This is a copy of an article published in the Journal of Palliative Medicine 2013 copyright Mary Ann
Liebert, Inc.; Journal of Palliative Medicine is available online at: http://online.liebertpub.com
Clearing Bowel Obstruction and Decreasing Pain in a Terminally Ill Patient via Manual Physical Therapy
Amanda D. Rice, PhD, Evette D’Avy Reed, PT, Kimberly Patterson, PTA, LMT,
Belinda F. Wurn, PT, and Lawrence J. Wurn, LMT
Decreasing pain and improving function and quality of
treatment techniques. At initial evaluation, she said she
life are important topics for patients that refuse, or are not
must reside near a hospital, due to PICC line and recurring
candidates for traditional medical interventions, and those
at end stages of disease. Patients with inoperable, metastatic
bowel carcinoma that experience pain and small bowel
She demonstrated improvement through the duration
obstruction (SBO) as a result of adhesions are a subset of
of therapy with significant pain decrease and functional
these patients. The standard treatment, adhesion and/or
increase. By discharge, her physician had removed the
resection surgery followed by post-surgical medications to
PICC lines because she had returned to eating a normal diet
prevent infection and decrease pain, may not be ideal in
(including hamburger). She was then able to travel overseas
end-stage cancer patients. We treated such a patient using a with her husband, a significant increase in her quality of life.
manual soft tissue physical therapy with goals of decreasing
her pain and alleviating symptoms of bowel obstruction
Alleviating pain and dysfunction, and returning life
secondary to adhesions successful y, using a protocol we
quality are challenging goals in patients with inoperable
developed initial y to open fallopian tubes that were blocked gastrointestinal cancer. Here we report a successful
nonsurgical treatment for abdominal adhesions, pain and
dysfunction in a terminal y ill patient. Before therapy,
The patient was a 61-year-old married woman with a
she lived with recurring SBOs, repeat surgeries, pain and
history of multiple abdominopelvic surgeries over the last
dysfunction. Her only nutrition was intravenous TPN.
12 years including hysterectomy, ileostomy and ileostomy
After undergoing this manual soft tissue physical therapy,
reversal with chemotherapy and radiation for treatment of
she was able to eat a normal diet, and participate in
stage IIIB ovarian/peritoneal carcinoma. She experienced
SBO episodes every 2-3 months and had five adhesiolysis
and/or resection surgeries to attempt to repair the
References
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CHESTER J. CULVER, GOVERNOR PATTY JUDGE, LT. GOVERNOR INFORMATIONAL LETTER NO. 668 Iowa Department of Human Services, Iowa Medicaid Enterprise Subject: Smoking Cessation Program for IowaCare Recipients Effective: February 1, 2008 Effective February 1, 2008, the smoking cessation program that began January 1, 2007 for Iowa Medicaid members will be expanded to include
Safer Britain, Safer WorldThe decision not to replace Trident The decision on whether or not to replace Britain’s nuclear weapons system must be taken on the basis of what will most contribute to the security of the British people. A decision not to replace Trident will best meet that requirement. It will strengthen the international disarmament and non-proliferation regime