The Art of Breathing

The Art of Breathing

Jessica Wolf’s programme of Breathing Coordination

My Post Grad Certificate in Jessica Wolf’s The Art of Breathing

My Post Grad certificate – 1 June 2018             Angela Bradshaw MSTAT DMU DCR(R)

Synopsis

As I got into my car to drive myself home, following completion of my 60 hour Post Grad certificate in Jessica Wolf’s ‘The Art of Breathing’,  Steve Wright was playing Kate Bush’s ‘Wow’ on the radio – one of my all time favourites!

What serendipity, within the body of the song is this phrase

‘When the actor reaches his death 

You know it’s not for real, he just holds his breath’ 

Essentially that’s what we’re all doing when we hold our breath, we’re losing vitality, literally dying a little death.  With this amazing work, you can learn how to cooperate fully with the breath, allowing breath to flow through you efficiently, easily, uninterrupted.  We are then fully fuelled in life, fully alive, through the ups and downs of our lives, the events, the surprises, shocks, the mundane and everything in between. 

In every activity breath is required, and in sleep too, breath is required.  In every moment of your life you are breathing. Breath = life. That’s stating the obvious really.  But sometimes,  hiding in plain sight is a way of evaluating how well you breathe.  Have you ever considered this before?    How well you breathe has a huge impact on how well you’re fuelling your systems with oxygen and  therefore how well you recover from challenging activities, eg walking up hills, ( Kate Bush has reappeared in my head with ‘Running up that hill’ some of these lyrics are also appropriate)

‘ And if I only could

I’d make a deal with God

And I’d get him to swap our places

I’d be running up that road

Be running up that hill

With no problems’

When we understand how to consciously cooperate with our breathing pattern, allowing it to move in a perpetual cycle of motion, uninterrupted, we’re so much more vital.  Our diaphragm is able to move unimpeded, efficiently guiding the stale air out of the lungs, to prompt a full and easy, natural inhalation, that’s perfectly orchestrated with the demands our whole selves are experiencing in that moment.

The diaphragm can’t be directly influenced.  But we do have conscious control over other parts of the respiratory system, which fortunately means we can indirectly positively influence the ability of the diaphragm to move.  How efficiently it is in its movement during the respiration cycle.  By allowing our ribs to move fully, keeping our abdomen soft and available for movement, this then means the diaphragm is able to move unimpeded and in a more balanced fashion within the torso. One of my colleagues describes the diaphragm as ‘the conductor of the orchestra’ which I think is a wonderful phrase. It enables us to understand the importance of the role of the diaphragm and what happens if the orchestra isn’t listening to the conductor…..we get chaos in the respiratory system! And if one faction of the orchestra is out of time with another, we get noise, not beautiful music!  Timing is important too.  Naturally our breath works in perfect harmony with our selves, our environment and emotions and physical state and demands we have on the physical self. 

If we have faulty breathing patterns, or misuse our respiratory system in some way, we have a detrimental effect on our ability to breathe well.  Faults come about for a variety of reasons.  They can be postural.  Literally squishing the lungs with poor posture, reducing their potential to receive air as the breathing space is reduced by a poorly arranged skeletal system. Posture is very important.

Disease can also affect the way we breathe.  Respiratory disorders such as asthma affect our breathing patterns and can set us up  with ways of breathing that are no longer natural. Trauma to the chest can obviously impact our breathing efficiency negatively too to varying degrees.

Jessica Wolf, on qualifying as an Alexander Technique Teacher immediately then spent 20 years being mentored by Carl Stough in Breathing Coordination.  Carl was affectionately called Dr Breath by his athlete students – this was a great indication of how much they liked his work and how beneficial it was to them as they learned how to cooperate with their own individual breathing patterns and rhythms as they were running and also as they were recovering too from practice. They noticed their ability to recover from training improved dramatically once they applied his work to their own discipline and style in training. Their times improved too.

Carl also worked with patients suffering with emphysema.  He managed to get patients off oxygen and into mobility again by teaching them the ways they could help themselves to aid the movement of the diaphragm.

Carl’s original interest in priming the diaphragm was through the voice.  As a choral conductor he wanted his students to be able to produce the best sound.  An inefficient diaphragm affects the vocal tone and strength.  By working with his students individually, he was able to teach them how to strengthen their diaphragm, by learning how to coordinate their breathing naturally again.  Their voices naturally improved as a consequence.

Interestingly F.M.Alexander was known as ‘The Breathing Man’.  Both men were geniuses in their own right and happened to notice the importance of Chest Poise in the efficiency of breathing.  Both men used hands on guidance to aid their verbal instruction when working with students.

Jessica has managed to distil her 20 years experience with Carl and extensive Alexander Technique teaching into an accessible programme of simple effective procedures to enable easier breathing, and an ability to improve the efficiency of the diaphragm.  This has a positive effect on the vocal tract too.  The Art of Breathing enables us to prime the diaphragm.  We then are able to exchange breath capacity for coordination/ this helps us speak on the breath more efficiently, using the breath as a support.  We can sing phrases more efficiently too with reduced need to ‘take breath’ – we get better at trusting the breath and allowing the body to organise how much we breathe we need for a particular activity.

Alexander’s own procedures are also very beneficial in restoring a more natural breathing rhythm and pattern to return.

With Jessica’s Art of Breathing we can find additional ways of cooperating with the breath in a myriad of ways in very differing circumstances.

