resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Branding: Set Your Practice Apart
Dr. Brad started his practice seven years ago on a shoestring budget. He created his generic logo in five minutes using a website because he didn't have the time to figure out how to make something special.
News in Brief
New President / CEO Takes Office at Yo San University. Electroacupuncture for Constipation?
Dedicated to Defending Chiropractic
Whether you're a veteran DC or a first-trimester student, the name George McAndrews should be part and parcel of your professional vernacular, as familiar as the word chiropractic.
Assessing Core Stability and ROM: 5 Basic Checks
One of the first steps in addressing core stability is assessing static posture, ranges of motion, and motion of the pelvic bones, sacrum, femurs, lumbar spine and thoracic spine.
Little Sticker, Big Impact
It's the end of an election year. Hilary Clinton and Donald Trump were the subject of conversation for everyone, everywhere for the entire 2016 calendar year. I don't think any of us can deny that this election affected us all very deeply on a personal level.
A Simple Protocol for Holiday Stress
It's winter, a time when we should be deep in reflection, eating warming foods and sleeping long hours. Following nature's rhythms, we restore our bodies and minds in preparation for the renewal of spring.
Molecular Motors: Tiny Machines Behind the Rhythm of Life
In the clinic, we aim to restore healthy patterns of movement for qi that has gotten trapped or misdirected, or may have even collapsed. We may be focused on freeing stagnation, releasing heat or redirecting counterflow qi, but it often comes down to helping re-establish a flow of sorts.
2016: A Year in the Life of Acupuncture
Happy Holidays, may you, your family and friends have peace, joy and blessings throughout this special time of year. As 2016 comes to a close, we can look back and celebrate the many events and accomplishments for the profession of acupuncture.
Southwest Acupuncture College Brings It to Division 1 Athletes
When Michael Phelps' photograph with the distinctive round marks left by cupping went viral, the Division 1 student athletes treated through the Dal Ward Athletic Center at the University of Colorado (CU) could relate.
Herbs for Digestion: The Power of Bitter
Many cultures (and indeed herbal clinicians) around the world have long respected the role of bitter herbs and foods for promoting digestion. For example, aperitifs – drinks consumed before a meal to stimulate appetite and digestion – were originally derived from bitter herbs.
6 Steps to Make 2017 Your Best Year Yet
People often ask me what defines success. Success, for me, is simple: doing exactly what you want to do in life. Whether it's the kind of practice you run, your life at home, your hobbies or something else, it's achieving anything you put your mind to.
Another Chance to Make a Difference
Just a few months ago, "the worst natural disaster to strike the United States since Hurricane Sandy" hit Louisiana. During this storm, one area experienced 31 inches of rain in 15 hours as almost 7 trillion gallons of water rained down in just one week across the state.
Chiro School Reunion: Whatever Happened to...?
I opened the door to the closet slowly, carefully, since I knew it contained a large number of precariously stacked file boxes. It also held numerous outdated gizmos with electrical cords of various lengths that could trip or strangle a person.
Can a Multivitamin Reduce Breast Cancer Recurrence?
There is a great deal of controversy regarding the value of multivitamin supplements in cancer prevention. However, with respect to preventing breast cancer recurrence, an important study was published in the Journal of Breast Cancer Research and Treatment in 2011 by Kwan ML, et al.
What We Can Learn From Spine Surgery
Patients with lumbar stenosis presumably present for conservative care to improve their quality of life and avoid surgery. However, providing clear guidance to these patients can be difficult for a number of reasons.
DVT: Know the Signs and You Could Save a Life
I lost a friend several months ago. He died from a pulmonary embolism (PE) secondary to a deep-vein thrombosis (DVT) that originated in his lower leg. Bobby was in his mid-60s, soft-spoken and had a big heart.
Overuse Injuries in Young Athletes (Pt. 2)
Most overuse injuries are benign, but there are some high-risk injuries that, if unrecognized or inappropriately treated, can result in significant loss in time from the sport or even require leaving the sport.
End of an Era Looms at NYCC
New York Chiropractic College recently announced that Dr. Frank Nicchi will retire in August 2017 after 36 years with the college, the past 17 as president.
Meshing TCM With Environmental Pediatrics: Where's the Overlap?
Pediatrics has a long history within Chinese medicine dating back to the late Han dynasty (i.e., the late 200s CE), with the two primary areas of emphasis being herbal medicine and xiao er tui na (pediatric massage).
