The techniques applied were: Relaxation Tecniques in all sessions, Advanced techniques, Moxibustion, Sedona Method, Aromatherapy and Su-jok.

Analysis of results: after the first session the patient felt relaxed, wich resulted in a prolongation of sleep/rest. In session #9 the patient manifested an asthma attack; the use of Aromatherapy had a positive result, as the asthma symptmoms disapeared througout othe treatment. In session #13 the patient manifested feeling very different, with a increase of self esteem, so he decided to go out more often, and left the sleeping pills on his own will. The patient was able to sleep for more than seven hours.

Conclusion: the results were positive with reflexology, the patient regained self esteem and confidence; accepted the changes in his life and eliminated bad thoughts. Expressed willingness to work and his sleep/rest stabilized.

feet at session #1

feet at session #15

Case Study #2 Alzheimer

Results of the research for the poster on the 8th RIEN Conference

Therapist: Joaquim Manuel Vilas-Boas

Patient: male, 77 years old

Pathology: Alzheimer

Diagnosis: 2007

The Alzheimers is a neurodegenerative disease that causes the decline of intellectual functions, reducing the capacity of work, social relationships and interfering in behaviour and personality. Initially the patient begins to lose his most recent memory, might even recall accurately events of years ago, but remember that has just had a meal. With the evolution of the disease the person is affected on allertness, orientation, comprehension and speech. The person with Alzheimer becomes increasingly dependent on the help from third parties.

Symptomatology: very rigid bodie, impaired speech, bad mood, does not like to walk, likez to eat a lot and very sweet things.

Medications: Quetiapine and Memantine (Alzheimer) and Loflazepato ethyl (sedative).

Start of sessions: 04/11/2013

Treatment: 15 reflexology sessions were performed with the duration of one hour, with the periodicity of 3 times per week. During the treatments several techniques were applied: Relaxation Techniques, Advanced Tecniques, Eunice Ingham's Method, foot taco technique (tai reflexology), cranial nerves, Metamorphic Technique. At all sessions different techiques were applied. The reflexes worked were the Central and Peripheral Nervous System, Liver, Stomach, Colon, Kidneys and Bladder. 

Analysis of Results:  in the first five sessions the patient had little improvement. From the sixth session it was applied the Craanial Nerves Technique, Foot Taco Technique (Tai Reflexology), Metamorphic technique, and improvements began to appear, such as: being calmer, better sleep, better walk and better reaction to other people.

Conclusion: It was concluded that the Reflexology treatments helped the patient to improve his mood and a positive change in his interpersonal relationships.

feet at the 15th session

Case Study #1 Ischaemical Cerebral Vascular Accident

Results of the research for the poster on the 8th RIEN Conference

Therapist: Mónica Baltazar ( Reflexology and TCM student in Centro de Reflexologia da Madeira since 2011)

Pacient: female, 67 years old

Pathology: Ischaemical Cerebral Vascular Accident

Diagnosis: 07/06/2011

Cerebral Vascular Accident: neurological disease caused by the sudden decrease of blood flow to a particular region of the brain. May be caused by the clogging of a cerebral artery, being unable the arrival of blood to that region of the brain (ischemic stroke) or "disruption" of an artery (hemorrhagic stroke). It is a state of medical emergency and in Portugal is the main cause of death.

Symptomatology: facial assymmetry, tremor at rest, impaired deglutition (liquids), muscular rigidity, paralyzed right side, difficulty in opening the left eye. Impaired speech. Moodiness, crying jags. Obstipation.

Medication: Propycil (hyperthyroisism), Vastarel (anti ischemic), Concor (treatment of chronic heart failure), Risperidone (treatment of schizophrenia), Fluoxetine (antidepressant), Isoptin (coronary heart disease), Zanator (hypercholesterolemia), Diazepam (anxiolytic).

Start of sessions: 03/11/2013

Treatment: 15 reflexology sessions were conducted for a duration of one hour, with thw frequency of 2 times per week. During the treatments were applied : Relaxation Techniques, Eunice Inghams Method, Advanced Techniques, Metamorphic Technique, Aromatherapy, Acupressure and Moxabustion. In Acupressure L2, L3, GB60 and GB67 were stimulated points.

Analysis of results: in all sessions were worked with different techiques the reflexes: Central and Peripheral Nervous System, Pituitary, Liver, Stomach, Colon, Kidneys and Bladder. The relevant changes, compared to the patients state, was at the mood level (wouldn't cry so hard after sessions) and at the muscular level ( made several moves with her right leg voluntarily). Changes occurred in the first few sessions; after the third session the patient crossed her right leg over her left leg; at the sixt session had spasms throughout the whole treatment. After the ninth session, both legs folded to the abdominal area, and tried to sit up alone. At the tenth session, moved her right leg from side to side at request of the therapist and fully opened her left eye.

