CE INSTITUTE LLC BLOG

by Selena Belisle, Founder/Instructor, CE Institute LLC 

One of my favorite goats named Creamy has developed caprine arthritis encephalitis which is also known as CAE. Creamy was delivered to us with an original herd of approximately 100 goats.  She is of unknown age but is likely over five years old, and she has a lovely cream colored coat which contributed to her name.

We were told that CAE did not exist within the herd when it was acquired, despite there appearing to be visual scars on the animals that indicated otherwise. CAE is a devastating disease which usually results in culling the herd, and termination of infected animals.

Creamy has been with us for a couple years without any signs of CAE. Then, during her last pregnancy and delivery, things went awry.  She was pregnant with two calves which is fairly normal for a goat. She delivered one calf, and then didn't deliver the second calf until five days later.

CAE Symptoms Develop

Immediately after delivery, Creamy started showing significant symptoms of CAE. They were gradual and became worse with each day, until she was walking on three legs only within about 2-weeks. She was separated from the herd, kept dry with a sawdust bed, provided anti-inflammatories and other medicine to no avail. 

Her right front knee was excessively swollen, and I thought I may be able to manually manipulate the fluid away from the knee joint, but despite Creamy being an incredibly patient and mild mannered goat, she wouldn't allow me to touch her knee for very light manual lymphatic drainage techniques.  At one point, during her medical care, her knee was shaved which provided better access to directly manipulate the skin with MLD, but unfortunately she was not having it, and I did not press the matter to avoid distressing the animal.

Creamy's Weight Loss

It took about 2-weeks of non weight-bearing on Creamy's right front leg before her right shoulder atrophied. The atrophy was slight but clear between her right and left shoulder. Creamy also lost weight which is normal for goats after delivering their calves, so it's unknown if Creamy's weight loss was from her delivery or CAE or likely both.

Goat with CAE Gets Even Dirtier

Like all farm animals, goats can be fairly dirty and Creamy was no exception. Unfortunately this situation worsened when another animal peed on her which was weird given she was fairly isolated.  I found half her head and a rear back quarter soaked in urine.  It might have been possible that she hobbled to one of the horse stalls and laid down in the urine too.  Unfortunately we'll never know how it happened, but it was important for me to remove it and get her clean.

Making the Decision to Provide a Caprine Spa Session to an Ill Goat

I asked Creamy's more experienced care givers if it would be acceptable to wash Creamy and we were all at a loss. This was a no win situation where the animal's coat would have either remained soaked in urine for a good amount of time, or risked health issues from being wet in the cold. 

We ultimately agreed that I if I worked quickly to clean Creamy and dry her, it could be successful.  Luckily, I was able to clean Creamy in local spots only with multiple, inexpensive disposable washcloths within about 30-minutes, then quickly dry her within another half hour, so her health was not compromised with her quick and efficient, one-hour caprine spa session.

Goat Spa Session

Our barn is in northern Vermont where it is very cold in the Winter, so washing an ill animal during sub-zero temperatures (end of February) in a moderately heated barn was undesirable. Nevertheless, I wanted this goat to feel clean while ill, so I did it.  I purchased:

From Dollar Tree at $1.25 each:

• Disposable washcloths
• Extra large puppy pads
• Animal brush

From Walmart:

• Heated radiator ($50)
• Hair dryer ($10)
• Set of towels ($10)
• Oatmeal gentle dog wash ($5) 

Creamy received similar to what most ICU patients would receive as a sponge bath with the following steps:

• I collect a clean pail of tepid water
• I dunked an individual disposable washcloth into the tepid water
• I rinsed Creamy with the disposable washcloth
• I repeated this process over and over with clean cloths, until all urine was removed from her coat

I did not use the oatmeal cleanser on Creamy. The disposable washcloths seemed to have some type of gentle cleanser on them which satisfied the cleansing and rinsing process with individual cloths.

