Chapter 06: Massage: Benefits to Patients

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Chapter 06: Massage: Benefits to Patients

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Description

In this chapter, Ms. Sumler talks about what massage offers the cancer patient and tells several stories about patients' reactions to massage. She also discusses the supportive attitude of many MD Anderson clinicians, particularly in rehabilitative and supportive care. She notes that to document the safety of massage in the first three years of the massage program, she took patients' vital signs before and after massage. Next, Ms. Sumler talks briefly about the value of yoga for oncology patients. She ends this chapter with comments about how massage makes her contemplative practices manifest.

Identifier

Sumler,PSS_01_20180501

Publication Date

5-1-2018

City

Houston, Texas

Topics Covered

The University of Texas MD Anderson Cancer Center - Building the Institution; Overview; Definitions, Explanations, Translations; Professional Path; Offering Care, Compassion, Help; Patients; Patients, Treatment, Survivors; Cancer and Disease; Professional Practice; The Professional at Work; Multi-disciplinary Approaches

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Disciplines

History of Science, Technology, and Medicine | Oncology | Oral History

Transcript

Tacey A. Rosolowski, Ph.D.:

Yeah, move on. Well, let me ask you about—because I know you do quite a lot of teaching, as well. So tell me about the teaching piece.

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

So I think after we were able to attend the Memorial Sloan Kettering’s course—I also attended with Curtiss Beinhorn, who’s our other staff massage therapist here, and Curtiss came on shortly after I did. And so we came back, and we developed this program, a training program for massage therapists to work with cancer patients. And we had a lot of support from a lot of the faculty, and so we—Curtiss and I taught kind of the massage component, and then we had faculty teaching kind of cancer 101, kind of complications of cancer, palliative care topics, different... They’ve changed through the different years. We had chaplaincy. We had dieticians teaching on nutrition for cancer patients, different things. They were really a comprehensive training program for cancer patients.

Tacey A. Rosolowski, Ph.D.:

What was it called? That’s okay. That’s something... (laughter) It’s okay. People forget details, and when you look at your transcript you can put that in. That’s what I searching for. I was like, what is the name of that thing?

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

I know, it’s like, my mind went... All those years, I should know it.

Tacey A. Rosolowski, Ph.D.:

No, no, it happens, believe me. (laughter) Not to worry, a detail that can be added. Yeah. Now, you mentioned that there were faculty who were really supportive. Who were some of the folks who were most in your corner about this?

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

Oh, goodness, over so many years... I mean, really, I would say—you know, I’d have to just say so many of the—probably all of the physicians from Palliative Care and Rehab Medicine, we’ll just have to say. Of course, Dr. Bruera [oral history interview], Dr. Zukhovsky, Dr. Konzen, Dr. Shin, Dr. Dev... Just on and on.

Tacey A. Rosolowski, Ph.D.:

Okay, yeah. Well, that’s really great. And so that was taught over a number of years. And was it a yearly thing? Twice a year?

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

It was a three-day course, and it was an annual event that we taught over three days.

Tacey A. Rosolowski, Ph.D.:

And who could attend?

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

You had to be a licensed massage therapist. There were some cases where we had exceptions, because some states do not have licensing (laughs) for massage therapists, so kind of on—by one by one we had exceptions, or we might have a nurse or somebody who did not have a massage license who wanted to attend, so... But primarily it was licensed massage therapists.

Tacey A. Rosolowski, Ph.D.:

And how many people would attend these over the years?

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

When it started we had 40 people, a maximum of 40 people, and then it grew to 75, and then our maximum was 100. And that would be kind of 100 plus, (laughs) because we would have other massage therapists who were contractors who would help us with the hands-on portion, so... Yeah. And then eventually it grew, so first it was just massage, and then eventually we added an acupuncture and yoga for yoga teachers component to the training.

Tacey A. Rosolowski, Ph.D.:

What’s your philosophy about teaching other massage therapists? What do you hope to achieve when you, as a teacher...? Because everybody’s a different teacher. So what do you want to achieve when you go in to train other massage therapists?

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

Yeah, I have two goals, and so one goal is that I would really hope that anyone who’s ever had a cancer diagnosis won’t be told that they can’t get massage, that I can’t touch you. So, and then—but really for the massage therapists, that—especially for massage therapists who this is their first type of training that they’ve had on this level—is to begin to see that there’s so much more outside of basic training, and to begin to think critically, to be—to know what they don’t know.

Tacey A. Rosolowski, Ph.D.:

Now, that’s the second time you’ve mentioned thinking critically. Can you give me an example of why that’s so important in what you do?

