Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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The Risks I Took
We all take risks when we choose this profession. For some, it is not knowing if you can make a living practicing TCM. For others, it is parental or cultural disapproval.
Treatment of PTSD: An Opportunity for the Practice of Integrated Medicine
PTSD is widespread across America today. Not only do many of our honored men and women in uniform bring it home with them from the war zones they have been active in, but it often follows any life-threatening event people go through when their lives have been in danger.
News in Brief
Investigating the Cellular Impact of Mechanical Force; National Board Seats (Not-So) New Officers at Annual Meeting.
Key Changes and Updates to the 7th Edition CNT Manual
Acupuncture Today recently interviewed Jennifer Brett, ND, L.Ac. regarding the updates to the CNT manaul.
NCCAOM Video Contest
The NCCAOM is excited to announce the launch of the second annual video contest "Because it Works!" 2015.
Going On-Site With Chiropractic Care
The Foundation for Chiropractic Progress has released a position paper highlighting the financial, clinical and patient-satisfaction benefits of providing chiropractic care at on-site corporate health clinics.
Marketing with a Microphone
When given an option, it stands to reason that people prefer to do business with those they know, like, and trust.
Nomenclature and Classification of Lumbar Disc Pathology: Version 2.0
The Nomenclature and Classification of Lumbar Disc Pathology consensus, published in 2001 by the collaborative efforts of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology, has guided radiologists, clinicians and the public for more than a decade.
Meet Cheyenne: Your Future Colleague
Allow me to introduce you to Cheyenne (Chey), the daughter of some of our family's closest friends. We attend and serve at the same church together, and have known each other for many years.
An International Life: An Interview with Mary Elizabeth Wakefield
I met Mary Elizabeth Wakefield during her class last summer in Seneca Falls, New York at the Finger Lakes School of Chinese Medicine.
Integrative Medicine for the Underserved: A Seat at the Table
Numerous organizations have risen to the challenge of providing care to medically-underserved populations and here we feature one such group.
Should You Change an Athlete's Natural Running Form?
Once past the ankle, impact forces travel at about 200 mph into the knee. In addition to allowing the quad to absorb force, bending the knee (E) prevents the hip and pelvis from moving up and down too much (F), which is important for injury prevention and efficiency.
Free Yourself From the Pocketbook Practice
Let's take a journey together; there's an important lesson to be learned. Imagine a town or city just like yours.
Sports Medicine 101: Surgery or No Surgery?
In the world of sports medicine, many careers are saved by surgeries that correct traumatic damage to the body. Muscle tears, ligament damage, fractures, spinal disc herniations, and joint instabilities are a few of the issues frequently addressed with surgical intervention.
Desert: A Metaphor from the Study of Genetics
In most of the human lives I know about, there are stretches of time which feel stagnant, or worse. We can feel adrift, or wounded and sidelined, and these times don't seem to carry much usefulness while they are unfolding.
The Source-Luo Point Combination, Part 2
The Da Cheng includes symptoms for the source-luo points that indicate when to use them for treatment. Yang defines the method as the guest-host (it is one of a variety of acupuncture point combinations called guest-host).
The Three Heater Official
This Official, belonging to the element Fire, is responsible for maintaining and regulating the heating system of the body, mind, and spirit. It is named for its function. The trunk is divided into three "burning spaces" or "jiaos."
Creating Relationships at Southwest Symposium
The month of May brought many interesting activities. As I have said in many previous columns this year, this profession is moving in a very exciting direction. Make sure you are getting involved. If you're not, you just might get left behind.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 3)
A patient with sacroiliac fixation and dysfunction ordinarily demonstrates a noticeable leg-length inequality when placed in the prone position on the adjusting table.
I was sitting in a Pizza Hut in Peoria, Ill., with my friend Reggie, sometime in the spring of my senior year in college, when he started doodling on his paper placemat. In those days, the company had a picture of U.S. on the mats, showing all the locations of the "Huts" in the country.
Q&A With the First VA Chiropractic Residents
As you may have read previously, a major step forward for the profession occurred in July 2014 when the Department of Veterans Affairs began piloting a chiropractic residency program at five locations.
December, 2013, Vol. 13, Issue 12
Know What You Are Dealing With: Radiation Therapy and Massage
By Tracy Walton, LMT, MS
Radiation therapy, often abbreviated as XRT for "X-Ray Therapy," is sometimes brushed aside as having fewer side effects than other cancer treatments. But radiation therapy can have strong effects on the body and some require significant adjustments in the massage session.
Myths and misinformation about massage and cancer treatment prevent patients from receiving good, supportive massage therapy care.
Radiation therapy is roughly classified as external beam radiation therapy (EBRT or EBT) and internal radiation therapy. External radiation is the more common of the two, where the patient lies on a surface and a machine, called a linear accelerator, delivers a beam of radiation to the tumor.
