Background. The Old Massage Contraindication 4/1/2011. Cancer, Massage, and the Vital Organ Principle. More Hidden Contraindications

Transcription

1 ,, and the Vital Organ Principle More Hidden Contraindications A Webinar with Tracy Walton, MS, LMT Part 5 of the in Care Webinar Series Background Tracy Walton Author Educator Researcher Therapist Specialist in massage therapy and cancer care 2 The Old Contraindication 3 1

2 Today s Webinar Set foundations Effects of cancer on vital organs Effects of cancer treatment on vital organs Sample massage adjustments for each vital organ Interview questions for each 4 Foundations 1. The concept of Circulatory 2. The Filter and Pump Principle 3. The Vital Organ Principle 5 Is Circulatory? Back in Webinar 1, We challenged the claim But that was about massage spreading cancer This is about increased circulation challenging a person s body during disease 6 2

3 Is Circulatory? Many massage contraindications based on the assumption (or possibility) that massage increases circulation blood flow, overwhelms a compromised organ 7 Is Circulatory? We don t know.? It could be. It might not be. Research has yet to tell us yes or no. This might take a while. 8 In certain medical conditions?? If it is circulatory, does it matter? Maybe, maybe not. We observe that some people feel worse after circulatory massage 9 3

4 In the absence of information We need guidance A guideline. A principle. First, do no harm. 10 If it is circulatory, does it matter? In certain medical conditions?? Maybe, maybe not. We observe that some people feel worse after circulatory massage 11 If it is circulatory, does it matter? In certain medical conditions?? Maybe, maybe not. We observe that some people feel worse after massage with circulatory intent 12 4

5 And base this guideline on the possibility that massage is circulatory. Not the assumption that it is What is with Circulatory Intent? Effleurage Petrissage Repeated compressions 14 The Pressure Scale Medium pressure 15 5

6 The Pressure Scale Pressure Level 3 Medium Pressure - Used to warm up muscles for deeper work - Body mechanics needed; adjacent joints rock - Effleurage petrissage, repeated compressions thought to be 16 circulatory at this pressure and above What is with Circulatory Intent? Effleurage Petrissage Repeated compressions + Pressure Level 3 Medium Pressure (or above) 17 What is with Circulatory Intent? Effleurage Petrissage Repeated compressions + Pressure Level 3 Medium Pressure = Increased Blood (or above) Flow 18 6

7 Foundations 1. The concept of Circulatory 2. The Filter and Pump Principle 3. The Vital Organ Principle 19 The Filter and Pump Principle 20 The Filter and Pump Principle If a filtering organ or a pumping organ (liver, kidney, spleen, or lymph node) (the heart) is functioning poorly or overworking, do not work it harder with massage that is circulatory in intent. 21 7

8 The Vital Organ Principle If a vital organ is compromised in function, use gentle massage elements and adjust them to pose minimal challenge to the client s body. 22 Vital Organ Compromise Vital Organ Compromise Contact Lubricant Pressure Joint Movement Friction Position Site of massage Draping Speed Rhythm Session length Session timing Session intent consultation referral 23 Vital Organ Compromise Vital Organ Compromise Dial it down; take care with Pressure Joint Movement Friction Position Speed Rhythm Session length Session timing Session intent 24 8

9 The Vital Organs Brain Heart Lungs Liver Kidneys 25 Three Steps of Metastasis 26 The Vital Organs Brain Heart Lungs Liver Kidneys 27 9

10 and the Brain effects depend on location of lesion Clinical Features Headaches Nausea Seizures Neck pain/stiffness Disturbances in special senses Speech disturbances Mood and personality changes Memory loss/confusion Problems with balance Weakness or paralysis Numbness/tingling in arms/legs 28 Attention/ memory problems Chemotherapy Attention/memory problems (Chemo-brain) 29 Attention/ memory problems Good communication Simple questions Care with info-gathering Session timing/ appointment reminders Compassion Chemotherapy Attention/memory problems (Chemo-brain) 30 10

11 Questions about Brain Function Has cancer or cancer treatment affected your nervous system at all? Any effects on brain or mental function? If so, what are the effects? Do you have any problems with memory or attention? Any problems with balance or movement? Any problems with etc. (see slide #41 for more possibilities) 31 The Vital Organs Brain Heart Lungs Liver Kidneys 32 Heart function Be alert for DVT, adapt to risk of DVT No spa/heat treatments that raise core temperature Avoid massage thought to increase general circulation Chemotherapy Radiation therapy Heart function 33 11

12 Heart and Activity Questions Has cancer or cancer treatment affected your heart function at all? If so, how? Is your doctor concerned about it? Are there any medical restrictions on your activities? Any restrictions on saunas, hot tubs, heat? What is your activity level, day to day and week to week? What is your energy level? 34 The Vital Organs Brain Heart Lungs Liver Kidneys 35 Breathing difficulty Contact Lubricant Pressure Joint Movement Friction Position Site of massage Draping Speed Rhythm Session length Session timing Session intent consultation referral 36 12

13 Breathing difficulty Position for ease of breathing Slow speed Even rhythm 37 Adapt Position for Breathing Problems Seated Sidelying Semi-reclining Adapt to claustrophobia Adapt to breathing equipment 38 Adapt to Breathing Problems Adapt to claustrophobia Adapt to breathing equipment 39 13

14 Lung and Breathing Questions Has cancer or cancer treatment affected the function of your lungs? Is your breathing affected? Are there certain positions that help your breathing? Any that make you uncomfortable? In what position do you sleep? Do you use any breathing support, such as oxygen? Activity level/energy level? 40 The Vital Organs Brain Heart Lungs Liver Kidneys 41 Liver Failure Clinical Features - Jaundice -Easy bruising, bleeding - Itching - Osteoporosis - Encephalopathy - Ascites Focus here on easy bruising, bleeding Itching The Filter and Pump Principle 42 14