The personal benefits I have noticed since working with Jessica in this way, for around 68 hours so far, has been an ability to find the reflexive breath.  Breathing is now so much easier!  My chest poise has improved too and is easier for me to find, return to and rely on also.  A previously difficult spin class, was a breeze this week as I wasn’t over managing my breath, just allowing it to come and go with the changing demands of the class, hurray! And in yoga I’ve noticed that if I just follow my breath, the poses are easier.  I’m not forcing anything, just flowing and binds are becoming closer to being achievable. I have never managed a bind to date in all of my years of yoga ( about 20 years), but now I can see it will happen as my whole self is more flexible. Allowing movement, and suspension of the skeletal system, aided by my natural breathing pattern and rhythm enables so much! Hallelujah.  I’m amazed at what I can do and at this age…..I’m going to be 50 years old this year.  A golden oldie!! But full of life and wonder at what the human body can do, is capable of and how it opens the door to ourselves in incredible ways.

What has been most enjoyable is having a release in the jaw, that allowed my true voice to come forwards for the first time, without apology.  It feels good to be me!  Naturally me. 

How does that sound?

How would you like to be fully natural, naturally you on every level, starting with the breath?

Please get in touch with me if you’re interested in opening the door to yourself.  I’d highly recommend it in this day and age of forcing, struggling and trying too hard at life.  Lighten up, find your breath, let it take you into your actual natural flow.  Then life feels abundant, easier, more you…..

I’d recommend a course of lessons to really effect a positive change.  3 months of hour long lessons would be a good starting point if you’re keen to treat yourself to a natural holistic programme incorporating posture and breath, to aid easy movements, free your voice, expand your ability to care for yourself on many levels, spiritually, emotionally, physically.

It’s a breath of fresh air!

www.angelabradshaw.com

       

New Cross Hospital Sonographers Learning Application of Alexander Technique In Clinical Practice

Sue Burford, Clinical Ultrasound Manager at New Cross Hospital, invited me to run an educational Study Day for her team of sonographers in the elements of Alexander’s Technique, to help enable her staff be able to practice effective Self Care in their clinical practice.  This took place on Saturday 13th January 2018.

Who looks after the health care workers in Ultrasound departments?  It seems that like many of their global sonographer colleagues, many of the team had succumbed to pain and injury in their professional vocation.  This is a common scenario for many sonographers across the world.

I am uniquely placed to help Ultrasound practitioners learn how to use themselves well again.

How so?

Firstly, it’s my own professional medical background prior to retraining as an Alexander Technique Teacher.  I was a radiographer first – I trained at Withington Hospital in Manchester 1986-1989, so I have a good understanding of bone structures and how to make that skeletal structural knowledge personal and use it dynamically in action.  I then became a sonographer ( I gained my DMU in 1994, training at St Thomas’s Hospital and Kings College Hospital), most recently working as Advanced Practitioner of Obestetric Ultrasound at St Peter’s Hospital in Chertsey when I too succumbed to a Work Related Musculo-Skeletal Disorder of my Right Upper Limb [ scanning arm] in the summer of 2007.

I discovered Alexander Technique after my resignation, after I had tried all the conventional treatments recommended by my rheumatologist. The irony!  But the timing was truly divine.  It happens to be my vocation now, to teach other people how to avoid injury and pain in activity, and how to recover from those already gained.  I understand the demands of clinical practice on sonographers having spent many years in the profession myself, and how all the pressures of working in the NHS may combine and lead to burn out, exhaustion and debilitating injury.  But it really doesn’t have to be that way! We can educate ourselves to be able to change our behaviours and be able to use our bodies in line with their natural design at work.  It’s another set of skills that we aren’t generally taught in mainstream education unless you happen to be educated in a forward thinking school that includes Alexander Technique as part of its educational philosophy.  It’s a pity it’s not taught in every school ( yet!) or in every Radiography School or Ultrasound Programme.  It would help many Health Care workers be able to prevent future pain and injury by understanding how to consciously manage their movement and postural patterns and habits to a more natural way of performing.

This is where I can help. My own injury healed very quickly, once I understood the ways I had been abusing my poor shoulder. My rheumatologist told me my injury would never heal.  Thankfully he was wrong! Once I understood the importance of the head, neck, back relationship.  Where natural movements take place from, a whole new way of behaving opened up.

In a Self Care Study Day with me, I teach everyone how to notice their own personal postural and movement habits, and then how to arrange some small and simple  changes to ensure that they can start complying with our actual natural design. It’s a fascinating personal journey of discovery. Some surprises usually are revealed.  Some of our daily behaviours hiding in plain sight are discovered to be unnatural!

Alexander’s Technique is a simple practical method enabling us to reorganise ourselves to behave in a natural way.

The afternoon session includes everyone having individual ‘hands on’ at the ‘scene of the crime’ i.e. in front of the Ultrasound machine itself and mocking up scenarios that we find in clinical practice.  How you respond to the machine, the transducer, the patient, whether you sit, stand all impacts on your musculo-skeletal system. It helps the sonographer community to learn together in this way. We aren’t always aware of what we are personally doing when we get busy in our work. If a colleague spots us doing something unnatural at work, we can helpfully point it out, and vice versa.  The more we practice this, the better we become at managing ourselves.  It takes time, but is a practical way of managing Health and Wellbeing at work during clinical practice.  No separate time needs to be set aside to do exercises.  We simply think about what we are doing, and how we are doing it, at the time of the activity.  This makes us literally more present and accountable for our actions. It’s embodied awareness and holistic mindfulness in action whenever we choose to think about ourselves in this way.  And it is always a choice. But how empowering, an invisible advantage silently being applied as we go about our business!

Here are some comments from the participants….

