Is kinesiology taping as effective as a parachute??

I recently saw this article  in The New York Times and have to say it got me a little riled!! Basically it is asking whether Kinesiology Taping (KT) works, and more importantly where is the proof if it does.  It obviously doesn't work because there is no existing research evidence to support the claims made by I'd say thousands of professionals like myself and their clients that it does!! I say that with my tongue firmly lodged in my cheek!!  And here is my beef with 'evidenced based practice'.......we deal with people not statistics, cases or cohorts even the most evidently sound treatments are commonly never 100% effective for everyone.  You see there is a point at which the statistics become significant, meaning we can say something works.....and that's ok for those people that fall into the majority 'significant' group, but what about the ones that lie outside of it?? Or more importantly, what about listening to the INDIVIDUAL PERSON and when they say something works, and as a therapist we see something that works, and use this as our evidence?? I use KT tape loads, I've been using it for years, if I didn't think it worked, and if my clients told me it was a waste of time I wouldn't bother, simple as! I'll just share 2 examples - personally when I was pregnant I had all the usual aches and pains associated with a growing bump, didn't want to be taking painkillers so got myself taped, it made pregnancy much more comfortable, nothing adverse happened, I had full term healthy happy babies.  A client of mine who was in the palliative stages of pelvic disease had ascites (huge swelling of the abdomen) meaning that it was extremely uncomfortable and painful trying to move around her house.  I used KT to help lift the weight of her belly and give her lower back some support.  She was able to get out of bed easier, able to walk with less pain.  Nothing adverse happened, sure, she passed away within a few weeks, but I don't believe the KT caused her death, it actually helped her make the most of what time she had left as she was able to do more of the stuff she wanted to do.  But, if I had looked for the evidence to back up such applications I wouldn't find it.....so should I be doing it??   Hopefully this work  being done in Leeds will enable therapists like me to back up my many anecdotal success stories. While I'm on this topic, please do read one of my favourite ever research abstracts (if it's even possible to have a favourite piece of research) from the BMJ entitled Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials.  There's absolutely no proof that they work, but I know I'd rather have one strapped to my back if I ever find myself gravitationally challenged!

The value of your £€'s

Friday saw Ireland's annual Daffodil Day, which is the Irish Cancer Society's main national fundraising day throughout the year.  Over the next few months Relay for Life will be held in a number of Irish counties, and again, the ask will be there - please dig deep and give a few bob (or more!). I recently had a conversation with a friend, who had had a dear friend die of advanced cancer.  Understandably she was very upset at the loss of her friend, but also very angry that her friend hadn't been one of the lucky ones, and what was the point in donating millions to cancer research when as far as she could see it wasn't making the slightest bit of difference. Does that sound familiar? I'm sure it will to many.  I think it it is totally understandable, I'd be fairly pissed off too losing a friend at such a young age, it is a tragedy! But, I have to say that in the 17 years I've been working in cancer care that I have seen exactly how our money and consequently research is making a difference.  When I started working at the Christie nearly every other patient had a horror story to tell.....how they'd had a delayed diagnosis resulting in their disease being beyond curative, or that they'd had all the treatment they could and now, well, now it was very much in the hands of the Gods (if that's what you believe).  I'm not working in an acute hospital ward anymore, but I see clients daily who have had a cancer diagnosis, who have had their treatment and are now CANCER FREE! People who are living beyond cancer, and have every reasonable expectation that they will continue to be cancer free! And even those who may have some residual disease, or 'hotspots' that need a close eye keeping on them, medically their management is very much a long term arrangement, with continued reassuring surveillance and a confidence that 'we'll deal with whatever happens' is very much the case.  Recently a very dear friend of mine had what was believed to be a recurrence of her cancer - I worried for her and felt sick all the time she was waiting on results.  She on the other hand was very calm, her medical team giving her the confidence to know that if it was back, then they have the ways and means to combat it again.  Years ago I fear that her options would have been very restricted! And that is all down to research, and every pound or euro that goes into a collection pot is in some way helping to ensure that more people will live beyond cancer, so please support Daffodil Day, support Relay for Life, YOU will be helping to save lives! #wewontgiveupuntilcancerdoes

Butterflys flutter by!