Once Creamy was clean in the two areas that were soiled of urine, I then used a hair dryer to dry the areas that were cleaned.  It was important to get Creamy as dry as possible to prevent pneumonia or other illness in the dead of Winter with this severely compromised goat.

Spa Session Tired Goat with CAE

Creamy was fairly tired when I finished her mini-spa session. She was standing on three legs the entire time, leaning into me.  I also believe the hair dryer noise was likely unnerving to her, but she accepted it without much issue.  It's almost like she was aware that it was necessary, and the warm heat of the hair dryer might have even felt good to her.  It's hard to say given the goats cannot speak and you have to take their physical cues as communication.

 A Satisfied Clean Goat

Creamy jumped up onto her three legs to greet me the next time I entered the barn after her spa session.  It's like she wanted to show me that she was doing much better.  Please keep in mind that Creamy has been receiving round-the-clock medical care from her care givers, so I will never know if her improvement was from her spa session or medical care or both.  But there was no mistaking that she was happy to see me again, and excited to get another rub down.

Eating During Massage

Creamy is a hearty goat and she continued to eat despite being ill.  Sometimes when I went to the barn to massage Creamy, she would eat the hay that was left for her. Prior to her spa session, she would be lying down and she would not get up when I entered which was sad to see, given during previous visits without CAE, Creamy would patiently follow me around with the rest of the herd until it was her turn for attention.  Some of the goats demanded immediate and nonstop attention, but Creamy was patient and different. Very loveable.  I also do not know if Creamy was eating before I arrived for her rub down, or if she started eating while I massage her, but she did eat during her massage and she seemed to enjoy it.

Creamy's Rub Down

Massaging Creamy was simple bodywork, and similar to what she's been receiving from me for two years now.  I applied a circular effleurage/friction technique. The goat herd seems to favor this style of massage over anything else such as traditional straight effleurage or petrissage. 

I usually wear either vinyl or nitrile gloves when physically working with the goat herd. This herd has the common orf virus which can be transmissible to humans; however, the herd did not have any active outbreaks during this Winter 2022 visit.

The goats favorite circular therapy technique is bilateral alternating massage with both hands on their lower mandible or hips. The more mild manner goats enjoy their mandible massaged, and all of the goats enjoy the alternating bilateral circulatory massage of their hips.  They'll either stay in place until you stop, or start leaning into you for more pressure. Then when you do stop, they'll usually follow you around for more.

Important Disclosure

It is important to note that I am NOT an expert in animal care nor caprine livestock, despite being a born and raised Vermonter. I have bottle fed over 100 calves from this goat herd, and massaged them all.  But, my real health care experience is massage therapy practice for over three decades, and I have provided spa services for the past 27 years - for humans (although some humans have equally behaved like animals if not worse).  Today, I teach CE hours for the massage, nursing and cosmetology fields as an expert instructor of multiple modalities for human health and cosmetology care. 

I am often asked about bodywork techniques including MLD for animals, especially given equestrian massage has been a nonstop growing industry for years. While I have multiple horses available to work with including beautiful Clydesdales, I prefer to work most with the goat herd and their kids. These goats are the most affectionate, loving animals and a true pleasure to work on.

To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

#caprinemassage #goatmassage #goatmld #goatspasession #goatcleaning #cae

Ablative lasers vaporize the top layers of damaged skin. They are usually more aggressive than nonablative lasers that leave the skin intact.

An article in the Seminars in Plastic Surgery reports:  “Although ablative lasers result in far more down time and a more difficult recovery process, they remain the lasers that produce the most dramatic outcomes.”[i]

Skin must be whole and intact to provide most hands-on bodywork, including MLD.  

Because ablative laser treatment destroys the outer layer of skin, bodywork and all hands-on services including massage and MLD are contraindicated until the skin has healed.

