Face Masks & Massage Update

Okay. So.

I’ve been trying for like a month to put together a full newsletter for you, but then stuff keeps changing and mask mandates are confusing, the State’s rules are confusing, and life is generally confusing. So, I spent the last couple of days doing some research and here is where we’re at:

Town of Orono:

The Town of Orono’s emergency mask mandate is still *technically* in effect. They are meeting on June 3 to discuss repealing it

State of Maine:

The State of Maine has “retired” the page with the reopening checklist for massage facilities. It now refers you to a page on general guidance and say they will be following CDC recommendations.

US CDC:

The CDC has absolutely no massage industry-specific guidelines that I can find, though many pages hadn’t been updated in months. In an American Hospital Associate article, I read that the CDC still requires masks in healthcare settings.

A recently updated page, Key Things To Know, states that they are still working to understand how well the vaccine prevents you from spreading the virus, though early data show that vaccines help keep people with no symptoms from spreading COVID-19. They are still learning, including how effective the vaccines are against variants.

Massage Industry Experts:

I got probably the most useful, but still sort of nebulous information from Ruth Werner, a massage pathology expert in a blog post she wrote, What the CDC’s New Mask Recommendations Mean for Massage Therapists. It aligns with what I have been thinking the last couple of weeks.

What Does It All Mean?

For right now, I’m going to go with please keep wearing masks for your massage appointment. At the moment, you technically still need to wear masks in the building, based on Orono’s rules. Once that is repealed, it is okay for vaccinated clients to come into the office without a mask. You will still need to wear one at least when laying face up on the table.

Plan to wear a mask for at least part of your massage appointment through June, even if you are vaccinated. I will reassess at the end of the month. This could change if we have a surge or a dramatic drop in COVID cases.

Watch for updates of the various COVID-related policies on the website, bear with me as I sort all that out.

Stay tuned for a more exciting newsletter with information about new add-ons and other information!

Stay Well,
Tricia

Massage After COVID-19

This is a serious topic, friends. If you want to schedule a massage after you have had COVID-19, you absolutely HAVE to let your massage therapist know that you have had the virus. It could literally mean life or death.

Ideally, you need to let them know well before your appointment date. You need time to connect to discuss how serious your case was. It may also be necessary for you to reach out to your healthcare team for feedback. The best plan is to talk to them before you make an appointment.

Why Worry About Massage After COVID-19?

The biggest concern is the risk of blood clots associated with COVID-19. While blood clots have primarily been seen in patients hospitalized with severe cases, there are still a lot of unknowns. Autopsies of patients who have died from COVID often show severe clotting, which contributed to multiple organ failure and death. You can read an interview about COVID-19 and clotting issues written by a massage pathology eductator here.

Massage Gets the Blood Moving

One of the benefits of massage is that it improves the flow of blood through your muscles and organs. A massage stroke presses down on your muscles, stretching and warming them. Those muscles have blood vessels supplying them, and that same motion pushes the blood in the direction of the stroke.

Maybe you noticed that these strokes are often deliberately pushing blood towards your heart. Once there, it travels to the lungs for fresh oxygen, and then back through your organs and muscles again. Because of this, it is possible to dislodge a clot and send it traveling through you body to create big problems.

What Does My Massage Therapist Need to Know?

Your massage therapist will want to discuss the severity of your COVID symptoms, how long you were ill, and whether or not you were hospitalized. Even if we’re not talking about massage after COVID-19, it’s important to know if you’ve had a history of clotting issues. People with a serious history of clots will need to discuss the risks of circulatory massage with their doctor.

You may have noticed they keep asking you about your ability to exercise and increase your heart rate/respiratory rate. They’ll want to know if you’ve had any new or unusual muscle aches or pain. It’s also important to know if you have seen any unexplained marks, rashes, bumps, or other lesions on your skin. These are all screening questions to help rule out blood clots.

