Sunday, August 28, 2011

Kindly remove your fantasies from my profession.

I am a critical thinker and an outspoken fan of the scientific method.  Which is why it probably seems strange to some people that I am also a massage therapist by trade.

I do massage because it feels good.  I was drawn to it after experiencing massage while healing from my own spinal surgeries; precisely the kind of anecdote I now write off as nonevidential.  Massage is poorly studied (a problem I often dream of correcting), but there are indications that it is beneficial for chronic low back painosteoarthritisfibromyalgiachemotherapy-induced nausea, and a host of others.  (Here you can find a great list of things for which massage has been studied on a small scale, most of which are punctuated by the maddening phrase, "Further research is needed.")

I recognize that the benefits of massage are partially intangible.  There is something about taking an hour for yourself, during which you are listened to, touched in a therapeutic manner, and generally cared for that works wonders for your sense of well-being.  I am even willing to acknowledge that these less measurable details are probably responsible for the oft-bullet-pointed benefits of massage: lowering blood pressure, decreasing anxiety, reducing headaches, etc.  To go one step further, I'll even admit that our #1 showing on the osteoarthritis and fibromyalgia studies is probably due to the current dearth of medical treatments for those conditions.

So in the end, I do massage because it makes people feel better.  I don't make promises I can't keep; I can't cure anything, but I am pretty sure that I can make you feel better.

Which is why the massage community drives be absolutely batty.

In massage school, I had my first introduction to the world of "energy therapies."  This stuff was integrated seamlessly into our training, but it just never made sense to me.  We were learning real things, things that made sense, and then they would throw this energy stuff into the mix and blow my mind altogether.

I thought I had some sort of mental block.  I tried to understand it in my own terms.  I even sought to reconcile this stuff with what I knew by thinking, 'they say energy, I think emotions.  It's really the same thing.'

But it turns out, I did have a mental block.  My brain is pre-programmed to reject nonsense.

Massage therapy is the manipulation of soft tissues for the purpose of muscular relaxation.  So how - HOW - did the massage world get so tangled in woo?  How did reikicraniosacral therapyreflexology, or anything involving qi get so ingrained into our practice?  Why must one accept nonsense as a prerequisite to practice massage?

It's not just my city or the MT's I know.  It is prolific throughout the U.S., and if internet forums are any indication, the world.  Associated Bodywork and Massage Professionals (ABMP) is the largest professional organization for massage therapy in the States.  Here is a sampling of cover stories from the last few issues of its publication, Massage & Bodywork:
  • Energy and the Integrative Vision
  • Reflexology Relief
  • BodyReading the Meridians
And there are many more pseudoscientific gems within its pages, interspersed with a few great articles about massage therapy practice.

I just don't - can't - understand why, with such a fantastic tool (massage) at our disposal, the massage community at large has elected to beef up its image with absolute nonsense.

Earlier this year in Texas, a bill was introduced that addressed 23 different CAM modalities, each one of which was either too vague to define any specific practice, or complete and utter nonsense.  (If you care to read the bill, here you go.)  Essentially, this bill specified that those practices were CAM, were not meant to diagnose or treat anything, and their practitioners were not licensed to perform them.  It allowed for any person to seek out these "treatments," and required that the unlicensed practitioner provide the client with a printed form containing specific verbiage, all to let the client know that they were getting an unproven treatments from an unlicensed, probably untrained person.

Immediately, the massage world went into fits.  You see, passage of this bill would have prohibited massage therapy schools, which must follow a state-prescribed curriculum, from teaching any of the 23 CAM modalities listed.  That means that not only would they have been barred from teaching energy healing in the basic licensure programs, but they would not have been able to offer CEU classes in craniosacral therapy, Shiatsu (or any other TCM), aromatherapy, Ayurveda, or a few other brands of woo.

I understand that this impacts the schools' cash flow, and I don't wish to harm them in that way.  But I am just a little bit offended that the institutions whose purpose is to teach massage therapy - real, scientific, measurable - will fight so adamantly for their right to teach nonsense.

It's like teaching a class on reindeer training and gift delivery methods, branding it Clausology, and then fighting for your right to practice it unfettered.  

This concludes my rant for the evening, and probably my presence in the good graces of dozens of massage therapists.

