Case Study - Nasal Inhaler/Foot Scrub

Section 1: Primary Concern

G.L. is seeking aromatherapy to support a “cold” she has.

Section 2: History of Primary Concern

G.L. has been dealing with her “cold” for about three days. She describes this cold as coughing, sniffling, sneezing, sinus mucosal drainage, and headache.  G.L. states that she visited with a family member about five days ago who was coughing and sneezing.  She says that she seems to get a “cold" each February.  The client states that in the past, she would take some over-the-counter cold remedies (Dayquil), which helped suppress the symptoms but seemed to prolong the “cold.”  She states that she has also used the over-the-counter analgesic Advil (ibuprofen), which helped her headaches associated with her previous “colds.”  G.L. went to her primary care physician (PCP), who tested her for COVID-19, influenza, and strep—all results were negative.  Her PCP recommended she seek an aromatherapy support plan.  

She admits she has been using a homeopathic remedy called “ColdCalm.”  G.L. believes this homeopathic medicine has had a mild effect on her symptom profile.  The client denies using any other remedies, herbs, or supplements.  She denies drinking alcohol, caffeine, or using recreational drugs.  The client denies having any allergies associated with plants or nuts.  

G.L. has come to this aromatherapist several times in the past for various concerns.  

Section 3: Observations and Impressions  

G.L. is a 5’9”, 145 lb., 25-year-old single female.  She has excellent muscle tone, naturally blonde hair that looks clean, and clear skin.  Her eyes and nose are slightly red.  The client’s nose and lips look somewhat chapped.  She uses many tissues during the appointment and is coughing regularly.  The aromatherapist also notices that the client rubs her head off and on throughout the interview.  Her posture is slightly slouched.  Her voice is soft, and she clears her throat several times throughout the interview.  She keeps regular eye contact.  She smells clean like she recently showered, and her clothes were clean and neat.  No other odors were noticed.  The aromatherapist did not observe G.L.’s iris or tongue.  

• What are the goals of your support plan? The support plan aims to support her body’s ability to overcome her “cold” and support her upper respiratory system by using a nasal inhaler and foot scrub.  Using essential oils as a topical application allows the constituents to be absorbed through the skin (Petersen, 2022).  Essential oils can also be absorbed into the bloodstream by inhalation (Petersen, 2022).

• What is your theory for creating a support plan for this client? The support plan should include essential oils with antibacterial, antimicrobial, anti-inflammatory, antiviral, bactericidal, expectorant, and rubefacient properties.  Rubefacient properties help increase the blood flow to the skin, allowing the constituents from essential oils to be better absorbed through the skin (Petersen, 2022).

• What led you to formulate this theory? The client could use essential oils with the above properties to support upper respiratory healing. 

Section 4: Holistic Support Plan

1. MATERIALS

• Peppermint Mentha xpiperita (L.) var. vulgaris essential oil

• Rosemary Rosmarinus officinalis (L.) CT cineole

• Sniffy Stick which has a large external cylinder, smaller inner cylinder, and small bottom plug.

• Absorbent cotton cylinder

• Cornmeal

• Fine mineral sea salt

• Sweet almond Prunus amygdalus (Batsch) var. Dulcis

• Ceramic bowl

• Stainless steel spoon

• Stainless steel measuring spoons (tablespoon and teaspoon sized)

• 4-ounce square cobalt jar

• 20 mL glass beaker

• 1 glass stirring rod

• Distilled water

2. APPLICATION METHODS

The client prefers a topical application and nasal inhalation and finds these most convenient.  Topical methods offer therapeutic benefits via skin absorption (Petersen, 2021).

Nasal inhalation allows the constituents of the essential oils to be absorbed through the bloodstream through the nasal mucous membranes (Petersen, 2022). 

3. EXTERNAL FACTORS

G.L. has used both of these essential oils in the past and enjoys them.  She has tested negative for both skin patch tests previously.  Her aroma preference is herbal, minty aromas.  As described in the “History of Primary Concern” section, she denies having plant or nut allergies.  The client agrees to stop using the homeopathic remedy since it is contraindicated during the use of peppermint essential oil.  She denies being pregnant, is not currently nursing, and has no minor children at home; the client also denies having asthma, epilepsy, or hypertension.  The aromatherapist advised G.L. to wash her hands after using the topical application because it can irritate the eyes.  She agrees not to use this essential oil for more than three weeks.  G.L. states that the cost of the blends is not an issue.  The aromatherapist advised that the toxic constituents in both essential oils include menthol, menthone, piperiton, and thymol in peppermint essential oil; and borneol, camphor, and pinene in rosemary essential oil.

