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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.
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.
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.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
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.
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.
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.
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.
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?
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.
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.
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.
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.
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
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.
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.
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.
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."
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.
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.
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.
February, 2010, Vol. 10, Issue 02
Cancer, Treatment and Detoxification
By Tracy Walton, LMT, MS
Some time ago, a client going through intense chemotherapy treatment asked me if deep massage would help her cleanse the drugs from her system. She had read about a number of liver cleansing protocols that suggested very deep massage to facilitate the process of elimination.Her question touched on a number of issues in the oncology massage world and there were several layers to my response to her. I share my answers here, because the issues are relevant for our many clients in chemotherapy.
The Effects of Massage
In the massage profession, we have learned, read, taught and repeated the belief that massage helps move toxins out of the tissues and out of the body. However, we have not always been clear on which toxins, from which tissues, or through which routes of elimination. Almost any substance in the blood, even a nutrient, can be considered toxic if there is too much of it in the blood or tissues, so our use of the term is ambiguous. I once had a physician on my table that was a huge fan of massage therapy, but told me that the profession's liberal use of the word toxin always made him uncomfortable. Invariably, when he asked a massage therapist what the term meant, he received vague, unsatisfactory answers.
Our use of the word toxin seems to imply a waste product or poison that shouldn't be there. In the realm of chemotherapy, the reagents and products of breakdown are known to be toxic, so at least we are on more definitive ground there. But to my knowledge, there is no solid base of research to support the notion that massage moves toxins out of the tissues. By solid, I mean more than a single study. Instead, to be given serious consideration, we need multiple studies, from multiple investigators, in peer-reviewed publications, reporting similar results on this point.
That said, my client was talking about chemotherapy and wanting to eliminate chemotherapy drugs from her body. These medications and their metabolites do have toxic qualities which is why they are used to destroy tumors.
She was suffering greatly from the effects of these toxins she wanted them gone, period. I told her there wasn't much known about the effects of massage in the toxin department, so I couldn't say whether deep effleurage and petrissage would, in fact, speed it out of her system. I also told her I had other concerns about the detoxification approach, which I have described here.
The Intent of Massage
When we work with clients in chemotherapy, our intent is to ease symptoms and support our clients in integrating and managing the effects of treatment. For this reason, we do not impose additional challenges to the body by working it too hard (MacDonald, 2007). So I told my client that even if we knew for sure that deep massage strokes would chase the drugs out of her system more quickly, we wouldn't necessarily choose that approach.
Instead, it makes more sense to let the body set its own pace of detoxification. The organs of detoxification -- the liver, kidneys and skin -- are busy enough without the potential additional demand of a deep, draining, circulatory massage. I told my client that, even without research or clear understanding about massage and detoxification, this is our rationale for working gently.
Additional support for this gentle approach comes from our clinical observations: When clients in chemotherapy receive deep work, they feel worse, not better, afterward. Whatever the reason for that, deep massage is too much for them. These clinical observations inform our practice much more than any attempt to explain them.
A Good Referral
My client continued to press me about what I thought she should do after chemotherapy. She asked about a number of detoxification protocols involving ingesting large amounts of salt water and other substances. They had to do with cleansing the colon and liver. I listened, but stayed neutral. I told her I couldn't advise her either way, it was out of my scope of practice. I told her she had great questions, but that I thought such practices would be safest if done under the supervision of a naturopathic physician or another physician experienced in natural medicine after chemotherapy. And I urged her to raise her questions with her doctor and chemotherapy nurse.
These referrals gave her somewhere to go with her questions and her urge to detoxify. At the same time, I managed to stay within my scope of practice. This can be challenging when our clients ask us for our opinions and advice and these questions come up a lot when we have a whole hour available to our clients. It is important to navigate them in an unbiased way, with supportive listening and good referrals. In the end, this can be a great service to our clients.
Gloving for Chemotherapy
Whenever we talk about chemotherapy and massage, the question invariably comes up about chemotherapy eliminated through the skin: will the massage therapist, in continuous contact with the client's skin, unwittingly absorb some of these toxic substances? For our own safety, should we wear gloves when providing massage to clients in chemotherapy? Should we avoid contact with them altogether? Therapists are understandably concerned about the possibility of picking up chemotherapy by-products through their hands but, like any rumor, these fears have been overblown and somewhere along the line we came to believe it was dangerous to touch all patients in chemotherapy.
Space limits a full discussion of this issue here, but there is an excellent place to go for deeper understanding. The Society for Oncology Massage (www.s4om.org) provides detailed discussion for massage therapists, clients, caregivers and other health care providers. There is a Resource Link for massage therapists where the chemotherapy, toxicity and touch issues are well-addressed. Careful analysis of the risks is provided, bringing massage into alignment with nursing practices during chemotherapy. Conditions under which a therapist might wear gloves are identified, and the current understanding of the issues is made plain.
There clearly is room for more dialogue and research in the profession of massage about the precise effects of our work. There is growing energy devoted to these questions and more resources to turn to. We have the second Highlighting Massage in CIM Research conference to look forward to this May in Seattle (find out more at www.massagetherapyfoundation.org/researchconference2010.html) This conference follows closely on the heels of the second Oncology Massage Healing Summit in Minneapolis (find out more at www.nwhealth.edu/conted/seminars/oncology.html).
I attended both of these conferences the first time around, and they were some of my favorite experiences. In settings like these, the science and practice of massage are addressed by thoughtful people who bring their whole hearts and minds to their massage inquiry. Toxin or no toxin, movement or no movement; by holding massage therapy up to the light, we will come to more fully understand the work of our hands.
Click here for more information about Tracy Walton, LMT, MS.
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