CE INSTITUTE LLC BLOG

Anyone can join in the fight against human trafficking. The U.S. Department of State has published an online resource entitled “20 Ways You Can Help Fight Human Trafficking,” which outlines their recommended strategies:

Learn the indicators of human trafficking on the TIP Office’s website or by taking a training.  Human trafficking awareness training is available for individuals, businesses, first responders, law enforcement, educators, and federal employees, among others.

If you are in the United States and believe someone may be a victim of human trafficking, call the 24-hour National Human Trafficking Hotline  at 1-888-373-7888 or report an emergency to law enforcement by calling 911. Trafficking victims, whether or not U.S. citizens, are eligible for services and immigration assistance.

Be a conscientious and informed consumer. Find out more about who may have picked your tomatoes or made your clothes at ResponsibleSourcingTool.org , or check out the Department of Labor’s List of Goods Produced by Child Labor or Forced Labor. 

Encourage companies to take steps to prevent human trafficking in their supply chains and publish the information, including supplier or factory lists, for consumer awareness.

Volunteer and support anti-trafficking efforts in your community.

Meet with and/or write to your local, state, and federal elected officials  to let them know you care about combating human trafficking and ask what they are doing to address it.

Be well-informed. Set up a web alert to receive current human trafficking news. Also, check out CNN’s Freedom Project  for more stories on the different forms of human trafficking around the world.

Organize a fundraiser and donate the proceeds to an anti-trafficking organization .

Encourage your local schools or school district to include human trafficking in their curricula and to develop protocols for identifying and reporting a suspected case of human trafficking or responding to a potential victim.

Use your social media platforms to raise awareness about human trafficking, using the following hashtags: #endtrafficking, #freedomfirst.

Think about whether your workplace is trauma-informed and reach out to management or the Human Resources team to urge implementation of trauma-informed business practices.

Parents and Caregivers: Learn how human traffickers often target and recruit youth  and who to turn to for help in potentially dangerous situations. Host community conversations with parent teacher associations, law enforcement, schools, and community members regarding safeguarding children in your community.

Businesses: Provide jobs, internships, skills training, and other opportunities to trafficking survivors. 

Take steps to investigate and prevent trafficking in your supply chains by consulting the Responsible Sourcing Tool and Comply Chain to develop effective management systems to detect, prevent, and combat human trafficking.

Health Care Providers: Learn how to identify the indicators of human trafficking and assist victims. With assistance from local anti-trafficking organizations, extend low-cost or free services to human trafficking victims. Resources from the Department of Health and Human Services can be found on their website.

Human Trafficking Prevention Educational Materials

The Blue Campaign is a national public awareness campaign designed to educate the public, law enforcement, and other industry partners to recognize the indicators of human trafficking, and how to appropriately respond to possible cases. 

January 11, is National Human Trafficking Awareness Day, aka #WearBlueDay. Why blue? It’s the international color of human trafficking awareness.

The Blue Campaign provided training on identifying indicators of human trafficking and reporting suspected cases to over 23,000 individuals. 

Additionally, more than 280,000 people received training through Blue Lightning Initiative partnerships. Online Blue Campaign shipped more than 2.2 million pieces of outreach materials to requestors across the United States.

The Protocol Toolkit is a vital resource for healthcare institutions seeking to develop protocols to respond to human trafficking. This tool is designed for a variety of healthcare settings.

The PEARR Tool—Provide privacy, Educate, Ask, Respect, and Respond—is a robust, evidence-based framework designed to equip healthcare professionals with the skills to assess trafficking and interpersonal violence. 

PEARR fosters safe environments where patients feel empowered to share their experiences naturally, thereby opening doors to essential support. This trauma-informed, person-centered approach strengthens patient-provider relationships and enhances health, safety, and overall well-being.

Additional information about human trafficking, including resources available to trafficking victims can be found at various private, state and federal organizations.  To learn more about human trafficking, please visit:

 The Florida Department of Health (https://www.floridahealth.gov/programs-and-services/prevention/human-trafficking/index.html)

 The FBI (https://www.fbi.gov/investigate/violent-crime/human-trafficking)

The US Department of Homeland Security (https://www.dhs.gov/topics/human-trafficking)

If you think you are a victim of human trafficking, or have information regarding suspected human trafficking of a person in Florida, contact:  Florida Abuse Hotline 1-800-96-ABUSE (1-800-962-2873).

