Holy Yoga Specialty Classes Yoga Therapy for Chronic Diseases By Gina Tricamo, M-HYI Session 1: Cancer and

Heart Conditions Cancer

A Meditation: I look up to the mountains; does my strength come from mountains? No, my strength comes from the Creator of the entire Universe, who made heaven, and earth, and mountains. He won't let you stumble; your Guardian God won't fall asleep. Not on your life! He will never doze or sleep. God's your Guardian, right at your side to protect you Shielding you from sunstroke, sheltering you from moonstroke. GOD guards you from every evil, He guards your very life. He guards you when you leave and when you return, He guards you now, he guards you always. Psalm 121

Discussion: Cancer is one of the most feared diseases in our modern times, although heart disease comes first in the number of fatalities. Cancer of all types can be related to ones diet, habits, genetics, environmental factors and abnormalities in the immune system. There are abnormal cells, with the potential for uncontrolled growth, in everyones body. Healthy immune systems can get rid of the cells before tumors develop. When preventive measures are taken, at an early age, the probability decreases greatly. However, in most cases, when these HEALTH OPPORTUNITIES occur the only option is intervention. Seeking opportunity in the health issue is important for wholeness in body/mind/spirit. Hospitals, clinics and therapist are now utilizing the integration of western and eastern treatments as intervention and finding a higher success wait in survivors.

Findings: Yoga as an Integrated/Complementary Intervention In many cases the cancer patients undergoes a series of various western medical treatments such as chemotherapy, radiation, medications (tamoxifen to block female hormone estrogen from stimulating the cancer cell) and surgery. Cancer can make a person feel victimized by the medical system over which they have very little control. Harsh medical approaches and other experimental treatments often cause difficult side effects. It is natural to feel powerless within these circumstances. The Yoga Therapist can guide the student to take a holistic plan of action to feel better in the moment; students increase chances of longterm survival and change in the whole psychology of the experience. Often people feel betrayed by their bodies and through yoga therapy learn to find relaxation and joy in their bodies spaces where true healing take place. Research has indicated that yoga therapy is helpful in managing stress, managing side effects, chronic pain and assist in coping with the strong emotional thought processes from the various battles of the health opportunity. Survival Rates charted from a 20 year period taken from The Lancet publishing: Thyroid and Testicular Cancer 90% Melanomas and Prostrate Cancer 80% Endometrial Cancer 80% Bladder Cancer 70% Breast Cancer 65% Cervical Cancer 60% Colorectal, ovarian and kidney cancer 50%

Lets look at the research findings from the application of Iyengar (Restorative) Yoga Therapy from the University of Calgary in Canada:

The study showed the effects of a seven week program of restorative yoga on women (primary breast cancer survivors) who engaged in practice once a week for a seventy-five minutes session. The session consisted of gentle breathing in the pose Viparita Karani (Legs-Up-theWall) followed by fifty minutes of modified gentle asana and fifteen minutes of deep relaxation pose Savasana (Corpse Pose). The students were encouraged to engage in self practice at home as well. Compared to the controlled group, the yoga group had significantly less: tension anxiety depression confusion anger fatigue diarrhea emotional irritability The group: experienced improvement in their physical fitness and heart rate showed reduction of toxicity of treatment (in many cases doctors have to stop treatment or reduce doses in ways that may diminish its effectiveness) reported more pain researchers speculated that there was more increased body awareness as the result of their yoga practice) These yoga methods are especially helpful with pain in the later stages mindfulness-based meditation (focus) relaxation chanting (tonal sounds) guided imagery and relaxation

Yoga Practice Suggestions: Classes for cancer patients are gentle. There may be a wide range of strengths so take in consideration and use modifications, adaptations, props and blankets Movement rather than holding poses. Gentle flow that is slow and mindful movements of the body releases tension Most poses are done sitting in a chair (once again allow for variations) or using the chair as a prop for floor asana

1. 2. 3. 4. 5. 6. 7. 8.

