Client Background

Client “A” is a 39 year old woman. She has had Bilateral Primary Lymphoedema in both her legs, but mainly presents in her bum and upper thighs for around 21 years. She noticed it had developed after having her daughter at age 15.  Her Doctor is very resistant to any testing, he has informed her that it is just fat, and she needs to make more of an effort to lose weight. Clients’ mother and 4 sisters also have lymphoedema in the same areas she does. 
Client A changed her diet to reduce and remove high inflammatory foods. 
Client “A” finds both legs are affected relatively equally, but experiences little swelling below the ankle bones on both feet. Skin quality of both feet and legs are equal, soft, slight warm lower legs and typically cool feet. 

Client “A” agreed to come weekly for 4 weeks, then after that time we’d reassess. I explained about measuring the limbs as a way to see fluid loss, but Client “A” was extremely self-conscious about her size didn’t agree to the measurements. 

​Treatments were performed in a zero gravity chair with a pillow under clients’ ankles. 
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Treatment 1 March 14th 2019  
As both legs are affected equally, I ran RLD for the legs left, right, left and right again. 

Observation
Both feet felt quite stiff and tight, it felt like there was a bubble sitting on top the subclavian vein, and it was slightly tender at the subclavian and across the upper lymphatics. Groin lymph and hip to knee felt quite tight. 

Client Comments
Client “A” felt tingles and slight sensations of fluid moving, as I was starting the left foot for the second time. She felt relaxed and lighter by the end of the session. I touched base with her the next day; she said her legs felt light and energized. She had energy that evening and slept great.  
Next appointment in 7 days 
 
Treatment 2 March 21st 2019
As both legs are affected equally, I ran RLD for the legs left, right, left and right again.

Observation
Could still feel a bubble over the subclavian vein, client noted it felt slightly tender this time. Upper lymphatic still felt quite tight, but it loosened up quicker this time. I could feel more fluid movement as I pushed fluid down from the upper lymph to the groin lymph. Immediately after we finished, she needed to use the washroom.

Clients Comments 
Client “A” could feel “whooshing” and temperature fluctuate while I did linking of the subclavian veins.  She said she felt almost like she had goosebumps, she felt tingly all over and it came and went during our appointment.  She messaged me that night saying after her appointment she went to do errands but had to leave the store without her thing due to having to badly pee. She’s said it just hit her, and she had to pee NOW. Client A commented she had to tighten her Birkenstocks 1 notch as there were too loose from the last time she’d wore them. 
Next appointment in 7 days. 
 
Treatment 3 March 28th 2019
As both legs are affected equally, I ran RLD for the legs left, right, left and right again.

Observation
There is still a bubble over the subclavian; it feels like there’s more movement to it, Client “A” commented it felt bruised.  Upper lymphatic felt noticeably different today, less congested feeling and moved much easier. Hip/knee/thigh felt crunchy. Kidney to bladder sweep, client said it felt like I was scratching an internal itch. After we were finished, she used the washroom right away. 

Client Comments
Slight tingling all over today.  A few days after the 3rd treatment, Client “A”contacted me. She said that she she’s peeing enough for 3 people, having bouts of diarrhea, feels exhausted, and not sleeping great. 
Next appointment in 13 days. 
 
Treatment 4 April 9th 2019
As both legs are affected I ran RLD for the legs left, right, left, and right again.
​
Observation
Both feet were considerably cooler in temperature than normal, lower legs, and feet were more swollen than they typically are. Bubble over subclavian is considerably better, the fluid moved easily, and client felt a difference immediately. Fewer crunchies in kidney to bladder sweep. 

Client comments
Client “A” said she noticed about day 9 that her legs were swelling more, felt heavy and tired. 
Next appointment in 7 days. 
 
Treatment 5 April 16th 2019 
As both legs are affected equally, I ran RLD for the legs left, right, left and right again. Client “A” commented she felt I was using more pressure this time than previous appointments. It was not intentional on my end, but client “A” was comfortable with the pressure so I continued using more pressure for the duration of the appointment. 

Observation
​More crunchy areas than normal in the hip and knee areas on both feet. Subclavian was quite tender. Kidney to bladder sweep was tight, and a cooler temperature than the rest of the feet. 

Client Comments
Client “A” said that kidney to bladder sweep felt itchy. She felt tingles and was shivering by the time we finished our appointment.  We spoke that evening, Client “A” stated she felt that she swelling had reduced considerably, and she’s been peeing just about every 15 minutes for an hour. She also experienced bouts of diarrhea, all that evening. She had no pain or discomfort, to use her words she said it felt like a nice cleanse. I touched base the next day, Client “A” said she was up twice during the night to pee, but felt great that morning. She said both her kids and husband commented how good her legs looked! 