Excellent presentation.  Physically and mentally refreshing, thank you.    Tracy Cockburn  Midwife Sonographer New Cross Hospital

 

Very interesting and helpful.  Will try hard to think, move and apply the principles I have learnt today.  Very keen to learn more.  Thank you Angela.  Suzanne Bowen – Clinical Specialist Sonographer New Cross Hospital

 

Very good tips, will be using this method.    Shama Niazi – New Cross Sonographer

Angela was excellent at presenting the technique and understood the role of a sonographer so the course was pitched perfectly to our daily job – fab!   Elaine Brooks – New Cross Hospital sonographer

I found the part on grip most useful as I have tenosynivitis in my right thumb.  Hopefully taking this session on board will help alleviate the problem.  Becoming aware of my posture particularly the shoulder girdle will help with the pain between my shoulders and the fact that I raise them too much.  Anne Thomas – Clinical Specialist Sonographer, New Cross Hospital

I’m newly qualified in scanning and feel I am still ‘finding my feet’ with regards to posture and positioning for scanning.  The day has made me think about all of this and hopefully consider my posture, and make some changes or try something new!   Joanna Finn- Midwife Sonographer

The session gives lots of information to take home and think about and try to put into practice.  I think it would be good to have an AT teacher stood behind you during an actual U/S list since I’m sure my posture gets worse during the session / day.   Tracey Pinfield – Sonographer New Cross Hospital

Enjoyed the day.  Very knowledgeable  and enthusiastic teacher.  Will definitely order new more supportive saddle stool / remove stirrup bar to get closer to the bed.      Laura Minton.  Sonographer – New Cross hospital

Very useful session.  I will ‘think more’, adapt as taught and listen to my body!!  Thank you very much.           Sharon Smewing Sonographer New Cross and City Hospital.

I enjoyed the semi-supine activity.  I think it was pitched at the right level, with attention to individual sonographers.  It will be interesting over the coming months whether we’ll be able to change our habits and maintain a natural posture in life and scanning!   Thank you!    Katherine Mapes, Clinical Specialist Sonographer New Cross Hospital

Thank you for an informative session today.  A good team building day for sonographers. Amanda Tyler – Clinical Specialist Sonographer RWNHS Trust

Get in touch if I can help you in your department.

Very Best Wishes

 

Angela

 

 

 

Self Care Strategies For Sonographers

Self Care For Sonographers – Study Day, November 2017

Monica Franklin, High Risk Matron of ANC and the FMU at Guy’s and St Thomas’s Hospital Trust in London contacted me to ask if I would run a Self Care Study Day for her staff.

The specific focus was to help educate her sonography team with some simple and practical ways of Self Care to reduce the incidence of pain and injury that are so commonplace in the Ultrasound profession. Of course I was delighted to help, it pleases me enormously to be able to share with my Medical Imaging colleagues, the methods I have personally used to aid my own recovery from a Work Related Musculo-Skeletal Disorder of my Right Upper Limb.

My own injury led to my resignation from my post as Advanced Practitioner of Obstetric Ultrasound in 2007.  I resigned reluctantly, as I truly loved my profession and I was hoping to be able to manage my injury to protect my chosen vocation.  At that time, I had not yet discovered Alexander’s Technique.  I believed that after trying a myriad of conventional treatments recommended by my Rheumatologist, which were only fleetingly successful in alleviating my pain levels, that the only way to prevent my injury from getting worse was to resign.

After I resigned, I found the Alexander Technique! It was a revelation and very quickly I was hooked on it and decided to retrain as a teacher of Alexander’s Technique.  I now believe it was all meant to be.  Whilst I was devastated to leave Ultrasound as a profession, I absolutely love helping my sonography colleagues learn how to manage their own health and wellbeing in clinical practice.

It’s totally possible to learn how to prevent pain and injury in sonography.  How??  You may well ask, as many sonographers believe that pain and injury are an occupational hazard that one must just ‘put up with’ as part of the job description.  It really doesn’t have to be that way.

It’s All In The ‘How’ – How Do You Scan?

How we perform an ultrasound scan, is of the upmost importance.  There is a lot of emphasis placed on ergonomics these days, which is all for the good. However, it’s absolutely crucial to understand our own part in the scan, the human element of the examination.  How we are functioning as we scan needs to have some attention, how we approach our patients, how we manage difficult conditions, how we manage impossibly long scanning lists, short lunch breaks, no tea breaks, short staffing situations – all play a huge role in how well we are functioning ourselves.

This part of the examination, the human element, is not something we are taught as we learn how to scan, unfortunately. It would be a very wise investment if it became introduced as a mandatory part of the ultrasound training, it’s as important as the academic elements of the syllabus. Protecting the staff from unnecessary injury goes a long way to boosting morale, retaining the workforce we have and enabling individuals to maximise their earning potential in this field.

The sun was shining for us on Friday 17th November 2017, the date of this Study Day! The Education Room was the perfect space for the morning presentation.  I like to go through the theory of how the practical application of Alexander’s Technique can help us learn how to conduct ourselves more naturally in the clinical environment.  Identifying our personal postural habits and movement and behavioural patterns goes a long way to enabling us to choose more natural ways of working.  Becoming more accurate with our personal body maps is also crucial and this is where Medical Imaging practitioners have an advantage, our knowledge of anatomy is already very detailed, now we get to make that into personal wisdom that can be used as we go about our daily activities.

Semi-Supine – How To Constructively Rest

Constructive Rest is always a part of the educational training I deliver.  I personally credit this practise as the way I naturally healed my own injury relatively quickly.  I recommend this daily to Ultrasound practitioners as a way of recovering from pain and injury and restoring natural alignment but also as a method of preventing future injury.  As our lives are now so busy, it’s important to factor in time for rest.  This is an excellent way of restoring balance to the musculo-skeletal system. It only costs you your time.  Twenty minutes is the optimal time, although if you had less time it would still be beneficial.  At the peak of my own injury, I would sometimes do this for longer, even 45 minutes wasn’t unheard of!  And it’s certainly worth it.  You can’t put a price on your own Health and Wellbeing.  It’s only when it comes under threat, that we realise how precious it is. I know now that there is nothing more important than your health.  I now make it a priority.  I had to change my mindset and behavioural patterns to do this.  Previously I put other people first.  Now I realise it’s actually responsible to put my own needs first in order to meet my commitments and duties.  Similar to the airline philosophy of ‘putting on your own oxygen mask before you attend to your child’.  It’s important.

