Ep. 05 – Carolyn Tague

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[00:00:55] Ericka Clinton: Good day everyone. Welcome to another episode of Collaborative Connections, a Space for Sharing and Learning, sponsored by the Society for Oncology Massage. My name is Erica Clinton, and I will be your host today. Joining us is Carolyn Tig, a certified massage therapist in the state of California since 2006.

[00:01:21] Ericka Clinton: Carolyn is a preferred practitioner and recognized education provider with SS four oh Web. Carolyn has recently started a professional organization for hospital-based therapists called Association of Massage Therapists in Healthcare, known as amt. And Carolyn, I wanna welcome and thank you for joining us today.

[00:01:46] Ericka Clinton: Great to be here. Thank

[00:01:47] Carolyn Tague: you, Erica.

[00:01:49] Ericka Clinton: Welcome. So we wanted to have you on today to share about the work you do in infusion centers. Um, and this is kind of an interesting category for oncology massage therapists, um, being welcomed into a hospital setting and particularly an infusion center. So can we kind of find out how you got the opportunity to work in infusion?

[00:02:15] Carolyn Tague: Yeah. Um, and just to back up one thing to the intro, um, so, uh, Karen Armstrong and I started the association for, um, massage therapists in healthcare. So I just wanted to clarify that, um, and thank you for, for mentioning that. Yeah. So the infusion centers, um, it’s really an amazing place to work within a healthcare.

[00:02:36] Carolyn Tague: Um, Setting. And so I was lucky enough, um, when I started at U C S F in San Francisco there, there was already a grant in place. And so, um, the grant was for foot massage and reflexology for infusion center patients. And so I was really lucky and I got to just kind of walk into that gig.

[00:02:56] Ericka Clinton: Wow, that’s a nice opportunity.

[00:02:58] Ericka Clinton: Yeah, it’s a really nice opportunity. Um, so can you describe for our listeners, In infusion, what the work is like. Obviously the grant you had was for reflexology and foot massage. Um, but does it go beyond those parts of the body? Like what’s usually your focus for a, a patient getting infusion?

[00:03:18] Carolyn Tague: Yeah. Yeah.

[00:03:20] Carolyn Tague: Um, you know, because the grant started that way, our service has continued with a focus on feet. Um, and actually I think there’s a lot I’ve come to really appreciate the advantages of that, and I can describe that. I know some places, um, offer, you know, shoulder and neck and hand massage and all of that, and it’s lovely.

[00:03:42] Carolyn Tague: Um, but I, I really find that there’s some significant advantages to just focusing on foot. And reflexology. Um, so basically, and to kind of fill out your, your whole question. So basically what we do is we get a list of patients for the day and we see their names and their diagnosis. Um, So we have a sense of whether they’re for chemotherapy and the infusion center that we work in also, um, provides, uh, medications for MS patients, um, folks who need iron or, uh, you know, B 12 shot, you know, drips and things like that.

[00:04:21] Carolyn Tague: So we do wanna find out, you know, what the diagnosis is for each patient. Um, We do an intake, so we ask questions, but as far as working on the feet in particular, it has the following advantages. It keeps us safe and physically out of the way of the nurse and the patient lines. We don’t have to, um, worry about, you know, potentially moving the IV pole or.

[00:04:49] Carolyn Tague: Only doing one hand because the other hand has the IV line. Um, the nurses are in and out all the time. So by staying kind of physically at the other end of the body for the patient, we’re not in the nurse’s way. Um, and so there’s the safety kind of logistics aspect of it, but then also there’s this like really sweet, um, Opportunity to interact with a, with a patient.

[00:05:16] Carolyn Tague: Um, basically you’re sitting kind of face to face but at a socially appropriate distance. Um, and so you just, you know, you’re working on their feet and a lot of patients, ’cause they’re there for so many hours, they really appreciate somebody to talk to. And so some patients tell us their whole stories.