A First for the Profession: CCE Accredits First Chiropractic Residencies
The Council on Chiropractic Education (CCE) has awarded accreditation to all five chiropractic residency programs currently administered at Veterans Administration facilities, "the first residency programs in the nation ever to be awarded this distinction, a significant advancement in the evolution of chiropractic education," according to a VA press release announcing the milestone.
A Letter to the Profession from the New President at AAAOM
Volunteering for a national, nonprofit organization brings with it such highs, lows, and accomplishments, as well as a steep learning curve.
A Q & A About Updated Codes
Yes, indeed there was an update to ICD-10 on Oct.1, 2016. This is a regular update to the diagnosis coding system and this type of update will occur every Oct. 1, just as it did when the ICD-9 system was in place.
March, 2004, Vol. 04, Issue 03
Spotlight on Research
Nurturing Touch in the Neonatal Intensive Care Unit (NICU) at Stony Brook University Hospital on Long Island, New York
By Editorial Staff
Editor's note: This periodic column keeps you abreast of the latest research documenting the benefits of massage and bodywork.Recently, Massage Today spoke with Patricia Cadolino, LMT, CIMI, facilitator of the nurturing touch massage program in the neonatal intensive care unit at Stony Brook University Hospital in New York. Below is Patricia's poster session, which was presented at the 2002 and 2003 AMTA National Conventions, followed by the interview.
A parent education program for premature or medically fragile infants in a critical-care hospital setting. This is a supportive and developmental-care program that encourages and empowers parents to provide individualized touch for their high-risk infants.
1. Hand Containment: This is the first introduction of touch providing a safe, supportive environment. When the infant cannot be held, parents are instructed to hold their infants through the portholes in the incubator.
Benefits include: Enhanced family bonding, stabilizing infants' heart rates, improved breathing patterns, and decreased oxygen needs.
Benefits include: Enhanced family bonding, improved heart rate and breathing patterns, increased weight gain, improved lactation, and helps regulate body temperature.
Additional benefits of positive touch: Minimizes the negative impact of hospitalization and helps infants avoid touch aversion; reduces pain and stress from the many necessary medical procedures.
Benefits include: Increased weight gain, decreased fussiness and crying, more organized sleep patterns, and earlier discharge from the hospital.
Depending on the infant's weight and gestational age, and with medical clearance, parents are advised on the best form of touch that will most benefit their babies. These techniques emphasize the variations in premature responses. Parents are taught to read the stress and behavioral cues to avoid putting additional stress on the infant while providing safe, positive and loving communication through touch!
Interview With Patricia Cadolino
Massage Today (MT): You've been at Stony Brook for five years?
Patricia Cadolino (PC): Almost six years.
MT: Can you tell us a little bit about how things have changed from the time you started your work at the hospital until now, and discuss the evolution of your work over that period of time?
PC: Sure. I started out part-time on a research grant. It was a Ryan White research grant. Ryan White was the boy who contracted AIDS through a blood transfusion. The hospital applied for an alternative medicine grant through the [Ryan White] foundation, and in that grant was massage and acupuncture. I was hired on that grant as a massage therapist, and that is when I was working with HIV and AIDS-infected infants, drug-addicted infants, pregnant women and adolescents. The hospital went on to open their own complementary center, but it did not work out and the center was shut down; however, there were administrators that were so supportive of me and my work, and they hired me as a state employee. I was the first in New York state. It was quite the venture [for a] government hospital. Once I became a state employee, I was on the professional line, and that is how I started. From that point, I kind of just made my own way. They gave me what I needed: an office, a treatment room...
MT: So, you were hired as a state employee of the hospital in the capacity of a massage therapist?
PC: Yes. They gave me a different title as a "clinical support specialist" under the nursing division, because everything [must be] listed within specific categories and titles. That is how the administrators got me into the position. Basically, I have just worked hard in lecturing and educating, and teaching medical students.
MT: What types of lecturing and educating are you doing?
PC: All about massage. When I am in the pediatric department, I discuss what I know from my pediatric background. Otherwise, it is reviewing the benefits and the research, and how massage can be used in a hospital setting and a home setting.
MT: How would you classify the differences between using massage in a hospital setting versus a private office setting?
PC: The benefits are great while the patient is in-house, but you never do any kind of deep work while they are in-patient. And with the younger children, we try to get the parents to massage the children at home. I don't treat many younger kids out-patient here. It is mostly adults.
MT: Has the scope of what you're doing shifted from infant massage to other types of patients?
