resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
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.
Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
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.
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.
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.
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.
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."
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.
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.
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.
Asking the Insurance Rep the Right Questions
One of the first or last questions a potential patient often asks is: "Do you take insurance?" An ill-informed or optimistic, "yes" can result in delayed or non-payment. Instead, just say: "Let me check if you are eligible first."
Lab Rats (Roaming the Streets)
The title of this article is an accurate description of American consumers (regardless of age) in the modern era.
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.
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.
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.
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.
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.
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.
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.
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.
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."
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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