So please, don’t be embarrassed, don’t brush it off. Let your massage therapist know and answer their questions honestly. They are trying to keep you safe!

COVID Exposure: How Close Is Too Close?

COVID exposure: How close is too close when it comes to massage risk?

COVID-19 is creeping in around the edges, friends, I’ve had to discuss with a few clients what is “too close” when it comes to COVID exposure.

How few people between you and a positive COVID test is too few? Our faces are pretty close to each other when I work on your neck and shoulders, even with a face mask and shield. 

What if your spouse has a coworker test positive? Is spending time with a person outside who was exposed via their child’s school too close? These situations have presented themselves recently, and the clients and I agreed to err on the side of caution. 

COVID exposure: how close is too close when it comes to massage risk?

At this time, if someone who lives with you is exposed at work or elsewhere, or if you are notified of a risk of exposure, please cancel your appointment. Within a few days, you’ll know if the people between you and the positive individual have tested negative, or shown signs of illness, or you can get yourself tested (find a testing site near you). Then, we can discuss getting you rescheduled. 

If you aren’t sure about what you should do, please feel free to contact me to discuss. As I’m often in with clients during the day, the best way to reach me is via email or text. I can quickly respond to you between appointments and disinfecting.

As always, if you’re not feeling well, definitely reschedule. You can review symptoms and my COVID-19 policies here. Unsure if getting a massage is safe for you? Read more about my High-Risk Client Policy here.

Many of you worry about my losing income/business, and you are awesome. However, I would rather reschedule one appointment than risk making a dozen clients sick and closing for weeks. Thank you for continuing to be understanding and helping me keep massaging during this pandemic.

Massage In A Time of COVID: Week 7

Holy $#*! It’s August

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Welcome to massage in a time of COVID week 7. As it works out for most of these newsletters, I started this one has a one month update. Then, life got in the way and it’s now something more like a month and a half-ish update. Things are still going okay, everyone coming in has been fantastic about wearing masks and being patient and understanding. I range anywhere from “This is good, we got this!” to “OH MY GOD WHAT AM I DOING?!” but as Dory says “Just keep swimming!”

I’ve settled into the cleaning and disinfection routine pretty well. It takes about 20 minutes to get everything wiped down. Then, it needs to air dry for 10 minutes or so before I put linens back on the table in preparation for the next appointment. I found I have to set an alarm reminder or I might forget to put the sheets on!

A few things that have been tweaked as time progresses:

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  • I now have a card with a date range to give you that reminds you to contact me if you learn about exposure to COVID-19 or test positive.
  • MassageBook should automatically send you a request to update your intake form the day before your appointment. I’m double-checking that you’ve updated that instead of emailing or texting a check-in.
  • Please wait 14 days to schedule if you have traveled out of the state.
  • Please wait 14 days to schedule if you have had visitors from out of state that you haven’t been able to socially distance from.
  • There’s a written policy for COVID-19 exposure on my website.

University of Maine Students Returning to Orono:

  • If you are a regular client, but just returning to Orono for classes, please wait 2-3 weeks before scheduling a massage.
  • Regular clients employed at the university: I’ve talked to many of you about exposure risks, testing, etc. I trust you to be aware of your risks, and I believe most of you are getting tested regularly. Just let me know how things are going.

Meanwhile, I’ve opened up the schedule through October. Just keep in mind that there’s always a chance we may have to cancel your appointment if cases in Orono increase too much or (God I hope not) I get exposed.

Wash your hands, wear a mask, and stay negative, my friends.

Massage in a Time of COVID: Week 2

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This past week, I saw 15 massage clients. That may have been a few too many appointments during COVID times – because I was pretty much dead by the end of the week. Mostly because Thursday and Friday both had four appointments each. By the time you spend half an hour cleaning and resetting the room after each one, it makes for a very. long. day. Everyone was still awesome and helpful and I truly appreciate that! Most everyone remembered their masks and got their health information filled out ahead of time, which definitely makes life a little easier. 