If you believe you have been a victim of trafficking or have information regarding suspected human trafficking of an adult anywhere in the U.S., or of a child outside Florida, call the National Human Trafficking Resource Center at 1-888-373-7888, text HELP to 233733 (BEFREE), or visit the National Human Trafficking Hotline online at:  https://humantraffickinghotline.org/en

Some healthcare providers might want to provide medical intervention during emergencies, but are afraid of doing so for liability reasons such as committing a medical error due to the emergency circumstances, such as when a person is unconscious and unable to provide dialog that led to their medical condition. Unless you're a trained emergency medical professional, it's possible that things could go wrong during an emergency, even if you had the proper training!

As such, it’s important to know that there is something called Good Samaritan Law, which can be different from state-to-state, and even internationally. On a recent airline flight, a flight attendant in international airspace loudly proclaimed the good samaritan law when no one volunteered to provide urgent medical care to an individual in need. The flight attendant proclaimed a caregiver cannot be held accountable for providing emergency medical assistance to that individual if any harm is done during a reasonable effort to provide care.

This Good Samaritan Law is important to know because in September 2025, Javier's restaurant in the Aria Resort & Casino and MGM Resort International was sued for wrongful death when no life saving medical care measures were attempted which they claim resulted in well-known actor Mike Heslin’s death. The wrongful death lawsuit claims:
Staff "stood by, took no immediate lifesaving action, and failed to initiate or support efforts that could have saved Michael’s life."

• Failed to perform CPR and did not retrieve an automated external defibrillator (AED).
• Failed to keep a stock and inventory of emergency response equipment, including, but not limited to, an automated external defibrillator (AED), or failed to train their staff on where the AEDs were stored.
• It was also stated that a woman allegedly attempted to perform CPR on Heslin at one point. However, the complaint alleged that an employee “forcefully interfered” and removed her from the scene.

If an attorney can sue waiters and a restaurant for failure to provide emergency medical assistance, can you imagine what they would do if a healthcare worker did not provide the same?

While it’s important to always work within your own licensed scope of practice, emergency life threatening situations when other more qualified healthcare providers are not available can become exceptions to what can be practiced. All healthcare providers should know basic emergency life saving measures. These include:

• Learn the heimlich maneuver for choking patients.
• Learn or update CPR certifications and install or locate the nearest AED device to your workplace, especially if you work on cardiovascularly compromised patients, which includes more vulnerable populations such amongst retirement villages or hospice care.
• It would also be important to learn of any medical equipment requirements that are required by law at your healthcare practice, and to ensure you are properly trained to use anything within your scope of practice that could provide life saving measures to anyone in need.

Florida's Good Samaritan Law provides immunity from civil liability for individuals who provide emergency assistance in good faith, protecting them from lawsuits if their actions are not grossly negligent or malicious, even if the aid doesn't succeed or causes minor harm. The law's purpose is to encourage people to help in emergencies without fear of legal repercussions for good-faith efforts or resulting medical errors.

A good samaritan law would generally apply to private citizens, although it could also extend to medical professionals acting in an emergency outside of their usual healthcare setting or scope of practice. 

Exceptions to the good samaritan law are, it should not to be regularly used to operate a medical facility without sufficient medical staff. For example, if patients are regularly coding in the medical facility, then there should be a doctor on staff and other trained medical professionals to run the codes. Consistently operating outside of one’s licensed scope under the good samaritan law is a manipulative abuse of practice and likely punishable by law when proper licensed healthcare is not being provided by medical staff.

Good samaritan laws usually do not protect individuals from liability if their actions involve gross negligence, manipulative conduct, complete recklessness, or malicious intent. 
An example of this would be cutting a person’s abdomen open on an airplane, without proper training, sanitation or reason to do so. There must be some good faith in your emergency medical care for the good samaritan law to apply.