Continuing Care
After this appointment Client “A” went away on a trip, she had over a 6 hour flight, and spent a week and a half away. She expressed great concern over the flight and how her legs would manage. She didn’t want to start her holiday with heavy swollen legs. I showed her the subclavian point on her hands, and showed her the direction to rub the subclavian point on her feet, for her husband to work while they were away. She said that the first day was the worst, she had her husband work her feet that night, and it made an immediate difference. Client “A“ said that the rest of the trip was peachy, even the flight and drive back home she was able to manage the swelling well herself. 

I’ve continued to treat Client “A “roughly twice a month for almost a year. We watched fluid recede from her “fat pockets “as she called them. She found fluid collects in the inner parts of her knees, side of one lower thigh, and the insides of her elbows. She commented on dropping a bra size, and she did a happy dance as she gave away her “extra fat “clothes as she coined them. Client “A” Experienced a range of symptoms that seemed to vary, frequent urination, diarrhea, upset stomach, nausea, sloshing feeling, energy, fatigue and dull aching feeling. She didn’t experience something every time, she made connects to food, activity and barometric pressure that seemed to affect what symptoms she had.  Client “A” also starting seeing a massage therapist part way through our year, she found coming for RLD and a massage within a day of each other she felt the best and it seemed to last the longest that way. She measured her legs herself at home and is down 10 inches across the tops of her upper thighs, and down 30 pounds.

Summary of RLD Treatments
My Observations
The first 4 treatments I certainly felt more of a difference in her feet than I could physically see. My client certainly experienced some intense symptoms. I’ve still never had anyone else react to RLD the way she did. And to be truthful I don’t really know why. I urged her to keep trying the RLD treatments and to log her food and symptoms to see if she could see a pattern. She noticed almost immediately that if she ate food high in inflammation she experienced symptoms after RLD. I told her that if RLD was able to lower her inflammation she’d had fewer symptoms after RLD. She stuck to a lower inflammation diet for a bit a noticed a reduction in symptoms. Now a year plus into RLD treatments she infrequently experiences intense symptoms after RLD, most commonly she pees a lot. I did defiantly notice a difference in the appearance of her lymphedema as we continued, looser fitting pants that previously were skin tight, new clothes to fit her skinner legs, and she had to tighten her Birkenstocks.                                                              

Clients Comments
Client “A” is beyond thrilled with the results of the RLD treatments. We’ve shed a few tears through the weeks over the changes she saw and felt. Often after getting up from my chair after RLD she’d say she felt like she was floating, walking on air, her legs might drift away they felt so light. Usually saying that as she dashed to the bathroom, the first few appointments.  Client “A” said she feels like she attracts less public attention from people and feels more comfortable in her skin. She’s threatened to come live with me if I ever move away. 

MYCAW Results
The MYCAW form was completed at the first appointment. Concern 1 was size and concern 2 was uncomfortable, both listed at a 6 on the scale of 1-6. She listed her wellbeing at a 6 on a scale of 1-6 as well. At the end of our 5 treatments, Client “S” redid the MYCAW form and rated concern 1 and 2 at a 2-3 on a scale of 1-6, and wellbeing at a 2. She said that she feels there’s room to improve her wellbeing but feels its loads better with RLD in her life. 

Reflective Practice
Self-Evaluation:  When I first started RLD treatments with this client, I was very unsure of myself. She gave me great feedback as to how things felt, and I trusted that she was being honest with me. As we continued my confidence grew epically as we saw results. I love using RLD and I like the flow of the methods. I understand how the lymphatic works to be able to explain it to a client, but also to understand what I might be feeling in a client’s feet. I knew very little about the Lymphatic system before RLD and I had no idea of its effects on the systems of the body. I personally don’t experience lymphedema so seeing how much it’s affected my client was heartbreaking. Now when I see people that have lymphedema I want to talk to them and recommend that they try RLD, I want it to help them as much as it’s helped client “A”. Watching RLD have an impact on each client differently has been such a gift.

"I thoroughly enjoyed working with this client, she's a gem and without her this case study would of been very different. RLD has changed her life and I'm grateful have been a part of that". 
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​Thank you Jessica for travelling from Manitoba, Canada to Tampa, Florida in 2019 to learn RLD. ​

​During 2020 is has been a real joy to connect with and introduce RLD online to reflexologists around the world, including USA, Canada, Argentina, New Zealand, South Africa, Sweden, Poland, France, Belgium, Greece, Portugal, Ireland and UK, its sustainable, fun & interactive!  

Find out more about RLD training HERE

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Are you a reflexologist interested in adding RLD to your practice, or taking a refresher course?

Writing a blog post is something I often think about before getting distracted by the next thing, and then the original thought is out of date. Its been a 14 months since my last blog!

At the beginning of lockdown in the UK I set up the Reflexology book club Facebook group. The idea came while sorting through my book shelves, a virtual interactive book club for reflexologists, somewhere to share and enjoy our books together. An excuse to read some that I haven't looked at since 2004, when my reflexology journey began.

