Click here for Part 1 if you missed it...
After the visit, I was left with a persistent, nagging feeling. I decided to talk to the nurse and the naturopath who were involved with her care. I told them, frankly, that I had a weird feeling about what I had found -- like nothing I had experienced before. Could they please encourage her to get this checked out? I then backpedaled, saying I felt like Chicken Little and it was probably nothing.
The naturopath said she would send the ultrasound order right away and contact the client to schedule. The nurse said that blood had been drawn this morning to run some labs. She would add some additional tests to the requisition to get more information for the doctor's diagnosis. They both said it was better to be safe than sorry. They told me that they trusted that if I was this concerned about the situation, it should be taken seriously.
The naturopath was grateful that I had brought it to her attention. I also discussed this with the colon hydrotherapist in our clinic. (After all, she has only palpated a thousand abdomens or so.) She said compacted stool in the colon can occasionally feel that way, but she always sends those clients back to the doctor. I shared that the client was interested in a colonic, and the colon therapist assured me that she would flag her file to verify clearance from the doctor before proceeding with treatment.
Later, I reviewed this case with my mentor. He validated my sensory experience and suggested other ways for me to stay present when these situations happen. We discussed how my time spent outside the treatment room, coordinating care, was not reimbursed. This is an interesting aspect of the medical field: extra time spent conferring with colleagues is not usually paid for. I'm not sure how to remedy this. Though it was a lot of work, I would do it again in a heartbeat. But is that financially sustainable over time? I don't know the answer, but I was grateful to have a safe place to discuss this issue.
The client was scheduled to see me the following week. I was nervous about her results and her reaction to the situation. The ultrasound did show fibroids. (Yes!! I nailed it! Oh wait, back to compassionately remembering this is a person and not a round of Jeopardy...) I asked for a copy of the report to include in my notes. Her treatment plan was being altered to address her hormonal imbalances. She was cleared for further massage. And she had also done the guided visualizations a couple times on her own. It seemed that the mass had changed somewhat. Could I work on it some more? Anecdotally, lymph drainage has been reported to reduce the swelling around uterine fibroids, so we decided to give it a try.
When I touched the fibroid, the weird panic feeling was there again, but less so. I drained the abdomen again and demonstrated dry skin brushing to encourage lymph flow. She became tearful while she shared that she had a history of trauma in this area of her body. I told her that there were other practitioners in the office that might be able to help her discuss her thoughts from this time of her life. I charted our discussion, the referral, and the perceived difference in size and position of the fibroid, relative to the navel.
The client was excited to work on this issue physiologically, lymphatically, and emotionally. She felt hopeful that when she went back for a repeat scan in four months that there would be improvement. She gave me a big hug.
Massage therapists have the potential to augment health care in a profound way. But it will not happen if we do not step up and develop our interprofessional communication skills. We need to study and practice medical writing. We must network with practitioners in other fields of medicine and expose ourselves to how they work. This will inform how we can mesh with the healthcare team. It is vital for us to share these experiences with our colleagues, to advance our profession as a whole.
Be brave and reach out to others. You will find that many practitioners are tired of working alone and will appreciate the connection. Use social media to educate and collaborate. Attend a Bodyworkers Confidential meeting and share your stories. It will require a community effort to raise the standard of massage care. Are you ready to take the baton?