To learn more about healthcare laws and medical errors prevention, please register for one of our courses at:  https://ceinstitute.com/collections/mandatory

Understanding human trafficking is crucial for several reasons. Recognition can save lives with the following purposes: 

• Being able to identify trafficking situations can lead to intervention.
• Effective support: Knowledge helps you support anti-trafficking efforts in your community.
• Awareness creates change: Raising awareness promotes societal change to combat this crime.

By learning about human trafficking as a healthcare worker, you contribute to creating a safer, more informed community that can help prevent exploitation and support survivors.  

Types of Human Trafficking

The United States Department of State recognizes two primary forms of trafficking in persons which are forced labor and sex trafficking. 

Forced Labor sometimes also referred to as labor trafficking, includes activities involved when a person uses force, fraud, or coercion to exploit the labor or services of another person. 

Sex trafficking encompasses the range of activities involved when a trafficker uses force, fraud, or coercion to compel another person to engage in a commercial sex act or causes a child (person under 18) to engage in a commercial sex act. Sex trafficking occurs in various settings, such as fake massage establishments, escort services, brothels, city streets, truck stops, strip clubs, hostess clubs, hotels, and motels.  

Perpetrators of human trafficking span all racial, ethnic, and gender demographics and are as diverse as survivors. Some use their privilege, wealth, and power as a means of control while others experience the same socio-economic oppression as their victims. 

Physical transportation is not required for this crime; a trafficker can control a victim mentally, compelling them to act on the trafficker’s behalf. According to the United Nations’ International Labour Organization, human traffickers victimize an estimated 27.6 million people worldwide.

77% of all victims are in forced labor

23% of all victims are in sex trafficking

57% are men and boys  

43% are women and girls

Within Sex Trafficking the Statistics are:

78% are women and girls and 22% are men and boys

92% are adults and 8% are children

Within forced labor the Statistics are:

33% are women and girls and 67% men and boys

73% are adults and 27% are children

The US Department of Homeland Security states Human trafficking has been reported in all 50 states and the District of Columbia, on Tribal land, and within U.S. territories. In FY 2024, DHS agencies helped over 800 human trafficking victims, provided protections to more than 24,000 people, and made 2,500+ related arrests. DHS supported 914 indictments, 405 convictions, and trained thousands in identifying and reporting human trafficking.   

Identifying Victims of Human Trafficking

There are several physical, behavioral and environmental indicators to consider.  These indicators may appear alone or in combination, and not all victims will show every sign.  

There is no single profile of a human trafficking victim as traffickers may target anyone who can earn them a profit regardless of age, sex, socioeconomic background, nationality, or immigration status. 

The following are examples of groups who may be at increased risk:

• Individuals who have experienced childhood abuse or neglect
• Children and youth involved in the foster care and juvenile justice systems
• People experiencing homelessness
• Individuals living in poverty
• Survivors of violence such as intimate partner or domestic violence
• Unaccompanied alien children
• Individuals displaced due to political instability, war, and disaster
• Individuals working in industries with fewer legal protections
•  Physical Indicators 
• Delayed care or an unexplained progression of an illness
• Evidence of severe workplace injuries, including prolonged and unprotected exposure to toxic chemicals or hazardous conditions
• History of multiple STIs/STDs, multiple pregnancies, or frequent requests for STI/STD testing, substance use and/or poor hygiene
• Physical signs of injury or mistreatment, including
• Long-term trauma
• Bruises in various stages of healing
• Signs of physical or sexual abuse
• Malnourishment
• Severe exhaustion
• Behavioral Indicators Include:
• Overly fearful or nervous behavior
• Use of scripted answers and/or stories about their condition
• Talk that minimizes abuse or the state of their injuries
• Being unwilling or hesitant to answer questions
• Being unaware of their location or the date/time
• Symptoms related to depression or PTSD
• Refusal of care or the need to leave despite medical advice

Environmental Indicators Include:

• An individual consistently speaks on behalf of the patient or requests to be present during examinations
• A person who may be in possession of the patient’s ID or money and/or insists on filling out all paperwork
• A person who lacks essential information about the patient’s medical history or identity, despite claiming to be related
• Reports of experiencing high-risk environmental factors, such as living at a workplace, sleeping in crowded conditions, or not having a fixed home address 

Traffickers’ methods of control

Not all control is physical – it can be mental as well.  Traffickers use force, fraud, and coercion to compel labor or services and commercial sex. Force may involve threats or acts of physical assault and sexual violence directed at the victim, others present, or family members, which makes the threat even more credible.