Tuning In (attached hand-out) Vertical, horizontal and head tilting shoulder shrugs full circle rotations of shoulders cat/cow modified shoulderstand breath work meditation

Safety needs to be the primary concern when choosing asana for people with cancer or any health opportunity! The treatment of cancer can lead to extreme fatigue. Do not overdo the practice (less is best with more rest). Gentleness is the highest priority in preventing injury. Patients undergoing chemo should be instructed to avoid quick changes in posture (most injuries occur combining movements such as lifting and twisting at the same time) Some poses lead to fractures where the cancer has spread and weakened the bones Avoid exhausting already depleted energy by gentler movement rather than holding poses for any length of time Avoid hot yoga due to risk for lymphedema ( a frequent complication of breast cancer, especially infection of the lymph nodes under the arms) Avoid not stretching for a week after surgery When moving the arms keep elbows bent to reduce stress and less pressure at the fulcrum of the shoulder When doing cat/table pose keep the arm of the affected side elevated (avoiding swelling from the force of gravity) Place hands on wall to modify downward facing dog and avoid lymphedema Avoid breath retention (cancer students need the oxygen) Avoid belly breath (it can increase fatigue for those seriously ill, depleted or using multiple medications) Holistic Complementary Intervention: Acupuncture Diet Measures / Specific Detoxify Remedies Massages (lymph drainage massages) Therapeutic Oils/Herbal Medicine (ginger for nausea, valerian for insomnia and anxiety) Therapeutic Touch, Healing Touch n Energy Work for cancer patients Palliative Pain Intervention

 Psycho-therapy and Spiritual Life Coaching I look up to the mountains, from where does my help come from? My help comes from the Creator of the entire Universe. Mental Health, Spiritual Belief and Faith Spirituality is an important part of yoga as medicine. Facing cancer stirs up fear and worries about death. Creating a spiritual space opens up acceptance to whatever is to take place. The cognitive processing of acceptance then increases the values of hope and faith. In turn, spiritual focus improves the quality of life and assist in the dying process. In most cases when presented with a health opportunity, it creates a time of reflection and seeking a deeper spiritual understanding and desire for spiritual growth relationally. Integration of a holy yoga therapeutic practice creates a safe and sacred space to breathe in the meditative words of scriptures and create wisdom and discernment within the value of relationship with an intimate, caring and loving God. Lets look at an interesting study on the psychological and spiritual growth and transformation to understand the value of holy yoga therapy as a means to meet the whole person in body/mind/spirit. An evidence based study, Psychological and Spiritual Growth Associated with the Experience of Breast Cancer by Kathleen Wall, PhD and Arielle Warner, PhD, at the Institute of Transpersonal Psychology, was conducted from the experience of breast cancer with clients participation in a yoga based psycho-social intervention. Twelve women, diagnosed with breast cancer, within the past five years, shared their growth and transformation during the intervention. The measurement was within four categories: Coping Behaviors and Attitudes Related to Distress and Challenges 2. Spiritual Transformation Related to Pre-Cancer Issues 3. Spirituality 4. Evaluations of Priorities and Values 1.

Coping Behaviors and Attitudes Related to Distress and Challenges 100% of participants found benefits from their diagnosis So, I am grateful for having breast cancer. There is so much I have gained from having itI wouldnt change it. 92% of participants expressed support from family and friends The way they have helped me is the growing sense of community. I just really strongly felt people were there for melet me know that they love me is a very valuable gift. 75% of participants demonstrated positive thinking and gratitude Rather than being negative about it, I pretty much embraced it. Because I pretty much felt like, if Im really crabby and negative about this Im not going to get anywhere. Im not going to get well. Im not going to feel better, so I wasnt negative. I was always kinda like; Im going to be okay. 67% of participants acceptance of research and education Treat it like a project. You go to the doctor, you have to know what questions to ask, make a list, just continue asking, read about it 50% of participants responded to group support I needed to talk to other people or just be around other people so I went to the support group and of course I was the youngest one there and basically went in there and cried for two hours. They just let me go off and vent. Im so scared. I cant get through 5 minutes. 50% of participants attitude to get the cancer out - My immediate response was get it the hell out of me, now! That was my instant reactionhave it done, over with, get everything off, but away, I wanted that cancer off me. 42% acknowledged spirituality, meditation, and faith as way to cope with distress I went to the library and I got books on positive thinking and meditation and I got books on, not really the bible, but religion based booksso whenever I started to feel sort of panicky I would do these meditations in my head: God is with me, God will send you through, that kind of thing. It was weird how I kind of carried myself through, God carried me through.

33% reflected on denial And I was just in denial, I dont think I want to deal with this cancer. 25% view on facing the fears I surrendered to the fear and I just started feeling the fear. Ok, Im just going to just feel the fear and go with it and not keep trying to pretend.