Wednesday, August 17, 2011

When New Motherhood Meets Quackery

I hate being wrong.  Even more than that, I hate admitting when I'm wrong.  Not only do I hate the admission, I'm terrible at it and will avoid it whenever possible.  (Just ask my husband.)  So I hope you will appreciate my discomfort as I write this confession...

When my son was a few months old, he began teething.  It happened suddenly, and it appeared to cause him intolerable pain.  He wouldn't nurse and couldn't be comforted for more than a few minutes at a time, a heartbreaking situation for any parent.  Desperate to find relief for him, I picked up a bottle of Hyland's Homeopathic Teething Tablets.  As soon as Mikey would start to cry, I'd shove a few tablets into his mouth.  It seemed like magic - he would immediately stop crying.  Even better?  You can't overdose on homeopathy!  I could safely give him as many tablets as it took to soothe his pain!  At ten bucks per bottle, we must have gone through more than a dozen bottles during the course of his teething.  We had them in every bag, car, room, and sometimes our pants pockets.  I would attest to anyone who asked that this stuff worked.

My understanding of homeopathy at that point was limited.  In fact, I didn't understand it at all.  Now that I do, I shake my head in embarrassment at my behavior during those months.  I'll chalk it up to being a hormonal new mom, but in reality, it was entirely my failure to study something that I desperately wanted to be real.

Just in case you don't know, here's a rundown of homeopathy:

In 1796, German physician Samual Hahnemann came up with the "law of similars," on which homeopathy is based.  At the time, cinchona bark was used to treat malaria.  Hahnemann noted that cinchona bark tended to produce the same symptoms as malaria.  Homeopathy is founded on this observation.  It uses the principle of "like cures like."  For example, cayenne may be used as a treatment for fever, since cayenne and fever both cause sweating.  Pause and absorb that little tidbit of absurdity before we move on.

A homeopath will assess the patient's symptoms, and decide which "remedy" is appropriate.  The next step is to prepare the remedy.  During this process, a tiny amount of the "active" ingredient is placed into a comparatively huge amount of water.  This tincture is shaken in a very special way, including ten sharp whacks against an elastic substance, a process known as succussion.  After it is succussed, they take a tiny amount of the tincture and dilute it again into a large amount of water, then succuss again.  Then they do it again.  And again.  And again and again and again until all that remains is water.  Let me reiterate: all that remains is water.  It's JUST WATER.

Homeopathic remedies have been tested repeatedly, and have been found to contain NONE of the original "active ingredient."  When testing became available to prove this, the homeopaths formulated a response: Water has memory.  It can remember that long-lost drop of belladonna it used to contain.  Somehow, though, it manages to forget all the fecal matter it has carried.

If they are preparing a tablet, here are the additional steps: Pack together a bunch of little lactose tablets (sugar pills).  Take your homeopathic tincture and place a drop on each tablet.  Let it dry.  Tah-dah!  Homeopathic pills.  Even if water had magical memory and like actually did cure like, they have let all the magical water evaporate from the pills!  I haven't yet heard anyone say that lactose has memory.

To clarify the dilutions: If you look at the back of a package of homeopathic preparation, you will see a number followed by the letters C or X.  Hahnemann's C scale means diluting a substance to a factor of 100 at each stage.  A 2C dilution means diluting something to 1:100, then taking some of that diluted substance and diluting it to 1:100.  This works out to be one part of the diluted substance in 10,000 parts of diluent.  Hahnemann believed that a substance gets stronger the more it is diluted.  Most homeopathic remedies are diluted to 30C.  

At 30C, you would have to consume 10^34 gallons of water, or 10 billion times the volume of the Earth, to consume a single molecule of the original substance.

Oh, and that Oscillococcinum you can buy at CVS, right next to the real medicines as a cold remedy?  Duck liver diluted to 200C.  You do the math.

Anyone who takes a moment to understand the basic tenets of homeopathy can surely see the absurdity here.  Unfortunately, so few of us take that moment.  Our society is currently scrambling toward anything labeled as "natural," "organic," or "chemical-free."  Unfortunately, this has made us easy prey for charlatans, quacks, and crooks.  I was so desperate to find some relief for my son that I turned to something that is patantly ridiculous, and I believed that it worked.  In retrospect, of course it made him stop crying.  I was shoving pure sugar into his mouth.  It always makes me happy to have sugar in my mouth.  In fact, if I learned that making a certain noise would cause people to put sugar in my mouth, I'd probably make it a point to make that noise more often.  