4. YOUR REASONING

Peppermint M. xpiperita essential oil has antibacterial, anti-inflammatory, antimicrobial, antiviral, bactericidal, expectorant, and rubefacient therapeutic qualities (Petersen, 2022; Natural Medicines, 2022).  Rosemary R. officinalis essential oil has antibacterial, antimicrobial, bactericidal, expectorant, and rubefacient therapeutic qualities (Petersen, 2022; Natural Medicines, 2022).  The main constituents in peppermint essential oil include the monoterpenol menthol (36-46%) and the ketone menthone (15-25%).  Rosemarinus officinalis has the following main constituents: oxide, 1,8 cineole (42.5-50%); monoterpenoid ketone, camphor (11.67%); and the monoterpene alpha-pinene (11.84%).  Peppermint is a top note with a minty, herbal aroma, and rosemary is a middle note with an herbal aroma.  Sweet almond P. amygdalis var. dulcis helps relieve dryness, inflammation, soreness, and skin itching (Shutes & Siegmund-Roach, 2022).

5. FORMULAS

Formula 1: Nasal Inhaler (Total: 0.66 mL)

• Peppermint Mentha xpiperita (L.) var. vulgaris essential oil: 13 drops (0.43 mL)

• Rosemary Rosmarinus officinalis (L.) CT cineole: 7 drops (0.23 mL)

The aromatherapist used the small glass beaker to dispense the outlined drops as indicated in the formula.  Then the cylindrical cotton absorbent pad was placed in the beaker for about one minute to soak up all the essential oil.  The absorbent pad was then pushed into the inner cylinder of the sniffy stick, sealed, and placed in the large cylinder.  This inhaler was labeled and given to the client.

Formula 2: Foot Scrub (1.2% dilution)

• Peppermint Mentha xpiperita (L.) var. vulgaris essential oil: 13 drops (0.43 mL)

• Rosemary Rosmarinus officinalis (L.) CT cineole: 7 drops (0.23 mL)

• Cornmeal: 2 ounces

• Mineral sea salts (fine): 1 tablespoon

• Sweet almond Prunus amygdalus (Batsch) var. Dulcis oil: 1 teaspoon

• Small amount of warm water to create a thick paste.

The aromatherapist put the dry ingredients into the ceramic bowl.  Separately, the aromatherapist put the liquid ingredients together (essential oil and sweet almond oil) and stirred them with the glass rod.  Then added the liquid ingredients to the dry ingredients and mixed them.  The aromatherapist added enough warm water to make a thick paste out of the material, put it in the square cobalt container, and labeled and gave it to the client.  

Both items were dispensed with instructions which are listed in the next section.  

6. CLIENT INSTRUCTIONS

Nasal inhaler instruction: use as needed over the next two (2) weeks up to four (4) times daily. When ready to administer, open the cap, put it under the nose, and inhale for 1-4 seconds. 

Foot scrub instruction: First, wash the hands.  Then get the feet wet either by soaking in warm water or running them under the bathtub while sitting on the tub's ledge.  Use a spoon to scoop out some of the scrub and massage each foot for about three to five minutes.  Take care to rinse well. Then wash hands again.

The daily usage between the two different applications should not exceed four administrations daily. 

The client is scheduled for a follow-up appointment in two weeks. 

Section 5: Outcomes and Evaluation

G.L. came in for her follow-up appointment.  She stated that she loved the way the foot scrub felt on her feet. She ran out of this after four days of use of the foot scrub.  She stated that she used the nasal inhaler as directed throughout the day.  She stated that she did not go over her recommended daily dose.  She came in with a better posture today.  Her eyes are clear.  Her nose and lips are not chapped today.  The client is not sniffling or blowing her nose during this appointment.  G.L. does not clear her throat at this appointment.  She is talking clearly and looks well-rested, and appears and smells clean.  She stated that after about five (5) days of use of the nasal inhaler and foot scrub, she noticed that she was no longer noticing the symptoms of the “cold.”  She stated that she would come back in the future if she needed another aromatherapy support.

Section 6: References

Natural Medicines. (2022). Peppermint[Monograph]. https://naturalmedicines.therapeuticresearch.com/databases/food,-herbs-supplements/professional.aspx?productid=705 

Natural Medicines. (2022). Rosemary[Monograph]. https://naturalmedicines.therapeuticresearch.com/databases/food,-herbs-supplements/professional.aspx?productid=154

Petersen, D. (2022). AROMA 203 aromatherapy I (20th ed.). Portland, OR: American College of Healthcare Sciences. 

Petersen, D. (2022). Aromatherapy materia medica essential oil monographs (21st ed). Portland, OR: American College of Healthcare Sciences. 

Shutes, J. & Siegmund-Roach, S. (2022). The carrier oil palette: fixed oils, butters, herbal oils, and CO2 extracts for the carrier oil palette. Aromatic Studes, LLC. ISBN: 9781737233169