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B Vitamins Improve Memory, Prevent Brain Atrophy
The 2010 OPTIMA study showed that the accelerated rate of brain atrophy in elderly with mild cognitive impairment could be slowed via supplementation with homocysteine-lowering B vitamins, which included folic acid, vitamin B12 and vitamin B6.
Avoid Random Treatment of Trigger Points (Part 2)
We must acknowledge that the fascia, which surrounds literally everything in our bodies, including every muscle fiber, is more than just a covering.
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.
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.
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.
Expanding Access, Branch by Branch
The big news coming from Capitol Hill isn't merely the recent introduction of a pair of bills designed to expand chiropractic services in the Veterans Affairs and military health care systems; after all, similar legislation has made its way through Congress before, never reaching the Oval Office for presidential signature.
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!
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.
Help Update the LBP Practice Guideline
The Council on Chiropractic Guidelines and Practice Parameters has announced the release of an updated Clinical Practice Guideline for Chiropractic Management of Low Back Pain for stakeholder review and comment.
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.
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.
Impacting Chiropractic's Future With Technology
When it comes to electronic health records (EHR), Robert Moberg and Dr. Steven Kraus are two of the leading industry experts on the topic.
A Reality Check – and a Chance to Educate
Imagine working in the public relations department of nutrition retailer General Nutrition Corporation (GNC) and reading the The New York Times announce...
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."
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.
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.
Primary Spine Care: Addressing Concerns & Criticisms
The Dec. 1, 2013 issue of Dynamic Chiropractic included an article describing the implementation of a training program for primary spine practitioners (PSP) within a metropolitan region and supported by a large BC/BS plan.
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.
Interpersonal Skills 101: Enhancing the Value of Our Patient Interactions
Recently, I read an interesting article in our local newspaper titled "The Value of Human Interaction." The article presented comments from a senior editor for Fortune magazine who discussed "Civility in the Business World."
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.
Low Back Pain: Posture and Movement Analysis
When performing static and dynamic movement analysis of the lumbopelvic hip area, begin with standing visual posture analysis of the pelvis, and then perform lumbar range of motion and assess what you might see during normal versus abnormal lumbar flexion motion.
Atypical Femoral Fractures and Bisphosphonate Use: What to Watch For
Bisphosphonates (BP) are popular drugs, with more than 8 billion in sales in 2008; however, profits have declined as patents began expiring. Nonetheless, BP remain the most commonly prescribed drugs for patients at risk of osteoporotic fractures, with several million prescriptions written every year.
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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