Controlling victims through fraud is often false promises – of education, a relationship, a specific job, good pay and days off, paying off a debt, sending money home to support the family, or generally of a new more secure life – but the reality is something different and inescapable.

A traffickers coercion with victims can be subtle or overt. Some common tactics include taking identity documents and threatening arrest and/or deportation, inhumane treatment, blackmail, shaming, isolation, addiction, and economic coercion, which can be taking advantage of existing debt or creating a debt.

To learn more about human trafficking prevention, please register for one of our courses at:  https://ceinstitute.com/collections/mandatory

Medical errors are defined as an unintended injury that happened to a patient as a result of their medical care.  An example of an unexpected error is exposing a client to an unknown and uncommon allergen.  The only way they would know they were allergic is by being exposed to it, and that could happen for the first time in your workplace. 

Applying an unscented cream or lotion to a client’s skin that contains an ingredient that the client is allergic to, such as parabens or other preservatives is an example of an unexpected medical error when the result is severe contact dermatitis or rash. It is not a common standard of care to test a client for allergens to preservatives prior to applying a lotion or cream to the skin, unless extreme allergens are disclosed during their health intake prior to medical intervention.

While that is an example of an unavoidable medical error, a similar medical error that would be considered AVOIDABLE is applying essential oil(s).  That’s because essential oils are commonly known to cause skin irritations or worse. In extremely rare cases of essential oil exposure, anaphylaxis could result, which could prove life threatening if a proper emergency medical response is not immediately and effectively provided. 

One study titled Art of Prevention: Essential Oils - Natural Products Not Necessarily Safe published Nov 2020 stated: “Approximately 80 essential oils have been shown to cause contact allergy…”1  Healthcare professionals utilizing essential oils should know that skin and allergic reactions are common with essential oil use. They should also learn which oils more commonly cause skin sensitization and irritations, plus how to perform a patch test prior to exposing a client to a new essential oil to avoid a negative result or medical error. 

Healthcare providers must know how to respond to potential common adverse effects of their medical care. In the case of essential oil allergic reactions, a practitioner could respond by pouring whole milk or unscented host oil over the exposed area. This would show that a trained duty of care was provided during an adverse medical reaction to the essential oil use.

The difference between avoidable and not avoidable medical errors here is within your medical expertise for DUTY OF CARE, which is what a patient is paying for and counting on. Medical error malpractice claims and financial awards are harder to achieve when the error is unexpected and a proper duty of care was provided prior to, during or after the unexpected injury.  

Medical errors that result from gross negligence are likely going to be the most susceptible to medical error malpractice action.  Malicious injuries sustained in healthcare practices, such as applying a known essential oil to a client because you do not like them would not be considered a medical error.  In that case, the provider could be charged criminally for assault as well as be liable for medical malpractice and abuse.

For greater medical errors prevention training in healthcare, please visit: https://ceinstitute.com/collections/mandatory

1. Sindle A, Martin K. Art of Prevention: Essential Oils - Natural Products Not Necessarily Safe. Int J Womens Dermatol. 2020 Nov 12;7(3):304-308. doi: 10.1016/j.ijwd.2020.10.013. PMID: 34222588; PMCID: PMC8243157.

Medical errors are unintended consequences of medical treatment, regardless if it was unexpected, avoidable, evident or harmful to a patient. Any type of unexpected injury to a patient resulting from medical care would be considered a medical error.

Sometimes a healthcare provider could have avoided an error but did not through negligence. Contrarily, a medical error can happen that was unexpected and not avoidable. Regardless of how a medical error occurs, a healthcare provider, and sometimes even managers and/or establishment owners are liable for the error.