WHAT I LEARNED THIS WEEK

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I learned that between “COVID Brain” and generally having to re-learn and change my routine, I’m still kind of scattered and forgetful. It’s equal parts hilarious and embarassing. I’ve messed up a couple of appointment lengths, ending a little too early, which of course I didn’t charge for the part I forgot. The people I messed up with were gracious and understanding.

Since I have to let the disinfectant air dry for 10 minutes, my most frequent thing is forgetting to go back in and put the sheets on the table. I *mostly* catch that before you arrive, but a couple of you had to watch me put the sheets on (insert facepalm here). I’ve started setting a reminder alarm so I’ll get them on BEFORE your appointment. 

Did you know there is an art form to disinfecting a yoga ball? You do now!  Hold it between your feet, spray and wipe one hemisphere. Rotate and repeat on the second hemisphere! Or chase it across the room, a less efficient option.

THINGS I AM CHANGING A LITTLE

INTAKE PROCESS: I now have a second laminated form that I go over with you when you arrive. I’m asking the same COVID-19 symptoms & exposure questions plus a few that are screening you for potential clotting risks. The good news is, it seems like clots are potentially less of a risk for those who have had mild to moderate cases of COVID-19, so some of my anxiety around that is lessened a little.

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HEALTH INTAKE FORM: Everyone will need to go in and review/update their intake form on MassageBook prior to each appointment. If you’re coming in weekly and we’ve been in contact, then we can do it bi-weekly. Other than that, I want to keep an ongoing track of any health changes and also make sure you’re looking at the COVID-19 policies each time. 

30 MINUTE MASSAGES: I’ve decided to stop offering 30-minute massages for the time being. It takes at least a half an hour to clean, disinfect and reset the room between appointments, and I feel like a half-hour of massage followed by 30-40 minutes of cleaning and prep just doesn’t make sense at this time. If you have a gift certificate for a 30-minute massage or study break, you can apply it towards an hour massage. If you’re truly in pain and can’t afford an hour, contact me and we’ll talk.

SCHEDULE YOUR MASSAGE TODAY!

I have opened up online booking for all existing clients (this means if you have been in within the last year) through the end of August. I encourage you to book online. It’s still the fastest way to get your appointment. Playing text/email/message tag takes forever, more so now than before.

Meanwhile, wash your hands & stay negative!

THANK YOU AGAIN!

Massage & COVID-19 Risks: Close Contact

I’d like to start talking a little bit more about the risks of massage during COVID-19 so that you know what you’re getting into if you decide to come in for an appointment. To start with, let’s look at one of the biggest factors… close contact.

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We all have heard from the start of the pandemic… keep at least six feet away from each other – whether it was with or without masks. Now, the popular scientific community opinion is to wear a mask, but still stay six feet apart. I don’t know if you’ve had a massage recently… but we’re not six feet apart.

Working Around Close Contact Rules

So, I’m asking everyone to wear a mask and stay as far from me as my office space will allow until you get on the table. At this point, you’re still keeping a mask on, or are face down with the pillowcase acting as a mask. However, even though I have on an apron, mask, and face shield, we are nowhere near six feet apart. Sorry, but my arms just aren’t that long.

I realized how fleeting the protection is from the face masks and shield when I feel a puff of breath from a client. That means that somehow “vapors” from that client are still reaching me, and mine are probably reaching them. Granted, since we’re both wearing masks, the risk is greatly decreased, but as I like to keep saying THERE ARE NO GUARANTEES.

Well Great, Now What?

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To start with, make sure the mask you’re wearing to your massage appointment fits well. There shouldn’t be big gaps on either side of your nose, blowing breath upwards. Nor should there be gaps pooching out at the sides, blowing breath out to the sides. (You might have noticed, I’m kind of all over the place during a massage.)