Practicing MLD is a wonderful nonpharmacological benefit for clients  who have pain or swelling; however, practitioners should be thoroughly trained in all treatment precautions and contraindications prior to practicing.  To learn more, please register for manual lymphatic drainage training with us at:  https://ceinstitute.com/collections/lymphatics

#orthopedics #orthopedicsurgery #MLD #manuallymphaticdrainage #lymphaticdrainage #bodywork #bodyworker #massage #massagetherapist #mt #LMT #lymphedema #postsurgical #cosmeticsurgery #plasticsurgery #swelling #edema #chronicswelling #incisiondrainage #pressotherapy

[i] Preissig, Jason, et al. “Current Laser Resurfacing Technologies: A Review That Delves beneath the Surface.” Seminars in Plastic Surgery, Thieme Medical Publishers, Aug. 2012, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3580982/#:~:text=Ablative%20lasers%20vaporize%20tissue%20and,produce%20the%20most%20dramatic%20outcomes.

Manual lymphatic drainage (MLD) is used to reduce swelling, which can result in pain relief, increased range of motion, physical function restoration and more.  It is often performed post-surgery to help prevent secondary injury and increase healing times and outcomes.  The two most common post-surgical MLD treatment requests are for cosmetic and orthopedic surgeries.

MLD practitioners must have post-surgical MLD training when working with post-surgical clients.  They must also communicate with the surgeon to ascertain each MLD client's specific requirements for their post-surgical treatment and healing processes.  The following are some suggested questions a MLD practitioner can ask a surgeon when providing post-surgical MLD.

Practitioners can request this information in the form of a treatment prescription if desired.  It is always best to request treatment directions in writing:

1. Would an increase of circulation be harmful to this client?
2. When can I start MLD appointments for this client?
3. Does the client have any surgical drains, implants, injectables or joint replacements?
4. Does the client have any areas I should not touch? If yes, where?
5. Can I work around the client’s stitches and if yes, how far of a distance should be maintained between my hand and the client‘s stitches (Practitioners can add: I will use only the weight of my hand to manipulate the skin to create drainage).
6. Do you want me to wear gloves when working on the client’s skin, or are well sanitized hands acceptable? Follow-up: If I must wear gloves, when would it be acceptable to use well sanitized bare hands?
7. Is there anything that could happen with the client where or when I should not administer MLD? (Practitioner can add: I do not work with active bleeding, fevers or any sign of infection).
8. How long of an appointment and how frequently can MLD be provided?
9. Are there any special directions that should be followed or considerations to be made?
10. Practitioners should add any other questions that seem appropriate and useful.

Practicing MLD is a wonderful nonpharmacological benefit for clients seeking a reduction of swelling and pain after surgical procedures.  To learn more, please register for training with us at:  https://ceinstitute.com/collections/lymphatics

 #orthopedics #orthopedicsurgery #MLD #manuallymphaticdrainage #lymphaticdrainage #bodywork #bodyworker #massage #massagetherapist #mt #LMT #lymphedema #postsurgical #cosmeticsurgery #plasticsurgery #swelling #edema #chronicswelling #incisiondrainage #pressotherapy

For years, we have taught our MLD stretching, stroking and v-flushing strokes to be applied in retrograde, from distal to proximal on the arms and legs.  Some of our students questioned this because of training they received elsewhere, where they were trained that taught all MLD strokes are to be applied from proximal to distal which is different than how we teach at CE Institute LLC. 

We allow students to apply MLD strokes in whichever direction they feel is appropriate, whether it be distal to proximal or proximal to distal, as long as they are working towards the regional nodes of the area.  And we will continue our distal to proximal MLD strokes because of the recent published science that supports this successful retrograde practice:

In the Plastic and Reconstructive Surgery Publishing: September 2021 - Volume 148 - Issue 3 - p 425e-436e doi: 10.1097/PRS.0000000000008252, there was an article published called:  Retrograde Manual Lymphatic Drainage following Vascularized Lymph Node Transfer to Distal Recipient Sites for Extremity Lymphedema: A Retrospective Study and Literature Review

In this article, they stated that after a vascularized node transfer procedure:  "standard retrograde manual lymphatic drainage significantly improved circumferential reduction rates and Lymphedema-Specific Quality-of-Life Questionnaire scores."