Any type of medical error could result in a medical practice claim. Our newest Medical Errors Prevention training here at CE Institute LLC is to teach healthcare providers how to minimize their risk with medical errors that could result in malpractice claims, regardless of how the error occurred.

Almost all healthcare practices are filled with managers. If you’re self-employed, then you are your own manager and responsible for your entire practice. Managers could be culpable for medical errors when the error occurs under their management role. VICARIOUS LIABILITY can hold employers and managers liable for actions of their subordinates. Vicarious liability practices might be enforced differently from state to state.

In the state of Florida, even a 1-person licensed massage establishment must have an assigned DEM (designated establishment manager) registered with the state of Florida, per Florida state law. Different states could impose various management requirements in healthcare practices, beyond a private or public healthcare institution’s requirements.
While Florida’s DEMs were initially installed to help prevent human trafficking in illegitimate massage establishments, these DEMs are now being held responsible for other provider’s treatments and their results within the establishment.

If you are wanting to, or considering moving into a managerial role at work, or perhaps you are already managing, then you should request your managerial tasks be provided to you in writing, to negotiate and/or fulfill them. If you’re offered a managerial role, here are some medical error prevention issues to consider prior to accepting the position. Feel free to request a tour of a potentially new work facility and/or speak to other staff PRIOR to accepting the offer, or ask the employer if your managerial position will provide the budget and resources to create a safe, quality workplace. A partial list of possible managerial medical error malpractice issues you should look out for in addition to facility medical error risks are:

1. Staffing i.e. staff are overbooked to provide quality care.  Shortening or not providing services billed to insurance would be considered insurance fraud and could be criminally prosecuted.
2. Scope Creep i.e. staff are providing responsibilities outside of their licensed scope of practice.
3. Quality Issues i.e. existing management is unqualified to manage by leaving potential malpractice issues unresolved, and you do not have a budget to fix problems, such as the upholstery on treatment tables is ripped or torn so it cannot be properly sanitized between patients, etc.
4. Supply Issues: i.e. there’s not enough towels or sheets, so they’re being reused causing more sanitation concerns. Adding a shortage of sanitation supplies to this would create catastrophic negligence.
5. Managerial experience: if your role is to manage others but you do have managerial experience or training, or those managing you do not have the expertise to make good work decisions to avoid error.

Maintaining or accepting a managerial role in healthcare is regularly a negotiation. 
Not only would salary or compensation be negotiable, but you should also negotiate for a quality work environment or work-related training (i.e. management classes) to reduce YOUR risk of being responsible for medical errors that were completely avoidable.
Remember that your risk for malpractice claims is likely greater when avoidable medical errors are committed. These issues we just reviewed can be proactively addressed prior to an avoidable medical error occurring. For greater medical errors prevention training in healthcare, please visit: https://ceinstitute.com/collections/mandatory

Cyrotherapy is one of the latest and greatest modalities for spas and healthcare establishments. While it has been practiced for decades, there are many new uses, offerings and applications within the cold thermal therapies industry. 

Cyrotherapy is generally recommended for a variety of medical benefits or purposes. These range from natural, opioid-free, pain relief options to applications intended to reduce swelling. Human body detoxification might be a goal when heated and cryotherapy applications are contrasted. There are endless indications and noninvasive uses with thermal therapies that include cold applications.

Cyrotherapy offerings range from cold plunges to exfoliating ice treatments, ice massages and more; there are plentiful cryotherapy applications available to almost any practitioner at any budget.  Cryotherapy applications can be budget friendly with simple applications such as ice packs to multi-thousand-dollar investments with various cryotherapy machinery or equipment. Because of the opioid epidemic, there's been a lot of research as of late investigating non pharmacological pain relief including the use of hydro and thermal therapies.

Cyrotherapy is one of the latest and greatest modalities for spas and healthcare establishments. While it has been practiced for decades, there are many new uses, offerings and applications. It is generally recommended for a variety of medical benefits or purposes. These range from natural, opioid-free, pain relief options to applications intended to reduce swelling. Human body detoxification might be a goal when heated and cryotherapy applications are contrasted. There are endless indications and noninvasive uses with thermal therapies.