Book club became a welcome distraction from the stress and worry of the global pandemic and the ripple effect its having on our lives. Each week we met up online for live Q&A sessions with authors of reflexology books & related publications. The live sessions are available to watch in the Facebook group if you missed them first time around. They range from using reflexology from preconception to end of life care and sock fluff to science and many diverse topics within as well as business ideas for reflexology practice.  

Book club was about giving, and being part of our reflexology community, a safe place where we can feel held and supported. I'm extremely grateful to everyone who took part, authors who generously shared information of value with the group and members who were inspired to buy more books. (I bought six!)

In May, with no end to lockdown in sight I was persuaded to teach RLD online by reflexologists who wanted to make the most of the time as their RLD courses were postponed. Teaching online has exceeded all my expectations and feedback's been fantastic! A copy of my book is used to support the learning experience and the cost of the course reduced accordingly (print or kindle edition).

​It's a year since it was first published and to celebrate, I'm giving away a place on the RLD online course to say 'THANK YOU' everyone who ordered a copy and would like to find out more.  

Grateful thanks for all book club contributors 

Client 2, a young Mum with primary lymphoedema in her legs, who has RLD once a month to help relieve the discomfort of this. The warmer weather exacerbates the symptoms. On arrival she described her legs as, 'feels like they're going to pop' and she also had lower back pain. By the end of the session her jeans were visibly looser and the pain gone.  

Client 4, Another client I haven't seen for a while, has a busy lifestyle with high powered stressful job and a family. Over the years she's had reflexology for various stress related issues. Currently struggling with the menopause and an outbreak of eczema which had spread to her face. Years of experience has shown me that RLD is wonderful for all her symptoms. 

Client 5, was new to reflexology, had liposuction at the beginning if the week and was in a lot of pain from the procedure. The consultant advised some post-op MLD and while searching for a  practitioner found the RLD website and rang for more information. I explained that what I do is not MLD, discussed the research results and we both agreed its was worth trying as there's a lack of MLD therapists in the area. Without mentioning what might happen during the session, all the usual sensations were present,  tingling, flow, slight-almost pins & needles etc.
I believe in 'less-is-more' when it comes to trying to explain our work to clients. It was a remarkable session for both of us. 

​don't fully understand what they mean until you feel it yourself!) 
Each day the swelling rapidly became less and less and the release of pressure was such a joy to feel.
Less than 3 weeks after the operation, the operated leg, foot, ankle were back to their 'normal' size.  Bruising completely cleared. Surface wound healed. Me, getting around very well (with the use of crutches!) I even managed to get on a bus!
Of course, eventually the swelling would have come down, and the bruising would have disappeared, and my healing/mobility would have improved over time. Also, I am younger than the usual candidate for hip replacement (58yrs). 
I still have a way to go to heal completely. However, I truly believe that those 20 minute hand RLD sessions were (and continue to be) extremely beneficial in supporting my recovery.
Thank you Sally Kay!"

family, friends and colleagues have all commented on the difference in the wrist and shape of her arm. The swelling has reduced so much..... twice at annual check-up appointments at the lymphoedema clinic, smaller size compression garments have been needed. She continues to to wear the sleeve and does the daily SLD exercises. In this time she has also lost weight, and swears its the RLD. I suspect its a combination of more confidence, exercise, lifestyle changes and improvement in general feelings of wellbeing. 

At last weeks appointment, reflecting on how good she feels, we looked back at her original measurements, the whole arm, including wrist and hand was very swollen. The 3rd, 4th & 5th Distal segments are the stubborn area, and this is where most of the remaining swelling sits. Comparing the first measurements has inspired this blog entry, and I was surprised by how long its been since the last post! 
Absolutely amazed to see that the circumference of 6 of the 9 cylindrical segments were more than 3cm smaller!!! We were both speechless......

It has been, and continues to be an incredible year. ​Thank you everyone for being part of the RLD journey, its like a ride on a magic carpet! This year it too me and RLD to Toronto, Alaska and Seattle for  training and presenting at Reflexology Association of America RAA conference. Next year I look forward to taking RLD to Europe, Taiwan, Australia and New Zealand. 

Thank you to everyone who nominated me for awards from the International Council for Reflexologists ICR and Association of Reflexologists AoR, I am truly humbled by your support to be honoured in this way.  

The blue line on the graph shows how the swelling reduced during 6 treatments, these were weekly apart from between 2nd & 3rd treatments, due to Christmas etc. when there was a 3 week gap. 

Before RLD 1, the swollen arm was 29.9% bigger than the normal arm, and contained 561.68ml
After RLD 6, the swollen arm was 12.8% bigger than the normal arm, and contained 240.40ml

I still get so excited by the results!

Watch this space, I'm seeing her again, same time next week..........