PC: It is such a mix; I wear many, many hats. My love is working with the children because I went on for further training. I have been certified for 11 years to teach baby massage, but I went on for further training to work with the premature babies. I went to the University of New Mexico, and St. Luke's Hospital in Kansas City, Mo., in the Tender Touch program. So, since I had been trained to do that, I went to my bosses and supervisors and said, "This is what I would love to do," and they allowed me to do it.
MT: Do you have the support you need from other staff members, or do you find that some staff members are still a bit reluctant to embrace the benefits of massage?
PC: A little bit, but it is getting so much better. I really do see a shift. I see a change happening.
MT: Do you see massage evolving into a regular practice in hospitals everywhere?
PC: Yes, I do. I'm quite proud because I worked really hard to make a lot of positive connections with some key people in the hospital, and I've made my way. I think perseverance, a lot of courage, and consistency has really catapulted me into such a different arena, such a professional arena. I'm like a fixture now, and it's really quite nice, so I will get more referrals now, but you have to remember, the hospital's huge - about 3,000 employees - so it's a very big place; still, I have made great strides over a short period of time to incorporate massage into the [hospital program].
MT: If there were a couple of areas where you wish you had more support or more feedback from your work colleagues, what would those be?
PC: Definitely more referrals. It is a state hospital, so there is always a financial piece that comes into play, and a lot of the patients can't afford it. There are a lot of services that the hospital provides for free, so I see that the staff wishes that it [were] just part of the hospital stay. [Massage] is a fee-for-service.
MT: How much does that fee usually run?
PC: It is $40 per half hour, which is very reasonable. I worked in another hospital where it was $100 a massage.
MT: Are any of these patients able to get your services covered with their insurance?
PC: Only a few. The New York State No-Fault Insurance Law states that insurance companies must pay for massage; unfortunately, you have to get into a car accident to get massage [covered].
MT: Are you still working in the NICU (Neonatal Intensive Care Unit)?
PC: Yes. In fact, I implemented a nurturing touch program, which is a parent-education program that deals with developmental care. Each baby is assessed, and I work with the parents on the form of touch each baby is ready for. Initially, I used to have to charge parents for this class, and I used to feel so guilty, so I again went to my administrators, presented this, and they decided to make it a part of the baby's hospital stay, so it is free of charge. That is one service that I'm really pleased with.
MT: In some regards then, at least financially, the hospital seems to be trying to work with you in as much capacity as it can. With any program, money always seems an issue.
PC: Always, right.
MT: Making massage part of the baby's stay, does the hospital incorporate the extra fees into the overall charges, or does it absorb the fees?
PC: They added it under parent education. Also, there is the staff support issue, which is how I presented it to the administrators. It's not only a beautiful benefit to the parents. There is so much involved - it's very intense. When you're dealing with the parent of a premature baby, touch-and-go. And what happens is, instinctively, the parents really shut down. There is the fear of attaching. They don't want to become attached, and it's very scary because the baby is very sick, and in that fear, they refrain from touching. There are a lot of studies that have been done on this and it's phenomenal.
So, the parents are afraid. Or, on the flipside, you'll have a parent ever so gently stroke their baby with the tips of their fingers, but neurologically the baby can't handle that and can't process it, so the baby responds in a negative way: the monitors start flaring, the baby's oxygen saturation levels drop, and the nurse will come over and say, "Mom, please don't touch the baby." Because when you touch the baby, the baby gets upset and it becomes a very negative dynamic.
Now, the mother feels more depressed because the baby didn't respond well. So, with my program, pressure is everything. You have to have moderate pressure; it's relaxed, but moderate. And it's more like just holding and containing, not so much stroking, right away. And the baby processes that beautifully; they can handle that. It's comforting to them.
MT: What is the reason for that? Why is holding and containing ok, versus stroking?
PC: It takes the baby a while to process that hold and that's why we do it in stages: because some babies can handle the stroking right away, but others can't - they get overstimulated. A full-term baby at birth is not neurologically complete. So, as you can imagine, a premature baby is way under the gun. That is why it is such a blessing that I'm there, because I'm able to work with the parents early on. They get the confidence and the know-how of how to interact with their baby in a positive way. The baby responds better and the parents feel better, and it creates a wonderful family dynamic that is a little bit healthier.
Not that this is a cure-all, obviously. And I have worked with a lot of parents that have lost their babies. But the positive note on that is, at least the parents have some time to connect with the baby in a positive way before the passing.