Spiritual Transformation Related to Pre-Cancer Issues 75% illustration of letting go A time when both of us looked at each other and said okay, you know, we need to let go of the stupid petty stuff in the past and just let go because thats not what is really importantwe kind of let go of so much that had been pestering both of us. I mean little things and words that were said and angry things that hadwe let go of a lot at that point 75% illustration of Self-care: slowing down and receiving I learned that I needed to slow down, that I needed to take more time and that would benefit my family in the long runthere was a need for me to stop and just look at where I was and say hey! You are working yourself to death. It was so good for me to realize that there needed to be a back and forth with it. Not just me giving to others, but receiving as well to receive graciously. 42% illustration of empowerment and self-esteem And just in general I felt that I had sort regained the ability to cope with things that I felt not competent about the year before. Spirituality 66% participants indicated enhancing spirituality its like a finding almostlike finding my faith in Goddiscovering it, maybe, Ive always believed in it, and Ive always believed in God and Ive always tried to follow the golden rulebut it was a completely different meaning for me when I went through this experiencefor me it was more of a discovery of how I believe or what Ive believe. 50% participants expressed feeling taken care of by God/the Divine I just reached both of my hands up like this, straight upI had a vision of blue light of consciousness and it was reaching down to me and I felt that every thing was going to be ok and everything else was going to be taken care of and from that point on it was

different this is where I am and its all going to be ok. I dont know how exactly its all going to work out but everything will be ok. A clarity about that. There was a time during the night, it was a semiconscious state but I do remember feeling very surrounded by angels or presence of something there, very connected to something, that was in my opinion unearthly, but that was a very difficult night. At that point, I kind of felt like ok, Im going to get through this somehow, I am going to get through it. I think that was all part of the plan for me. But he really, this higher power, which I chose to call God does really care about me. 33% participants reported no spiritual change I would have thought it would have open me up to be more spiritual but I think I was in such confusion, such unsettled living conditions that kept me, my mind busy and didnt put me into my spirituality as much as I would like to. 77% participants shared existential reflection I, wellI dont [think it is] God, but its like you know that first of all things can happen, and can happen to you.

Evaluations of Priorities and Values 58% participants illustrate appreciation and strengthening of personal relationships The relationships with people are like for me one of the most important things in life, if not the mostand like family and friends, relationships with people became much, much higher. I mean it had a high priority before, but it moved it to a different scale. 50% participants expressed a greater appreciation for life I learned to appreciate the things I took for granted before and to set priorities differently. A sense of what is important in life, I have been able to look past material needs now, I just dontI dont need anythingthere is not a lot of wants anymore. 41% participants illustrate reaching out to the community I kind of look at my cancer now and I thinkI never would have helped out those people in any way. Because of the [breast cancer] I feel more human and I reach out to more people in need. In conclusion, the data gathered suggest that the experience of breast cancer, combined with the opportunity to practice yoga created a

recognizable association with psycho-spiritual growth and transformation, in addition to distress and challenges. As yoga therapist it is important to understand and be comfortable with the specific dialogue that occurs with the challenges of being diagnosed. We have the opportunity be still, connect in a non-judgmental way to listen with the ears of Christ, have compassion with the heart of Christ, gently extend our hands with the touch of Christ and utilize the gifts of the Spirit to guide the cancer patient(s) towards the grace of being fully present in body/mind/spirit through the stages of their journey. HEART CONDITIONS
A Meditation: I I I I I I will will will will will will pour water over you scrub you clean remove the stone heart give you a new heart put a new spirit in you put My Spirit in you Ezekiel 36:24-26

Heart disease is the number one killer in the modern world. Men and women are both affected by it and research indicated, that even though symptoms show up in men at a earlier age, women suffer more hearth attacks then men. Men and womens symptoms vary as well. Men have the classic heart attack symptoms; pain radiating to the shoulder, jaw, or arm. Women have milder pain in the chest and abdomen, fatigue and weakness and months of vital exhaustion. We all know someone or have been personally affected by a heart issue. In most recent years, we are seeing younger and younger adults impacted with these conditions and in many cases, in the case of strokes, lives are changed completely. In my own private practice the clients with heart issues shared one of their on going fear was when would there be another unexpected heart attack with severe or detrimental consequences. It is important to enter into a compassionate and reassuring practice as they begin to move through their life changes. We will be focusing on: Risk factors

Benefits of yoga therapy Specific Poses Appropriate adaptations/position avoidances for heart issues