The Feedback?  Here it is  below from all 8 attendees.

10/10 It would be useful to have more sessions after being able to practice in our routine lists.                                                                                                       Cristina Llorens -sonographer

10/10 The 1:1 session is really helpful in recognising the habits that are bad for your body and how to improve it.                                                 Izuan Halik – FMU Sonographer

It was good to have the presentation and discussion first to be able to understand the necessary changes needed in the practical. It helped to see changes in colleagues as much as myself to remember what it is important.   Penny Hamilton – Midwife Sonographer FMU

Overall the Alexander Technique to me is about being aware of myself when working and ensuring that I am looking after myself as I am important.  Thank you for today Angela!   Aimee Isiboge – Sonographer FMU

10/10 Theory was really helpful – understanding is the key!  Fantastic that Angela is a former sonographer as everything about her journey rung true with me.  Practical session with a real patient would make practical session more realistic ( obviously can be difficult to arrange).            Nicola Luescher  – Midwife Sonographer FMU St Thomas’s Hospital

Thank you for a useful day.  Good to hear your personal experience of RSI as I think alot of sonographers could recognise themselves with similar symptoms and experiences.       Alison Smith  Tutor Sonographer

Thank you for the session, it was very helpful.  I will definitely attend individual lessons / workshops.  Vahideh Zahiri – Midwife Sonographer, FMU St Thomas’s Hospital

Thank you Angela for coming today and spending the day with us sharing your knowledge.  It’s difficult to believe that a severe injury can be cured.  However having you as an example of a great recovery, it is very motivating.  I will 100% continue working on my body to recover.  Many many thanks!!            Elsa Moro

And indeed it can be difficult to believe that a recovery is possible.  I was told by my rheumatologist that my own injury would never heal, and that at best it would ‘stay the same’.  Not an appealing thought.  And he was wrong!!!

I only wished for some relief from the pain.  It never occurred to me that my body would be able to completely recover.  But it has!  In fact, I am now in better shape than I was as a teenager.  How about that!  Improving with age.

I do hope this encourages you to explore Alexander’s Technique, and find out what it could do for you.  It truly is an invisible advantage that can free you from injury and pain and empower you with very simple tools to enable your best health and wellbeing.

If I can help you in your department, please get in touch.

Here’s to your good health!

Sincerely,

[Ultrasound Scanning] A Personal Protocol For Sonographers To Aid Health And Wellness In Clinical Practice by Angela Bradshaw MSTAT DMU DCR(R)

Altnagelvin Hospital – Saturday 14 October 2017

Synopsis

As a newly appointed Lead Sonographer for the hospital, Melanie invited me to run a Study Day for the sonographers in her team on Saturday 14th October 2017 as she wanted to be sure that the sonographers were all aware of techniques and methods for minimising the risk of joint or Repetitive Strain Injury, which can be a common scenario within the profession.  In this busy acute hospital there are a variety of Ultrasound examinations taking place, abdominal scans, obstetric, gynae, infant hips, small parts, vascular, involving in-patients and out-patients.  Additionally there are also biopsies and more specialist examinations to attend to as they arise.

So how is it possible to look after your own health and wellbeing as a busy sonographer performing many scans per day?

It’s a pertinent question and one we looked to address during the Study Day. 

   

    

Alexander Technique

My Self Care Skills course, Alexander Technique For Sonographers – Level 1 is accredited by the College of Radiographers in the UK with Continuing Professional Development Points.

Alexander’s Technique has much to offer the Medical Imaging Profession.  In our training as radiographers, sonographers, mammographers – our focus is on patients, their anatomy and physiology, their disease patterns, an in depth knowledge of imaging modalities and how to practise safely within legal parameters using the lowest possible radiation dose (ALARA), and ultrasound frequency and keeping examination times to a minimum. Their health and wellbeing is always at the forefront of our minds.

It seems to me that it might be wise to begin introducing the idea that we also need to mindful of our own health and wellbeing too.  This will create a strong and healthy workforce, able to withstand the rigours of the profession, maintain maximum earning power potential and ability to care for patients fully and efficiently.  It would be a wise investment too for the NHS who need to protect their staff.  Our profession is short of qualified professionals. Looking after the staff we have in place makes financial sense.  And it’s not all about the numbers either, it’s also about empowering staff with morale, security and an education in personal health care.

This is what my passion is now, teaching my colleagues how to prevent pain and injury in the clinical setting and educating them in holistic ways of recovering from those already gained. It’s always such a joy to see sonographers experience a new way of operating around the patient and u/s machine.  It’s often such a surprise.  But it’s a definite possibility to become aware of how to use your body to its mechanical advantage whilst scanning, whether that’s in a seated position, or standing position, or dealing with an immobile patient in a bed or an obese patient that can make imaging very difficult.  There’s always a way of using your body more naturally, to help you navigate the conditions you’re encountering better and without a price to pay on your personal health and wellbeing.

I always ask for feedback at the end of my Study Days in order that I can fine tune and improve what I’m offering.  Here I’m sharing what the sonographers at Altnagelvin Hospital though of this educational training.

A total of 19 sonographers attended.  Of the 17 who gave me feedback I got 8 sonographers give me a 10/10, the lowest rating was an 8.  This is pleasing!

Everyone said they would recommend this course to a colleague. 

In terms of more detailed feedback, here are some of the comments I received.