No, I probably didn't cause him any harm with my actions.  I just wasted some money and made myself into somewhat of a fool.  But I am not okay with being foolish.  I live in a world in which a healthy dose of skepticism can be quite confrontational.  I think I have permanent bite marks on my tongue from all the time I spend trying not to offend people.  I understand that we must respect others' choices and beliefs, but the fact is that sometimes people believe things that are patently wrong.  I certainly did for a time.

Wednesday, August 3, 2011

Mine to Tell

Ours to Tell is a wonderful project, begun in March of this year.  By inviting women to tell their personal stories about abortion, it seeks to change the false perception that women who choose abortion are callus, misinformed, or any of a thousand other inaccurate adjectives frequently applied.  
I posted this piece to Ours to Tell on March 28.  I must thank my mother - my brave, strong, wise, beautiful mother for allowing me to share her story.

The abortion that changed my life happened in 1972, eight years before I was born.  My mother, a 16-year-old preacher’s kid, found herself pregnant and terrified.  She knew what happened to girls in her community who got “in trouble”.  Her father would force her to marry her boyfriend, another 16-year-old whom she may have loved, but certainly did not want to marry.  She and her boyfriend made the most difficult decision of their lives and pooled their money to obtain an abortion.  My grandfather went to his grave never knowing.
Four years later, when Mom was a college student visiting home for the holidays, she met my dad at a church party.  They were married 92 days later, and will celebrate their 35th anniversary next week.  My brother is 32 and I am 30.  My son, my mother’s only grandchild, is 2.
I’ve spent my life surrounded by those who would rail against abortion by calling it a violation of God’s will.  To those I would say this: Do you believe my parents’ 35 years of marriage is God’s will?  My brother’s existence, or mine or my son’s?  None of this would be, if my mother hadn’t made the decision she did at 16.  If you believe in a god who planned for the three of us to be on this planet, a god who sanctioned my parents’ union, then you cannot believe that the decision my mother made at the age of 16 was a violation of that god’s will. 
Mom is a nurse, and worked in women’s health for most of her career.  She is an amazing wife and mother, an astonishingly successful professional, and a kind and loving person.  She is not a murderer.  Nor is the man with whom she conceived a child all those years ago; He is a good man with a beautiful family.  
I fight for women’s rights because I believe it is the moral thing to do.  I am often asked, “How can you look at your beautiful child and still support abortion?”  The answer is easy for me.  I look at my son, and I am eternally grateful for the abortion that paved his way into my arms. 

Tuesday, August 2, 2011

This is not progress.

Originally posted on my Facebook page May 19, 2011:

There is a curious thing happening to the American view of health.  We have stopped looking at health as merely the absence or modulation of disease, and have started paying attention to lifestyle habits that promote wellness.  This is a wonderful change, with the potential to save billions in health care costs, not to mention untold amounts of suffering from disease.

There is a drawback, though.  This acknowledgement that we play an important role in the wellness and maintenance of our own bodies has opened our minds to all sorts of new ideas.  Some of them are great - for example, we now have a much better understanding of the chemical makeup of our foods, and how that affects our bodies.  However, many of the ideas being hyped to American consumers to promote health are utter bunk, complete ridiculousness.  The negative extension of our desire to do something positive for our bodies is that people are suddenly much more receptive to snake oil salesmen.  The number of unproven supplements, products, and treatments claiming to be the magical key to health and longevity is staggering - Americans spent $33.9 billion on them in 2009.

Compounding the problem are people like Dr. Mehmet Oz, the strapping young TV physician of Oprah's making, who has now completed his slow drift into the ether and planted his flag firmly in the camp of woo.  Proponents of alternative medicine have done an extraordinary job of reclaiming ideas that Western medicine has been pushing for decades - healthy diet, exercise, avoidance of destructive behaviors - and rebranding them as components of unscientific concepts.  Not only does this lend some idea of effectiveness to whatever supplement or plan they're selling, but it allows them to throw stones at the medical community for not thinking of it first. 