I’m wearing a face shield, which helps, but I think I’m going to look into one that actually fits the opposite way of traditional face shields. I like to call it the “half a doggy cone of shame”. The traditional top-down shields still leave space below for your breath to float up and mine to flow down, which is the part that is really close to you, especially when I’m working on your neck (and I don’t think you want me to skip working on your neck).

Think Outside the Appointment

Consider these risks and ask yourself if you are healthy enough to risk the chance of exposure. But also, think about beyond just you and me. I’m doing my best to stay healthy and not become exposed to COVID-19.

BUT.

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What if I am? What if you get that call from me that says I had a client who tested positive for COVID-19? Do you feel like being in close contact with someone is worth the risk? Is there someone that you don’t want to bring that risk home to? It’s a lot to think about, I know. But it’s important to consider all the risks when deciding to schedule a massage during this pandemic.

As always, I appreciate your thoughtfulness and patience. Stay negative.

Massage in a Time of COVID: Week 1

How The First Week Went

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This past week, I saw 8 massage appointments. It was mostly friends and a couple of people who had something like a million appointments canceled over the duration of the shutdown. (I may be exaggerating a tad). I want to THANK BIG TIME everyone who came in!

It was inspiring! People filled out the requested health forms without complaint, arrived wearing a mask, and let me check their temp with my no-touch thermometer on arrival. Some of you were so intent on being helpful, you tried hard to touch as few things as possible while you were there. You hand sanitized and kept your mask on for your massage, and I am so, so, grateful. It really helped make a stressful, scary time much more manageable.

WHAT I LEARNED THIS WEEK

I learned that yeah, for the time being, I’m going to need to leave the one hour space between appointments. It takes me 20-30 minutes to wipe everything down, let it air dry, and then get set up for the next appointment.

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I learned/realized that one of the disinfectants I bought is a cleaner AND disinfectant, so I can save a little time using that. At the end of the day, I may use the separate cleaner and disinfectant just to give everything a good scrub and then let it air out until the next day.

I also learned that having people just request appointments was a big pain in the butt. So, you can schedule online like normal now!

THINGS I AM CHANGING A LITTLE

After my first day of trying to use the new Hands Heal EHR to take the appointment notes, I realized I hated it. So, literally the only thing it was doing for me was the fancy COVID-19 screening form. Nevermind that, then.

I’ve gone in and updated the intake form on MassageBook, it does have some symptoms screening questions, and I have added some information on the waiver page reminding you of policies and risks. I will be asking everyone to update that form before every appointment, even if you’re coming in more than once a month.

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Today I’m working on a more thorough screening process for when you arrive for your appointment. I’ll be making a second laminated form to the one that I use for taking your notes that will be specific to COVID-19. There are some risk factors that are really hard to predict, particularly clotting risks. (Even if you don’t think you’ve had COVID) So, I’ll be asking you some specific questions to hopefully rule out those risks. I think I will probably also write a specific blog post about it if I can distill it down into bite-size morsels.

SCHEDULE YOUR MASSAGE TODAY!

I have opened up online booking for all existing clients. Right now the schedule is open through the first two weeks in August. I encourage you to book online. It’s honestly the fastest way to get your appointment. Playing text/email/message tag takes forever, more so now than before.

Be sure to review the COVID-19 Policies and High-Risk Client Policy before scheduling. As always, if you have any questions, feel free to contact me.

Meanwhile, wash your hands & stay negative!

THANK YOU AGAIN!

Safety Preparations

Let me preface this post with my recurring mantra… THERE ARE NO GUARANTEES. Meanwhile, I take your safety seriously, and will my best to make your massage experience as safe as possible. I just ask you do take the proper precautions on your end, so hopefully, we can all stay safe and healthy.

In the meantime, I wanted to give you a more thorough rundown of some of the stuff I’ve been doing around the office. These steps are based on a combination of guidelines from FSMTB, AMBP, the State of Maine, and other resources.


