resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
July, 2012, Vol. 12, Issue 07
Additional Insights Into Massage for Peripheral Neuropathy
By Lauren Muser Cates, CMT, S4OM
I have written this as a sort of companion piece to Rita Woods' February article which beautifully explained a protocol to address chemotherapy-induced peripheral neuropathy (CIPN).I use a version of this protocol myself, as do many therapists in the oncology massage community. Much of what Rita shared in the article is good practice and the work that she and Charlotte Versagi have both done in the name of providing massage therapy for people affected by cancer is to be commended. Nevertheless, as the president of the Society for Oncology Massage, I am writing to share some additional background and practical considerations.
I want to start with the assertion about the cause of chemotherapy-induced peripheral neuropathy (CIPN). There is no doubt that many chemotherapeutic agents result in PN, but the exact mechanism is still unknown. There is no clear answer about why certain chemotherapeutic agents cause PN, or even why this protocol works well with PN caused by some agents and not with PN caused by others. The theory Rita proposes is reasonable and is supported by the anecdotal response rate, but the truth is that we really don't know what causes CIPN or why some people get it while others don't.
Working with a client who is suffering from CIPN is much bigger than simply the feet and/or hands that are affected. Safe application of this protocol with a client who is undergoing chemotherapy requires a good deal of consideration. Even a seemingly basic protocol like this one can have grave consequences for the client with cancer if proper precautions are not taken. When we talk about PN, it's also important to remember that there are other reasons a client affected by cancer treatment may be suffering from PN (tumor-related impingement and surgery-related primary nerve damage to name just two). In addition, there are a number of drugs used to treat cancer (thalidomide, velcade and methotrexate, for example) that do not respond well or at all to this protocol.
In my experience with this protocol, working "to the bone" is unnecessary and, in some cases, unsafe. A variety of cancer-specific concerns come to mind when I consider working this deeply. The four most serious are:
It is also important to note (and would be important to communicate to a client) that when CIPN has progressed to the point of total numbness, the application of this protocol will result in the return of pain before the return of normal sensation. Many people describe their CIPN as beginning with tingling and other degrees of paresthesia before it progresses to numbness. For some, it never progresses to numbness. If we imagine the progression of CIPN as a piece of thread going through the eye of a needle, we can imagine this protocol as pulling that thread back through and out of the eye of the same needle. As the protocol begins to take effect, sensation may be returned in reverse order of the way it was lost. Passing back through the eye of the needle, so to speak, can be painful at first.
In addition, it is possible that you may encounter swelling in the extremities. Swelling is a big question mark that can potentially point to serious considerations like vital organ compromise, infection or DVT with any client. When working with a client with a cancer treatment history, this question mark is even bigger.
In closing, it boils down to scope of practice and making good and ethical choices about what is and is not within one's scope. Addressing CIPN is certainly within the scope of practice for a massage therapist with a breadth and depth of knowledge that is appropriate to dealing with a compromised client. It is clearly outside the scope of practice for a massage therapist who does not have this background. It is simply not enough to "just work lightly" (as many therapists say they do with oncology clients) and it is unethical to blindly follow a protocol without a complete understanding of a particular client's medical condition.
Lauren Cates is the current President of the Society for Oncology Massage and an NCBTMB Continuing Education Approved Provider. For additional information related to working with clients with a cancer history, visit the Society for Oncology Massage website at, www.s4om.org. Lauren can be contacted at:
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