• A very useful and enjoyable morning.  There aren’t many Study Days where you leave feeling taller, better and more relaxed than when you came in!                                                PACS manager Altnagelvin Hospital (attended morning only)

• Excellent, Angela you presented in a very sensitive understanding manner!                                  Reporting Sonographer, Altnagelvin Hospital

• Found course very useful to show good practice especially as a beginner                                     Student Sonographer, Altnagelvin Hospital

• This was a really useful team exercise.  It was great to have all the sonographers together so we could explore all our bad habits and how to improve them.  Having it as a team exercise means we will be able to support each other implementing the techniques we learned today.                                                                                                                  Lead Sonographer, Altnagelvin Hospital

• I thoroughly enjoyed the course today.  As I am a visual / practical learner.  I enjoyed the activities the most and felt these were very helpful.  Potentially more time could be spent on the practicals? Thanks                                                                                                      Sonographer, Altnagelvin Hospital

• Very useful to help with correct posture for day to day work.                                                                    Sonographer, Altnagelvin Hospital

• Excellent, very helpful and hopefully we will be able to put into practice.  Maybe an update may be considered after a period of time of using this technique.  Thank you.                                                                                                                                                                Fetal Sonographer, Altnagelvin Hospital

• Presentation and activity was great.  Also great to demonstrate how I scan and how to improve this.                                                                                                                                               Medical Imaging Radiographer, WHSCT.

• Semi-Supine and practical scanning activity most helpful and enjoyable! Presentation was good but activities the most useful for me in a practical job.                                                 Sonographer, Altnagelvin Hospital.

• Very pleasant Saturday with a very pleasant speaker.  Educational and interesting.  Will definitely try and improve my own posture and implement what’s best to protect myself from injury.                                                      Sonographer, Altnagelvin Hospital

• I think it was perfectly pitched.  As a sonographer who has had right shoulder, arm and neck issues over the years, needing physiotherapy, very useful to learn theory first and then practical – good both watching others and then direct involvement.  Very useful.  Will take a lot of remembering to try and implement new techniques.  In a busy worklist it is too easy to keep going to get the job done quickly without giving our posture, table height etc proper consideration and adapting when necessary.                                                                                 Sonographer, Altnagelvin Hospital

I am so pleased that this training was so well received!  It’s simple but not easy, as we’re up against our personal habits.  Change is often a challenge, but knowledge and awareness  is all and this gives us choices over our future self.  Health and wellbeing can be yours!  A fully active personal and social life can be yours too.  Just a little bit of thinking about yourself goes a long way to helping you be the best version of yourself.  Natural and cared for.

Do get in touch if I can help you in your department, I’d love to help.  www.angelabradshaw.com

To your good health!

Best Wishes

Holistic Healthcare For Mammographers [Self-Care Programme Outline]

I was delighted to be invited for the second time to take a Self Care Study Day for the Mammographers at The Countess of Chester Hospital, on Thursday 2nd February 2017. It was two years previously that I had run a similar day, for the staff here at the Breast Screening Unit.

Superintendent Radiographer, Sara Millington said “ I found the training so beneficial, that I wanted members of staff who had been unable to attend last time to have the same training in order to prevent further or future MSK Problems”

So for some this was a refresher, and for others an introduction to the beginnings of a simple #SelfCare strategy, accessible to all and easy to implement into clinical practice and everyday life. We had a full day of learning. The morning session took place at Longhouse, in a conference room where we learnt the theory and principles of Alexander’s Technique. I tailor each course to the modality. My educational teaching programme, Alexander Technique For Radiographers, Level 1 is endorsed by the College of Radiographers, and supports all specialist radiology modalities.

Conference Room B, Longhouse all set up and ready to go for #SelfCare! 

Can you spot the auspicious rainbow on the photo below??  What a lovely affirmation as I came out to the car part way through the morning.  Right before we practised a Semi-Supine session.

I created my programme of #SelfCareSkills to help other Medical Imaging professionals reduce pain and injury levels, maintain earning power and ability to function well physically at work and in their private lives too.  I absolutely believe it is possible to recover from a repetitive strain injury  purely by practising #AlexanderTechnique as a daily habit.  This came about as a result of my own personal journey from being an Advanced Practitioner of Obstetric Ultrasound and experiencing a Chronic WRMSD, being told by my Rheumatologist that my injury would never heal, that ‘ at best it would stay the same’ ( not an encouraging thought!) and trying all the conventional therapies he recommended to abate my pain levels.  All to no avail.  But this led on to me experiencing an epiphany during my first #AlexanderTechnique lesson, as a personal exploration through my desperation actually!  I left my first lesson pain free, which was an amazing turn of events.  It certainly got my full attention as it had been many years since I had been completely pain free.  I had got very used to putting up with a degree of pain at all times, even while asleep!

I also believe it shouldn’t be accepted that so many radiographers become injured through the course of their working lives and that this is seen commonly as an occupational hazard.  A little bit of education goes along way to empowering radiographers to help themselves to function optimally in their chosen profession with no adverse physical effects or negative impact on their earning potential or length of chosen career.

What happens in a Study Day for Mammographers with me? I’m detailing below an outline of what we covered in Chester.  It is a typical representation of a 6 Hour Intensive Workshop.

I liked this poster within the department reminding patients to be Body Aware and Make Time For Breast Screening.

For me this could be converted for the staff to read

“Know Your Body”

‘Make Time For Self Care’

It’s truly too important to forget.

Every member of staff in the Mammography Department is equally as important as the patients they are there to serve.

Including ourselves, our whole selves, in our clinical duties in the Breast Screening environment is fundamental to Best Practice.  If you’re not functioning optimally, you can’t help your patients or serve them optimally.  So #SelfCare is your duty! Be Mindful of how you are going about your practice and make sure you’re using your mind and body as carefully as the equipment and with as much compassion and care you offer to your patients.

Here you can see a sequence of photographs that were taken with permission from the mammographers taking part in the educational training, to give you an idea of what we cover in the practical application of Alexander’s Technique in the afternoon session.