Personal Prevention

Face Coverings/PPE:

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  • Everyone needs to wear a face mask.
  • If you don’t have a mask, I have one for you.
  • I will be wearing a mask and face shield during your massage, this includes a fresh mask for each client and a sanitized face shield.
  • A fresh apron is used for each session.
  • I will wear nitrile (latex-free) gloves if one or both of us have any open cuts/scrapes, or broken skin.

Hand Sanitizer: Bottles of hand sanitizer are available upon entrance to the office, as well as in the massage room.


In the Massage Room

The Massage Table: The table has a protective cover over the padding & table warmer that can be disinfected. It makes the table a little bit slippery, but you get to keep all the comfy padding. I disinfect all the hard surfaces of the table after each appointment.

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Air Flow & Purification: The windows do not open. So, there is an air purifier in the office with HEPA filtration and UV sanitation that is in constant use throughout the day. A fan will be used to get air moving out of the office between appointments.


General Stuff

Linen Storage: The sheets and other linens are in closed storage areas.

Dirty Laundry: After each session, the laundry is placed in a closed, step-lid container.

Trash Cans: The trash cans are now all closed, step-lid cans to help contain germs.

Table Covers: The cloth table coverings have protective vinyl over them for easier cleaning & disinfecting.

Disinfecting: I use a checklist to help thoroughly clean & disinfect every area of the office between appointments.

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How I’m Doing: A dry erase board in the office has my temperature (morning and afternoon) and if I have any symptoms, as well as the number of contacts & places I’ve visited in the last 5 days. I’m also willing to use the touch-free thermometer to check my temperature on your arrival if you wish.

General Clutter: This part hurts my heart because I love all my gifts from clients and shiny doo-dads, but I have cut down on the number of things around the office that might collect dust and germs.

Self-Serve Items: The self-service baskets of mints, chocolates, and tea have been put away. The candy will still be out in small amounts for your sugar rush! Water will be available.


One more time: THERE ARE NO GUARANTEES. If you are coming in for a massage, I am trusting you to be honest with me about your health and your risks, as well as your potential exposure to COVID-19. Safety is a two-way street right now. See the COVID-19 Policies section for more details, and be sure to check out the High-Risk Clients section to make sure you’re not missing an important risk.

Thank you for your continued patience, cheerleading, and moral support!

Back to Massages: The Plan (So Far)

I’m so excited that you’re so excited to get back to getting massages! Here’s a little information to help keep things calm:

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  • I have not picked an opening date yet. Don’t worry. It’ll come to me eventually, I’m considering a lot of different things (including Maine COVID-19 data) before I start scheduling.
  • I’m going to start with those of you I had to cancel three or more times over the last few months. I know a few of you have elected to wait a little longer, and that’s fine! Please take any health risks you may have into consideration.
  • I will reach out to you to schedule. I’m not ready to open up online booking just yet. It may be a little fussy, to begin with, but once we get going, I’ll open up online booking!
  • Since I’m going to start with an hour between appointments to clean and reset, this means probably only 3-4 appointments a day, 2 on Sundays. Once I get a feel for the cleaning routine, I may be able to shorten the time between appointments again.
  • If you have pre-scheduled appointments into late July & August, chances are we will keep them. I may just need to ask you to shift the time a little to allow for cleaning.
  • Please be patient and we’ll get back to massages again soon ❤️
  • Feel free to contact me if you have any other questions!

Massage Changes in a Time of Changes

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Okay friends. We’re getting serious now, and I need you to know some things. Massage in the age of COVID-19 is not going to be the same as it was before we closed, changes are afoot. Things are going to be pretty different, and probably a pain in everyone’s butt.

But here’s the thing… I’m adjusting my mindset to think about these changes as adding to the existing culture of care at Birch Tree Wellness. This is about taking care of you. It’s about doing what I can to help you with your pain and stress, PLUS having you arrive healthy and leave healthier.