Here's a great example: "I lost 20 pounds in a month on the hCG diet!"  Well, of course you did.  They made you cut back to 500 calories per day before they would inject you with hCG, a hormone that has been proven in well-controlled clinical trials to have no effect at all on weight loss.  You lost weight because you barely ate anything, not because they injected you with magic.  And yet, proponants of this plan will harpoon the medical community and Big Pharma (a favorite scary-word for the alties) for refusing to back it.

The relationship between science and alternative medicine is fascinating.  Many purveyors of these therapies disregard science (the "your science can't test my woo" notion), instead preferring anecdotal "evidence".  On the other hand, they simlutaneously crave the legitimacy that science can lend, as evidenced by the trumped-up and discredited studies performed by professional kooks like Andrew Wakefield, the notorious enemy of childhood vaccines.

The fact that we are taking ownership of our health is fantastic progress.  But the inclination to buy into ideas that are prescientific, pseudoscientific, discarded, or just plain delusional is just plain scary.  The dangers of these kinds of therapies are far worse than just draining your wallet.  Ten years ago, most parents would have scoffed at the notion of treating their child's infection with homeopathy (read: expensive water) instead of antibiotics.  Now, though, there are voices ringing in parents' ears: Antibiotics are evil!  Superbugsuperbugsuperbug!  Most parents are not scientists; they're just trying to do the best they can for their kids.  That can be difficult with this much mud in the water.

The beauty of science is that it is always learning.  It adjusts its views based on what is observed.  To disregard the scientific system in hopes that an unproven treatment will do the job is beyond silly.  It's dangerous.  How have we forgotten all the good that Western medicine, with its drugs and its sterile surgeries, has done for us?  Has it escaped our notice that we will get to live twice as long as our great-great-great-great grandparents because of those advancements?

I like the idea of magic as much as the next person, but let's leave it at Hogwarts.

Sunday, July 24, 2011

Things My Husband and I Argue About

When Joe and I argue, it's pretty benign.  We know plenty of couples for whom that is not the case; couples whose little tiffs end in a dozen stitches, a trip to IKEA to buy new glassware, or fresh sheets on the guest bed.  We are not that couple.  Our arguments usually end in paying the babysitter (we prefer to argue on date nights), a goodnight smooch, and happily sleeping a couple of feet apart.

That's because we actually like to argue.  We're like a high school debate team that never got over it.  Unfortunately, we agree on just about everything, so unless one of us is willing to switch sides for the sake of a verbal spar, we're fairly limited on debate topics.  As a result, we have a few pet topics that we revisit every few months.

So since this is my blog and I can't help but win, I will share one of my favorites:

Joe thinks he and I are soulmates.  I disagree.

Before you decide I am frigid and soulless and unworthy of Joe's affection, let me clarify.  It's not that I don't think Joe and I are suited for one another.  It's that I don't believe in soulmates at all.  I do believe in love, obviously.  I love my husband.  But my understanding of why I love my husband is much different than Joe's explanation of why he loves me.

I love Joe for several reasons.  In the beginning, it was because he was cute and funny and sincere.  I got a little chemical boost from my limbic system, too: my brain got a hefty dose of seratonin, dopamine, and norepinephrine when we were together.  As we spent more time together and my affection for him grew, it threw in some vasopressin and oxytocin (the "cuddle chemical").  But beyond all the hormones and boring science-y stuff, there is one key ingredient that turned a biological high into a lasting bond: I chose Joe.

Because I made that choice, we have spent six years making a life together.  In six years, we've experienced a lot together - good things, bad things, funny things, angry things, painful things, giggly things.  And every time we experience one of those things together, my love for him grows.  Because I believe that a loving, lasting relationship is built on a foundation of all the things you experience together.  Our first year of marriage was the hardest.  We're both a little stubborn, and we were working on that foundation.  Looking back, surviving those tough times together is a large part of what strengthened our bond.  Either of us could have walked away during that tough time, but we didn't.  Me, because I had made a choice.  Joe, because he believed we were fated to be together.

