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News in Brief
Parker Announces Executive Director of Parker Professional; Athletic TIPS Program Getting Financial Support; ANJC Award Recipients Named.
Look, Listen and Learn to Code
Study of the Current Procedural Terminology (CPT) Evaluation and Management (E&M) coding system can leave a doctor of chiropractic a bit confused. The description of the five new-patient and five established-patient examination codes takes up several pages in most coding books. The degree of detail and charts used to describe the codes can be overwhelming.
An Introduction to Evidence-Based Clinical Practice - Again
One of your patients is in for treatment and catches you off guard by asking you a question about a news article she recently read. It seems that a new intervention for back pain was found to reduce the rate of serious side effects by 50 percent.
Ask and You May Receive
A friend of my mother has had a problem with her ears for almost 20 years. Whenever the wind blows, it sends shooting pain through her jaw. She has seen any number of medical specialists over that time, but with no relief.
Putting Public Health Into Action: Thinking Globally, Acting Locally
The Chiropractic Health Care section of the American Public Health Association (APHA) met at the 141st APHA Annual Meeting and Exposition in Boston late last year, and it was another triumph for chiropractic and its public health advocates.
Preserving the Natural Resources and Culture of Chinese Herbal Medicine
As the world experiences unprecedented population growth and ever-increasing ecological pressures, the topic of preserving Chinese medicine's natural resources has attracted steadily increasing attention from practitioners.
Qigong to Empower Our Youth
Qigong is an ancient form of exercise and meditation used to promote longevity and health. This practice has traditionally been used by adults to balance the body through mindfulness, focused breathing and gentle movements.
Betraying Patients and the Profession
Imagine flying from New York to Paris on a jumbo 747. Your thoughts are on your vacation and experiencing the City of Lights. Midway over the Atlantic Ocean, you overhear the flight attendants talking in muffled voices.
New Knee, New Pain (Part 2)
The patient presented to the chiropractic clinic with symptoms of genu varum and pain on the medial aspect of the tibiofemoral joint.
Gaining an Independent Occupational Code with the U.S. Bureau of Labor Statistics
One of the most important national activities currently taking place in relation to the development of the field of AOM profession is the Department of Labor's Bureau of Labor Statistics' (BLS) revision of the 2010 Standard Occupational Classification (SOC) system.
The Importance of Staying Focused
Our world is so full of over stimulation and constant information. We live in a fast paced, ever-changing society. If you seek you will receive.
The Many Faces of Cervical Compression
When evaluating the neck, there are any number of orthopedic tests to be considered.
Why Stretching Doesn't Work
Like most chiropractors, a good part of my day is spent working with sedentary office workers who spend eight to 12 hours a day glued to a desk chair in front of a computer.
Climbing the Ladder of Opportunity (Part 1)
President Obama spoke of building "ladders of opportunity" in his State of the Union and Inauguration addresses.
We Get Letters & E-Mail
Let's Restore Integrity to Health Care – Starting With Us; MDs Offer More – So Can We.
An Alternate Method For Choosing The Right Formula For Your Patients
A constant question for us in the clinic is when to make adjustments and when to stay the course. A patient comes in and says, "Things are the same as last week."
Using Facial and Scalp Acupuncture To Treat Neuromuscular Facial Conditions
As a practitioner and instructor of facial rejuvenation acupuncture I have gotten many calls over the past 10 years from individuals seeking help for various conditions affecting the facial muscles, nerves, and overall function of the face.
Embracing the Light
Four years, ago I was diagnosed with a labral tear in my hip that was excruciating and "required surgery" according to an orthopedic surgeon. I tried everything and although the symptoms had mostly abated, I had to give up Yoga practice and everything that could exacerbate the tear.
Acupuncture Ambassadors: A Chat with Leader Anthony M. Giovanniello, MSAc,LAc
When you first meet Anthony Giovanniello, you realize he's a humble practitioner, yet is bursting with a type of dedication that you can't help but be overwhelmingly inspired by.
The Deficiency Myth
If you went to the same kind of medical school I did and took the same kind of licensing exam I took, you were trained to seek out and expect to find primary deficiencies here in the U.S.
Gallop Confidently Into The New Year
Happy New Year! As you may know, this is the year of the Wooden Horse. I received a wonderful gift for Christmas. It is a beautiful glass sculpture of a horse, by Luili Gong Fong, a Chinese artist.
Increased Breast Cancer Risk: Another Implication of High Cholesterol
In addition to being a known risk factor for heart and cardiovascular disease, recent studies have highlighted the link between high cholesterol and increased risk of breast cancer. Breast cancer is the second most common malignancy in women after skin cancer.