[00:05:35] Carolyn Tague: Some tell us, you know, they just like chitchat. They ask us questions. Um, so there’s that, uh, opportunity. And then there’s the patients who for whatever you know, reason, it’s the time of their, of their infusion. They’re tired. The medications sometimes make them sleepy. They can also just kick back and close their eyes and be really rested while we work on their feet, so we’re not having to move, you know, their clothing or, um, uh, you know, disturb their head while they’re trying to rest.

[00:06:05] Carolyn Tague: So yeah, for us, um, it’s, it’s a kind of a small box to work in, but it’s really effective.

[00:06:13] Ericka Clinton: That’s wonderful. And it feels like the benefits. Could be about symptom relief, but are also there about connecting to another person.

[00:06:25] Carolyn Tague: Yeah, so you know, just talking about, you know, outcomes and, and potential benefits.

[00:06:29] Carolyn Tague: So clearly just like with all of oncology massage therapy or medically complex massage, you know, we’re really aiming to induce the parasympathetic nervous system so that the chemistry of rest repair restoration can, can actually kick on. So there’s all that physiological benefit. Potentially. Mm-hmm. But, but in addition to that, there is the psychosocial, um, aspect of companionship during a really long, kind of scary, um, and scary system, scary environment, scary diagnosis often.

[00:07:07] Carolyn Tague: So having that kind of companionship, that therapeutic relationship, um, is, is really part of the, the benefit and the, the, um, the outcomes that we hope to provide.

[00:07:20] Ericka Clinton: That’s wonderful. That’s really wonderful. And as you say, outcomes, my research brain kicks in and I’m like, oh, that’s probably something we should study.

[00:07:30] Ericka Clinton: Yeah, yeah.

[00:07:32] Carolyn Tague: No, I, I, I have a thousand ideas for studies and, you know, maybe someday, we’ll, we’ll figure out how to coordinate all of that. But there are some interesting studies, for example, um, there, and I meant to find it for you and I can make sure to get it in the link. Um, but, um, there is a lovely study that looks at.

[00:07:52] Carolyn Tague: Chemo induced peripheral neuropathy, C I P N, um, that shows benefit not only to, um, the symptoms of the peripheral neuropathy with massage therapy, but also um, preventative. Um, for chemo induced peripheral neuropathy. So it’s a, it’s a really, um, exciting kind of benefit. Obviously, it’s one study. Mm-hmm. Um, you know, one study does not prove anything.

[00:08:23] Carolyn Tague: Um, but it is a nice indication and it is something that we can share with our patients to, if there are ever any kind of questions or concerns like, is this safe? Um, we can cite that study as one study. Um, that shows potential benefit. Um, so yeah. But lots of, lots of research. Um, I’m always curious about the comparison of massage therapy with the cryo therapies.

[00:08:48] Carolyn Tague: Mm-hmm. You may have heard of like the caps that go on the head to, um, yeah. You know, reduce hair loss. Um, I would love to see a study comparing that to massage therapy to standard of care. Um, and same with the feet. Some people, some patients will come in with, you know, like ice chests full of gizmos to put on their hands and their feet, um, to help reduce the peripheral neuropathy.

[00:09:17] Carolyn Tague: And I would love to study the comparison of that intervention to massage therapy intervention to no intervention or standard of care. Um, so yeah, lots, lots of research to, to, um, to

[00:09:30] Ericka Clinton: work on. Yeah, that all sounds really interesting and I would love, I would love to see that study. Um, the group that I work with in New York, uh, we’ve been approached by one of the community hospitals who would like us to do, um, massage therapy during infusion.

[00:09:45] Ericka Clinton: But what of course they need is a proposal for me talking about the benefits and citing research. So, um, and I’m sure. And I’m sure our listening population would love to take a look at that as well. Yeah. Um, so benefits clearly there and possibly ones that we’re not even aware of at this time. Are there any concerns for people receiving massage during

[00:10:11] Carolyn Tague: infusion?

