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Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
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Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
January, 2014, Vol. 14, Issue 01
Help Wanted: A Call for More Oncology Massage Specialists
By Mia Miller, LMT
I am eager to see a dramatic rise in the number of massage therapists specializing in oncology massage. Consider this a call to action. Reviewing Gayle MacDonald's opening to her book Medicine Hands, "As patients travel the road of the cancer experience, they will have pain that the best medications cannot totally alleviate, their self image will be shattered, they will suffer from lost relationships, anxiety about the future and possibly a sore back from lying too long on a gurney." Here, she describes the deep and penetrating unease that is familiar to many with cancer.She doesn't say it exactly but, as a therapist, I see this as an invitation to utilize the power of presence when with a patient to affirm the fact this person we hold is dealing with more than a physical battle, but a threat that is often enigmatic and silent, difficult to share but with skilled touch, capable of being acknowledged and soothed for a time. It's teachers like Gayle MacDonald (through her texts) and Tracy Walton (her class) who have set the tone for much of my practice of oncology massage and encouraged me to use the movement of my hands over a sore back to both ease pain while affirming and celebrating the life of another.
An Early Career Choice
I discovered my desire to work with clients going through cancer when I was still in training at the Swedish Institute in New York, so the seed was planted early on in my career. I was in a clinical strategies class and writing a research paper on Hodgkins Lymphoma when I was introduced to a young lady in her mid-20's, who two years prior received this same diagnosis. She agreed to share her experience with me. During our afternoon together, I came to know better the various forms of psychological and physical distress she'd suffered as she went through treatment; the neuropathy that lingered in her hands and forearms, the weight and hair loss, ongoing GI distress, chronic fatigue and anxiety, poor sleep, hardened shoulders and increasing neck tension. She knew I was finishing up my training in massage therapy and lamented as she said, "I wish I had known I could have been getting massage when I was going through treatment." I heard her aching for the kind of care we can provide.
Within a year, I was in Seattle training with Tracy Walton in order to be clinically prepared to serve this growing population. I was so clear on the efficacy of the work we therapists could do and the need for our inclusion in comprehensive cancer care. After my oncology massage training, I came back to Los Angeles charged and ready to apply all I had been exposed to and to implement the protocols and think through the various options for treatment. I instantly felt I could establish a meaningful rapport with the various intake questions I had learned to ask and the critical pause of giving space for clients to share their difficult experiences. Many clients felt they could open up when asked to share the side effects of chemotherapy they'd been trying to manage or hopeful when wondering, could our work together help them feel less anxious or sleep better later that night?
Taking the Journey
Around this same time, I volunteered at Roze Room Hospice where many of my referrals were at the end stage of cancer, a wonderful plane in which to be introduced to the deeper emotional connection of our work. It seemed serendipitous that most of the children I saw at Children's Hospital of Los Angeles were in the rehab unit with a cancer diagnosis and finding their way to a new normal. The families were often right there during the massage and were sometimes soothed by the work in a vicarious way or able to learn a technique or two from me to try later on. I see how introducing comforting, skilled touch brings families together in a unique way and allows for a way to communicate without traditional dialogue.
Oncology massage allows me to think critically and problem solve, while engaging real nuances of our hands-on work in a way that is very energizing and provocative. I enjoy the need to monitor my pace and pressure particularly when I am establishing a baseline with a first time client. I honor the compromised lymphatic system and work mindfully in quadrants of the body that have even one lymph node removed so as to protect against lymphedema. I approach my work with more attention in several special ways and this benefits both of us. It's wonderful to see clients gain freedom of movement after scar tissue has been realigned or light up as they describe that after reconstruction their tissue begins to feel less and less like a separate part of them. There are countless examples of the many ways we help our clients as they journey through cancer and treatment, these are only a few.
The professional experiences I describe allowed me to get comfortable and gain some initial confidence, but in a strange way I felt I was on a little island. I know this is not unique to providing oncology massage, as many therapists in private practice feel the effects of working alone from time-to-time, but this growing concern of mine was bigger than that. I had this sense there weren't a lot, if any, therapists around me that were laser focused on providing massage for those going through cancer or if there were, they weren't particularly visible or easy to find. I knew that Memorial Sloan Kettering in New York City had doctors, patients, therapists, support staff, a whole community dedicated to integrating our manual therapy into the care they provided. This kind of environment seemed ideal and I wanted an equivalent here in Los Angeles. I longed for a community of colleagues as there is power in association.
I was aware of the Society for Oncology Massage (www.S4om.org) and how it serves to link therapists to each other and the wider public. I am very comforted by this organization's mission. I have yet to attend their annual Healing Summit which would certainly allow for networking with others who share this passion. I did decide to look up therapists on S4OM's locator service and called the one lady listed in my area. I met her and we talked over coffee. My resolve continues to solidify with each individual I meet that shares their experience and expertise with me.
While I found my passion to provide clinically sound bodywork in the context of cancer, it became more apparent on a purely practical level, that there just might not be enough of us trained and ready to meet the need. I can't even count the number of hospitals, clinics and oncologists treating cancer in Los Angeles alone and if we consider they need us to support their patients, then my initial conclusion seems obvious; there need to be more of us. As integrative medicine gains ground in our changing healthcare system, we will be in high demand. Clients who have already experienced the healing work we do, offer very specific anecdotal evidence to anyone in earshot. As massage therapists, we know how our work brings equilibrium and relaxation to our clients' body's and minds. I think the power of our skilled touch can have a profound impact, perhaps an even greater concentrated effect when mitigating the symptoms, challenges and side effects of cancer and cancer treatment.
Do you want to be challenged in a new way and increase both your curiosity and compassion as you work? Do you want to transform and improve the delivery of health care with your very own hands? Find an oncology massage certification course today and get started! You will be humbled by your increased ability to serve those in their critical time of need. The very act of showing up for another with a equal portion of skilled touch, clinical reasoning and an open heart will amaze and transform you both. I hope you'll join us as we expand and transform the parameters of caring for others through cancer today and tomorrow.
Mia Miller is a specialist in oncology massage and runs her private practice, Somatic Space, in Los Angeles, Calif. She is a passionate proponent of integrative medicine and a therapist at City of Hope and Children's Hospital Los Angeles. Visit her website: www.somaticspace.com.
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