It can be used to shrink a tumor before surgery, prevent recurrence after surgery, or it can be used as palliative care when lesions cause pain.
Two Types of Radiation Therapy
External radiation treatments are usually only a few minutes long — most of the patient's session is spent making sure they are properly lined up on the treatment table.
A radiation oncologist typically maps out a specific field of treatment to treat the tumor from a number of angles. This is done to best target the tumor and spare the healthy tissue surrounding it. The sessions themselves are also usually painless.
Internal radiation often involves the placement of small radioactive implants inside the body near the tumor cells. This internal application, also called brachy therapy, allows for a higher dose of radiation and a more focused approach without the risk of damaging too much neighboring tissue.
Internal radiation seeds can be implanted and left in the body (such as with prostate cancer), a wand can be placed and removed (such as with gynecologic cancer), or a radioactive iodine solution can be ingested (as with thyroid cancer).
Touch and Radiation Therapy
Education about massage and cancer is limited in most basic training programs. As a result, a common misconception among massage therapists is that any client going through radiation therapy is "hot" and "radioactive" and either the practitioner should only touch them while wearing gloves, or the client should not be touched at all.
But the truth is that, in the case of EBRT, the radiation source is the linear accelerator which stays in the room. The client is not "contaminated" and the therapist should make appropriate massage adjustments for other factors in cancer treatment. It is safe for a massage therapist to touch the client.
In the case of internal radiation therapy, clients are considered "hot" if the implants are still in and if they are still radioactive (and not expired seeds, as in the case of prostate cancer). You should ask the client ahead of the session.
Ask where and when the internal radiation was implanted, and if there are any contact precautions in place. Most people are already following these precautions and clients are unlikely to seek out massage unless they are cleared for contact.
Radiation is aimed at the cancer cells, but nearby tissues in the path of the beam may be affected as well. Clients can experience swelling, reddening or change in pigmentation and dry and/or itchy skin. They may lose hair in the radiation field.
Another common side effect is overall fatigue. It often starts up a few weeks after treatment begins and can linger for weeks or even months after treatment is complete.
Some side effects depend on where the radiation field is located. Here are some examples:
One complication of XRT is of particular note for massage therapists: Radiation treatment can injure lymph nodes, and lymph nodes in the neck, axilla or groin are often included in the field. This can put a client at lifelong risk for lymphedema, a disfiguring, debilitating and often painful condition that can cause a host of complications.
There is little specific research on massage for clients in XRT, but our clients tell us that the contact of skilled touch can be healing. Relaxation during a stressful time and relief from side effects such as nausea, fatigue and pain provide welcome possibilities for clients.
The key is making sure we apply this touch safely. Finding out how to best serve our clients going through radiation therapy, or who have recently completed therapy, starts with asking the right questions in the intake interview. Here is a "starter list" of questions for these clients:
Therapists will find many massage adjustments for radiation treatment echo common sense: On a current or recent radiation field, we use no friction, pressure, no heat, hot stones or cold therapy, nothing besides hospital-approved lubricants (metals are contraindicated and fragrances can be irritating) and generally no direct contact if it's a current field.
A simple hold through the drape may be possible over a dry radiation field, and the hands-on contact may be soothing. Any other sort of technique brings with it the risk of disturbing healing skin and other tissues, or further exacerbation of skin changes such as flaking, itching, blistering or weeping.
Because the risk of lymphedema is very real in many clients after XRT therapy, it is important to fully understand the condition before attempting to work with clients with histories of cancer treatment. Lymphedema risk is an example of a "hidden contraindication." The adjustments are not intuitively obvious and working safely requires good interviewing and hands-on skills.
If key lymph nodes were in the radiation field, there are strict massage adjustments in pressure, stroke direction, joint movement and position.
It is essential to avoid anything that would redden the skin or injure the intact lymphatic structures. "Just working lightly" is not a complete guideline here and the wrong pressure, thermal application, joint movement or stroke direction could trigger irreversible, chronic lymphedema.
For specifics, refer to Gayle MacDonald's Medicine Hands: Massage Therapy for People with Cancer.
Language is Important
When speaking with a client, we do not ask about "radiation burns" or refer to any areas as "burned." Although we essentially treat these areas as if burned, in cancer care these areas are referred to by more neutral terms: "skin changes" or "skin effects."
For complete massage therapy guidelines, therapists are referred to the Society for Oncology Massage, to the literature on oncology massage and to the growing availability of specialized training.
Because radiation treatment can place a significant demand on the body and effects are often cumulative, oncology massage therapy is careful and does not introduce any more stressors.
Click here for more information about Tracy Walton, LMT, MS.
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