Cyrotherapy offerings range from cold plunges to exfoliating ice treatments, ice massages and more; there are plentiful cryotherapy applications available to almost any practitioner at any budget.  Cryotherapy applications can be budget friendly with simple applications such as ice packs to multi-thousand-dollar investments with various cryotherapy machinery or equipment. We will primarily review hydro cryotherapies that utilize large quantities of water for therapeutic value here.

Le Spa du George V in Paris France offers a fancy ice chip production in a tiny cold room as pictured above. The ice chips can be rubbed on the skin for exfoliation of dead skin cells, and to affect cardiovascular circulation.  A client can also wrap the ice chips in a towel around a swollen ankle, wrist or other area to create an analgesic affect and/or to help reduce swelling.

MSC cruise lines offers a “snow room” on some of their cruise ships.  Customers could literally lie down on top of snow and pack their bodies with snow on top too; although, this would not be recommended due to sanitary reasons.  While cold temperatures often kill germs, the temperatures in this snow room are not cold enough to eliminate all pathogens.

If you can find a clean area of newly manufactured snow in a room like this (pictured below), you could also rub that new snow against the skin for exfoliation practices, as well as place any area of the body against the snow itself to create an analgesic affect or reduce swelling.

Cold plunges (pictured below) are generally a tub filled with cold water, around 40 to 60 degrees Fahrenheit, depending on the individual and their tolerance level.  Some are more tolerant of cold than others.  Even a few seconds of full immersion in a cold plunge can create a hunting response, which is the body’s defense against soft tissue damage where the skin of any area exposed to cold starts to turn pinker or reddish. It is not recommended to immerse oneself in a cold plunge for more than a couple of minutes.  Customers can also contrast between a cold plunge and hot tub to increase circulation and detoxification.

It's usually quite easy to spot a cold plunge tub amongst various hydrotherapies.  Cold plunges are usually smaller than the average hydrotherapy equipment, because people usually are not moving within them.  They might only spend a few seconds in a cold plunge before exiting. Good cold plunge tubs have superior handles available to enter and exit as well.  That’s because entering or existing a cold plunge could be difficult, which is why there could be extra handles in this cryotherapy feature, as shown below in the Eurospa’s small cold plunge in Quebec, Canada.

Another cryotherapy water feature can be found at Claridge’s Spa in London, England.  While their spa provides private changing rooms with bathrooms and showers, they do have a stone “cold” shower (pictured below) next to their steam room and shower. The cold shower features a water fall where cold water drops from a ceiling mounted fixture, plus there’s a hand-held wand that can be used for cold shower application.

When it comes to pain relief, anyone can apply an ice pack or follow R.I.C.E. (Rest, Ice, Compression & Elevation) for an analgesic affect, or to treat their own injuries; however, ice massage uses a slightly more skillful approach and can be additionally applied to treat areas where a client may not be able to comfortably reach on their own.

Ice massage is inexpensive and easy to apply when properly trained. There are a variety of applications or supplies that can be used to add ice massage to your practice:

Purchase 2-ounce paper cups, fill with water to the top of the cup and freeze. Tear away the top three-quarters inch of the cup, turn the ice cup upside down and massage the surface area with the exposed surface of ice. Continually tear away the upper part of the paper cup to continually expose the ice to the soft tissue through the ice massage application.  Next is a video showing our ice massage application:

Re-useable plastic cups are also available amongst retailers for ice cup massage applications. Please follow the manufacturer’s instructions when using this type of specialty equipment.  Practitioners can also use regular ice cubes with a small piece of paper towel or jar gripper. It is recommended to drape a client with a towel during ice massage to absorb melted ice from running over the client’s body or your equipment.

Ice massage is regularly practiced with lightly massage the skin with small, circular movements in a small, local area with ice. Leaving ice in one place for too long can damage the underlying soft tissues, causing greater pain and problems for your customer.

Ice massage is usually extremely uncomfortable when it is first applied. It will feel very cold if not painful to the client. Prolonged appropriate application of a couple of minutes will provide an analgesic effect, with pain relief and other benefits. Do not massage an area with ice for more than 10 minutes or less as needed, depending on a client’s medical condition and response to the treatment.