Common Disorders of the Temporomandibular Joint
The evaluation and management of craniofacial pain is a complex endeavor, which often encompasses the presence of temporomandibular joint disorders.
The Urinary Bladder Official
The Bladder Official is known as the Official Who Controls the Storage of Water. In Western medical terms, this organ collects the urine excreted by the kidneys.
June, 2011, Vol. 11, Issue 06
Caring too Much
By Ann Catlin, LMT, NCTMB, OTR
Years ago, while sitting in a restaurant with a colleague, I learned something about myself. We each worked as massage therapists in eldercare facilities and it was really nice to talk to someone who "got it." Our conversation took an unexpected turn.We candidly admitted seemingly unhealthy responses to our work — and they were quite similar: distancing more than we thought we should and feeling irritated with other caregivers. There was one thing that stands out. We each were avoiding our work by putting off seeing clients and rushing through sessions. This caught our attention because we both love our work. So, why were we avoiding it? It just didn't make sense. We had a good laugh at ourselves, got some relief and I'm grateful for it even years later (thanks, Jeff).
I now realize that we might each have experienced compassion fatigue. As it turns out, we aren't alone. Anyone in a "helping profession" is vulnerable. Nurses, doctors, counselors, veterinarians, social workers, chaplains, emergency response workers and people caring for aging parents can also experience this. Massage therapists are on the list, too. I think those of us who specialize in working with frail elders and people living with terminal illness are especially vulnerable. Choosing to serve this special population means we are sensitive people to begin with — not a bad quality to have, but maybe it means we need to check in with ourselves from time to time to avoid the toll of compassion fatigue.
Compassion fatigue is a relatively new term. Dr. Charles Figley, an expert on the subject, describes it as, "a state experienced by those helping people in distress; it is an extreme state of tension and preoccupation with the suffering of those being helped to the degree that it is traumatizing for the helper." He goes on to say that, "the capacity for compassion and empathy seems to be at the core of our ability to do the work and at the core of our ability to be wounded by the work."
Compassion fatigue results from the cumulative impact of taking care of people living with serious illness, trauma, abuse or severe conditions. It's different than job burnout, which is dissatisfaction with our employment situation, not necessarily the work itself.
Wanting Others To Be Happy
Compassion is our feelings and thoughts when we witness the suffering of another and the unconditional desire to alleviate that suffering. The Dalai Lama describes compassion as the "wish for another being to be free from suffering and wanting them to be happy." He also tells us that sometimes we confuse compassion with attachment, which is our own personal investment in the outcome of the situation. In other words, when we think we are feeling compassion, we actually are wrapped up in our own emotional needs rather than simply being open to the needs of the other person. Perhaps it's attachment that leads to compassion fatigue, not compassion itself. In my experience, when I truly feel compassion, I'm uplifted and it does my heart good. I feel love.
A perfect illustration of this happened just yesterday to a massage therapist named Jane in a workshop taking place in a long-term care facility. When Jane walked into the elder's room, she was stunned when she took in what she saw — an extremely thin, emaciated woman with severe bruising and discoloration on her arms and legs sitting in her wheelchair, alone. Jane described her first reaction as fear, which turned to sadness for this woman's condition and knowing that she really couldn't do anything to change it. But she conjured up the courage to stay present and focused her attention on this woman rather than the outer condition. The fear softened. She gently massaged the woman's shoulders and neck and she told Jane, "that feels good." Jane shared that following the session, instead of fear she felt good knowing she had made a difference by connecting with this woman. She was able to drop the attachment to the fear and sadness which allowed her to be present and both she and the elder were uplifted in the process.
Knowing the Signs
How can you recognize compassionate fatigue? Some of the symptoms might seem like "normal" stress responses and you might associate them with your work. After all, we live in a pretty stressful world these days. Some characteristics of compassion fatigue include:
Recognizing our vulnerability to these symptoms is important. How can we avoid this reaction or ease them when they happen? The answer lies in holistic self-care. Advice about self care typically includes physical support like regular exercise, getting enough sleep and good nutrition. However, we shouldn't stop there. Nancy Jo Bush, an oncology nurse, says that holistic self-care also includes setting empathetic boundaries; self awareness and self forgiveness; being in tune with one's spirituality and finding hope. The experts agree that reaching out to others and developing a support system is critical. Who would you turn to if you needed the support of an understanding friend? I personally like the advice from a practitioner working in hospice who says, "lighten up and don't forget to laugh."
That reminds me of an old Joni Mitchell lyric, "laughing and crying, you know it's the same release." Thanks, Joni. We'll all try to remember that!
Click here for more information about Ann Catlin, LMT, NCTMB, OTR.
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