HANDS-ON PAIN MANAGEMENT: Acupressure for Hospice Care Presenters: Amy Snow & Nancy Zidonis

Synopsis – Presentation & Lab (2-hours) Includes: PowerPoint presentation covering Traditional Chinese Medicine theories and concepts applicable to acupressure; Discussion regarding the use of acupressure for palliative and hospice animal care – Acupressure has been shown to mitigate pain, provide comfort, and lower the need for medications; Demonstration of a comprehensive acupressure protocol; Hands-on Lab for participants to locate specific acupoints for pain management and experience a session protocol.

Acupressure is an ancient healing art that began in China over four thousand years ago. Originally, acupressure, also called “Tui Na,” was used as a preventive medicine to maintain the health of both humans and their livestock, which were a highly valued resource in China. Acupressure connects us with thousands of years of natural healing.

Like acupuncture, the roots of acupressure lie in Traditional Chinese Medicine (TCM). All of the TCM theories and concepts underlying acupressure and acupuncture are exactly the same. Acupressure utilizes the same point system as acupuncture, yet differs in that you are adding your energy directly to the animal, rather than using a needle. This enables the practitioner to experience a deep attunement with the animal’s process, and has the added benefit of being noninvasive, perfectly safe, and always available.

Over 230 generations have consistently recognized the benefits of this ancient healing art. If acupressure were not effective it most likely would not have survived as a complementary therapy to current conventional veterinary medicine. Clinical observation has shown that integrative medicine is often the best approach to animal care. Acupressure is known to provide the following benefits: . Release endorphins necessary to relieve pain . Release natural cortisone to reduce swelling and inflammation . Reduce the need for pain medications . Build the immune system . Strengthen muscles, tendons, joints, and bones . Enhance mental clarity and calm . Resolve injuries more readily by increasing the blood supply and removing toxins . And, in hospice situations, allow the animal to pass peacefully.

Today we are fortunate to be able to make optimal use of both the western and eastern approaches and techniques in caring for companion animals and horses. The beauty of using acupressure is that we all have healing power available to us. A major part of helping animals to be comfortable during the hospice process is the intent the person brings to the session. Many people, with little knowledge of Traditional Chinese Medicine, can perform an acupressure session that contributes to the animal’s comfort.

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Chinese Medicine Theory Chinese Medicine is made up of theories. The Yin-Yang Theory is what distinguishes TCM from all other approaches to medicine. Yin and yang are the two aspects of chi, also seen as qi or ki, which is life-promoting energy. Yin attributes are similar to the attributes of water, which is cold, wet, flows downward, and is substantial. Yang attributes are exactly the opposite. Yang can be likened to fire, which is hot, dry, goes up, and has no substance. An example of this difference is between an edema, which is yin in nature, and a skin infection, which is yang in nature.

When the animal is happy and healthy, the two components of chi, yin and yang are in continuous dynamic balance and chi is flowing harmoniously. Yin and yang work together to keep the body functioning properly by circulating and nourishing all the bodily tissues. When there is a disruption of any type in the flow of chi, illness can ensue.

According to TCM, chi and blood circulate throughout the body along energetic pathways or channels called “meridians.” These meridians serve to enervate and promote the circulation of vital substances to nourish the body by providing chi, nutrient-rich blood and body fluids. Along these meridians there are specific pools of energy called “acupoints,” which affect the flow of energy and blood. When we stimulate these acupoints, we can effectively influence energy and circulation throughout the entire body.

There are 12 Major Meridians on which there are various numbers of acupoints. Each of the 12 Major Meridians are associated with an internal organ system. For instance, the Lung meridian is energetically connected to the Lung. When we stimulate an acupoint on the Lung meridian we are affecting the energy and influence of the Lung throughout the body.

A numbering system was applied to the acupoints as a sort of shorthand when TCM arrived on the western doorstep. As an example, the Lung meridian has 11 acupoints and the acupoint identified as Lung 7 (Lu 7), and in Chinese is called Lie Que, which translates as “Broken Sequence” because it’s location proximal to the styloid process of the radius bone takes the Lung meridian slightly off its direct path. The numbering system provides a quick short-cut to identifying and finding the point.

After thousands of years of clinical observation, each of the 360+ acupoints is known to have their own functions and energetics. This means we can select acupoints to address specific physical and emotional issues. For hospice and palliative animal care, we can

2 select acupoints known to mitigate pain and calm the mind so that animal will be more comfortable. There are other acupoints that can help the animal let go and pass easily.

Acupressure Session Protocol An acupressure session begins with you being grounded and centered. Breathing techniques help to focus on the animal with which you will be sharing the acupressure session. Simply take 3 deep breaths in and exhale slowly to the bottom of your breath. As you exhale watch your breath pass across the room. Follow this brief breathing exercise with taking a moment to consider how you can provide the best care for the animal. This is called your “healing intent.”

We are going to be using a dog session as the example to an acupressure session protocol. During the hands-on portion of the presentation, we will discuss the modifications necessary for working with horses and cats.

Opening Start by finding a comfortable location for you and the dog where it is calm and you both can relax. Take a moment to formulate the intent for this session. Begin by resting one hand near the dog’s shoulder. Using the heel of your other hand, place it at the top of the dog’s head and gently stroke down his neck, just off the midline – Follow the Bladder Meridian Chart above. Continue stroking down to the hindquarters staying to the side of the midline, then stroke down the caudal-lateral portion of his hind leg to the lateral side of his fifth digit. Your opposite hand can trail along the same path touching the dog lightly. Repeat this intentional stroking procedure three times on each side.

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Point Work Now you are ready for Point Work. Rest one hand on the dog wherever it is comfortable. You are going to perform the actual Point Work with the other hand. Use either the thumb or two-finger technique depending on what is most comfortable for you. • Thumb technique: Place the tip of your thumb directly on the acupressure point (also called “acupoint”) at a 45 to 90-degree angle and hold the point gently, but with intent, for about 10-20 seconds, or a slow count to 20.

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• Two-finger technique: Put your middle finger on top of your index finger to make a little tent and then place your index finger at a 45 to 90-degree angle gently, but with intentional firmness, directly on the acupressure point for approximately 10-20 seconds, or a slow count to 20.

Follow the Point Work chart for Pain Management above. Stimulate the acupoints on both the right and left side of the dog because all of the points are bilateral. Watch the dog’s reaction to the point work. Energy releases you can expect to see are: yawning, deep breathing, muscle twitches, release of air, softening of the eye, and even sleep. If the dog is overly reactive to a particular point and exhibits a pain reaction, leave it be for now. Try that point again at a later session.

Closing To complete your acupressure session, rest your hand comfortably on the dog’s shoulder. Place the heel of your other hand just off midline of the top of his head and stroke down his neck, over his back to his hindquarters, keeping your hand to the side of his spine and down the caudal-lateral portion of his leg in exactly the same way you did to start the session (Review the Bladder Meridian Chart Above). Your opposite hand can lightly trail

5 along the same path the working hand. Repeat this procedure three times on each side. It can take 24 hours for the effects of an acupressure session to be experienced.

Occasionally, the dog can appear to be worse during that time before it resolves, this is called a “healing crisis.” It occurs because the energy needs to flow throughout the entire meridian system before shifting and should pass within 24 hours.

Observation / Follow up Following the acupressure session, it’s good to observe if the dog is experiencing less pain. This acupressure session can be repeated as often as needed on consecutive days to help mitigate the animal’s level of pain.

During the presentation and hands-on activity there will be a demonstration of the complete acupressure session protocol plus an additional series of acupoints for palliative comfort care of respiratory, digestive, and other specific issues.

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