There are many other cryotherapy applications, including cryo chambers and machines to create cold rooms as pictured above and below.  The cryotherapy examples listed here are just a few.  Each cryotherapy modality would have its own specific indications, applications, uses, precautions, contraindications and more. To learn other thermal or manual therapy techniques, please visit our school for training option at: https://ceinstitute.com/

Did you know that strawberries and roses are from the same Rosaceae family?  The Rosaceae family of plant species, also known as the rose family, has over 4,000 known flowering species. It is thought to be one of the most important plant species of all.

Combining strawberries and roses can make both aromas more expansive. They would be naturally considered compatible within the same family with sweeter floral aromas.

Strawberry seeds can be used as the grit or exfoliator of a scrub.  Because they’re not water dispersable, this strawberry rose spa body scrub would need to be practiced in a wet room, where a client could shower off the seed exfoliant to wash down the drain.  A practitioner wouldn’t want to provide too many strawberry seed scrubs to avoid clogging drains.

In this video, we’ll watch Selena Belisle, Founder and Aromatherapy Instructor make a strawberry rose scrub from the heart of Paris, France.

By Selena Belisle, Founder/Instructor, CE Institute LLC

Did you ever experience that rolling pin massage back in the 1990s for cellulite?  There were instructions everywhere for it. It was a fad.  It was practiced with various essential oils such as orange and cinnamon, and you would vigorously roll the upper thighs with a rolling pin after neat essential oil application to the skin.  The instructions could vary to roll directly on the skin and through saran wrap too.  It seemed more appropriate to apply in your mother’s kitchen rather than a real treatment room too.

Fast forward to Summer 2025, and as I was walking through St. Christopher’s Place to Bond Street in London, England, where I came upon a sidewalk sign for SKH London Clinic. They were advertising various complimentary healthcare services including massage.  I like to try as many different services possible from the largest variety of practitioners to learn as much as possible.  One of the ways that massage therapists learn more about a service is by receiving it.  Naturally, I was intrigued when I saw Wood Massage advertised.  I went inside and asked what type of wood they used, and if it was bamboo?  They responded it was not, and then showed me a unique wood tool. So we booked an appointment, and I went back the next day to receive the bodywork.

The receptionist had told me their wood massage would focus primarily on the back of my legs and my abdomen.  However, my massage therapist, who was trained in India, asked if I would like to receive the wood massage as a full body treatment, so I said yes and agreed.  We started tart in the pronated position. She tucked two kleenexs in my underwear before she began to massage my back with oil.  She then started rolling a wooden massager over my back in various directions. She started with a larger broader massage tool, and then progressively worked into smaller tools.

The smaller tools used on my back massage included what looked like a wooden bell and a small round wooden brush with very large teeth.  Both were used to twist and friction the skin and underlying soft tissue.  To me, the bell and round brush felt better than the larger broader wooden tools. One of the more unique wooden massage techniques was when the wooden bell was placed over several vertebral spine at a time and twisted in opposing clockwise and counterclockwise directions. The entire back massage was performed from the left side of the table.  The therapist reached over the back to work the opposite side.

Once she finished with the back, she then moved onto one leg, then the other, with the smaller broad tool that was used on my back, plus the bell and round brush. She massage both legs with oil first prior to applying the wooden massage tools.  She did work from both sides of the table when she performed the leg massage with wood.  My feet were not worked on while in pronated position.  She then removed the tissue from my underwear and had me roll over onto my back.

Once in supinated position, she placed another two tissues on the anterior of my bottom underwear. The therapist then began to massage my abdomen with oil, which was solely provided from the left side of the table again.  Then she started the massage with another curved broad wooden tool.  She worked up to the rib cage and down to the ASIS. The middle of the abdomen was worked all the way inferiorly to just above the pubic hair line. The abdomen massage felt perhaps the best of all areas.  Once the larger broader tool was completed, she then moved onto the bell where it was twisted in clockwise and counterclockwise motions amongst others.