[00:10:13] Carolyn Tague: You know, I mean, um, My concern would be for a massage therapist who’s not properly trained, who goes in and thinks, oh, I can, you know, just I’ll, I’ll do this wonderful service, and they maybe go too deep in the tissue. They don’t know the precautions of lymphedema or other, you know, Contraindications. Hmm.

[00:10:34] Carolyn Tague: Um, so I think it really, really does depend on the quality and the, the training, the education of the practitioner. Um, because we can be safe, just like in all of oncology, we can be safe with pretty much any patient. We just have to know how to adjust our techniques. And so, um, if the. Provider is properly trained, I don’t have any concern.

[00:11:00] Carolyn Tague: Now with patients, they might have concern and so then it’s, you know, really going back to this idea of like, what can we share with them about the evidence, um, so that our, our services, evidence informed, um, and we pass that to patients, staff, doctors. Um, so having that kind of short list of studies or other, um, You know, technical information that might be helpful to them.

[00:11:27] Carolyn Tague: Mm-hmm. Um, but really as far as keeping safe and effective, i, I, I don’t have any, you know, concerns even during, you know, back in the day, um, you might remember that there was like a contra contraindication of providing massage during, you know, a 24 hour period of receiving massage, uh, of chemotherapy. Yes.

[00:11:49] Carolyn Tague: Um, and so that was a thing, right? And um, yeah, I think again, with the adjusted protocols, with keeping Safe and effective, gentle, um, and our, we glove, you know, that’s for our protection, correct. Even, even during chemotherapy, um, or bone marrow transplant, even during these really, really significant treatments, um, we can offer a safe and effective massage, in my opinion.

[00:12:24] Ericka Clinton: Wonderful, wonderful. So as a massage therapist, I guess working in infusion, are there, are there challenges? Being the massage professional in this kind of environment. Um, and I guess also I would ask, uh, what are the rewards for a massage therapist working in this environment?

[00:12:45] Carolyn Tague: Yeah, I mean, um, I used to say this was my favorite gig, um, because it’s so, it, it’s just, you know, it’s simplistic in a really good way, at least how we provide the service.

[00:13:00] Carolyn Tague: Um, we don’t chart. We do get feedback from each patient. We do an intake, but the, the structure of our service is pretty simple. Um, but that means we can see more patients. Mm-hmm. So in a five hour shift, we can see eight, 10 patients, which is really, really lovely. Um, So the rewards are fantastic. Uh, for, for the massage therapist, I think we get to actually interact with many of our patients, some fall asleep, and that’s totally great as well.

[00:13:31] Carolyn Tague: Um, but there really is that opportunity to meet people and, and be a listening, um, person and, and somebody who provides a therapeutic relationship. We’re not their psychologist, we’re not fixing anything. We’re not offering advice. None of that. But, um, There’s plenty of times where patients really wanna tell their story and it’s cathartic for them to just, you know, let it out and, and we can handle it.

[00:13:57] Carolyn Tague: You know, again, with proper training, with kind of the, the background and, um, holding space for, for people who are going through significant, um, medical or other concerns, um, we can, we can do that service really, really well. So, lots of rewards, challenges, um, Well, I guess in our case, if you didn’t like feet, that might be a challenge, but, but you know, I, I’ve really grown to appreciate the variety and, um, the beauty of reflexology.

[00:14:35] Carolyn Tague: Um, because again, in that, In that system, in that theory of reflexology, you are addressing the whole body. Right. So, you know, I often think of, you know, if somebody says, yeah, my neck and shoulders are, you know, I pay extra attention to the, the base of the toes and the big neck, you know, the, that area that’s associated, um, with that on the foot.

[00:14:55] Carolyn Tague: So, um, yeah. But, but otherwise challenges, I mean, yeah, it’s, it’s certainly easy on us physically. Mm-hmm. So, yeah, I’d be hard pressed to find a maybe ’cause I don’t know.