There Are No Guarantees

In lieu of a cure, vaccine, or other intervention for COVID-19, there is no way right now to reopen a massage practice without changes & protocols to protect all of us. Until that changes, there is no guarantee that that we will come away from our interactions unscathed. As I write this, COVID-19 cases in Orono & Old Town are estimated at 1-5 probable/confirmed cases.  In Bangor, 43 probable/confirmed cases. In Penobscot County, 101 confirmed, 2 deaths. We’ve been pretty lucky so far, but it’s far from over.

What I’ve Been up to Recently

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My previous newsletters/posts have been mostly about the supplies that I’ve been putting together in order to provide a safer massage experience. But let me tell you, that was just the tip of the iceberg. I’ve climbed out of my gardening cocoon and really started diving into all of the information out there.

I have taken two online continuing education courses outlining all that is entailed in creating a safer (note: not SAFE, just SAFER) massage practice. To give you an idea of what we’re working with here, here are some of the main sources I am referencing. I’ve also been reading numerous articles & books.

PPP: Protocols & Procedures in Progress

Information overload, right? Tell me about it! In a nutshell, this is what I’m doing to ensure your safety (and my own) while continuing to deliver the pain & stress relief you need. What I’m asking of all of you is to remember, I’m not doing it to be a pain in your ass.

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We’re all in this together. I love you all, and I will be beyond heartbroken if any one of you contracts COVID-19 as a result of your visit to my office. So, please… brace yourselves for a new norm for a time. It’s not forever, it’s just for now. Here are a few of the protocols I’m working to put in place:

Before Your Appointment

  • Update your online health intake form
  • Health check in 3-7 days before your appointment
  • Health check in 24-48 hours before your appointment
  • Wait in your car or outside until 5-10 minutes before your appointment

At the Office

  • Mandatory face masks worn for the entire time you’re in the office
  • Hand sanitizer will be made available for use upon arrival and any time you need it during your appointment
  • COVID-19 symptom screen upon arrival for appointment
    • If you have ANY symptoms, or your temperature is over 100.4°, we will need to reschedule your appointment
  • Signed informed consent about the risks associated with COVID-19

On My End

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  • I will be wearing a mask during your entire appointment
  • Daily self-screening. I will have a white board posted with:
    • My morning & afternoon temperature
    • If I have any COVID-19 symptoms (even if it’s *just an allergy cough)
    • How many people I have been in contact with, in the last 5-7 days
  • Protocols for what to do if I or a client have been exposed to or tested positive for COVID-19
  • Closing protocol in the event of COVID-19 exposure
  • Cleaning checklist for after every appointment

I’m pretty sure there’s more, but I think you get the idea! As the new policies are written, you’ll find them on my Policies Page. I know you’re probably freaking out about the face masks. There’s a way I can set up my face cradle so that you don’t have to wear the face mask when you’re face down. BUT you need to wear it the rest of the time. Also, yes, I will be using a touchless thermometer to check your temperature. Keep that in mind if you’re biking, walking, or running to the office.

I Repeat: We’re All In This Together

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I know this is a lot of stuff. That’s why I wanted to get it out now, while I work on my end to make it all happen. On your end, it’s mostly just being patient with me, being willing to jump through a few hoops, and being willing to keep that mask on. Be honest with me about your health and your risk of exposure to COVID-19.

I also need you to weigh the risks for yourself before you schedule. Watch the numbers of cases in our community. Think about your own health risk or the risks to those you are caring for. As I said in the beginning, there are no guarantees, we can just do the best we can to try to be safe, and maybe get a little massage in the process.

I still don’t have a firm date that I’ll begin scheduling appointments. I’ll be starting with many of you I had to cancel over the last several months. Stay tuned for more details, information, and to get an idea of what the appointment schedule will be like. Feel free to contact me if you have any questions.

Stay safe. Wash your hands. Be good.