Of course, I immediately went home and stuck some in my father-in-laws head, a point which is apparently good for stress, and he reported sleeping like a baby that night, so maybe there is some mileage in it!
An excellent short introduction to needling, which was nevertheless sufficient to add to my Sports Massage insurance with the fantastic Balens and get needling immediately. I ended up doing (an actually final this time) group purchase of needles for those of us who were on the course from Harmony. They gave us a pretty good deal in the end, and I now have hundreds of needles to stick in anyone I want!
Of course, I immediately went home and stuck some in my father-in-laws head, a point which is apparently good for stress, and he reported sleeping like a baby that night, so maybe there is some mileage in it!
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Sue Turner – An Introduction to the Osteopathic Treatment Principle of Balanced Ligamentous Tension25/2/2013 I have to think nice things about this talk, as I arranged it myself!
And it was a nice talk, so that was helpful. Sue did exactly what the title suggests - introduced balanced ligamentous tension, and gave us some quick demos that we could try on each other. She was enthusiastic and charming, and her good spirits were infectious. I really enjoyed her discussion of the uses of BLT, even if I was unable to see the acronym without thinking about sandwiches. (My wife later told me that all she could think about was exercise classes, but she is a vegetarian...) A highlight was finding some relief to the discomfort in my multiply-injured right thumb, which always reconfirms my belief in the effect of patient pain beliefs and desires on perceived pain levels. Even now when it is "healed" I feel the need to describe it as multiply injured and put healed in scare quotes! So, what did I learn from the experience of organising the talk? That it is worth overplanning in such events, and obtaining as much help as possible. That it is sometimes possible to get through crises without drama, so long as the previous planning has occurred, and that people are often quite helpful if allowed time and courtesy to be so. So far! Although next is organising (yet) another course, the sequel to this talk, so it will be interesting to see how far that stretches in the end... I had the chance to watch some osteopathy performed by a visceral osteopath working on a friend, specifically for visceral problems.
She has a painful lump which changes with her menstrual cycle under the area of her caesarian scar, a history of reflux and incompetent diaphragm, along with repeated vomiting from an undiagnosed dairy allergy for her first twenty-odd years. In some ways I was very impressed with the consultation. It was the first time I had watched a new patient performed by an experienced osteopath and I was really struck by how some things were quickly glossed over, whereas the things which were of interest were delved into in great depth. Especially elements of the patients diet, eating history, and history of pregnancy were covered exhaustively. After this, the treatment was largely things that I would have considered myself mostly able to perform myself (with the exception of the cranial part, although I was allowed to palpate for that part). Sadly, this lead to less concentration on the focus that my friend had for the treatment, but this was in favour of doing what was for the best of the patient at the time. I think that the problem is that I have built visceral osteopathy into a panacea for internal problems, rather than a facet to treatment that an osteopath possesses. My friend definitely noticed short term improvements in her condition, but why would there be quick changes in a lifelong condition (with seven years for the painful scar)? This is something to dwell upon in my own practice, as I begin to feel more confident working with some viscera, not to expect anything different from any other problem. And, just like with other patients, just because I think I could try to help with a specific problem, the priority needs to be a joint decision Slightly disappointing planning meant that CCA's clashed with classes leading to stopping early and skipping about.
The techniques and the ideas remained good and interesting, but the class has started to look like a grabbag of different techniques, a bit of functional, a bit of hvt, some Axx, some visceral, some cranial.... In some ways this has been great as it has given me a formal taste of how things work in teaching other techniques, and probably given me some confidence to attempt them and variants on real patients. Probably the highlight came when I asked Steve how we go about applying the stuff he was teaching in the real world, and he told me that I already had all I needed to make a start. No new courses, no need to train extra, just put myself out there and do lots of practice on real patients! It really brought home to me how close the end of the course was, and how soon I would really be in a position to try all sorts of things. Really exciting! Robin came to Manus with the aim of being a trifle iconoclastic and told us that he looked for competence above safety in CCAs. He talked a lot about osteopathy and it's politics, and their effects. However, as often seems to be the case in these kind of talks, he didn't have a lot to say when no-one was challenging or asking questions.
Almost certainly a failing in me, but I came away feeling like I had not really profited from the talk, except as a pleasant diversion. I did, however want to watch him in practice, but ended up too shy after waiting for twenty minutes afterwards, when he was still mobbed by a lesion of student fans. Perhaps I will go and visit as a patient one day? A fascinating introduction to the topic.
At one point I noticed that I had absent mindedly written "I really want to do this stuff, obstetric and visceral osteopathy, but how!?" Steve Sandler took us through maternal physiology and showed some techniques. I took pages of notes, and was really interested. The four hour class flew by in the end, and I was excited to try it out in clinic! In order to better get an idea of what I was trying to do in my dissertation with modelling, I did some investigation into different ways to generate accurate representations of 3d planes. First, I signed up for Wolfram alpha in order to try out their full editing and fiddling software. Whilst they do allow you to create a plane, and move it around, it still looks pretty naff. Next I tried this completely free one made by a helpful computer scientist, which does the same thing as Alpha, but quicker, more straightforwardly, and with no fuss. Only good up to two variables, of course, but then plotting a four dimensional plane is always heard to envision... Sadly, none of the diversion helped much with my dissertation results showing only a small effect size from the most important calculated variables. Fundamentally, what I am left with is a smallish bit of cardboard at an arbitrary angle, and a few small numbers on some axes. So, not so different from this one over here: I went into Christmas intending to apply DCP to as many patients as I could with the aim of practicing for my own good, and adding to my repertoire of regularly used HVT so as not to feel tied to a single patient position.
I achieved one of these - trying to fit "unnecessary" DCP in was just too hard for me. A real problem for me, since I need to be competent; but when everything is as rushed as it was over this holiday, it feels hard to take time out from doing appropriate treatment and examination to add less useful ones. Perhaps, with speed gains in other areas, I will feel better able in the future. In terms of HVT, however, I was able to adjust my techniques so that I have more confidence. I have also taken to asking tutors for their favourite versions of techniques in order to expand my possibilities. This seems to be working, and I am now luxuriating in trying, for example C Another two day intro, another new batch of techniques?
Well, these ones are really, really different! Devan came to teach us about the physiology of needling, and then lead us gently by the hand into sticking needles first in ourselves (right in the thenar eminence in my case - Devan said "Wow, I never saw someone do it there before". Really painful!) and then in each other. It was a graceful trajectory from single trembling fingers over forearms, to taking pictures of each other littered with tiny brass spikes. I was very happy with the lecturing style. There was a heavy focus on evidence and mechanism, which was fascinating on it's own, and also valuable revision of the mechanics of pain pathways. In particular, it was great to hear a formal explanation for trigger points! Next step, insurance and then away! Whenever I trained in Kempo, I always made sure that I trained both sides, and worked harder at things that I was less good at, rather than using the easiest techniques for the situation. I had believed I was continuing this in my osteopathic technique, and have so far pretty much avoided having a preferred side. However, it has become clear that I have preferred techniques for a situation.
For example, with HVTs: O/A: Supine CSp: Supine C/T: Prone Upper and Mid Tsp: Supine T/L: Lumbar Roll LSp: Lumbar Roll SIJ: Lumbar Roll Whilst I can perform alternatives where necessary, I have somehow lost the push to do everything (and have certainly heard tutors saying things like, as long as you have one way to get at the joints, you can learn more later). So, plan for the Christmas clinic and beyond: avoid the comfortable techniques, and (where safe/appropriate) get stuck into the things I find hard. This will go nicely with the recommendation to DCP just a little on every patient, in order to gain comfort doing so. |