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Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
By the Numbers: 3 Common Financial Mistakes With Major Consequences
Warren Buffett is on record for sharing the hidden art of becoming wealthy and making it simple enough for anyone to grasp.
Curbing Label Overwhelm
For the average consumer, reading a food package can be overwhelming: natural, organic, non-GMO, gluten free, free range ... you get the picture.
Are You a Bad Chiropractic Patient?
My father was a great DC. In fact, as you might expect, he was the doctor of chiropractic I measured all other doctors against. Sadly, he died at age 61 when I was in my early 30s.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Coding for the Subluxation: ICD-9 vs. ICD-10
When I attended chiropractic school, I was taught that chiropractors approach health care differently than the traditional medical establishment.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
Knee Pain From the Kinetic Chain
As practitioners of manual medicine, chiropractors often treat patients suffering from knee pain.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
Immunizations by Colorado DCs: Really?
You probably didn't hear about it, but back on Nov. 21, 2013, the Board of Directors of the Colorado Chiropractic Association (CCA) adopted "immunization authority" for Colorado DCs as its No. 2 legislative goal.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Physical Exam 101: The Hands
I am sure you are familiar with the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
The Science of Stretching
In 1986, Rob DeCastella set a course record by running the Boston Marathon in 2:07:51, just 39 seconds off the world record.
Remembering Clarence Gonstead and 50 Years of the Gonstead Clinic
Dr. Clarence Selmer Gonstead (1898-1978) took chiropractic practice from back-alley bone setting to an understandable biomechanical science. His life was dedicated to clinical competency.
Why You Should Include the Single-Leg Stance Test in Every Patient Assessment
The single-leg stance (SLS) test, also known as the single-limb stance test, unipedal stance test or one-legged stance / balance test, is often used in the geriatric population to assess static postural and balance control.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Fibromyalgia: Put the Pain in Its Place
While some fibromyalgia patients respond favorably to regular chiropractic care, others experience minimal relief. Unfortunately, many of these patients must rely on pharmacological management to relieve their constant pain.
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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