There is a certain wistful romance to Joe's viewpoint.  I like fairy tales, too.  But in my mind, to say you are fated to be with someone is not much different than saying you're sentenced to be with them.  Like it or not, you're stuck.  The universe won't have it any other way.  That means when the tough times come, you don't get the bolstering satisfaction of knowing you could walk out, even if you wouldn't.  Sure, the good times are probably just as sweet for thinking the universe had them pre-scripted.  But here's the clincher for me: If you believe that you are destined to be with someone no matter what, then you don't get to take any of the credit for the work you put into the relationship.

And it is work.  It's not easy to share your life with someone.  To learn the other person's quirks and habits, and figure out how to shape your own around theirs so that everyone ends up happy.  It's hard to carry the weight of someone else's dreams and fears in addition to your own.  But for me, true romance is in succeeding in this task.  The notion of pre-destiny or fate ruins the romance for me.

And if Joe wants to say any differently, he can get his own damn blog.

And because every argument makes more sense when it's jazz-backed and sung by a foul-mouthed Aussie, enjoy:

Friday, July 15, 2011

Mama Bear Sees Red

You should meet my son, Mikey.  He's two and a half.  Somehow, about a year ago, Mikey did something amazing: he stopped being a vaguely humanish being with all the burden of a rowdy puppy and started being a real person.  Much to my delight, it turns out he's a genuinely cool person.  He's clever, confident, sensitive, and creative with a sharp wit and a hard head.  (I realize that all parents think these things about their kids, but a lot of them are wrong.  I'm not.)

Mikey has always had a rich imagination.  Perhaps it's a hallmark of an only child, or maybe it's just Mikey, but he's perfectly happy to play by himself.  As his vocabulary increases, Joe and I have become privy to the worlds being constructed in our boy's mind.  They are vivid and exciting and silly, comprised of all the miscellaneous bits of information that enter his understanding each day.  For me, it's a joy and a privilege to join Mikey in imaginaryland for a few hours each day.

About a month ago, I left town for a few days.  The boys celebrated my absence with pizza, beer (for Joe), and a DVD set of the Superman movies.  By the time I returned, Superman had Mikey's imagination in a ferocious grip.  Mikey insists on being called Superman.  If he had his way (he often doesn't) he would wear his Superman shirt and cape every day.  He carries his new Superman doll, calls his play tent the Fortress of Solitude, and asks to watch Superman at every opportunity.  He has memorized lines from the movies (current favorites: "That's my beat, Chief!" and "Bye bye, baby!") and runs through the house pretending to push down walls and rescue people from the crashed helicopter.

Joe and I haven't seen any reason to stop this behavior.  It's harmless, creative fun.  He wants to be called Superman?  Fine, we'll call him Superman.  Wants us to tie a blanket around his shoulders cape-style?  Groovy.  And last Sunday, when he decided that Joe and I would henceforth be known as Batman and Wonder Woman... well, I've always wanted that invisible jet.

It's just a phase, right?  

Mikey attends a private Montessori school, where he has thrived since day one.  Today, the lead guide in his school pulled Joe aside for a chat when he arrived to pick up our son.  On his way home, Joe called me to share.  Audibly shaken, Joe described how the (well-meaning, I'm sure) guide told him she believes Mikey may be showing signs of an identity disorder and that this Superman fixation must be stopped, lest it result in permanent damage to his identity.  She asked if there has been some major change or event in our home that may have resulted in Mikey's identity confusion.  Basically, she scared the shit out of him by convincing him that our preschooler has had some sort of psychotic break.

Through the red haze of my anger, I think I understand what's at the crux of this.  Mikey asks people to call him Superman, and twenty other kids get jealous and decide they want to be superheroes, too.  I completely understand how that would be disruptive to the school, and I would have no problem at all with her asking us to keep the Superman game at home.  But I am livid at the mere suggestion that this fantasy behavior indicates some sort of urgent psychological crisis.  I can't help but think that it would be far more damaging to a creative child to tell him to stop imagining, stop pretending. 

So now I'm asking.  Parents?  Teachers?  Opinionated people?  Am I overreacting here, or did this guide step over the line?

Thursday, July 14, 2011

Yes, it hurts. What else?