Risk Factors: Type A personality (a behavior characteristic by aggressiveness, anger, hostility, a sense of constant urgency and a driving focus to over-achieve at all cost) High levels of stress Smoking Elevated cholesterol Genetic Disposition (family history) Overweight Diabetes High blood pressure Inflammations (rheumatic arthritis, gingivitis) Benefits of yoga therapy for heart issues: Reduces stress hormone cortisol Calms emotions of anger, fears, anxiety Increases attitudes of compassion and gratitude raises heart rate in aerobic range breath work improves cardiovascular conditioning and lung functions lowers LDL, HDL and cholesterol Antidote for depression Systematically unblocks large and small blockages Creates an overall sense of hopefulness Specific Asana: Yoga Chair Poses are over all the most preferred as they assist in warming up the subtle bodies and facilitate lowering heart rates, relieving angina pain, and release of spasms in the coronary arteries without posing further risk during the practice. I have found placing a block under the feet during chair poses aligns the knees with the hips and elevates any stressors to the systems. Yoga Chair series: Neck movements Shoulders alternating sides - up to ears movements, both shoulders up to ears, shoulder circles

Ankle movements Knee to chest movements Cat/cow movements Lateral bending of trunk with hands on hips Hip flexion, extension and rotation Seated spinal rotation Elbow flexion and extension movement Wrist flexion, extension and rotation movement Hands and fingers open and closing movement

Standing Posture: Standing Swinging Twist (gentle wind milling arms and moving fingers) Mountain pose and alternating lifting one arm at a time over the head with continuous breath Warrior I with hands on hips (intermediate) Modified side body angle with hands on hip and then releasing and drawing arm/hand down along leg for deeper side body opening (intermediate) Table poses: Cat series - cat/cow, lateral cat and hip circles Modified runner with back knee of floor (intermediate) Corpse poses: Knee to chest with the opposite leg bent at knee and sole of foot on floor Knees to chest movement (drawing knees to chest on exhalation and knees away from chest on inhalation for abdominal strengthening) Leg Stretch with strap with short holds (intermediate) Pelvic Lift and Tilt to Half Bridge (intermediate) Restorative Half Frog * Restorative Knees Down Twist (Prone and Supine) * Restorative Reclining Butterfly * Restorative Savasana * * Restorative poses are positioned with blocks. Restorative chest openers are relaxing, expand the chest, and allow deep breaths to bring oxygen to the systems and help in the development of collateral blood vessels.

Appropriate adaptations/position avoidances for heart issues Arm balance poses, full backbends and some standing poses can be too stressful Holding poses for a length of time is not suggested Breath should not be held for any length of time Iyengar advises against unsupported inversions due to the weight of the abdominal organs putting strain on the heart Iyengar advises to forego long holds of downward facing dog Iyengar advises when doing standing or warrior poses the hands are on the hips rather than overhead to lessen the burden of the heart Avoid straining or pushing in poses Relaxation poses for heart patients with shortness of breath need to be adjusted by propping against walls or a chair against the wall

As yoga therapist, are goal is to help facilitate a hopeful and positive outcome! There are many yoga methodologies of meditative and mindful practices specific for heart issues and bringing the student into a calm state. One may think that is an easy task, but most heart patients deal with hypertension and a sense of urgency, which challenging the idea of being still and calm. Joseph and Lillian Le Page, authors of Integrative Yoga Therapy, facilitated an 8 week yoga training called IYT Healthy Heart Program for doctors, nurses and heart patients at their Mountain Yoga Center in Garopaba, Brazil. The goal was for the patients to have the care necessary from the doctors, with nurses monitoring heart rate and diabetes level after each sessions, and doctor/nurses engaging in the Healthy Heart Program along side patient-participants. The therapeutic classes were two and half hours long and considered a complete yoga wellness intervention. The IYT Healthy Heart Program consisted of: Mundras (pressure point hand positions) and affirmations (positive injunctions) Pranayama and asana practice A ten-step yoga nidra (relaxation focus each body part integrated into wholeness of complete body) Sharing and group support

Results from a qualitative standpoint and quantitative research show significant improvement in a group of 18 measured for systolic blood pressure and diastolic blood pressure: SBL fell from 151.6 (before the first class) to 122.2 (end of program) DBL decreased from an average of 98.3 to 75.6 mmHg
Take heart [my daughter]; your faith has healed you [she] was healed from that moment. Mathew 9:22

Time open for questions, comments and/or reflections