I love butterflies! I find myself gravitating towards anything I find in a shop that has a picture of a butterfly on it.  I even have my mother on the case, and she's bought me some lovely stuff for my treatment room in keeping with the butterfly theme.  But, my obsession is so much more than a cosmetic/aesthetic one.  I love the whole 'you are one thing, something happens, then you are something else' symbolism.   I have always thought that it very much mirrors the journey that a lot of my clients have been on, and I really can't find any better way of saying this than in this picture.....isn't that what cancer survivorship is all about! 

I'm so crap at this!!

So, I've decided again to try and pick up on my blog and made my 'resolution' to write with a bit more regularity, we'll see what happens! But anyway, as I was going back through my old posts I came across the last one where I make excuses for not writing for so long.....this one.....and guess what, I have the very same excuse now.  Baby Gerard came into the world in January and if there is anything that this wee man has taught me it is the value of sleep, something that I have taken for granted, for most of my life.  Even when Elaine was a small baby, we never had any sleepless nights as she was the perfect little sleeper, but my son, oh no - a very different story! He didn't sleep for at least 6 weeks, neither did I, or his Dad!  It made me realise that it is no wonder that sleep deprivation is used as a form of torture!  Anyway am glad to say that now, nearly 12 weeks down the line we are now managing to get longer and longer sleeps and normality seems to be resuming! The thought of getting back to work with only an hour or 2's sleep was scary, but thankfully I think I'm now in a much happier place and I'm looking forward to getting stuck back into work, and I will try my very best to keep regular updates on here, even if it is only me that ever reads them!! :-)

Why I Relay.....

I am currently involved in helping to organise Kilkenny’s first ever Relay for Life event, which is happening on 20^th and 21^st July 2013.  ‘Why we Relay’ is a very important question, so here is my go at answering it…….

When I trained as a physiotherapist I never in a million years would have expected that I would end up working in cancer care, but here I am nearly 20 years on and I often get asked what brought me to oncology in the first place.  Well, it certainly wasn’t planned!   In the hazy Summer of 1999 (that was the year Manchester United won the treble…YAY!!) I found myself working as a locum physio in a hospital that I really didn’t like, I won’t name it or say why I hated it, but I really didn’t enjoy going to work in the mornings.  It got so bad that one day I rung the locum agency and told them I wanted out….there had to be something better than this, to which I was told ‘we only have one other placement at the moment and that is at The Christie’.  The Christie is a very well know cancer treatment hospital in Manchester and up until that point, I had, Thank God, never had any reason to visit it, so knew very little about it apart from the fact that everyone in there had cancer.  I think my thoughts at the time went something like ‘What would a cancer hospital need a physio for?’ or more to the point ‘what sort of physio would I be doing in there’ and I suppose my next thought would have been ‘don’t they all die?’.  But, me being me and I’ll try anything once decided that it couldn’t be any worse than the job I was doing and hating presently, so the very next week off I went to my new placement in the Christie Cancer Hospital. 

From the very first moment I entered the Christie I was just amazed.  It didn’t feel like a hospital, it felt warm and friendly, homely and cosy.  There was a really positive vibe around the place and it had a brightness that shone even on the dullest, dreariest of days, and Manchester certainly has a lot of them!  – it’s difficult to describe, but anyone who has been there will know exactly what I mean.   

I felt that I had been completely welcomed with open arms.  The physio’s that were working there were just brilliant and it took me no time at all to feel like I was part of the Christie family.  My work placement was on the surgical wards so it involved lots of pre-op assessments and then lots of post-op ‘getting going again’ – clearing chests, sitting patients out of bed, getting them walking and then getting them home– for many of them, this was just the beginning of an incredibly tough journey, a  journey that would impact on every aspect of their lives and for some would last for years to come.   They needed lots of help and support, and I quickly came to the realisation that these patients were so deserving and needing of physiotherapy input – and that THIS was why I became a physio in the first place – this was my ‘physio home’.  I fully expected the work to be stressful, upsetting and emotionally draining, and although there have been occasions where I have gotten very upset and cried about certain patients and their situation, I have to say that generally working in oncology has been a very positive, inspiring and life changing experience.  It has made me realise the important things in life and has completely changed my outlook and perspective on things.

Within the hospital there was an incredible openness about cancer – the word itself wasn’t said in hushed tones or avoided like I had experienced in other hospital wards in other hospitals.  All the patients  knew that all the other patients in there had cancer somewhere and that they were in the hospital for treatment of the disease or it’s symptoms.  This openness allowed a great sense of camaraderie and solidarity amongst fellow patients and amongst the staff – we were all united in the fight against this awful disease.  It is often said that ‘laughter is the best medicine’ I certainly believe that it enhances the effectiveness of anticancer treatments after all that I have experienced and observed over the years. 

