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I was wondering if I should even comment about this.. But I will.. Because I'm really bothered by it..And I run into similar situations often enough.. My last client yesterday.  She was Im guessing about fifty years old...She was very depressed looking.. Tired looking...She told me she had fibromyalgia(how do you spell it?) .   I asked  her were she hurt... She said both her arms are constantly aching. And her back hurts...She made it clear that her arms were her biggest problem.. She told me that she has had six months of deep tissue massage one to two times a  week and still not better..Talking to her further, she told me that she feels worse after the massages, and that they are so painful...She just wants to relax today...Someone gave her a gift certificate for a massage at the spa where I work... I did a complete trigger point scan..Found a trigger point in her left SI joint...a left side L4 spinal erector TP.. A really bad painful one in her Latissimus dorsi (edge of shoulder blade) on her left...One in her infraspinatus (another bad one)on her left.  And a really bad( when I say bad, I mean sore as hell) supraspinatus TP on her right side. Also a right side pectoralis TP.. She told me nobody palpated those Latissimus, infraspinatus or supraspinatus TPs before?   Long story short...I eliminated those trigger points..Wasnt painful either...She was unbelievably happy after her hour session yesterday. She couldnt believe her arms didnt hurt...... She rescheduled for another massage in four days...I will recheck her ..Im sure some of those TPs will come back..But her problem is over with...Another session or two will be about it.. Im just shocked.. All she was told by the docs was that she had fibromylagia or however you spell it, and all this massage that did  nothing for six months.!!!. My gawd???  I didnt want to know who was treating her...They obviously didnt know what they were doing... I cant believe it...She is going to be well here real soon..Her problem is simple.  Those people treating her in  must live in some kind of fantasy world?  Certainly not in reality.. So obviously easy... She had to quit because it was getting too expansive.  She told me that she paid $55.00 for each massage...I keep saying it.....But this massage education system we got going better stop teaching for the tests..Cause this is the result.

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Some people don't want to let go of pathologies and dysfunction because it is their self identity. They seek therapies but rarely complete or continue self therapy needed. They identify with the problem. Their life is built around the limitations and support groups. It takes time and gradual change to heal. These are people you should not feel  any lack in yourself for not healing them.

Besides healing is from within not something given. We can only offer a way. Do not blame yourselves if someone chooses not to clasp your out reached hand afraid to let go of the tree limb.

There's basic stuff to TP work, but it's mostly about developing the sensitivity.  Lots of things beneath the skin can feel to the practitioner like a trigger point--little, isolated nodules of fat, adhesions--stuff that I don't have a name for.  But those things are not painful. Helps to remember that trigger points are not in the skin; trigger points are in muscle tissue, and muscle tissue is in layers.  So, you won't find many TPs with light poking to and fro.  A TP can radiate light pain over a half-dollar sized area when you're close to its heart, but the TP itself is much smaller.  If you get the opportunity to work on another therapist, one who has TP problems and will communicate...who will help you learn to differentiate a TP from those other things...who will guide your touch to the "gateway" into the TP, jump at the chance.  Above all, don't be afraid of TP work--you can learn only by doing.  Start on yourself, the pecs and the calf (gastrocs, fibularii, tibialis anterior and posterior) are good hunting grounds on the front of the body.  You want to learn what one feels like to you the client and to you the practitioner. 

The body has many "triggers" through sensitivity to what lies under the skin you can feel the lines of tension which like a spiders web leads you to the cause. This goes beyond muscle, I believe it is the fascia which connects every cell in the body. It wraps muscle fibers into bundles and bundles into muscle, it cradles organs and allows muscle and skin to slide rather than stick. Much of what we do is simply to loosen, return fluidity and restore elasticity. illness and dysfunction can be attributed to loss of fluidity and elasticity. In this way even bone can be reshaped although because it is less fluid, less elastic than other tissue it is slower to change.

Through massage, diet, exercise, movement, breath our fluid life is enhanced.We help those who seek to enhance it and nothing more, nothing less.

Yesterday I only had one masssge on my schedual.... A hot stone massage.. its an hour and a half session.  The client was given a gift certificate as a birthday present from her children... I asked her if she had any aches and pains that I should know about...She said  that on occasion she suffers from sciatica as she touched her right hip...Pain radiates down the leg sometimes.. and a couple nights a week she has to sleep on a hot pad... So I did my usual trigger point scan and found a TP in her piriformis and another on her SI joint.. I also found one in her spinal erectors right side around the T11 area... I eliminated all of them... We finished the session in an hour....She told me she felt like she had a new hip.. She will use the remaining money on her gift certificate for a follow up visit next week.. All she will need is a half hour session to make sure those TPs are gone....This type of scenario is pretty much an every day thing for me...I mean if I have a fully booked day.. Six hours of massage...There is usually one client that has major TP involvement that Im able to help dramatically...She told me in the past she has had lots of physical therapy and massage for this problem... She said it helped some, but her pain never went away.. I asked her if at any time durring those treatments and massages if anyone ever mentioned the word trigger point, and she said no.  I showed her trigger point charts with her exact TP locations and pain patterns.. She nodded her head in approval.   I will see her again next week.. But I suspect her problem is over.

Gary W Addis said:

There's basic stuff to TP work, but it's mostly about developing the sensitivity.  Lots of things beneath the skin can feel to the practitioner like a trigger point--little, isolated nodules of fat, adhesions--stuff that I don't have a name for.  But those things are not painful. Helps to remember that trigger points are not in the skin; trigger points are in muscle tissue, and muscle tissue is in layers.  So, you won't find many TPs with light poking to and fro.  A TP can radiate light pain over a half-dollar sized area when you're close to its heart, but the TP itself is much smaller.  If you get the opportunity to work on another therapist, one who has TP problems and will communicate...who will help you learn to differentiate a TP from those other things...who will guide your touch to the "gateway" into the TP, jump at the chance.  Above all, don't be afraid of TP work--you can learn only by doing.  Start on yourself, the pecs and the calf (gastrocs, fibularii, tibialis anterior and posterior) are good hunting grounds on the front of the body.  You want to learn what one feels like to you the client and to you the practitioner. 

PTs rarely do TrP work.  In some cases, they are downright hostile to it. Travell stated that all TrPs had to be clear for 2 weeks before PT begins. Most PT have squat for palpation skills, and are in a hurry to fit things into 15 minute segments since they were foolish (as a profession) enough to after insurance money, which then dictates how they practice.  Hell, half the time they turn the actual work over to aides who have 4-6 hours total of massage training.  It's a disgrace.  PT has it's place, but they hate us.  What I tell my clients is that in all of medicine, the challenge is to use the right tool for the right job.  You don't see a podiatrist for brain surgery, and you don't see a PT for massage. Once everything is moving properly you see a PT to regain strength and hopefully balanced strength among opposing muscle systems.  Some listen, some don't.  I also tell them I don't do "Calgon, take me away!" massage.  If you're broken and in pain, I'm your girl. While I can do a little relaxation work, it's not my thing, and I fully support them seeing someone else for their relaxation needs, and seeing me to take care of more serious things.  The aches & pains that are a little more persistent. Most massage schools, especially ones attached to "career colleges" are a joke.  They under so many "hour requirements" for different segments of education, that they have no time for palpation. It makes me sick.

That being said, I know too many therapists who don't want to anything but swedish and other relaxation techniques.  they're not interested in solving mysteries, or expanding their skillset.  While it frustrates me, what really hacks me off is when these lamebrains don't recognize that X is out of their league, and refer their client to someone like me who can actually take care help them. To me it's dishonest to continue to take someone's money when you have no realistic plan on how you can help them, no desire to anything to learn more about the condition and what you can do about it, and no willingness to refer them to someone who can.   *getting off my soapbox*

Kay, I don't even WANT to do relaxation massage!  My goal is to solve problems for my clients and return functionality whenever and wherever I can.  I am constantly learning, like you said expanding my skillset.  I thrive on the mystery, the puzzle.  My clients love it!  I work out of my house and they don't care what is going on here - they come for relief, not relaxation.

Keep up the good work!!

Its a good soapbox.   Whats interesting to me is when I hear that a massage therapist is seeing a Medical Doctor or Chiropractor because they have Carpal Tunnel? 

Kay Warren said:

PTs rarely do TrP work.  In some cases, they are downright hostile to it. Travell stated that all TrPs had to be clear for 2 weeks before PT begins. Most PT have squat for palpation skills, and are in a hurry to fit things into 15 minute segments since they were foolish (as a profession) enough to after insurance money, which then dictates how they practice.  Hell, half the time they turn the actual work over to aides who have 4-6 hours total of massage training.  It's a disgrace.  PT has it's place, but they hate us.  What I tell my clients is that in all of medicine, the challenge is to use the right tool for the right job.  You don't see a podiatrist for brain surgery, and you don't see a PT for massage. Once everything is moving properly you see a PT to regain strength and hopefully balanced strength among opposing muscle systems.  Some listen, some don't.  I also tell them I don't do "Calgon, take me away!" massage.  If you're broken and in pain, I'm your girl. While I can do a little relaxation work, it's not my thing, and I fully support them seeing someone else for their relaxation needs, and seeing me to take care of more serious things.  The aches & pains that are a little more persistent. Most massage schools, especially ones attached to "career colleges" are a joke.  They under so many "hour requirements" for different segments of education, that they have no time for palpation. It makes me sick.

That being said, I know too many therapists who don't want to anything but swedish and other relaxation techniques.  they're not interested in solving mysteries, or expanding their skillset.  While it frustrates me, what really hacks me off is when these lamebrains don't recognize that X is out of their league, and refer their client to someone like me who can actually take care help them. To me it's dishonest to continue to take someone's money when you have no realistic plan on how you can help them, no desire to anything to learn more about the condition and what you can do about it, and no willingness to refer them to someone who can.   *getting off my soapbox*

Its just that for carpal tunnel...Massage is the best therapy....

Gordon J. Wallis said:

Its a good soapbox.   Whats interesting to me is when I hear that a massage therapist is seeing a Medical Doctor or Chiropractor because they have Carpal Tunnel? 

Kay Warren said:

PTs rarely do TrP work.  In some cases, they are downright hostile to it. Travell stated that all TrPs had to be clear for 2 weeks before PT begins. Most PT have squat for palpation skills, and are in a hurry to fit things into 15 minute segments since they were foolish (as a profession) enough to after insurance money, which then dictates how they practice.  Hell, half the time they turn the actual work over to aides who have 4-6 hours total of massage training.  It's a disgrace.  PT has it's place, but they hate us.  What I tell my clients is that in all of medicine, the challenge is to use the right tool for the right job.  You don't see a podiatrist for brain surgery, and you don't see a PT for massage. Once everything is moving properly you see a PT to regain strength and hopefully balanced strength among opposing muscle systems.  Some listen, some don't.  I also tell them I don't do "Calgon, take me away!" massage.  If you're broken and in pain, I'm your girl. While I can do a little relaxation work, it's not my thing, and I fully support them seeing someone else for their relaxation needs, and seeing me to take care of more serious things.  The aches & pains that are a little more persistent. Most massage schools, especially ones attached to "career colleges" are a joke.  They under so many "hour requirements" for different segments of education, that they have no time for palpation. It makes me sick.

That being said, I know too many therapists who don't want to anything but swedish and other relaxation techniques.  they're not interested in solving mysteries, or expanding their skillset.  While it frustrates me, what really hacks me off is when these lamebrains don't recognize that X is out of their league, and refer their client to someone like me who can actually take care help them. To me it's dishonest to continue to take someone's money when you have no realistic plan on how you can help them, no desire to anything to learn more about the condition and what you can do about it, and no willingness to refer them to someone who can.   *getting off my soapbox*

An 82 year old woman neigbor and friend was sent to a chiro by her lawyer after an auto accident.  The doctor hurt her even more.  I offered to help her.  She trusted me; I released TPs in about 10 minutes that caused her pain.  But the next day at the chiro, the good doctor warned her that MT would make her problem worse.  Two weeks--two full weeks-- she struggled to walk upright due to pain; doc's xrays purport to show disc problems.  Finally the pain got bad enough she came back to me.  Once again in less than half an hour, fully clothed, I released TPs in piriformis, QL, the little gemellus inferior, relaxed the ligaments between sacrum and illiac crest, and relaxed tightness in the joint itself.  She called the chiro and told him to go do something nasty to himself. 

This lady has become a big fan--she's sent the manager of a health food store and a hotel clerk to me.  I am a student, can't charge yet, but I'm banking good will that hopefully will pay off after  get my license in a few months.  But even if it doesn't earn me any money, knowing that I have relieved pain is a good feeling

 I don't suggest that all do this, but my friend's chiro appeared to be intentionally stretching her treatments out, maybe at the behest of the lawyer.  My friend wasn't interested in lawsuits--she was hurting and needed relief.  

I

Kay Warren said:

PTs rarely do TrP work.  In some cases, they are downright hostile to it. Travell stated that all TrPs had to be clear for 2 weeks before PT begins. Most PT have squat for palpation skills, and are in a hurry to fit things into 15 minute segments since they were foolish (as a profession) enough to after insurance money, which then dictates how they practice.  Hell, half the time they turn the actual work over to aides who have 4-6 hours total of massage training.  It's a disgrace.  PT has it's place, but they hate us.  What I tell my clients is that in all of medicine, the challenge is to use the right tool for the right job.  You don't see a podiatrist for brain surgery, and you don't see a PT for massage. Once everything is moving properly you see a PT to regain strength and hopefully balanced strength among opposing muscle systems.  Some listen, some don't.  I also tell them I don't do "Calgon, take me away!" massage.  If you're broken and in pain, I'm your girl. While I can do a little relaxation work, it's not my thing, and I fully support them seeing someone else for their relaxation needs, and seeing me to take care of more serious things.  The aches & pains that are a little more persistent. Most massage schools, especially ones attached to "career colleges" are a joke.  They under so many "hour requirements" for different segments of education, that they have no time for palpation. It makes me sick.

That being said, I know too many therapists who don't want to anything but swedish and other relaxation techniques.  they're not interested in solving mysteries, or expanding their skillset.  While it frustrates me, what really hacks me off is when these lamebrains don't recognize that X is out of their league, and refer their client to someone like me who can actually take care help them. To me it's dishonest to continue to take someone's money when you have no realistic plan on how you can help them, no desire to anything to learn more about the condition and what you can do about it, and no willingness to refer them to someone who can.   *getting off my soapbox*

Unfortunately,  chiros are like every other profession on the face of the planet.  You have the Good, the Bad, and the Ugly. I'm sorry she got one of the Ugly ones.  I've been seeing DCs for 30 years, and I've worked for 4 of them.  I've seen the harm a bad or ugly DC can do.  That being said, MDs kill over 300K people per year, more than 5x the number of civilians killed by guns.  I'm sad to say this, but I have come to believe that approximately 30% of the people in any given profession (including my own) have no business practicing it.  I've had a doc nearly kill me & 2 dentists cause me permanent damage.  Using the right tool fofr the right job is very important, especially in medicine.

Gary W Addis said:

An 82 year old woman neigbor and friend was sent to a chiro by her lawyer after an auto accident.  The doctor hurt her even more.  I offered to help her.  She trusted me; I released TPs in about 10 minutes that caused her pain.  But the next day at the chiro, the good doctor warned her that MT would make her problem worse.  Two weeks--two full weeks-- she struggled to walk upright due to pain; doc's xrays purport to show disc problems.  Finally the pain got bad enough she came back to me.  Once again in less than half an hour, fully clothed, I released TPs in piriformis, QL, the little gemellus inferior, relaxed the ligaments between sacrum and illiac crest, and relaxed tightness in the joint itself.  She called the chiro and told him to go do something nasty to himself. 

This lady has become a big fan--she's sent the manager of a health food store and a hotel clerk to me.  I am a student, can't charge yet, but I'm banking good will that hopefully will pay off after  get my license in a few months.  But even if it doesn't earn me any money, knowing that I have relieved pain is a good feeling

 I don't suggest that all do this, but my friend's chiro appeared to be intentionally stretching her treatments out, maybe at the behest of the lawyer.  My friend wasn't interested in lawsuits--she was hurting and needed relief.  

I

Kay Warren said:

PTs rarely do TrP work.  In some cases, they are downright hostile to it. Travell stated that all TrPs had to be clear for 2 weeks before PT begins. Most PT have squat for palpation skills, and are in a hurry to fit things into 15 minute segments since they were foolish (as a profession) enough to after insurance money, which then dictates how they practice.  Hell, half the time they turn the actual work over to aides who have 4-6 hours total of massage training.  It's a disgrace.  PT has it's place, but they hate us.  What I tell my clients is that in all of medicine, the challenge is to use the right tool for the right job.  You don't see a podiatrist for brain surgery, and you don't see a PT for massage. Once everything is moving properly you see a PT to regain strength and hopefully balanced strength among opposing muscle systems.  Some listen, some don't.  I also tell them I don't do "Calgon, take me away!" massage.  If you're broken and in pain, I'm your girl. While I can do a little relaxation work, it's not my thing, and I fully support them seeing someone else for their relaxation needs, and seeing me to take care of more serious things.  The aches & pains that are a little more persistent. Most massage schools, especially ones attached to "career colleges" are a joke.  They under so many "hour requirements" for different segments of education, that they have no time for palpation. It makes me sick.

That being said, I know too many therapists who don't want to anything but swedish and other relaxation techniques.  they're not interested in solving mysteries, or expanding their skillset.  While it frustrates me, what really hacks me off is when these lamebrains don't recognize that X is out of their league, and refer their client to someone like me who can actually take care help them. To me it's dishonest to continue to take someone's money when you have no realistic plan on how you can help them, no desire to anything to learn more about the condition and what you can do about it, and no willingness to refer them to someone who can.   *getting off my soapbox*

Awesome Gary...My perspective...A skilled massage therapist has much more to offer...Much more...Heaps more.  Of that,I have No Doubt.

Kay Warren said:

Unfortunately,  chiros are like every other profession on the face of the planet.  You have the Good, the Bad, and the Ugly. I'm sorry she got one of the Ugly ones.  I've been seeing DCs for 30 years, and I've worked for 4 of them.  I've seen the harm a bad or ugly DC can do.  That being said, MDs kill over 300K people per year, more than 5x the number of civilians killed by guns.  I'm sad to say this, but I have come to believe that approximately 30% of the people in any given profession (including my own) have no business practicing it.  I've had a doc nearly kill me & 2 dentists cause me permanent damage.  Using the right tool fofr the right job is very important, especially in medicine.

Gary W Addis said:

An 82 year old woman neigbor and friend was sent to a chiro by her lawyer after an auto accident.  The doctor hurt her even more.  I offered to help her.  She trusted me; I released TPs in about 10 minutes that caused her pain.  But the next day at the chiro, the good doctor warned her that MT would make her problem worse.  Two weeks--two full weeks-- she struggled to walk upright due to pain; doc's xrays purport to show disc problems.  Finally the pain got bad enough she came back to me.  Once again in less than half an hour, fully clothed, I released TPs in piriformis, QL, the little gemellus inferior, relaxed the ligaments between sacrum and illiac crest, and relaxed tightness in the joint itself.  She called the chiro and told him to go do something nasty to himself. 

This lady has become a big fan--she's sent the manager of a health food store and a hotel clerk to me.  I am a student, can't charge yet, but I'm banking good will that hopefully will pay off after  get my license in a few months.  But even if it doesn't earn me any money, knowing that I have relieved pain is a good feeling

 I don't suggest that all do this, but my friend's chiro appeared to be intentionally stretching her treatments out, maybe at the behest of the lawyer.  My friend wasn't interested in lawsuits--she was hurting and needed relief.  

I

Kay Warren said:

PTs rarely do TrP work.  In some cases, they are downright hostile to it. Travell stated that all TrPs had to be clear for 2 weeks before PT begins. Most PT have squat for palpation skills, and are in a hurry to fit things into 15 minute segments since they were foolish (as a profession) enough to after insurance money, which then dictates how they practice.  Hell, half the time they turn the actual work over to aides who have 4-6 hours total of massage training.  It's a disgrace.  PT has it's place, but they hate us.  What I tell my clients is that in all of medicine, the challenge is to use the right tool for the right job.  You don't see a podiatrist for brain surgery, and you don't see a PT for massage. Once everything is moving properly you see a PT to regain strength and hopefully balanced strength among opposing muscle systems.  Some listen, some don't.  I also tell them I don't do "Calgon, take me away!" massage.  If you're broken and in pain, I'm your girl. While I can do a little relaxation work, it's not my thing, and I fully support them seeing someone else for their relaxation needs, and seeing me to take care of more serious things.  The aches & pains that are a little more persistent. Most massage schools, especially ones attached to "career colleges" are a joke.  They under so many "hour requirements" for different segments of education, that they have no time for palpation. It makes me sick.

That being said, I know too many therapists who don't want to anything but swedish and other relaxation techniques.  they're not interested in solving mysteries, or expanding their skillset.  While it frustrates me, what really hacks me off is when these lamebrains don't recognize that X is out of their league, and refer their client to someone like me who can actually take care help them. To me it's dishonest to continue to take someone's money when you have no realistic plan on how you can help them, no desire to anything to learn more about the condition and what you can do about it, and no willingness to refer them to someone who can.   *getting off my soapbox*

Gordon, I have benefited from your expertise...your 3+ decades of experience.  Thank you for being so generous with your time. 



Gordon J. Wallis said:

Awesome Gary...My perspective...A skilled massage therapist has much more to offer...Much more...Heaps more.  Of that,I have No Doubt.

Kay Warren said:

Unfortunately,  chiros are like every other profession on the face of the planet.  You have the Good, the Bad, and the Ugly. I'm sorry she got one of the Ugly ones.  I've been seeing DCs for 30 years, and I've worked for 4 of them.  I've seen the harm a bad or ugly DC can do.  That being said, MDs kill over 300K people per year, more than 5x the number of civilians killed by guns.  I'm sad to say this, but I have come to believe that approximately 30% of the people in any given profession (including my own) have no business practicing it.  I've had a doc nearly kill me & 2 dentists cause me permanent damage.  Using the right tool fofr the right job is very important, especially in medicine.

Gary W Addis said:

An 82 year old woman neigbor and friend was sent to a chiro by her lawyer after an auto accident.  The doctor hurt her even more.  I offered to help her.  She trusted me; I released TPs in about 10 minutes that caused her pain.  But the next day at the chiro, the good doctor warned her that MT would make her problem worse.  Two weeks--two full weeks-- she struggled to walk upright due to pain; doc's xrays purport to show disc problems.  Finally the pain got bad enough she came back to me.  Once again in less than half an hour, fully clothed, I released TPs in piriformis, QL, the little gemellus inferior, relaxed the ligaments between sacrum and illiac crest, and relaxed tightness in the joint itself.  She called the chiro and told him to go do something nasty to himself. 

This lady has become a big fan--she's sent the manager of a health food store and a hotel clerk to me.  I am a student, can't charge yet, but I'm banking good will that hopefully will pay off after  get my license in a few months.  But even if it doesn't earn me any money, knowing that I have relieved pain is a good feeling

 I don't suggest that all do this, but my friend's chiro appeared to be intentionally stretching her treatments out, maybe at the behest of the lawyer.  My friend wasn't interested in lawsuits--she was hurting and needed relief.  

I

Kay Warren said:

PTs rarely do TrP work.  In some cases, they are downright hostile to it. Travell stated that all TrPs had to be clear for 2 weeks before PT begins. Most PT have squat for palpation skills, and are in a hurry to fit things into 15 minute segments since they were foolish (as a profession) enough to after insurance money, which then dictates how they practice.  Hell, half the time they turn the actual work over to aides who have 4-6 hours total of massage training.  It's a disgrace.  PT has it's place, but they hate us.  What I tell my clients is that in all of medicine, the challenge is to use the right tool for the right job.  You don't see a podiatrist for brain surgery, and you don't see a PT for massage. Once everything is moving properly you see a PT to regain strength and hopefully balanced strength among opposing muscle systems.  Some listen, some don't.  I also tell them I don't do "Calgon, take me away!" massage.  If you're broken and in pain, I'm your girl. While I can do a little relaxation work, it's not my thing, and I fully support them seeing someone else for their relaxation needs, and seeing me to take care of more serious things.  The aches & pains that are a little more persistent. Most massage schools, especially ones attached to "career colleges" are a joke.  They under so many "hour requirements" for different segments of education, that they have no time for palpation. It makes me sick.

That being said, I know too many therapists who don't want to anything but swedish and other relaxation techniques.  they're not interested in solving mysteries, or expanding their skillset.  While it frustrates me, what really hacks me off is when these lamebrains don't recognize that X is out of their league, and refer their client to someone like me who can actually take care help them. To me it's dishonest to continue to take someone's money when you have no realistic plan on how you can help them, no desire to anything to learn more about the condition and what you can do about it, and no willingness to refer them to someone who can.   *getting off my soapbox*

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