[00:15:14] Ericka Clinton: Well, I love the fact that when you came in the, the, it was already kind of by design, right? That massage therapists will welcome into that environment.

[00:15:24] Ericka Clinton: Um, and I think, um, you know, it’s, it’s kind of the. The simplest arena in hospital-based. Anything where a massage therapist could work, right? There’s, there’s not a lot of concern for, um, just presence in, in a very clinical situation where lots of things are going on. Um, and it does provide this real opportunity to make that time just a little bit easier to tolerate.

[00:15:59] Ericka Clinton: Exactly,

[00:16:01] Carolyn Tague: exactly. I had one patient, if I can share a story. Yeah. So one patient, um, came up to me afterwards, I was just kind of in the middle of the treatment room and I had seen her earlier. Maybe an hour earlier. And she, you know, kind of pulled me like aside, she wanted me this little air and she said, Carolyn, I just want you to know what you do is important.

[00:16:22] Carolyn Tague: I was on my way to chemotherapy. This was her first, um, her first treatment. And I was thinking maybe it would be just better off to die. And you know, that hearing that is kind of kind, it takes you aback. But she said, you know, when you came over and you offered me a foot rub, that’s what she called it. Um, it just, Humanized the whole thing.

[00:16:44] Carolyn Tague: And I felt like, oh, something just switched. And so, I mean, I, I quote her pretty much verbatim because it was such a, like, wow, that is like the core of what we intend to offer, um, our patients, this human contact with a, a, an ability to switch from chaos and, and pain to relaxation and healing. Um, so it was really, really beautiful that she was.

[00:17:12] Carolyn Tague: So generous in her kind of experience and, and wanted to share that with me. And, um, she’s the one who said, what you do is important. And so, yeah, it’s, it’s sometimes the, the less is more, the low tech is high return. Um mm-hmm. So, yeah, it’s, it’s a great environment to work in.

[00:17:37] Ericka Clinton: That’s, that’s really amazing.

[00:17:39] Ericka Clinton: Um, and it, it makes me think about how clients or patients will often acknowledge that the fact that they can get massage somehow makes them feel more normal. Like if it’s okay for me to be touched, Exactly. Then it then I, I could get through this. This is exactly maybe not the, the most horrifying thing, although in the moment absolutely scary.

[00:18:09] Ericka Clinton: The unknown is there, but the fact that, that they can receive touch and massage can feel good. Right. Um, kind of helps ease some of that, that unknown ness. Exactly. Um, exactly. But that’s an amazing story, and I love that. You know, I mean, that moment to also get that level of confirmation.

[00:18:37] Carolyn Tague: Yeah. It was really a gift.

[00:18:39] Carolyn Tague: Yeah. It was really a gift. And I’ve shared that with students. Students have shared with me, you know, the stories. Yeah. It, it goes, it, it’s, it’s a really, um, yeah, that’s one of many great stories.

[00:18:54] Ericka Clinton: That’s great, Carolyn. Thank you for sharing that. That was, that was really wonderful. Um, and I so appreciate all the information you gave us in this little bit of time.

[00:19:04] Ericka Clinton: Um, I know this area of oncology massage is really ripe with opportunity. For many of us, um, and, um, I think this, this little bit of information we shared Will, will help a lot of people start thinking about working either in infusion or the benefit. Um, to a patient getting, uh, chemotherapy. Nice. So thank you so much for your time.

[00:19:32] Ericka Clinton: Sorry. Um, I’m also really excited ’cause I know you and I are gonna do this again and talk about other things, but today was infusion, so we’ll leave it at that. Um, but again, thank you so much for your time and we appreciate having you on collaborative connections.

[00:19:47] Carolyn Tague: Yeah, thank you. And thanks to everybody who’s listening.

[00:19:51] Carolyn Tague: Thanks.

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