resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
December, 2009, Vol. 9, Issue 12
Learning and Unlearning
By Tracy Walton, LMT, MS
In oncology massage, we work with a diverse clientele, with wide-ranging clinical presentations. There are clients in survivorship, perhaps with lingering effects of cancer and cancer treatment in their bodies.There are clients in treatment, whose health can change from week to week, or hour to hour. There are clients at the end of life, whose body systems adapt gamely each day to shifting internal environments. And there are clients who are in the throes of diagnosis, in varying stages of health, navigating a barrage of information that we can only imagine, if we haven't been there ourselves.
In watching thousands of people with cancer and cancer histories, I am struck by how much information, and how many skills, patients learn along the way. They master medical information, often unfamiliar at first. They learn which people to bring into the loop, and whom to hold at bay. They learn how to care for their bodies, under "new normal" conditions. They discover how to filter information, and listen deeply to their hearts, their families, and their physicians.
Massage therapists learn, as well, alongside their clients with cancer and cancer histories. We learn how to listen better, and when to keep our beliefs or judgments about illness to ourselves. We learn to accompany someone along their path, following their lead, bearing witness, remaining present to the process that unfolds, however it unfolds.
Changing the Mechanics of Massage
We also learn and refine the mechanics of working with people in illness and treatment. We adapt many different massage elements, including our pressure, the movement of joints in the session, the client's position, our speeds and rhythms, and even the draping and lubricant we use. (MacDonald, 2007; Walton, 2006)
We adapt these and other things in response to myriad physical changes: bone metastasis, surgical incisions, medical devices, or vital organs functioning at less than ideal levels. We adjust massage to the risk of lymphedema, and to the reality of it. We accommodate symptoms, such as nausea, fatigue, and pain. We work around skin lesions, and adapt to easily bruised tissues. In order to work well and safely in these conditions, we also have to unlearn some things we might have previously held as true. I can think of three beliefs that we've reexamined.
The Belief that Massage Spreads Cancer
The belief that massage could spread cancer has persisted in our field, and it is still taught in some training settings. The belief has kept our hands tied. But with the right interview questions and complete client answers, skillfully applied massage is not expected to spread cancer any more than normal movement or exercise would, and these activities are typically encouraged by physicians, nurses, and PTs in oncology. There are numerous sources of thought and reasoning to help massage therapists unlearn this belief. (Curties, 2000; MacDonald, 2007; Walton, 2006)
Because the belief has persisted for so long, it takes thought, discussion, and full understanding in order to educate others. Simply casting off the belief, without putting proper massage precautions in its place, leads to an empty, uncertain, and unsafe application of massage.
Letting the Client Direct the Session
There are other things to unlearn, as well. We may have to unlearn our tendency to always follow the client's lead in directing the session. Although respect and empowerment of each client is important, as is handling a client's body within his or her comfort zone, there are times that a 100 percent client-centered session is at odds with what we know to be safe. Gayle MacDonald, author of Medicine Hands: Massage Therapy for People with Cancer, points out rightly that the oncology massage therapist may need to take a stronger leadership role in session planning, to avoid overstimulating a client in strong treatment, or injuring unstable tissue. (MacDonald, 2005)
This can be challenging, at moments, when a client wants the strong, vigorous massage that he or she had before cancer treatment. It can be hard to sell a gentler session, against protests that we are treating a client as though he or she is fragile. Yet our professional and ethical responsibilities mean that the client's safety trumps the client's preferences. In the best outcome, the therapist and client plan a massage session together: one that is safe, effective, and addresses the client's needs.
Intuition vs. Information
The role of intuition is another thing we examine closely, and question. For some of us, this means unlearning our reliance on intuition, alone. We may have been taught, "If you're not sure what to do, just follow your intuition, and everything will be okay."
In massage therapy, intuition is a highly prized decision-making tool. For good reasons, our intuitive skills are sacred. But intuition can be fallible. Not all of us have well-developed intuitive skills. Intuition may not be sending us clear signals every day, or we may not be interpreting them well. People tell me from experience that intuition may be "off" on days they've not eaten or slept well, or are under undue stress. Moreover, our own needs and fears, which may be easily provoked when working with clients who are seriously ill, can cloud our intuition and decision-making.
In the other extreme, our decisions are technical, based on information, alone. Intuition may be fallible, but information isn't always perfect, either. Information changes with the times, with the situation, and there are information gaps in our understanding of cancer. By working with people with cancer, we pledge to keep our information as current as possible. One of my favorite teachers taught me that the best combination of intuition and information amounts to wisdom.
Resources in Oncology Massage
For most of us, to unlearn and learn the important issues in oncology massage, we need live, hands-on training. In order to work well and safely, we need a classroom with the give and take of class discussion, opportunities to practice interviewing and massage planning, actual clients with cancer to practice with, and concrete cases to discuss. Others of us have the skills to educate ourselves: we can carefully study the literature, research practices in oncology, have access to the input of health care providers, and learn from our clients along the way.
All of us can turn to growing resources, like the Society for Oncology Massage (www.s4om.org), the newest edition of Medicine Hands by Gayle MacDonald, and the expanding body of research on massage and cancer. For convenience, I've indexed much of the literature on my Web site, at www.tracywalton.com.
The best massage decisions combine the sturdiest information available, professional experience, legwork, possible correspondence with a client's physician, and our own intuition. Sessions are planned in collaboration with the client, and designed to address the client's needs.
Learning and unlearning requires giving up old beliefs, and being open to new information and skills. This is a rich process, and sometimes a challenging one. On the way to wisdom, it's good to know that there are resources to support us.
Click here for more information about Tracy Walton, LMT, MS.
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