15 Easy bruising and bleeding: Petechiae and Ecchymosis 43 Liver failure with easy bruising/ bleeding 44 Liver failure with easy bruising/ bleeding Gentle pressure overall Gentle joint movement overall 45 15

16 Liver failure with Itching 46 Liver failure with Itching Firm, stationary pressure may be best 47 Liver failure Follow the Filter and Pump Principle 48 16

17 Questions about Liver Function Has cancer or cancer treatment affected your liver function at all? If so, how does that affect you? Is your doctor concerned about it? Any effects on skin? Breathing? Other functions? Do you have any swelling anywhere? Where? What causes the swelling? Any bruising or bleeding? Any itching? 49 The Vital Organs Brain Heart Lungs Liver Kidneys 50 Kidney Clinical Features - Blood in urine - blood calcium - Pain in side/abdomen - Liver function problems - Lump in side/abdomen - RBCs (anemia) - Fatigue - RBCs (polycythemia) - Weight loss - Fever 51 17

18 Comparing Anemia and Polycythemia Anemia Too few RBCs Thin blood Fatigue Dizziness Intolerance of cold Polycythemia Too many RBCs Thickened blood Congestion of spleen Breathing difficulty Dizziness Blood clots Poor clotting 52 Kidney Anemia with Fatigue Dizziness Intolerance of cold 53 Kidney Anemia with Fatigue Dizziness Intolerance of cold Gentle pressure Gradual transitions Slow speeds Slow rise from table Extra draping Dial it down overall!! THE VITAL ORGAN PRINCIPLE 54 18

19 Kidney Polycythemia with Congested spleen Breathing difficulty DVT risk Headache Dizziness Avoid circulatory intent Adjust position Adjust position Be alert for DVT Care with face cradle, pressure Slow rise from table Dial it down overall!! THE VITAL ORGAN PRINCIPLE 55 Vital Organ Compromise Vital Organ Compromise Dial it down; take care with Pressure Joint Movement Friction Position Speed Rhythm Session length Session timing Session intent 56 Impaired Liver Kidney Heart Spleen Follow the Filter and Pump Principle No general circulatory intent Avoid using pressure level 3 & above along with - Effleurage - Petrissage - Repeated compressions 57 19

20 Principles Vital Organ Principle Filter and Pump Principle 58 Essential Resources for Practicing Safely with People with and Histories MacDonald, G. Medicine Hands: Therapy for People with. Available at MacDonald, G. for the Hospital Patient and Frail Client. Available at Curties, D. Therapy &. Available at 59 Essential Resources for Practicing Safely with People with and Histories Walton, T. Conditions and Therapy: A Decision Tree Approach. Philadelphia: LWW, Description and link at Collinge, W. Touch, Caring & : Simple Instruction for Family and Friends View trailers at complete description at

21 The Society for Oncology 61 Contact Information Tracy Walton at Reach us at 62 Additional Questions on Facebook Facebook.com/DrBenBenjamin Some questions I cannot answer Some questions I can answer 63 21

22 in Care Other Webinars in this Series 1.,, and the Myth of Metastasis: Why Skilled Won t Spread 2.,, and Symptom Relief: (Pre-recorded) What does Research Tell Us about the Benefits of? 3.,, and Safety : How is Oncology Unique? 4.,, and Unstable Tissues: Hidden Contraindications 5.,, and the Vital Organ Principle More Hidden Contraindications 6.,, and Detoxification Does Have a Role, or Not? (Pre-recorded) (Pre-recorded) (Pre-recorded) 64 References Chapman C. Lymphedema 101: what every therapist should know. Therapy Journal Winter 2001;39(4): MacDonald G. Bodywork for Patients: the Need for a Less-Demanding Approach. and Bodywork: June/July 2005, MacDonald G. Easing the Chemotherapy Experience with, Magazine March/April 2000, pp MacDonald G. Learning from our Mistakes with Clients. & Bodywork, May/June 2011, pp Walton T. and Therapy: Essential Contraindications (Part 1). Therapy Journal Summer (2): Also available as on line course at Walton T. and Therapy: Contraindications due to Treatment (Part 2). Therapy Journal Fall (3): Also available as on line course at MacDonald, G., Radiation and, and Bodywork September, 2001, Photo/Art Credits Susan Mapel (Slides 7, 8, 14, 61) Eli Kowalski (Slides 22-25) Lippincott, Williams & Wilkins (Slides 23, 54, 58) istock Photo (72-74) Fotolia (Slide 53) Fotolia (Human Form Slides 38, 40, 46, 50, 56, 67) Stephen Fischer (Slides 45, 49, 53, 55, 66) Lenni Armstrong (Slide 39) Microsoft (Slide 80) 66 22

23 Other Webinars Available on Demand Unraveling the Mystery of Low Back Pain Unraveling the Mystery of Cervical Pain Unraveling the Mystery of Shoulder Pain Unraveling the Mystery of Knee Pain Unraveling the Mystery of Ankle Pain All Webinars Available at 67 SPECIAL OFFER JOIN the Benjamin Institute ing List & Receive a FREE Ebook on the Low Back Go to: And click Join Our Mailing List 68 CONTEST How to enter: Write a review of a in Care webinar on Facebook ( You re eligible for one entry per webinar What you can win: Autographed copy of Conditions and Therapy: A Decision Tree Approach A complete set of the in Care webinar series to give to a friend or colleague 69 23