Conclusion: it was concluded that reflexology treatments  helped patient improve her mood, relieve obstipation, facilitate spontaneos and voluntary movements with the member detaind by illness.

feet at the 1st session

feet at the 15th session

Caso Estudo 6 Tumor Benigno na Hipófise / Case Study 6 Benign Tumor pituitary incidentaloma

Trabalho de Investigação para o Poster Congresso RIEN 2014

Terapeuta: Débora Armada

Paciente: sexo feminino com 44 anos de idade

Ocupação: assistente de loja

Patologia: Incidentalomas hipófisários ou Tumor benigno na hipófise (<3mm)

Diagóstico: 2012, demonstrado através de uma ressonância magnética de rotina.

Incidentalomas hipofisários ou Tumor Benigno na Hipófise (<3mm): a história natural destas lesões ainda não está completamente estabelecida. Embora sejam tipicamente pequenos (<10mm no seu maior diâmetro) e clinicamente silenciosos, alguns incidentalomas hipofisários podem secretar hormonas ou causar efeitos de massa por compressão sobre estrururas vizinhas. Os incidentalomas hipofisários são, por definição, detectados durante a investigação de sintomas aparentemente não-relacionados à lesão hipofisária. No entanto, um considerável número de pacientes apresentam sintomas discretos atribuíveis a condições patológicas da hipófise, que não tinham sido previamente valorizados. Como por exemplo, a cefaleia, zumbidos, ddéfice visual e paralisisa dos nervos cranianos, bem como a pesquisa de evidências clínicas de hipopituitarismo. Os incidentalomas hipofisários constituem um grupo heterogéneo de patologias, e as recomendações terapêuticas irão variar de acordo com a incidência e a morbilidade endócrina ou neurológica relacionadas à lesão. De toda a forma, um aspecto importante e que deve ser considerado em todos os casos é que o conhecimento da existência de uma massa selar é capaz de provocar considerável ansiedade nos pacientes, podendo resultar em redução da qualidade de vida desses indivíduos.

Sintomatologia: os sintomas apresentados pela paciente são: cefaleias, tonturas e zumbidos nos ouvidos.

Medicação: a paciente não recorre a medicação de forma continuada, apenas quando apresenta alguma ansiedade. Usa um suplemento alimentar (ansioval) que contém substâncias tradicionalmente usadas para promover uma melhoria do sono, diminuir a ansiedade e diminuir a tensão nervosa. Produz sensação de calma, tranquilidade e sono reparador.

Data de início das sessões: 05/11/2013

Tratamento: foram realizadas 15 sessões de reflexologia integrada com a duração de uma hora, com a periodicidade de duas vezes por semana. Durante os tratamentos foram aplicadas técnicas de Relaxamento, Método de Eunice Ingham, Técnicas Avançadas, Su-jok, Técnica Metamórfica, Técnica das vértebras (C1, C5, C7), Moxabustão e Acupressão. Em acupressão foram estimulados os pontos F1, F3, BP6, IG4, B67. Em todas as sessões foram trabalhados com diferentes técnicas os reflexos Sistema Nervoso Central e Periférico, Sistema Endócrino, Pituitária, Fígado, Estômago, Cólon, Rins e Bexiga.

Análise de resultados: Durante todo o processo terapêutico, as técnicas de reflexologia foram aplicadas de forma preventiva e na redução da sintomatologia. Na 1ª sessão a paciente sentiu-se bastante mal, as dores de cabeça pioraram pelo que foi necessário interromper o tratamento e explicar um pouco como funciona o processo da crise curativa ( primeiro piora para depois melhorar). Depois de estar mais calma, a sessão continuou sem qualquer altercação. As técnicas que mais surtiram efeito na paciente fora, as técnicas avançadas em todo o Sistema Nervoso Central, Moxabustão nas áreas reflexas do cérebro, pituitária, fígado, estômago, cólon, rins e bexiga, e na acupressão. As melhorias eram sentidas pela paciente durante a sessão. Notou-se que os sintomas da patologia, tais como as dores de cabeça e a sensação de zumbido nos ouvidos, a partir da 4ªsessão começaram a diminuir. Por consequência as crises de ansiedade passaram a ser menos frequentes, reduzindo assim o número de vezes que a mesma recorreu a medicação.

Conclusão: É possível concluir que os tratamentos de reflexologia ajudaram a paciente a melhorar a sua qualidade de vida. É uma pessoa muito mais calma, lida melhor com a sua patologia e está atenta à progressão da mesma. 

pés na primeira sessão

pés na última sessão

Follow up: Para além das 15 sessões, foi feita uma ressonância magnética para determinar o tamanho do quisto; conclui-se que este, durante o ano 2013 não aumentou a sua massa.