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

Yeah, so I guess, like, there’s just so many un... I think when you’re trained to do massage therapy, primarily you’re trained to work with a healthy population, and so there’s not a lot of intake. There’s not—you’re not really taught to think what if something’s wrong. I mean, there’s maybe a little bit of that, and it’s probably changed since... When I started, there wasn’t massage school, (laughs) and then eventually there was, and so I went to, like, one of the first schools in the area. There was one school in Houston and one in Tomball, and I went to the one in Tomball. So it’s—and the hours have changed and all of that. But I think that you’re not taught what you don’t know, and that is what you really need to know so that you don’t harm someone. And also, just for an example, I was working with a patient for the first time. I didn’t know this person. And so they were—we were just getting ready to start the massage. He was just getting ready to lie down on the table. And he started complaining of pain in his back. And I ask him to tell me about his pain. And he said that it was his tumor pain. And so then he started to lie down on the table again, and he was just having so much pain. And I told him I thought he needed to sit up, and I ask him again, “Tell me about this pain.” And he said, “Well, it’s in my back, and I just feel like a knife is stabbing me.” And so I just pulled the call button, because this wasn’t a common thing for me. Well, it ended up he had a pulmonary embolism, so he ended up being transferred to the emergency room. But I think on another scenario, if I didn’t know what I didn’t know I could’ve just been thinking, oh, okay, that’s his tumor pain, or that’s his back pain or something, and just tried to massage him or something, but...

Tacey A. Rosolowski, Ph.D.:

No, that’s a great example. Yeah, no, I was just curious, and it was a little hard for me to connect with actually in practice what you would be talking about with critical thinking.

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

Yeah, I think—or, like, for a massage therapist who doesn’t have access, for instance, to a patient’s lab work, so I can look and see what the patient’s recent lab work on... If you don’t know that they’re on medications that could be compromising their platelets and putting them at a risk for bleeding, then you could cause not just bruising, like... If you like deep massage and you get a little bruise, some people don’t care about that. Somebody who’s having to deal with cancer treatment, you don’t want them to [have to] heal from their massage. A little bruise, but if they’re at risk for bleeding, if their platelets are low, then that deep massage could cause massive bruising. So it’s kind of being able to think about, well, if they’re on a new treatment and I don’t know about this treatment, I don’t know what the effects of that—what are the systems of the body that that treatment’s going to affect? And how might massage affect that?

Tacey A. Rosolowski, Ph.D.:

Yeah, it’s a whole different... I mean, putting the context of the massage in counter into—inside a much broader context, and thinking about the impact. That must be really interesting to do, I have to say. You don’t think about it in that way.

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

Yeah. It’s... Well, I love learning, and so it’s just—there’s always an opportunity to learn in every moment. Yeah.

Tacey A. Rosolowski, Ph.D.:

What are some of the most interesting things you’ve learned from this, things that you really hadn’t expected?

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

One thing really—that really kind of... It was kind of just one story that I’ll share with you, that it just really surprised me, was there was a young man who I went to go see in the hospital, and he had an unknown primary disease with widespread bone disease, and he had a lot of pain, and just nothing helped. And he had a lot of bone disease. He had low platelets. I knew it was going to have to be a light massage when I went into the room. Well, it’s one thing when you read someone’s chart—and I guess one thing that always amazes me is, like, you read the chart, but then you meet the person, and they’re a real person, and it’s so different from whatever you’re reading. And I walked into the room, and he had been a college quarterback, and so he just filled up the whole bed. He was, like, this big guy in this bed, young man, and the room was dark, and his parents were sitting in the chairs over by the window, and it was a small room, but they seemed like they were so far away, and they kind of—to me, it looked like Honey, I Shrunk The Parents. Like, they seemed tiny, like they were just teeny-tiny, sitting on the chair. Their son had a washcloth over his eyes, and he was so inward, just trying to deal with this pain. The room was dark. And I just thought, what am I going to do? How am I going to help this guy? Because I saw him physically, and he looked like an athlete. And so in my mind, still part of me thought that he had this athlete’s body that needed this deep massage, and I wouldn’t be able to help him, but I couldn’t do deep massage. And so we do a symptom assessment before each massage, so we use the ESA. So we have, like, 16 different symptoms. I’m not sure how many we assessed at that time; it might’ve been a little bit less. And so I had to ask him to rate—and his pain was an eight or a nine out of ten. And so I did the massage, and after—we had to rate before and after, and after the massage it was an eight or a nine. It was the same. And by the time I got back to the clinic, someone had already called to make sure I was coming the next day, and that happened every day. Every day his pain was eight or nine. It was either eight or nine afterwards. And either his parents or the nurse or his physician called to make sure we were coming back the next day. And I was—part of me was just thinking, well, this isn’t helping. And so I was walking to his room, and I decided, well, I’m not going to ask him to rate his pain today. We already know what it is. And so instead I asked him why was massage important to him, because, I said, “I know that massage must be important to you, because everyone (laughs) wants you to get massage [ ].” And he said, “Because during the massage I don’t have to feel the pain. I can feel the massage, and it feels so good.” And shortly after that he was discharged home for—it was a holiday, and they let him go home, and then shortly after that he passed away. And so I think what I learned from that was no matter how much I want to think I’ve realized something, like, that always I’m capable of having something—some veil come up in my vision where still part of me wanted to see him as an athlete instead of himself, or still part of me wanted to think a body like this has to have a massage like this, and this isn’t going to help. And sometimes just that human compassion and touch can be so valuable to someone, and maybe I didn’t change his pain but for half an hour he got to feel good. And I’d like to think that that was very valuable for his parents, and that that is part of the legacy of his journey with cancer that they got to have, and that was part of their story that they got to have, that this felt so good during that time.