Every mammographer was able to have a turn at experiencing AT hands-on.  We mock up scenarios and have staff members playing the role of ‘patient’ while the ‘mammographer’ is paying close attention to their personal habits during clinical practice and then, with my hands-on guidance,  being able to experience a different and more natural way of moving around the patient, equipment etc.  How you move your body, is of the upmost importance.  How you approach a distressed patient also impacts on the physical self, so we learn ways of minimising negative reactions, or responses that are less than helpful for the health of our future self.

The focus of the practical session was on greeting patients, positioning them and even how we press the exposure button without undue tension. We also got an opportunity to look at Breast Ultrasound too, and a very willing patient allowed me to be in the room with the Breast Physician who’d been experiencing shoulder pain.  While the doctor was scanning, I was able to assist her with differing ways of standing, setting up the Ultrasound machine more to her personal dimensions and easier ways of holding the transducer which alleviated her discomfort.  Hurray!

We also looked at setting up image reporting stations, sitting and standing and changed things to support the practitioner more fully. Simple but effective strategies that help the Breast Care staff look after their own health whilst they help the health of their patients too.  Win-Win-Win.  Everybody benefits, the staff, the patients and the NHS. It truly is a wise investment.  Morale gets a boost and the community of Breast Centre staff can continue to help each other long after the end of the Educational Training Day.

We practise constructive rest as part of the training, which enables participants to experience the value of this simple nurturing practice as part of their ongoing wellness programme.

It’s such a positive forward thinking policy to ensure that the team are aware of methods that can improve health and wellbeing, simply and easily.  It’s also incredibly cost effective for the NHS to protect their investment in these highly qualified, skilled, specialist mammographers and assistant practitioners and Breast Care Consultants too who enable so much in the management of patients’ health care.  It’s vital to also look after the healthcare of the healthcare workers!  I’m always delighted when a department makes it a priority. We may have to start being creative in the ways we go about funding this, for example if budgets are squeezed, is there a different avenue you could look at to raise the money?  Sometimes departments have used charity money for the health of their staff.  It improves morale no end too and when the staff are valued, supported and cared for in this way, it creates a harmonious environment whereby everyone supports each other and manages to thrive professionally and personally too. Wouldn’t it be a wonderful idea to also include this in the mandatory training of sonographers, radiographers, mammographers and other imaging staff to ensure that from the start individuals are aware of how they can best perform their clinical duties?  The investment in the staff training would then be protected from the start……something to consider if you are involved in the Higher Education programmes for imaging staff  in the Graduate and Post Graduate specialist training.

So what did the participants think of this training?  Here are some comments I received as part of the feedback.  Printed here with permission.

“The session has illustrated lots of very simple things I can do to alleviate / help rectify an RSI”                                                                                                     Breast Physician – Dr Sara Bundred

“Very helpful, a good balance of presentation and activity to re-inforce a completely new approach” Consultant Breast Radiographer  -Judith Kelly

“Thank you Angela, the day was informative and I have enjoyed it”     Mammographer, Vanessa Pryer

“I didn’t realise my posture was wrong until it was pointed out.  It has helped me to concentrate on myself as well as the patient.”  Mammographer, Radiotherapist Gill Owen

“Angela was excellent.” Anon

Please do get in touch with me if you’d like to discuss a similar event in your department.  It’s also a good idea to refresh the knowledge annually if possible to retain the benefit of the training. I’d love to help!

Until next time, be well!

Best Wishes

Angela x

Kate Granger #deathbedlive #hellomynameis

What a hugely inspirational lady, so special and leaving behind a wonderful lasting legacy helping us all to improve patient care and also to start being more open and honest with each other about taboo and sensitive subjects ❤

George Blogs

Going to try and keep this short. I’m struggling to find the words.

3 years, 10 months and 6 days ago, on 15 September 2012, I first tweeted about Kate Granger. I shared an article from The Scotsman, Dr Kate Granger, doctor and author living with terminal cancer I’d kept it open on my laptop for a couple of weeks, trying to find the best time to read it. My Dad, Bobby J, was terminally ill and clearly coming towards the end of his life. He died exactly two months to the day that I shared that tweet. Throughout Dad’s illness I’d tried to blog, to keep a record, to encourage discussion about death and dying, something of a niche blogging topic at the time.

It was in one of the early twitter exchanges that I had with her, and Quigs, that Kate shared her hope to make a difference:

View original post 616 more words

Sonographers learning Alexander Technique

The pleasure was all mine on Friday 4th March 2016 when I was invited in to The Royal Bolton Hospital Maternity Unit to teach members of the sonography team the beginnings of a simple #SelfCare strategy, accessible to all and easy to implement into clinical practice and everyday life. We had a full afternoon learning Alexander Technique For Radiographers, Level 1. My educational teaching programme supports all specialist radiology modalities.

Arriving to 3″ snow! What happened to Spring?

I created this programme of #SelfCareSkills to help other Medical Imaging professionals reduce pain and injury levels, maintain earning power and ability to function well physically at work and in their private lives too.  I absolutely believe it is possible to recover from a repetitive strain injury purely by practising #AlexanderTechnique as a daily habit.  This came about as a result of my own personal journey from being an Advanced Practitioner of Obstetric Ultrasound and experiencing a Chronic WRMSD, being told by my Rheumatologist that my injury would never heal, that ‘ at best it would stay the same’ ( not an encouraging thought!) and trying all the conventional therapies he recommended to abate my pain levels, to going on to experience an epiphany during my first #AlexanderTechnique lesson, as a personal exploration through my desperation actually!  I left my first lesson pain free, which was an amazing turn of events.  It certainly got my full attention as it had been many years since I had been completely pain free.  I had got very used to putting up with a degree of pain at all times, even while asleep!