The practitioner then moved onto my arms, one at a time.  Oil was applied first and then she supinated my arm to work primarily the inside of it.  Both upper and lower extremities were worked from superior to inferior, opposite of the venous return strokes that would regularly be applied in regular Swedish massage appointments.

Once she finished with the arms, she moved onto the anterior legs.  Careful attention was spent around the knees and the same wood tools used on the posterior were continued on the anterior legs. She did place the bell and twisted it over the patella which was unusual but good. The tools were used lightly but directly over my tibias but it was not painful.  The same over the vertebral spine. She finished some of the massaged areas with a smooth long round tool that was similar to a stick of bamboo.

The full body wood massage ended with an oil foot massage on the feet without any tools.  It was probably one of the least favorite massages I’ve had in an almost 40 year career.  It was not smooth, was occasionally painful, especially when working with too much pressure over the heads of the humerus. I was also worried about sanitation given I refused to start until the table sheet was replaced given it was partially soiled with splotched oil and facial make-up around the hole for the face. Some of the strokes felt good in some areas but most of the strokes did not. The massage therapist applied her skills with fairly rough application with just oil, so when hard tools were added, it felt worse. 

Notes that could have improved this bodywork appointment:

1. Allow privacy for the clients to disrobe, dress and mount or dismount the massage table.
2. Bolster the clients ankles in pronated position and knees in supinated position.
3. Provide a sheet or towel to cover the client with during the treatment instead of leaving a client fully exposed while draping underwear with klenex.
4. Wipe oil off feet at the end of the treatment prior to table dismount.
5. Use extra caution running wood over bony protuberances.
6. Provide cleaner linens by either changing these between clients and/or employer better laundering techniques.

By Selena Belisle, CE Institute LLC

The human body is made up of hundreds of lymph nodes. They filter harmful substances such as viruses and bacteria from our lymphatic fluid (aka lymph), before it enters the cardiovascular system.  Lymph nodes are an important part of our natural defense system or human immunity.  

Unfortunately, lymph nodes are a common place where cancer spreads as well. That’s why oncologists regularly biopsy a sentinel node in the same region as other cancers, to determine if an existing cancer has metastasized. 

In the medical illustration below, the lymphatic system is represented in red in the human body.  The little bean shaped balls on the lymphatic vessels represent lymph nodes in various regions. Clusters of lymph nodes are commonly found within the joints of the skeletal system:

Swollen lymph nodes typically exhibit themselves within lymph node regions, which can be viewed on the following medical illustration of the lymphatic system:

Lipomas are fatty lumps that form under the skin and usually over the muscle.  While all abnormal growths are cancers by definition, lipomas are not harmful and do not metastasize like a harmful cancer might.  

Telling the difference between a swollen or damaged lymph node versus a lipoma can be difficult, because they are visibly similar in size, shape and texture under the skin. Both could cause an obstruction of circulation, with the swollen lymph node being medically worse of the two, especially if it is a sentinel node.  In some cases, swollen or damaged lymph node(s) can lead to a condition called lymphedema. 

Medical institutions may claim that lipomas are softer and more mobile under the skin than a damaged lymph node; however, with almost 40 years of tactile palpation skills, I can state that it's impossible to determine the difference between the two by viewing or feeling them. They're both usually quite firm or hard, and neither is very mobile under the skin either.

Pressing on either may or may not cause pain, and is ill-advised regardless of what the diagnosis is. It is contraindicated to apply pressure on abnormal growths/cancers or any form of swelling, especially while the skin remains intact. Removing a damaged lymph node or lipoma would require surgery with sterilization methods to prevent infection and other medical problems.

You likely wouldn’t know the difference between a swelling lymph node or lipoma without a client telling you, or a medical diagnosis.  Lipomas often develop slowly over time, while a swollen lymph node might appear more quickly, due to trauma or an acute infection.  

Lymph nodes can also temporarily swell when they’re exposed to harmful viruses, bacteria and other agents, as the immune cells multiply within the nodes to kill the infection. This would be different from a permanent swelling of a lymph node which may appear visually similarly to a lipoma.

Here are some examples of each:

The picture at the top of his article depicts swollen lymph nodes, and here are some more images of swollen lymph nodes below around cervical area: