Ep 605 – PAD and COPD: "I Have a Client Who . . ." Pathology Conversations with Ruth Werner
A hospice client with advanced COPD and peripheral artery disease presents a complicated case involving the heart, lungs, and cardiovascular system. In this episode, Ruth Werner explores how endothelial damage, oxidative stress, and systemic inflammation contribute to chronic illness. But the more pressing question is: Can massage be safely provided to a client with these conditions who is nearing the end of her life? Resources: Association, A.H. (2024) Early diagnosis, treatment of peripheral artery disease essential to improve outcomes, reduce amputation risk, Medical Xpress. Available at: https://medicalxpress.com/news/2024-05-early-diagnosis-treatment-peripheral-artery.html (Accessed: November 2, 2026). Masked Peripheral Arterial Disease: Definition, risk groups and detection (no date) MESI Medical. Available at: https://mesimedical.com/insights/masked-peripheral-arterial-disease-definition-risk-groups-and-detection (Accessed: November 2, 2026). Massage Therapy Pressure Scale from Medical Conditions and Massage Therapy: a Decision Tree Approach by Tracy Walton. Available at: https://www.tracywalton.com/wp-content/uploads/2015/04/Walton-Massage-Therapy-Pressure-Scale-for-WEBSITE.pdf. (Accessed: November 3, 2026). Most Common Symptoms of Peripheral Artery Disease (no date). Available at: https://copd.net/clinical/peripheral-artery-disease-symptoms (Accessed: November 2, 2026). Papaporfyriou, A. et al. (2023) "Cardiovascular Diseases in COPD: From Diagnosis and Prevalence to Therapy," Life, 13(6), p. 1299. Available at: https://doi.org/10.3390/life13061299. Pizarro, C. et al. (2016) "Lower extremity and carotid artery disease in COPD," ERJ Open Research, 2(4), pp. 00037–02016. Available at: https://doi.org/10.1183/23120541.00037-2016. Polverino, F., Celli, B.R. and Owen, C.A. (2018) "COPD as an endothelial disorder: endothelial injury linking lesions in the lungs and other organs? (2017 Grover Conference Series)," Pulmonary Circulation, 8(1), p. 2045894018758528. Available at: https://doi.org/10.1177/2045894018758528. Tschopp, J., Dumont, P. and Hayoz, D. (2017) "True prevalence of COPD and its association with peripheral arterial disease in the internal medicine ward of a tertiary care hospital," Swiss Medical Weekly, 147(2728), p. w14460. Available at: https://doi.org/10.4414/smw.2017.14460. Host Bio: Ruth Werner is a former massage therapist, a writer, and an NCBTMB-approved continuing education provider. She wrote A Massage Therapist's Guide to Pathology, now in its seventh edition, which is used in massage schools worldwide. Werner is also a long-time Massage & Bodywork columnist, most notably of the Pathology Perspectives column. Werner is also ABMP's partner on Pocket Pathology, a web-based app and quick reference program that puts key information for nearly 200 common pathologies at your fingertips. Werner's books are available at www.booksofdiscovery.com. And more information about her is available at www.ruthwerner.com. Sponsors: Anatomy Trains is a global leader in online anatomy education and also provides in-classroom certification programs for structural integration in the US, Canada, Australia, Europe, Japan, and China, as well as fresh-tissue cadaver dissection labs and weekend courses. The work of Anatomy Trains originated with founder Tom Myers, who mapped the human body into 13 myofascial meridians in his original book, currently in its fourth edition and translated into 12 languages. The principles of Anatomy Trains are used by osteopaths, physical therapists, bodyworkers, massage therapists, personal trainers, yoga, Pilates, Gyrotonics, and other body-minded manual therapists and movement professionals. Anatomy Trains inspires these practitioners to work with holistic anatomy in treating system-wide patterns to provide improved client outcomes in terms of structure and function. Website: anatomytrains.com Email: [email protected] Facebook: facebook.com/AnatomyTrains Instagram: www.instagram.com/anatomytrainsofficial YouTube: https://www.youtube.com/channel/UC2g6TOEFrX4b-CigknssKHA Precision Neuromuscular Therapy seminars (www.pnmt.org) have been teaching high-quality seminars for more than 20 years. Doug Nelson and the PNMT teaching staff help you to practice with the confidence and creativity that comes from deep understanding, rather than the adherence to one treatment approach or technique. Find our seminar schedule at pnmt.org/seminar-schedule with over 60 weekends of seminars across the country. Or meet us online in the PNMT Portal, our online gateway with access to over 500 videos, 37 NCBTMB CEs, our Discovery Series webinars, one-on-one mentoring, and much, much more! 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