I also believe it shouldn’t be accepted that so many radiographers become injured through the course of their working lives and that this is seen commonly as an occupational hazard.  A little bit of education goes along way to empowering radiographers to help themselves to function optimally in their chosen profession with no adverse physical effects or negative impact on their earning potential or length of chosen career.

What happens in a Study Day with me?

Good to go!  A presentation given first with my helpful assistant ‘Alex’.

Here you can see a sequence of photographs that were taken with permission from the sonographers taking part in the educational training.  We practise constructive rest as part of the training, which enables participants to experience the value of this simple nurturing practice as part of their ongoing wellness programme.  After the theory comes the practical in the scan room, whereby everyone gets a chance to look at their seated scan posture, standing scan posture, moving around a patient, holding a transducer, setting up the monitor and more.  This gives an idea of the detail we go into. It’s effective to learn in a group too as you can see other people’s posture improving and can then go on to help your colleagues maintain the learning and embed the positive changes we discovered during the afternoon.

It’s such a positive forward thinking policy to ensure that the team are aware of methods that can improve health and wellbeing, simply and easily.  It’s also incredibly cost effective for the NHS to protect their investment in these highly qualified, skilled, specialist sonographers who enable so much in the management of patients’ health care.  It’s vital to also look after the healthcare of the healthcare workers!  I’m always delighted when a department makes it a priority.  It improves morale no end too and when the staff are valued, supported and cared for in this way, it creates a harmonious environment whereby everyone supports each other and manages to thrive professionally and personally too. Wouldn’t it be a wonderful idea to also include this in the mandatory training of sonographers, radiographers, mammographers and other imaging staff to ensure that from the start individuals are aware of how they can best perform their clinical duties?  The investment in the staff training would then be protected from the start……something to consider if you are involved in the Higher Education programmes for imaging staff  in the Graduate and Post Graduate specialist training.

So what did the participants think of this training?  Here are some comments I received as part of the feedback.  Printed here with permission.

Excellent presentation.  Very calm and effective teaching style.  Very useful afternoon.                                                                                                     Sonographer

Enjoyable afternoon, excellent presentation and practical session.       Sonographer

Very engaging.  Good opportunity to focus on this area of practice.  Lead Sonographer

Second time on the course, even more useful and enlightening than the first time. Sonographer

Really enjoyed this training as I have bad posture and was amazed at how having the correct posture reduces the tension and ache in many parts of the body. Thank you! Booking Clerk

 

Please do get in touch with me if you’d like to discuss a similar event in your department.  It’s also a good idea to refresh the knowledge annually if possible to retain the benefit of the training. I’d love to help!

Until next time, be well!

Best Wishes

 

 

Have a “Happenista” 2016.

Source: Have a “Happenista” 2016.

Mindful Mammography @ The Breast Care Centre, Glenfield Hospital

I was delighted to have been invited by Amanda Gibby, Breast Imaging General Manager at The Breast Care Centre, Glenfield Hospital to lead TWO Study Days in Self Care Skills ( based of the principles of the Alexander Technique), this week.  It’s wonderful to see proactive leaders working to help their staff reduce the risk of RSI.  Physical issues, pain and injury are significantly affecting large numbers of mammographers and Health Care Practitioners working in this Medical Imaging modality.

I am in my element teaching Medical Imaging professionals as it’s my own professional background prior to retraining as a teacher of Alexander Technique.  I created an educational training programme in Self Care Skills specifically to help my health care colleagues.  Mammography is a demanding role, requiring much of the practitioners.  There are many factors involved and many reasons why a Mammographer might succumb to injury in the course of their clinical duties.

This is where I can really help – my own personal experience of working as a radiographer ( and rotating through the mammography suite whilst at St Thomas’ Hospital), and sonographer, succumbing to a WRMSD in 2007, resigning my post due to this injury ,and then going on to take the three year, 1600 hour training to become an Alexander Technique teacher.  This allows me a complete understanding of the issues faced, and how we might go about changing behaviour to eradicate the incidence of injury. My own personal healing journey informs the way I teach and gives hope to those currently suffering. I am passionate in my belief that it is absolutely possible for a radiographer, mammographer or sonographer to be able to expect to have a full time career in their chosen modality without succumbing to a physical injury caused by their working practice.  It’s all a question of educating and training staff HOW to improve their own coordination, posture and movement patterns and habits.

Did you ever realise it was possible to improve your personal coordination? Probably not –  I didn’t before my Alexander training.

Did you ever think you could improve your posture easily with very little effort?  No?  Neither did I!

Did you ever believe it possible to improve with age?  No?!  I used to think that too.

This is some of the material we cover in my Self Care Skills Study Days.  In this introductory 6 hour practical session :  Alexander Technique for Medical Imaging Professionals – Level 1, we take a look at the common factors influencing our behaviour, posture and movement habits.

The Willow Room, small but perfectly formed!

Lecture Theatre Stage Right!

 

Lecture Theatre Stage Left!

 

 

We were fortunate to have the morning theory sessions in quiet rooms, ideal for the business of starting to think about yourself in a new way, with more awareness and then starting to become more conscious of your own personal postural and movement habits.

Wonderful Large Projection Of My Self Care Skills Presentation!

The presentation I deliver in the morning is light hearted and interactive, to me the best way to learn is when you’re enjoying yourself!

There is also a reward!

Preparing for a cosy Constructive Rest experience in the Lecture Theatre!

I like to include a semi-supine experience for the participants as this is something everyone can do for themselves at home, and after you’ve experienced this, you really understand the benefit.  It’s a very accessible nurturing practice which offers a therapeutic effect on many levels to the whole self.  Calming down the nervous system, restoring skeletal alignment, much needed down time amongst many other dividends. You’ll have to try it for yourself to find out what they might be!

We also refine our anatomical awareness and make it personal in this theory section.

After lunch we begin the process of specialist application of this knowledge to the clinical practice.  This is the ‘gold’! Where pennies drop, as to just what has been going on unnoticed for far too long while we’ve been busy looking after other people and putting their needs before our own.

