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Treating Pain: The Hypermobile Coccyx
When I write about the coccyx, I recognize that I am talking about a relatively small subset of patients. When I write for Dynamic Chiropractic, I am trying to reach 60,000 chiropractors.
The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
Taking Another Step Toward a Secure Future
In 2008, the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) released a literature review on chiropractic care for low back disorders.
Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
The Clinical Versatility of Milk Thistle (Part 2)
Evidence is growing that the silymarin complex of flavonolignans from milk thistle can impact serum ferritin and iron overload in various clinical circumstances.
From Antiquity to Modernity: Huang Qin Tang at Yale Medical School, Part 1
Traditional Chinese medicine is a coherent medical system with several unique characteristics: it originated almost 3,000 years ago; in its area of origin, it has been practiced without interruption since its inception.
Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
Is There a Neurological Basis and Correction for Macular Degeneration?
Macular degeneration, aka AMD (age-related macular degeneration), is a common eye disease and a leading cause of blindness in people age 50 years and older, according to the National Institutes of Health National Eye Institute.
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
Ethics: The Glue That Holds Us Together
Kudos to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for creating a code of ethics for the nationwide profession and for deciding to make courses in ethics a requirement for certification renewal.
Do Doctors Lie to Patients? (Do You Lie to Yours?)
In a previous column ["When Patients Lie (Bribe or Flatter)," Oct. 1, 2015], I discussed the issue of patients lying to doctors, and the many reasons why this can occur.
Lab Rats (Roaming the Streets)
The title of this article is an accurate description of American consumers (regardless of age) in the modern era.
Percussion Therapy: An Experiment
My study of qi began more than 20 years ago — long before my study of TCM, points or pathways. It all started with an awareness in my hands and physical manifestations in the way of blockages while working on clients.
Window of the Sky Points
The acupuncture points known as Window of the Sky are a modern creation. There is no reference in Chinese medical texts for an acupuncture point category called Window of the Sky.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
The MRI: What to Do With the Results
As I wrote in my previous article on this topic, it is my goal for you, the doctor, to be an expert in interpreting MRI images yourself; and to be able to independently make decisions based upon a combination of clinical presentations and findings, followed by the MRI images.
Chiropractic Around the World: WFC Country Reports December 2015
The following country updates are reprinted with permission from the December 2015 World Federation of Chiropractic (WFC) Quarterly World Report. Information is excepted for space and edited to DC-specific style guidelines.
RAND Study Recruiting DCs
Dr. Ian Coulter, RAND / Samueli chair for integrative medicine and senior health policy researcher for the RAND Corporation, has issued a call for participation, recruiting doctors of chiropractic for a practice-based research study that will examine "the impact of evidence, outcomes, costs and patient preferences on the choice of treatment for chronic low back pain and neck pain."
East Meets West
Gung Hay Fat Choi. Welcome to the year of the Monkey. There will be fireworks for both January and February this year. What great celebrations.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
Interprofessionalism: What it Means and Why You Should Care
Interprofessionalism in education and in practice is a growing trend across health care in the United States. The idea that team-based care and collaborative practice can improve health care has been around more than 50 years.
Enhancing Performance in Cross-Fit Athletes
Cross-fitness centers are expanding in number and increasing in popularity. To remain relevant to this growing portion of society, practitioners need to learn about the exercises and injuries common to this group.
Diet, Nutrition and the Context of Risk (Part 1)
Food and supplement safety is a topic that often comes up when I speak to chiropractors for CE relicensing, even when it is not the advertised subject.
April, 2009, Vol. 09, Issue 04
Hospice Massage: What is Our Role at Life's End? Part 2
By Ann Catlin, LMT, NCTMB, OTR
In part one of this series on hospice massage, I explored how massage eases the many dimensions of pain for the person suffering from a life-limiting illness. The value of massage therapy in pain management is an easy association to make. We feel confident in our role of easing pain and can point to concrete reasons why we know massage is beneficial. But what is our role in serving those who have entered the final stages of life? It's important to gain a broader perspective of the role of massage therapy in hospice care. We can start by understanding a few basics about the process and to recognize that the later stages of life are part of a continuum.