Tacey A. Rosolowski, Ph.D.:

That story’s connecting up with a lot of things that you’ve said this morning. I’m thinking about your description of how you walk into the patient’s room, and you’re trying to figure out what’s my reaction to the patient, kind of assessing how my reaction to the patient is affecting how I—that constant checking in with where you are in delivering your care. And the idea of helping a patient reconnect with their self in a—that inner self, that doesn’t suffer—way, that’s really... And even the whole community piece, having that done with witnesses who really do have an investment in the whole scenarios, because that’s their—part of their story, too. Yeah. We have a few minutes left today, and I just wanted to ask you if there was anything additional that you wanted to share this morning, a follow-up to that story, another story of that kind, of something surprising, or if there’s anything else that I have neglected to ask this morning.

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

I’ll share another story that you had asked earlier about kind of acceptance of the staff and all, and so this was a story that involved another patient, an inpatient, who I went to see, and this gentleman had had a recent lower extremity amputation. And he was a big man. I walked into the room, and his nurse was positioning him in a chair, and had all these pillows, and I could tell that they had been—it looked like they had been trying for a while to get him comfortable. And so I came in and introduced myself, and I said we could do massage in the chair, but he wanted to get back in the bed for massage. And so she called for help, and I waited, and they got him comfortable. Anyway, it turned out that he had gotten massage once a week for years, that he was this person who never wanted massage, and he went on a cruise with his wife and another couple and everybody got massages, and they loved them. They kept telling him he had to get a massage, and he didn’t want a massage, and finally he did. And then two weeks later he noticed that his chronic back pain still was okay. And so he just started getting massage regularly after that, and that was how he’d been managing kind of some chronic back pain that he had had. And now he had had this amputation and he said his back was just killing him, that his back hurt so bad. And so I was able to massage him and help him, and I left, and I was on the unit [ ] [completing] my dictation. And he called the nurse, and the nurse went in there. And then she came out and she said, “I just really wanted to thank you for seeing my patient. It just means so much to me that you did.” And I thanked her, and I said, “Could you please tell me why it means so much to you?” And then she started telling me all these things about Integrative Medicine, that she just loved Integrative Medicine and all of this. And I said, “Yeah, but you told me it means so much to you. Like, why? Why does it mean so much to you?” And she said, “Because when I have a patient that is suffering so much, and I have done everything that I can do, you can come in here and do something that I don’t have time to do. This is the first time he has smiled since he’s been here. Thank you.” And I was like, “Okay.” (laughs) And I think that that’s something that I hear, that, like, a lot, especially, of our nurses, some of them do massage their patients, but a lot of time they don’t have time to do things, and there’s just something that can help someone. A lot of times we’ll see inpatients who are just uncomfortable because they’ve been in beds so long that they’re not discharging because they’re in pain, and sometimes they just need some massage and then they can go home. (laughter) So...

Tacey A. Rosolowski, Ph.D.:

Wow. I had no idea.

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

Well, I mean, I think they’re good about getting rehab in to get people up and work with them, but sometimes it’s just a simple thing. Often it’s like the—people say, “It’s the position I was in during surgery. The surgery’s okay; it’s just, like, this position.” And they just need a little something to get them through that part.

Tacey A. Rosolowski, Ph.D.:

Yeah. Would you like to stop for this morning?

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

Sure.

Tacey A. Rosolowski, Ph.D.:

Okay. Well, thank you for sharing both those stories.

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

(laughs) Thank you.

Tacey A. Rosolowski, Ph.D.:

Those are—they kind of really bring alive what you do.

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

Thank you.

Tacey A. Rosolowski, Ph.D.:

Yeah. All right, well, thank you. And I’ll just say I’m turning off the recorder at 11:55.

Chapter 06: Massage: Benefits to Patients

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