MT: As far as the staff education is concerned, when you begin to develop these patterns of the baby responding to the parents, does the staff respond, as well? Is the staff learning along with these parents?
PC: I have done separate work with the staff. I just offer the research and my knowledge, and offer hands-on practice. One time, one of the neonatalogists had a grandchild in the unit, and he had me go in and work with his daughter-in-law; he thought that would be a great way to get the staff to see how it works. I've seen it evolve through just the perseverance and commitment and consistency, and people see [the benefits] over time. Now, the staff is starting to show the parents hand containment as a tool.
MT: Dedication seems to be a good word to describe what you have done because you have dedicated your time and yourself to this endeavor, no matter how long it has taken.
PC: Right. And I am really quite pleased. The hospital is going to be expanding and building a brand new unit that is state-of-the-art. They have called me in to be on the steering committee to make sure that things are done for developmental care for my areas of touch [with the] lighting and sound, all for the developmental care for the babies. I am so proud of that because this program will then be a part of the team. It will be a standard of care. I am really pleased with that.
MT: It has to be really stressful for you personally, working with these distraught parents and ill babies. Do you ever find yourself becoming emotionally involved? How do you find your balance to avoid emotional burnout?
PC: I am a very sensitive person to begin with, and I, initially, would cry when the mothers cried - I couldn't help it. I have children and I was able to relate. But I knew eventually, I would have to become strong to be able to deal with this, and I have. I have gained a lot of strength over the years, and breathing and meditation gets me through it, to be honest. I have to take care of myself and replenish the energy. That's what I have found works really well for me. Over time, just developing confidence has helped, too.
I'm not going to deny that, initially, it was scary to be in the position that I was in and have that type of placement. Once I gained confidence and strength, I found it a lot easier, and now I'm a lot stronger for the parents and I'm a good support for them.
MT: Do you have any advice for those wishing to pursue something along the same lines, especially in working with a hospital? How would you advise a massage therapist to get started?
PC: Every hospital is unique. They have different financial needs. A lot of the hospitals are in trouble, so it's hard to start adding new programs, but I would say to start with the Hospital-Based Massage Network, which is run by Laura Coke. There are many wonderful books on the market on how to begin a hospital-based massage program. Just research and know your stuff before you approach the hospital administrators.
MT: And certainly persistence, as you have been very persistent and that has led greatly to your success.
PC: Right, but I also know that a lot of people that have been persistent are still finding closed doors because of financial and insurance crises. There is a crisis, right now. Hospitals are losing money and laying off employees. Here in Nassau County alone, they were laying off a couple of hundred thousand people.
MT: And yet, in the midst of some of these layoffs, you have managed to sustain. That speaks to the validity and importance of your work.
PC: Right. I also think it's [because this is] a teaching, research hospital, and I made my own way to get money for research. I've worked very hard to get positive anchors.
MT: It's almost as though you have done most of the footwork. You've taken away the responsibility from the administrators to find the resources. You've come up with the resources...you've done it all!
PC: Yes, and I think that is why they feel so blessed with me as well, because they're so overwhelmed. They work 24/7 and they're overwhelmed with it; that's how the dance has been successful.
MT: Do you have any current research projects underway?
PC: Yes, I still have the research working with pediatric oncology patients, and we are teaching the parents how to massage them at home. And we're also working with the parents to do mind/body work - we're taking a look at reducing the parents' anxiety and stress, as well as that of the child. We'll be looking at pain and sleep scales to reduce the anxiety, and we'll be looking at cortisol levels for both parents and children.
We are working on another [project], as well, looking to work with cardiac patients, since the hospital has a heart center. We're currently in the discussion stages and planning, and it's looking good.
MT: Do you have anything else you'd like to add?
PC: Well, I'll just continue to make my way. The only thing I would really like to do this year is more in-services, more grand rounds. The more that I can educate the staff, nurses and doctors, the better off I feel that I'll be.
My favorite is the medical students. I find that working with the med students so early on really gives them a positive twist on massage. It is all going to roll and hopefully, they'll incorporate it into their practices, so that massage will become a standard of care. That's what I find rewarding: working with the medical students before they go out into private practice. I would like to see massage become the standard of care, and get it into more hospitals. And the same thing applies to the nurturing touch program. I'd like to see more intensive care units around the country have these programs for the parents and for parent education.
MT: Thank you so much for your time, Patti.
PC: You are so welcome!
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