Life-limiting illness means the person has been diagnosed with a progressive condition that affects quality of life and death is eminent within a more or less predictable period of time. When a person enters hospice care, he agrees that the focus of medical care will be comfort and quality of life--not curative. An individual may enter hospice care at any point along the continuum. Some are referred to hospice services at the time diagnosis of a life-limiting illness and receive hospice care for weeks or months. Others don't seek out hospice care until entering the final stages, referred to as actively dying. Active dying is the term used when death is eminent and the body systems begin to shut down leading up to the individual's transition. Certainly our role is going to be very different in serving the person who is actively dying.
When visiting an inpatient hospice unit affiliated with a hospice in the Chicago area, I asked the nurse what the average length of stay is. She told me that it is three days and that many of their patients are actively dying upon admission. This hospice unit offers massage therapy services to patients and their families. So again, I ask, "What is our role?" I'd like to offer a frame of reference that has served me well as a foundation from which to act. These are simple ideas that I have gathered along my own path of service.
Frame of Reference for Serving the Dying Person
To be a healing presence. There comes a point when massage as we know it is no longer called for. Instead we are called upon to bring forth something that comes from deep within--our ability to simply be present. Rather than cling to prescribed techniques, we must trust the simplicity of human compassion and our capacity to offer it to another. Our best resources when serving the dying person don't come from the techniques we've studied but from within our own hearts. We become the space-holder, allowing the dying person his/her own process and experience, and sometimes serve as an anchor for family members and other caregivers.
To enhance the quality of life. Doing what is called for in the moment to ease any form of discomfort is the best approach to take. One minute you might be offering a gentle foot massage or holding a hand and the next, moistening dry lips or helping to turn someone on their side to make breathing easier. One of my favorite quotes is from Mother Teresa: "Let us touch the dying, the poor, the lonely and the unwanted according to the graces we have received and let us not be ashamed or slow to do the humble work." Hospice service is about doing the humble work of each moment as it unfolds.
"But what am I supposed to DO?" you may ask. "If I'm there as a massage therapist, aren't I supposed to be doing bodywork?" These are questions I've heard from my students over and over again. The answer is two-fold: First, we must be willing to let go of our idea of what a session looks like. A session with a dying person may include gentle massage, focused touch or no touch at all. The length of a session varies according to what is called for at the time. The key is sound clinical judgment but also letting the rules go to truly serve the person. Confidence in our skills allows us to listen to our inner guidance and respond accordingly. Sometimes we really have to stop doing and simply BE.
Secondly, it is essential to have a repertoire of skilled touch approaches that are appropriate when the situation calls for them. I understand the need and desire to know some techniques that are safe and beneficial. The following are some hands-on approaches that may be useful in serving the dying person.
Sometimes the most compassionate thing you can offer is holding a hand or the feet while you focus your attention on the inner wholeness of the one you are touching. It is important to center yourself prior to making any physical contact.
Lifting and Shifting.1 This technique involves moving a part of the body for positional change and to ease pressure. Change the adjustment of the bed or add support of pillows under the arms or legs. Mindfully adjust the pillows under the head. Lifting a part of the body and holding it up for a moment relieves pressure.
Synchronized Breathing.2 This technique is effective to help ease difficult breathing. It involves synchronizing your own breath with simple massage strokes. First synchronize the rhythm of your own breath with slow effleurage strokes; breathing in as your hands move distally (toward your own body). Then breathe out as your hands move away from you. Let the sound of your breath be audible. This is a silent interaction. No words are necessary to encourage a natural synchronization with the rhythms of your breath and touch. If the person cannot tolerate physical contact you may remove the touch and focus only on the breath.
Support for the Bereaved
Hospice services must provide bereavement support or counseling for the family of the dying person. Bereavement means the extended period of grief preceding the death and following (usually for one year) the death of a loved one, during which individuals experience, respond and adjust to the loss. Supporting those suffering the loss of a loved one is a way to extend the gift of your touch and ease the impact of bereavement. Other caregivers in the hospice organization may also benefit from your services to alleviate the effects of caregiver fatigue and prevent burnout.
The National Hospice and Palliative Care Organization recognizes massage therapy as a valuable contribution to end-of-life care, stating: "Therapeutic massage is becoming a significant modality in end-of-life care because of its effectiveness in relieving anxiety, pain, and discomfort."3 Serving those in hospice care can be profoundly rewarding as we contribute to the quality of life at a very personal and sacred time of another's life. And, just as importantly, we will influence the nature of end-of-life care.
Click here for more information about Ann Catlin, LMT, NCTMB, OTR.
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