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The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
November, 2012, Vol. 12, Issue 11
Using Touch Therapy to Care for the Dying Child
By Tina Allen, LMT, CPMMT, CPMT, CIMT
Owen was a young teenage boy with a brain tumor and he came to the hospital as an outpatient toward the end of his life. Candace Linares, Pediatric Massage Therapist, remembers what he said to her on one of her visits, "Massage is the only thing that makes me feel better." He was in and out of the hospital for a total of three years, and during that time was able to tell her what helped him feel better. "I like my feet massaged," Owen said. "Today can you help my shoulder?"
As Owen became increasingly ill and began to enter the dying process, his requests for the massage therapist became less about actual massage techniques and more about to simply "be" with him. Two days before Owen's death, Candace entered his hospital room. At this point, he was unable to speak and in an unresponsive condition. Owen's nurse asked Candace to give him a massage. She began to massage his hand and then stopped. "I felt a very strong sense to stop and wait," she said. "I spoke to Owen and, at that moment, I realized that what would be most helpful was to be completely honest, and I said, ‘Owen I really do not know if you even want massage at this moment.' I instead quieted myself and held his hand." Owen passed three hours after this last visit.
No one wants to think of a child being too ill to play with their friends, or to even venture outside. Our hope is that they will get better and the memories of time in the hospital will be in the past. This is not always the case with children in palliative care. As a child's condition worsens, their palliative health care team begins to discuss options with the family. There are lots of considerations. Does the family want to let the child die naturally? Would they leave the hospital and make their child comfortable at home? More and more, parents are opting to make their child comfortable and enjoy those last precious days of life.
The Difference Between Pediatric Palliative Care and Adult Palliative Care
The causes of childhood illness and death are different than those of adults. So, the care of pediatric patients is also different. Not only are healthcare providers faced with difficult decisions, so are the pediatric patient's parents. They are faced with the reality of choosing between the benefits of using medical technology and improving the child's quality of life.
Palliative care for children aims to improve quality of life for the pediatric patient, as well as for their family. This is done through management of pain and other physical symptoms, as well as emotional and spiritual support. There is growing evidence that the health care system is failing children and families when they are confronted by a life-threatening illness. Children continue to undergo painful procedures and suffer from the symptoms of their diagnosis without ample relief.
In addition to the many traditional pharmacological approaches, there are numerous other pain management strategies and approaches, including complementary and alternative medicine (CAM). CAM is becoming increasingly popular for individuals with chronic or life-limiting illnesses. The term CAM is often used as an umbrella term to encompass many different approaches. This is where it is important to take a closer look at each intervention for its effectiveness. In regards to pain reduction in palliative care, the most utilized CAM therapies include massage, aromatherapy, hypnotherapy and reflexology.
Massage Therapy For Pediatric Pain Relief
Pediatric massage not only provides for pain management without the use of invasive interventions, there are a host of broader benefits for the pediatric client. Massage may aid in the reduction of stress, anxiety and other psychological symptoms, which in turn may improve their quality of life. Cortisol (stress hormone) has shown noted reduction in the use of massage therapy. However, when it comes to children living in palliative care, pain management is of serious concern.
Tragically, each year 50,000 children in palliative care die, with less than 1 percent receiving the care and pain management they need. Every one of these fragile lives deserves to pass free of avoidable pain. Pain is one of the most commonly reported symptoms of children in palliative care. A child's pain may increase along with the stress and fear associated with the life-threatening diagnosis, as well as the discomfort associated with their growing symptoms. Despite the fact that the modern medical system has the means to relieve a child's pain, many children suffer with their discomfort.
Pediatric massage is a gentle, noninvasive therapy which supports the physical and emotional health of pediatric clients, is one of the most commonly utilized CAM techniques, and has been shown to provide many benefits to the pediatric client including a reduction in pain. There are two theories that have been commonly used to help us to explain how massage therapy may be helpful in reducing pain. In the Gate Control Theory of pain, it has been suggested that therapeutic massage blocks pain signals from reaching the brain (i.e. "closes the gate"), which in turn reduces the experience of pain. The Deep Sleep Theory suggests that massage therapy slows substance P (a pain chemical) production and increases production of serotonin. These changes might increase the amount of time an individual spends in deeper sleep and minimizes their pain.
Living in the Moment
When working with children in hospice and palliative care, listening and living in the moment is very important. In some cases, if you have an appointment scheduled, call to confirm in case the young client has passed before you have your first session. This can happen at any time, but is even more common when working with this population. Knowing that the session you share may be the one and only requires focus and living in the moment. Listening can be one of the most important components to working with children using massage. It becomes even more important when there is chaos surrounding the environment. When a therapist enters a room where there is suffering and pain, you must listen. Not only do you need to listen to the words that are said, but also to words left unsaid.
Listen to Your Heart
As much as it is crucial that we listen to our client, their parents and the environment, we must listen to our heart and provide ourselves with self care. We talk about self care for therapists when working with all populations. However, when you are working with children who are terminally ill, self care is critical to provide the best care for not only yourself, but also your young clients.
Self care can take make many forms. From taking a day to relax, meditate and practice yoga, to having a massage yourself and/or speaking to a counselor or therapist. In doing this work, I often advise pediatric massage therapists to keep a confidential journal. A journal where we can relate our experiences, joyful memories and those moments we don't want to forget. Taking the time to write out our thoughts, gives you a chance to express your feelings without having them be so raw and on the surface.
Working with children who are dying brings out many emotions; happy, sad and calming. Knowing the child you have worked with has finally becomes comfortable, falls asleep and passes, is a wonderful benefit that gives the family comfort. Because they now know their little one is finally able to rest in peace.
Click here for more information about Tina Allen, LMT, CPMMT, CPMT, CIMT.
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