Just what goes on in the Mammo Room? Beginning our practical session

Hands-on work conveying important information – everyone gets a turn!

A whole new way of moving around the machine, the patient and more!

Golden Rule #1 is never to be #2!  Remember to think about yourself first, this can be a very tall order indeed particularly when we’re so used to looking after others! It’s time to be kind ( to ourselves) – that way we get to serve MANY more patients, with greater ease, energy and efficiency.  Who doesn’t want that to be featuring in their working day plus having energy to spare for a fully active private life?  Yes please!!

The great thing about learning in a group is that it creates a supportive community amongst colleagues.  Everyone can then help their friends and colleagues if they happen to have lapsed back into an unhelpful bodily habit ! You don’t mind so much if someone pats you on the shoulder for example, if you’ve taken part in a practical session whereby an important observation was made –  one person’s habit was to lift the shoulders unnecessarily, but they were completely unaware of this before!  Habits die hard, so if we can all help each other, knowing this is for the greater good i.e aim of full physical health, this is taken rather better than if someone ‘tells you off ‘ or barks at you to ‘stand up straight’!  Light friendly compassionate communication and with humour is more conducive for positive change in behaviour.

On that note, can I help you in your department?  Get in touch with me here if you’d like to find out more!  Hope to work with you sometime soon!

My Very Best Wishes

Milton Keyne’s University Hospital Invest In Their Sonographers Self Care

Yesterday I had a fun and rewarding afternoon teaching sonographers at Milton Keyne’s University Hospital a short version of my #SelfCareSkills programme!  The Superintendent Sonographer of the Out Patient’s Department here, invited me along during an audit afternoon to deliver this educational training so that her staff can retain their optimal health and wellbeing.  Like many sonographers globally, the staff here have been experiencing aches and pains during and after their clinical working practice.  Sometimes these aches and pains are more serious.  In my own case, what I considered to be a ‘sore shoulder’ that I was hoping would magically go away sometime, actually turned out to be a Work Related Musculo-Skeletal Disorder of my right upper limb that was also significantly affecting my entire cervical spine and the nerves to my right arm.  Don’t underestimate aches and pains.  They are red flags – your body is trying to communicate to you that something is amiss.  If you ignore the signs, the dysfunction gets worse and may lead to something more serious. I was fortunate not to have damaged any nerves permanently.  I was also fortunate that my right shoulder stopped me from continuing my path of self harm.  Inadvertently, over many years, my own patterns of postural and movement habits contributed to my WRMSD.  I unconsciously caused my own injury, and was completely unaware of this!

It was a wonderful turn of events that I discovered Alexander Technique and enabled myself to heal naturally.  My shoulder quickly healed.  My neck too.  My right arm is no longer swollen or blue.  My fingers are no longer numb or tingly.  I am now in better shape than I was as a teenager, hurray!  An unexpected bonus that I never expected!

It’s always a pleasure for me to pass on all that I’ve learned to fellow sonographers.  So the afternoon was most enjoyable for me, helping other medical imaging colleagues discover how to pay attention to themselves and their own postural and movement habits so that they don’t inadvertently cause themselves an injury or physical harm unnecessarily.

Sonographers At Milton Keynes Hospital gathering for our #SelfCareSkills training afternoon.

Feeling right ‘at home’ teaching in an X-ray room!

We covered a large amount of information in the first part of the session.  Refreshing our anatomical knowledge and making it personal is always very interesting and enlightening!  This enables us to accurately body map and create more fluid movement and action any time we choose to think about it.  We learned what we do when we stand, how we stand, how we sit and how to constructively rest too.  Semi-supine is an excellent daily habit to acquire if you’re interested in attending to your own personal health and wellbeing.

Semi-Supine
A wonderfully gentle, nurturing practice for relieving unnecessary physical tension and restoring natural alignment

Following the semi-supine session, we got into the theory of applying Alexander Technique principles to the activity of Ultrasound scanning.  It’s more challenging to think about your own self whilst busy doing something, but absolutely possible!  We learned how to start giving ourselves undivided attention and how to start applying that in the clinical role.

The best is saved until last, practice in the actual Ultrasound room!  This is something that can’t be rushed.  We have to get used to paying attention to our whole selves constructively before we get to the crux of the matter.

We mocked up scenarios similar to those we would encounter on a daily basis.  The whole group got to observe sonographers displaying personal habits they have while scanning patients. Very interesting to see what actually happens to your posture, spinal alignment, breathing etc when in front of a monitor, next to a patient!  Then what happens when we pick up a transducer.

I left the sonographers with much food for thought as the afternoon came to a close.  The great thing about my #SelfCareSkills programme is that the learning continues to deliver over time, long after the training session has ended.

So what did the sonographers think of this afternoon?  Here are some of the comments I received.

Thanks for coming!    Superintendent Sonographer

10/10 Excellent   Reporting Sonographer

Enjoyable, thank you.  More time in the Scan Room would have been good. Sonographer

10/10 Thank you, I shall be using lots of your tips in my day to day activities.  Sonographer

Practical session most useful.   Sonographer

It was very useful and helpful to improve my Technique as a sonographer.

10/10 Another practical session would be great.  sonographer

Lovely to read the feedback after the event!  It warms my heart to hear how beneficial the training days are.  If you can arrange a WHOLE day, it’s a huge advantage as the individuals get more hands-on experience and time in the practical part of the training at the machines.  As you can see from my feedback here following the Half Day at Milton Keynes, that’s what the sonographers want more of.

But whatever you can offer your staff is great, it’s often a balancing act between the workload, the time, the department diary and budget.  Do get in touch with me here if you’d like to arrange some training for your own staff in Self Care!  Hope to work with you soon!

My Best Wishes