Category: Pain

Things I Didn’t Know

You learn something new every day:

In Women, Hernias May Be Hidden Agony – NYTimes.com.

Unlike hernias in men, which are far more common, those that afflict women are usually small and internal and rarely cause an obvious bulge. Symptoms can be suggestive of other problems — ovarian cysts, fibroids, endometriosis or adhesions from a previous operation — but surgically correcting these conditions does not relieve the devastating pain.

“On average, women go through four prior surgeries, and some a lot more than that, before the real cause of their pain is identified,” said Dr. Deborah A. Metzger, a gynecologist in Los Altos, Calif., who specializes in chronic pelvic pain.

When a woman lies flat on the examining table, the signs and symptoms of a hernia disappear. And the usual exam, an ultrasound, rarely reveals the real problem. Lacking an accurate diagnosis, doctors often send patients to be drugged up by pain specialists and psychiatrists.

Not only is this something to keep in mind, the next time I have a client complaining of intermittent, undiagnosed abdominal pain, it helps to explain a few things.

First of all, when doctors can’t find the source of a problem, they often decide that the problem must be ‘psychosomatic,’ i.e. ‘not real.’ They may not directly say so, but sending a woman suffering from excrutiating abdominal pain to a psychiatrist can be an act of violence in itself. It sends the signal, “I don’t believe you,” and “you must be crazy.”

Second of all, it illustrates a scenario where non-invasive therapies like Reiki could appear to have an effect, however temporary. Lying flat on a table causes the hernia symptoms to disappear, and a treatment which mainly promotes relaxation–and thus the release of abdominal pressure caused by stress–could mask the symptoms for awhile longer.

This doesn’t mean I’m recommending Reiki for hernias. It does mean that I have a some better questions to ask in cases of pelvic pain.

When to See a Doctor

Know your anatomy!You wouldn’t think people would ever get their massage therapist confused with their M.D., would you? You’d be surprised.It’s touching and flattering, how often I am asked for my input on potentially serious medical conditions. Possibly this is due to the fact that 1) I see a lot of people in varying degrees of pain, uncertainty and confusion, 2) I ask probing questions, 3) listen to the answers, and 4) read continually. Finding news of effective treatments for the conditions that plague my clients is one of my joys. I learn as much from them as they learn from me.

However, it ought to be staggeringly obvious that I am not a doctor. Massage and bodywork can be excellentsupplemental treatments for all manner of ills, but they should never be a substitute for comprehensive medical attention. When you have a diagnosis, I’m happy to tailor your session to support your treatment plan, but I know my limits. Here are some of the symptoms that will cause me to refer you for a check-up before I’ll see you again.

  • You have areas of unexplained hypersensitivity, or severe numbness. Since I work on a lot of people, I’m familiar with the range of pain sensitivities in healthy people. If you’re flinching when I touch you lightly in a place that shouldn’t hurt, if you have no feeling in a major limb, or if you insist that I ‘go harder’ when I’m working deeply in an area which should be sensitive, I want you thoroughly checked by a neurologist.
  • You have severe constipation over a long period of time. I once had a client who wanted two-and-a-half hour sessions to address her chronic constipation, but who categorically refused to see a doctor about it. “What could a doctor do?” she asked me, seemingly rhetorically. “Check you for diverticular disease and colorectal cancer,” was my response. It would be irresponsible of me to continue treatment until these possibilities have been ruled out.
  • You have unexplained swelling or bloating in your extremities. “It will go away on its own,” is often what my clients report hearing from their doctors. But if the swelling has no obvious cause, I think you should be tested forheart, liver or kidney problems.
  • You have a suspicious-looking mole on your back. One minor service I provide for my clients is keeping an eye on areas of the body that they don’t normally see. Most people know to visit a dermatologist if they have anirregular mole that changes appearance; if you’ve got one on your back, I always ask if you’ve had it looked at.
  • You suddenly start having migraines. Many of my clients have suffered from migraines for years; they find that regular massage can reduce the frequency and severity of their episodes. But if you’ve never had a migraine before, you should see a doctor before getting a massage.

A doctor’s job is often to do triage in an emergency; my job, as I see it, is not to ‘fix’ a problem, but to facilitate healing over the long term. Massage is less like a drug and more like a tonic–it stimulates the immune system, the parasympathetic nervous system, the endocrine system and the musculoskeletal system to balance and repair themselves. The subtle connections among seemingly disparate systems and processes fascinate me. My clients never have to worry that they’ll bore me, telling me their aches, pains, worries, triumphs, or last night’s bizarre dream. But they also know that they can count on me for the occasional blast of common sense.