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Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
September, 2012, Vol. 12, Issue 09
Compassion Really Is Good Medicine
By Ann Catlin, LMT, NCTMB, OTR
Some think compassion is an attribute reserved for spiritual leaders. But compassionate presence isn't just reserved for people who travel a moral high ground. It's something we all can cultivate and draw upon when life calls us to the bedside to care for someone in need.For massage therapists, compassionate presence is both a personal quality and a professional skill that has an increasing relevance in today's health care.
There are various definitions of compassion. Benevolence and loving-kindness are other words that describe this heart-centered human experience. All the definitions have, at their core, this commonality: compassion is heartfelt concern for the suffering of another, or one's self, coupled with feeling moved to do something to bring about increased wellbeing for the one who is distressed. I'm sure we can all think of times when we experienced compassion: with a client, with a loved one, with a pet, with the homeless old man on the sidewalk. We would likely all agree that it's good to feel compassion. Scientists are interested in the impact of compassion and they're finding that it's, well, good medicine!
Interestingly, the study of compassion is thriving. The Center for Compassion and Altruism Research and Education within Stanford University's School of Medicine conducts scientific studies of compassion and altruistic behavior. Researchers here are finding that compassion lends itself to being measured. Scientists are looking beyond Western "hard science" — traditional, biological science — to see what they might learn about human behavior and emotions from other paradigms, especially heart-centered ones such as Eastern philosophies. Neuroscientists are using brain studies to look at how compassion affects us biologically.
Antonio Damasio, Professor of Neuroscience at the University of Southern California, reports that emotional states are created by brain activity in the hypothalamus, basal forebrain and brain stem primarily, plus they rely on the release of neural chemicals. For example oxytocin, a peptide, known as the "care and connection" hormone, which is stimulated by touch and physical contact. Evidence also suggests that brain measurements don't show much difference between a person suffering extreme pain and the person who witnesses such an experience in another.
Research conducted by Richie Davidson, founder of the Center for Investigating Healthy Minds at the University of Wisconsin reveals that when people experienced in mediation witness people suffering, MRI scans show increased brain activity in areas related to nurturing and social connection. When people who do not meditate observed the same suffering, their brain activity increased in areas related to more negative emotion such as sadness or aversion, resulting in their wanting to leave the situation. When this second group was taught and practiced loving kindness meditation, their brain scans revealed changes similar to the first group.
A study published in the Journal of Clinical Oncology showed that 40 seconds of compassionate communication from a physician could reduce anxiety among breast cancer patients, as well as increase the patient's confidence in the doctor and positively impacted the doctor-patient relationship. If you've been to a doctor's appointment recently, you've likely noticed the ever-present computer screen in the room and the doctor's attention is focused on the screen for, at least, part of the visit. While I understand the efficiency of electronic documentation in health care, I fear that this procedure is one more insult on an already fragile doctor-patient relationship in modern health care. I appreciate the work of Paul Tournier, a Swiss physician and proponent of "medicine of the person," an attitude emphasizing that attention be given to the holistic nature of health problems. This approach places the person on the same level as technique or theory. It embraces dignity, suffering, intact abilities, acceptance, validation, intuition and purpose. Dr. Tournier encouraged authentic communication with patients and recognized how it could improve the experience for healthcare professionals helping them to find greater satisfaction in their work.
Cultivating Compassionate Presence
For years, I've made the point that compassion is a natural human quality that is omnipresent and that we can bring it forth with intention. Because I'm in the process of cultivating my own awareness, I enjoy finding guidance from the masters. In a conversation between The Dalai Lama and Paul Ekman, a prominent American psychologist and researcher, they agree that compassion is cultivated through training rather than it being a spontaneous emotion. Ekman believes that compassion is different from emotion. He explains that emotions arise spontaneously and that we are born with the capacity to experience a range of emotions. But compassion, he claims, needs to be cultivated if we are to extend it in the world. Once we have integrated compassion into our world view, we are more likely to automatically respond compassionately, even to strangers. With practice, as in meditation, compassion becomes a part of our permanent nature and then arises more spontaneously. There is a myriad of heart-centered mediations. I've modified this one that's taught by Jack Kornfield, a leader in bringing Eastern meditation practices to Western culture. The intention is to bring the mind and heart together.
Practicing Compassion Meditation
Sit comfortably. Be in your body and focus your attention upon your breath. If you wish, place one or both hands upon your heart center. First, you will direct loving kindness to yourself.
Picture two or three people who care about you. Imagine them looking lovingly at you. These might be people in your life now or in the past or even spiritual figures. What would they wish for you? Repeat these simple phrases imagining they were saying them to you.
How does that feel? Notice what arises and remain centered. Try not to judge any thoughts, but simply let them pass through your mind. Most loving kindness meditations use the word "I" where I've used "you." The reason I've suggested it this way is that I've found in my own practice that it's powerful to accept loving attention from others. You can substitute the words so that they resonate for you.
Now picture someone you would like to send compassion to. It might be someone you are close to, a client or a stranger. It might even be someone you are having a challenge with. Repeat the same phrases, directing them to this person. You might even hold a photo of the person in your hands.
Again, sit for a few minutes simply noticing anything that arises. To end, take in a deep, cleansing breath and bring your awareness back into your body. Offer thanks for the experience in whatever way you wish.
Touch is Person-Centered Care
I believe massage therapists have the power to offset the impersonal nature of healthcare today. We carry the torch of Tournier's vision of person centered medical care! Our service is sorely needed in hospitals, eldercare, homecare and hospice where so many people feel lonely, helpless and broken. We can do a lot to offset these feelings and offer a sense of well-being in their place. There are times we can draw upon simple techniques combining compassionate presence with touch. The following focused touch technique can be used anytime you are called to the bedside. Let's say a 72-year-old woman has been coming to you for three years for massage. You get a call from her daughter telling you that your client has had a serious stroke and now she's in the hospital. Could you please visit her there? As you walk through the hospital, you feel nervous and many thoughts are running through your mind. What will she be like? I know I can't massage her like before, so what can I do? Will she be in pain? Will I be sad to see her this way? I feel so bad for her. What should I say?
First, it's important to center yourself before you enter the room. This helps to focus your attention and calm you. You are touching her with your presence and energy just entering the room. So take a deep breath and ground yourself.
As you walk into the room your client (friend) appears to be sleeping. There are monitors attached to her and an oxygen tube at her nose. You might feel a little stunned to take in the scene. It's a normal reaction to be a little shocked. You decide not to wake her but rather sit quietly in the chair across the room and while sitting there you feel sad and a little afraid. This is exactly the kind of situation where the compassion meditation can serve you well. Compassionate presence informs you and leads to the next right action. Now you are ready to offer the gift of your touch.
This simple technique is especially useful when you are with someone who is seriously ill. Focused touch is a powerful expression of compassion when words are lost, creating a sense of well-being and decreasing feelings of loneliness.
Stand at the bedside. Gently place one hand either under her hand or upon the forearm. Then cradle the shoulder with your other hand. Simply hold her while silently saying the compassion meditation, directing the words to your friend. Presence will inform the quality of your touch. To close, slowly release the touch, keeping your attention on your friend. Offer thanks for the experience.
In closing I send these thought to you: May you be well and live your life with ease. Thank you for the opportunity to assist you on your path of service. Pass it forward!
Click here for more information about Ann Catlin, LMT, NCTMB, OTR.
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