So ‘Why do I Relay?’ Well I Relay to say ‘Thank You’.  Thank You to each and every single person that I have had the privilege to work with and help along their cancer journey for allowing me to join them on their journey and learn so much, experience so much and become not just a better physio, but a better person too!

Ta Ra for now! 

Exercise can help Cancer Related Fatigue – Official!!

“You know when you’ve had a really hard day at work, and you flop down on the settee in front of the telly at the end of the day……if the phone rings across the other side of the room, you might feel so tired that you choose to ignore it.  But, if you smelt burning from the kitchen and saw black smoke you would be able to jump up and go and find out what’s going on…….well, the way I am feeling at the moment, if that was me, I think I would have to take my chances with the fire, as I have absolutely no energy reserves left, I have nothing!” 

Cancer Related fatigue (CRF) as describe above by a patient of mine a few years ago is a very common side effect of cancer or cancer treatment.  It is suggested that most people undergoing treatment for cancer will at some stage experience a degree of CRF.  In my experience I would have to say I think everyone who has cancer or is having treatment will suffer with CRF at some stage throughout their treatment journey.  It can happen during or after treatment and can persist for weeks, months even years for some people.   It can affect every single aspect of a person’s life – every day activities, hobbies, work and social life, and can have a detrimental effect on their wellbeing and state of mind.   CRF can be quite debilitating, but the good news is that help is available, and it can be alleviated.   A physio is typically the last person on earth that a patient feeling fatigued would want to see, but actually, we are probably one of the most important members of the cancer rehabilitation team when it comes to treating CRF.  We are able to assess a person’s individual level of fitness and activity and prescribe an appropriate activity or exercise programme to help that person break the vicious cycle of CRF.  It’s all about finding a balance between having the right amount of rest (which is important to enable the body to repair and recover from the treatments) and the right amount of activity, which will maintain and improve muscle strength and  cardiovascular fitness.  As these improve so too do energy levels meaning that fatigue is reduced. 

A research review (here) paper was published last week, which confirms everything  that us physio’s have always known…..that if you have CRF then rest is most definitely not best!    

Physiotherapy in Cancer Care

The term Cancer describes a multitude of complex diseases each with its own distinct nature and course. Traditionally the focus of cancer treatments have been primarily medical, with the strive to increase survival from the disease being the main driver. Whilst survival and longevity are no doubt the focus for everyone who has a diagnosis of cancer, survivorship and rehabilitation are also very important. These 2 words encompassing what it means to live with the consequences of the disease or its treatment and for life to return to a semblance of normality. People who have been diagnosed with cancer often present with a myriad of complex problems which occur as a direct result of the disease itself or of the treatments which they have undergone. Physiotherapy has a key role to play in the management of people with cancer throughout all stages of the disease, from diagnosis, through medical treatment, into remission and even in the later stages of the disease.
Within the context of cancer care, the primary goal of physiotherapy is to assist the cancer survivor to be able to live their life as fully as possible, by assisting them to achieve their goals whatever they are and to enable them to have a degree of control over their lives and a greater quality of life.
Research Studies have shown that Exercise and activity is effective in alleviating many of the longer term side effects of cancer treatment, such as fatigue, reduced function, depression and anxiety, decreased fitness and strength etc.  Also, those cancer survivors who are physically active can reduced their risk of the cancer recurring, and hence the risk of dying from the cancer by up to 50%.
People who have cancer may present with some of the following common problems as a result of their disease or as a consequence of the treatment they have undergone:

• Reduced mobility, for example difficulty climbing stairs or getting out of a chair
• Reduced exercise tolerance and general fitness, maybe not able to walk to the local shop anymore
• Joint stiffness and pain
• Weakness, for example struggling to lift a kettle or to pick something from the floor
• Shoulder or neck problems following treatment for breast cancer or head and neck cancer
• Lymphoedema and swelling
• Problems with breathing control
• Neurological dysfunction, for example altered balance, problems with feeling or touch or difficulty getting a body part to work properly for you
• General fatigue and lethargy
• Reduced independence or a greater dependence on others for everyday activities
• Reduced confidence
• Increased fear and anxiety
• A worry about finding the balance between how much to push themselves and how much to rest

All of the above can be helped by undergoing an assessment and treatment from a physiotherapist who is experienced and knowledgeable in cancer care.   See my website www.homephysio.ie for more info!