I’ve been thinking a lot lately about pain.  Not the mystical, sweeping pain of the misunderstood emo generation, but chronic physical pain.
A recent conversation with an acquaintance has haunted me for several days.  This woman has a 17-year-old daughter with lupus.  While this is a horrible situation that cannot be fully understood by anyone who isn’t living it, I am always saddened to see how this diagnosis permeates every moment of their lives.  This child feels well, her labs are all within normal limits, and she wants to get out and experience some things.  Unfortunately, her mom has convinced her that anything short of sitting in a darkened room will be the genesis of her untimely demise.
I’m certainly not arguing that she shouldn’t be cognizant of her condition and make some changes to her life.  But I believe wholeheartedly that to give oneself fully to a diagnosis, to the exclusion of any other interests, is a greater death sentence.
This might seem arrogant coming from me, an apparently healthy woman, so let me clarify my position.  I was born with spondylolysis, a spinal defect that often leads (and in my case, led) to a painful condition called isthmic spondylolisthesis beginning in childhood.  I didn’t find out about this defect until I was 20, because when you have pain every minute of your life, you don’t know any different.
imageAfter a few years of nightmarish surgeries, here’s my robo-spine.  I’m sorry I can’t offer you any of the classically compelling 20-year-old-on-a-walker pics, because I enforced a strict no-cameras policy during that period of my life.
Suffice it to say, I know pain.  I have known it for all my three decades, and I will know it for every minute of the rest of my life.  I have lived the reality of having pain be your last fading thought as you drift off to sleep, and the first thing to penetrate your consciousness when you wake up.
Robo-meIt would be very, very easy for me to give in to the pain.  To sit down, draw a disability check, take some medication to ease my awareness of the hurt, and devote my grey matter to a constant awareness of it.  Every time I sit in my spine surgeon’s waiting room, I am surrounded by folks who have gone that route.  (If there is a new receptionist, they usually look past me to find the patient when I sign in.  I guess there aren’t many people in my condition striding up to the desk in pretty shoes and smiling a hello.)
Obviously, I didn’t choose that path.  And that is the point of this post: that people have a choice.  Your body may not work like everyone else’s does; you may have to deal with pain or limitations that others don’t.  But you can still choose to move beyond your diagnosis and live - truly live - your life.
How?  Well, I’m no expert, but here’s what works for me:
1. Understand what “chronic pain” means.  Our bodies have evolved into this amazing feedback system as a means of protection.  Pain exists as a warning - “that hurts, you should stop doing it.”  That’s why we pull our hand out of the fire, immediately relax the strained muscle, or stop running when our bodies have reached their limit.  Pain is your brain’s text message to the body to change your situation immediately to avoid further injury.  Chronic pain, however, has no purpose.  It’s the body’s broken RSS feed that keeps posting the same junk over and over again, no matter how many times you try to unsubscribe.  That means chronic pain requires no response from you.  Nothing you do is going to change the pain, and you are not in any imminent danger of further injury, so in this case the pain is simply something to be felt.
2. Recognize that all pain is not bad.  There is pain with injury, with deterioration, with inflammation.  But there is also pain with growth and strengthening.  Get past the fear of sensation that paralyzes us into inactivity.
image3. Find your strengths (I promise you still have some) and play to them.  You may have physical strengths that allow you, with awareness and sensitivity to your limitations, to perform physical feats you never thought possible.  Exhibit A: this photo of me with my best friend, Tricia, after completing my first triathlon.  This is nine years after my most recent spinal surgery.
You may find that your strengths are not physical.  Great.  Focus on your career, your art, your parenthood, or whatever fulfills you.  Just do not allow yourself to sit around ruminating on what you’ve lost.  There is plenty left to occupy your life.
4.  Make a choice.  There are days when I would prefer to sink into a funk, when it just seems too hard to see the good stuff waiting outside the fog of pain.  But then I remember: I’ve made the choice to be more than my pain.  That choice has allowed me to achieve things I never thought possible and to live the life I want to live, not just the one I was stuck with.  So even on the bad days, I continue to make the choice.  And at the end of the day, I’m always glad I did.
Chronic pain is a relentless instructor who molds and morphs your body and mind into something you don’t even recognize.  The onus is on you, the sole inhabitant of your body, to take what’s left and make it your own.  You can make it something you like, or something you despise; something you celebrate, or something you fear; your vessel for navigating this world, or your prison.
I don’t understand why, but in this instance the easy choice always seems to be the more difficult one to make.