● Low blood pressure (hypotension) is having lower-than- normal blood pressure that can cause insufficient blood and oxygen to the organs. This can result in temporary or permanent damage to organs. For example, if insufficient blood flows to the brain, brain cells do not receive enough oxygen and nutrients, and a person can feel lightheaded, dizzy or even faint. Going from a sitting or lying position to a standing position often brings out symptoms of low blood pressure. This occurs because standing causes blood to “settle” in the veins of the lower body, and this can lower the blood pressure. If the blood pressure is already low, standing can make the low pressure worse, to the point of causing symptoms of light headedness, even fainting. Nail technicians should assume every client is hypotensive when standing from a chair or getting out of a pedicure chair and offer their aid. A person who usually has normal blood pressure is in a state of ultra relaxation and her blood pressure may go down to a point where it can cause her to fall or stumble when getting out of the chair. Diabetes mellitus (1 or 2) , usually referred to as diabetes, is a chronic disease in which a person has high blood sugar either because the pancreas does not produce enough insulin or because cells do not respond to the insulin that is produced. Blood sugar indicates the concentration of sugar (glucose) in the blood. Glucose, the primary source of energy for the body’s cells, is transported from the intestines or liver to body cells via the bloodstream and is made available for cell absorption. Insulin is a hormone produced by the body primarily in the pancreas. Insulin also provides signals to several other body systems, and is the chief regulatory metabolic control in humans. The human body naturally tightly regulates blood glucose levels as a part of metabolic homeostasis (“balanced”). Diabetes affects the entire life of a diabetic, from how the person eats to the long-term health of the heart, kidneys and feet. People suffering from diabetes have one of two types of diabetes mellitus, 1 or 2. Type 1 diabetes usually is diagnosed before age 20 but can occur at any age including adulthood, especially in those in their late 30s and early 40s. The pancreas produces little or no insulin. It may develop very abruptly over a period of a few days or weeks and shows itself in the following three-step sequence: 1. Increased blood glucose. 2. Increased use of fats for energy and for the formation of cholesterol by the liver. 3. Depletion of the body’s protein stores. This will show as a sudden drop in body mass that isn’t stopped even when eating large amounts of food. A sufferer will also feel very fatigued and generally “under the weather,” and experience intense thirst. The distinguishing characteristic of patients with Type 1 diabetes is that they are life-long dependent on exogenous insulin (injections). They require long-term medical attention both to limit the development of its devastating complications and to manage them when they do occur. The pedicurist must assume this client has some degree of neuropathy (loss of feeling in the feet). Generally, Type 1 insulin- dependent clients cannot be soaked because they are prone to extremely dry skin that can easily become infected. Always assume the diabetic person has some vascular damage in the feet, and that gentleness is important in massage. Type 2 diabetes results from the combination of resistance to insulin and inadequate insulin secretion. It is characterized by hyperglycemia and associated with microvascular (such as retinal, renal, possibly neuropathic), macrovascular (such as coronary, peripheral vascular), and neuropathic (such as autonomic, peripheral) complications. Type 2 diabetics may or may not be dependent upon insulin for life and may be on oral medications. They may at some time become insulin dependent, sometimes due to obesity. Always ask whether this person is insulin
dependent and if his or her doctor has given permission for the person to have a pedicure. Do not soak an insulin-dependent diabetic. Type 2 diabetes is far more common than Type 1 , accounting for 80-90 percent of all known cases of diabetes in the United States. In most cases, the age of onset is more than 40 years, with the majority diagnosed between the ages of 50 and 60. Unlike Type I, this type develops slowly and can go unnoticed for some time. Arteriosclerosis – To accommodate the pressure created by the pumping of the heart, arteries must stretch with each heartbeat. Half the deaths in the United States each year are caused by cardiovascular diseases, which are accompanied by circulatory problems. The single greatest killer of Americans today is hardening of the arteries or arteriosclerosis, which prevents the arteries from stretching with the pumping of the heart. Persons with circulatory problems cannot be soaked nor have massage on their legs . Reflexology may be appropriate. Lymphedema – Lymphatic obstruction is a blockage of the lymph vessels that drain fluid from tissues throughout the body and may cause localized and chronic fluid retention and tissue swelling of the extremities, called lymphedema. Primary lymphedema is hereditary, while secondary lymphedema is caused by infection, cellulitis, damage to the lymph system, and chemotherapy. Early diagnosis is difficult, though the sufferer may report “heaviness.” Generally, by the time of diagnosis, it is incurable. The lymphatic system is a parallel vascular system to the artery/ venous blood system that returns interstitial fluids to the bloodstream where they are returned to the tissues. The soleus muscle, also known as the calf pump, executes movement of lymph from the legs towards the heart and back into the blood system. As a person walks, the soleus contracts, squeezing lymph up the leg via the lymphatic vessels. When the muscle relaxes, valves in the vessels shut, preventing the fluid from returning to the lower extremities. Symptoms may include severe fatigue; a heavy swollen limb or localized fluid accumulation in other body areas, including the head or neck; discoloration of the skin overlying the lymphedema; and eventually, deformity of varying degrees. Only persons with minor swelling should experience pedicures, and they should not be soaked . This person should be massaged very gently upward. A trained lymphatic therapist can perform lymphatic drainage on early- stage lymphedema, a technique that must be specific and requires training. The technique requires the therapist to manipulate other areas of the body and should not be performed by a manicurist. Foot/bone abnormalities – Foot deformities, whether congenital or acquired, can cause pain for the client if the technician is not knowledgeable about the deformity. For example, hallux valgus, a bunion, often causes the client pain, and extreme pain occurs if the pedicurist performs the foot pulling massage movement on the toes. Massage on any foot with deformity is contraindicated because they are very susceptible to injury and high pain upon manipulation. Recent sun or use of sun bed – Use of a tanning bed or recent exposure to the sun can cause skin irritation that is not evident if it was experienced just before the treatment. The result may be a burn-like response to massage or products that can become blisters, or the outer layer of the epidermis may peel, and sometimes an open lesion may develop. Do not perform any treatments or massage on a client who has recent overexposure to the sun or uses a sun bed service. Skin disease of any kind – Not only is it reasonable to ask this question for the safety of the client regardless of whether the disease is active, it also is important for the safety of the nail professional. Conditions range from actinic keratosis to melanoma, and the technician should seek thorough education on the topics. Many are non-pathological and will not prevent
Book Code: NTFL1024
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