We have found this and so much more research to build supportsour MLD teachings and practice.  We said we'd post updates for our training on our social media whenever possible, as new information develops.  This information was only published a couple months ago, and we hope you enjoy the knowledge that working distally to proximally with MLD strokes can be effective!  To learn about this and more, please register for one of our MLD classes at:  https://ceinstitute.com/collections/lymphatics

Past CE Institute LLC MLD students!  Make sure you are following us on social media and check your emails for refresher classes and dates that are periodically sent, when available!

#MLD #manuallymphaticdrainage #lymphaticdrainage #bodywork #bodyworker #massage #massagetherapist #mt #LMT #lymphedema #postsurgical #cosmeticsurgery #plasticsurgery #swelling #edema #chronicswelling #incisiondrainage #pressotherapy

Manual ymphatic drainage practice has branched into many different types of treatments, some are effective and some not so much.

In this 12 1/2 minute video, we'll explain 5 different types of treatments that are commonly advertised as lymphatic drainage services, and provide some basic information about each treatment. The different types of treatments that we will quickly review are:

1. True Manual Lymphatic Drainage (MLD)
2. Lymphatic Massage
3. Incisional Drainage
4. Pressotherapy and Compression Garments
5. Machinery

For professional manual lymphatic drainage (MLD) training, please visit and register for class at: https://ceinstitute.com/collections/lymphatics

#incisiondrainage #pressotherapy #lymphgarments #mldmachine #MLD #manuallymphaticdrainage #lymphaticdrainage #bodywork #bodyworker #massage #massagetherapist #mt #LMT #lymphedema #postsurgical #cosmeticsurgery #plasticsurgery #swelling #edema #chronicswelling

Manual lymphatic drainage (MLD) does not provide one protocol to fit all scenarios.

There are three distinct type of manual lymphatic drainage appointments that cna be scheduled and practiced, including full body, local and hybrid MLD treatments.  Our manual lymphatic drainage full body training teaches all three of these MLD applications.

To learn more about MLD, please visit and register at: https://ceinstitute.com/collections/lymphatics

 #MLD #manuallymphaticdrainage #lymphaticdrainage #bodywork #bodyworker #massage #massagetherapist #mt #LMT #lymphedema #postsurgical #cosmeticsurgery #plasticsurgery #swelling #edema #chronicswelling #melanoma #skincancer #nasopharyngealcancer #facial #esthetics #cosmetology #esthetician #cosmetology #treatment #appointments #hybridservice

Clearing the terminus is a common way to start and finish an MLD appointment, whether the practitioner provides a full body, hybrid or localized session.

In this video below, watch where the lymphatic terminus is located and how to clear or pump the lymphatic terminus with your hands. For professional MLD training, please visit and register at: https://ceinstitute.com/collections/lymphatics

#terminus #lymphaticterminus #MLD #manuallymphaticdrainage #lymphaticdrainage #bodywork #bodyworker #massage #massagetherapist #mt #LMT #lymphedema #postsurgical #cosmeticsurgery #plasticsurgery #swelling #edema #chronicswelling

With the increase of plastic surgery, skin cancer and nasopharyngeal cancers, painful post-medical treatment facial swelling is increasing amongst the American population.  MLD (manual lymphatic drainage) facial services can relieve painful and sightly swelling and as such, is a service in growing demand.

The lymphatic system is partly responsible for removing excess fluid from human tissue to relieve swelling. It collects the excess fluid that the body’s cardiovascular veins cannot collect and leaves behind. As such, swelling is a normal result when the lymphatic system is damaged or when human tissue is traumatized.

HOW LYMPHATIC DRAINAGE WORKS
Lymphatic drainage primarily uses human touch over the epidermis to help relieve swelling. Drainage is achieved through specialized strokes and techniques that are applied in a specific order with professional training. In a lymphatic facial session, the practitioner uses their finger pads to apply these very fine movements around the collarbone, jawbone, through the neck, around the ears, and over the entire face during the service. Most lymphatic facial appointments can be completed within about 30 to 60 minutes.

LYMPHATIC DRAINAGE WITH ONCOLOGY
About twenty years ago, lymphatic facials were mostly provided for cancer patient survivors. Oncology treatments often include the surgical removal and/ or radiation of lymph nodes, which could subsequently cause swelling. And because we now have more cancer survivors living longer, we still see plenty of this work.

LYMPHATIC DRAINAGE FOR ESTHETIC AND COSMETIC PURPOSES
Today, many lymphatic facials treatments are practiced for cosmetic procedures, with most of those being in conjunction with plastic surgeries. Unfortunately, facelifts, blepharoplasty, nose jobs, and other aggressive esthetic enhancements can result in immediate swelling. While most clients will heal beautifully, it can be a slow and painful process. Lymphatic drainage treatments can help clients recover more quickly with less pain when excessive swelling is reduced.

Lymphatic facials can also be practiced daily after a facial operation when working directly with the surgeon. Surgeons who have recognized that increased circulation aids in the healing process have started prescribing lymphatic facials before a facial procedure so that the client can have a more effective healing process and result.

Brides, grooms, models, and anyone who wishes for a noninvasive improvement of facial features can also benefit from a lymphatic facial. A lymphatic drainage practitioner can temporarily ameliorate facial puffiness and the appearance of fine lines or wrinkles. It is a wonderful option for a client who might have partied a bit too hard the night before a big event and woke up the next day wondering what happened to their face.

There are other cosmetic bonuses to a lymphatic facial. It can temporarily reduce dark under eye circles and relieve sinus pressure. While these are not lymphatic facial goals, given their unreliable and limited results, they are common side effects that many clients will experience with this work.

LYMPHATIC DRAINAGE FOR MEDICAL PURPOSES
And although it is less common, other medical procedures such as dental implants, wisdom tooth removal, and jaw correction can all benefit from multiple lymphatic facial appointments. These procedures can cause extreme swelling in some clients who will do almost anything to relieve it.

The best part of a lymphatic facial is that it is a nonpharmacologic option to reduce swelling and pain, which is terrific for clients who are either allergic or unable to take opioids or NSAIDS. There are many medical facial procedures, including facial cancer skin grafting procedures where an adverse opioid client would find little relief – except for perhaps an ice pack or a lymphatic facial.

IN SUMMARY
I know this technique and information must sound wonderful for those who did not realize that they could achieve any of this by simply learning how to work with the lymphatic system. But I must reemphasize that lymphatic drainage results are only temporary. That is because we are working on living human tissue, which is continually fed by blood supply. So, while the client continues to live and breathe, their tissues will continue to receive blood supply, which can cause more potential swelling. The medical reason why someone would seek this quick result is because any immediate swelling reduction could accelerate the healing process. There are additional reasons why lymphatic drainage is beneficial despite the temporary results, which are thoroughly reviewed in a formal lymphatic drainage training class.

In this brief 8-minute video below, we'll review these details including some of the medical conditions that are seeking lymphatic facial services, aka MLD.

For comprehensive MLD training, please visit and register at: https://ceinstitute.com/collections/lymphatics

#MLD #manuallymphaticdrainage #lymphaticdrainage #bodywork #bodyworker #massage #massagetherapist #mt #LMT #lymphedema #postsurgical #cosmeticsurgery #plasticsurgery #swelling #edema #chronicswelling #melanoma #skincancer #nasopharyngealcancer #facial #esthetics #cosmetology #esthetician #cosmetology