June 22, 2012 § 15 Comments
As a holistic practitioner and somatic therapist, I have come to appreciate that the best way to approach serious health issues is to become informed about the course of an illness as well as its medical treatment. While holistic medicine emphasizes prevention and works very well to resolve many chronic health conditions, sometimes more drastic means are needed to either greatly improve one’s quality of life or to extend one’s life. For some, surgery may be the best option, yet surgery, by its very nature, is traumatic and intrinsically threatening. If you or a loved one are facing surgery, it is my hope that the following discussion will prove helpful in some way.
Let me begin this discussion by expressing my gratitude to all the skilled surgeons who make it their life’s work to improve the health and well-being of others. I have personally benefited from their skill and am grateful for the way it has enhanced my life experience. Nevertheless, the topics I will now discuss are valid and address issues that are often overlooked or ignored in a pre-surgical work-up.
It is not uncommon for surgical candidates, who may have been coping with chronic pain, to be in a state of exhaustion prior to the scheduled surgical date. Discomfort, fatigue, and insomnia can also trigger feelings of anxiety, fear, and despair. A surgical intervention at this point, even when medically necessary, can be physically, mentally, and emotionally overwhelming. Neurologist Robert Scaer, M.D., explained,
Preoperative anxiety and panic have long been a significant concern to surgeons, from the standpoints of behavioral management, intraoperative complications postoperative pain, and postoperative outcomes. Fear of death, injury, postoperative pain, and even of helplessness and unconsciousness may be a source of preoperative anxiety.
Surgery can also be accompanied by a profound sense of loss. In humans, loss is a complex, cumulative phenomena that can usher in waves of grief. In my clinical experience, patients have reported profound grief due to the loss of bodily integrity, loss of an organ, loss of strength, or the loss of a familiar sense of self. When they later tried to explain these feelings to their doctors, their feelings were often minimized or ignored.
Post-Traumatic Stress Disorder (PTSD) Following Medical Experiences
Unfortunately, in too many cases, prior negative life events, traumas, emotional or physical illnesses are ignored or unidentified by physicians as pre-surgical risk factors for PTSD in patients coping with a serious or life-threatening disease. Additionally, exposure to numerous invasive pre-surgical diagnostic tests have also been found to greatly increase feelings of helplessness and loss of control. Together, these factors may place the patient at greater risk of developing post-traumatic stress after surgery, delaying recovery.
Considering one’s circumstances and past history can go a long way to alleviating distress following surgery. The next post will offer some practical suggestions to prepare for surgery.
Please feel free to comment on this post and if you choose, share your experiences of surgical intervention and recovery.
The Body Bears the Burden: Trauma, Dissociation, and Disease by Robert C. Scaer, Md
June 11, 2012 § 25 Comments
In my clinical experience, it is common for patients to report discomfort associated with scar tissue, especially following a surgical procedure. While the formation of scar tissue is a natural function of healing, it can also become a chronic source of pain and discomfort that can last for years.
Recently, at the 3rd Research Fascia Congress, Jean-Claude Gimberteau presented an amazing video of in vivo scar tissue. The video provided a clear visual of tissue and fascial disorganization associated with scar tissue. Viewing these powerful images, as well as coming to a deeper understanding of the process of tissue repair, have helped me to become more effective in working with scar tissue.
Typically, when I assess scar tissue, I gently palpate the area around the scar and the scar itself. I look for areas where the tissue is able to move freely or for areas where the tissue has become thickened and dense underneath the scar, or where the scar is being pulled into the body. As I attempt to mobilize the area, I ask the patient to describe where they feel sensation. Many times they report feeling pain, tension, or tugging in another part of the body, away from the scar. This is when they might experience an “aha!” moment, coming to understand that the scar may be somehow linked to another area in the body where they have been experiencing tension or pain. This demonstrates how scars can continue to alter over time to effect the internal landscape of the body, long after the scar appears to be healed.
This image is of a patient who underwent breast reduction (lollipop) surgery, twelve years ago. It is a very invasive surgery and results in large areas of scar tissue. The patient’s chief complaint was anxiety. In Traditional Chinese Medicine, stagnation in the chest can create heat-induced anxiety. I was curious to see if her scar tissue was blocking the flow of qi, blood, and lymph through the upper body. Palpation demonstrated that there was a good deal of fascial restriction along the scars with a grayish-green discoloration of the skin between both breasts (stagnation).
The image shows how I set the acupuncture needles along the scar, at an angle. Then, I gently tugged on the needles, mobilizing the underlying tissue until the fascia begin to release. I also used glass cups to lift the underlying fascia and increase the flow of blood, lymph, and qi through the area. In the image you can see how the circulation increased as the grey-greenish area began to pink-up. The patient had a good result. Her anxiety lessened considerably and her breathing improved. She was now able to expand her diaphragm more easily upon inhalation, allowing more flow through the upper body.
Have you ever experienced residual pain around a scar, long after it had healed? Did you receive treatment for the scar? Would you consider acupuncture to help mobilize a scar?
June 6, 2012 § Leave a Comment
Under your skin, encasing your body, and webbing its way through your insides like one huge spiderweb, is FASCIA. Fascia is the connective tissue that surrounds our muscles, bones, nerves, blood vessels, and organs. It literally wraps around the entire body, connecting it from top to bottom.
Since it is connected to basically everything in the body, you'd think it must be pretty important, right.
June 4, 2012 § 11 Comments
I recently had the privilege of attending the 3rd Fascia Research Congress, held in Vancouver, B.C., March 28-30, 2012. It was a gathering of academicians, scientists, and clinicians who are dedicated to researching fascia, the connective tissue matrix under the skin which links to nerves, veins, tendons, adipose, ligaments, bone, and muscle. You’ve heard me reference this tissue system before because it is where all the exciting things happen in the body!
Fascia functions to provide a smooth gliding surface for body structures so that they can quickly and easily move across each other. It also supports tissue hydration and tissue remodeling. Two topics that really peaked my interest at the congress were fluid dynamics and post-surgical scar treatment because they are intimately involved in maintaining health and wellness.
Fluid dynamics play a critical role in regulating collagen and elastic fibers and microfibrils, hyaluronan, proteoglycans, and glycoproteins. Fluid flow within this matrix functions to regulate cellular hydration, nutrient transport, tissue function, lymphatic flow, and cell-to-cell communication. Fluid stagnation, as seen in edema, is inflammatory and begins to remodel tissues in a negative way, leading to fibrosis (an abnormal development of excess connective tissue).
Scar tissue can dramatically change the internal environment of the connective tissue matrix and its fluid dynamics through the disorganization of tissues and the cascade of inflammatory mediators (biochemicals). The formation and ramifications of adhesions associated with chronic inflammation or surgery were also discussed and the take away piece from these lectures was the importance of soft tissue mobilization, as soon as possible post-surgery, to effect the best possible repair.
If you have ever experienced edema, adhesions, or chronic inflammatory conditions, was there a particular therapy that helped you to recover? Would you care to share your experience?
If you’d like to know how you can keep your fascia system flexible, check out this great blog: Nicole Rae Fitness