by Shari
With the recent passing of BKS Iyengar (the teacher of my teacher, Donald Moyer) and the exponential growth of yoga inspired by Mr. Iyengar, I have been thinking a lot about health outcomes and why yoga is such a powerful self-help tool. You see, in my day job as a home health physical therapist, health outcome is measured very differently than it is in a complementary alternative health care model that yoga falls within.
My patients too often don't get better. My job in aiding their recovery often feels like I am trying to put a small Band-Aid on a gaping wound. I can’t change the situations that lead to their poor health. They suffer from the chronic life challenges of poverty. Years of poor health management, from an uncaring overworked, depersonalized, underfunded health care delivery system, and the chronic stress from living marginalized lives lead to chronic health issues. To often these patients are living in polluted urban environments, where walking is not done by choice because it is unsafe. They also are victims of poor health from years of eating processed, nutritionally void meals. The places where they live are commonly food deserts, where fresh food is unavailable without having to take public transportation via circuitous routes. Many of my patients don’t have cars. My care often feels inadequate because I can’t change their life circumstances even when they are doing all they can do to regain their health.
For example, J was in her early 80's when I met her. She was a homemaker, a long-time smoker who had remained physically inactive though very slim. She had been diagnosed with osteoporosis in her 60's and her family started a walking program with her. They also enrolled her in a senior exercise class at the near by senior center. She was pretty stabile for about 15 years and maintained independent living in her own home. But then her husband became ill, and she couldn't care for him any longer, so he was institutionalized. He died approximately one year later. After that she had a bout with pneumonia and her long history of smoking finally caught up with her; she was diagnosed with chronic obstructive pulmonary disorder and became oxygen- and steroid-dependent for respiratory management. She was also placed in an assisted living facility by her family because of frequent falls due to leg weakness. I was her home health PT. She was compliant with her exercises but wasn't really walking more than a couple of steps because of extreme fatigue. Also, she suffered from several osteoporotic fractures from "hugs" from her family. She was really upset by this because she felt like she was crumbling from the inside out. The pain from the osteoporotic fractures and the immobility from not walking and being pushed in her wheelchair by staff further eroded her overall health. She died in her sleep—with no major medical cause—several weeks after I discharged her.
For example, J was in her early 80's when I met her. She was a homemaker, a long-time smoker who had remained physically inactive though very slim. She had been diagnosed with osteoporosis in her 60's and her family started a walking program with her. They also enrolled her in a senior exercise class at the near by senior center. She was pretty stabile for about 15 years and maintained independent living in her own home. But then her husband became ill, and she couldn't care for him any longer, so he was institutionalized. He died approximately one year later. After that she had a bout with pneumonia and her long history of smoking finally caught up with her; she was diagnosed with chronic obstructive pulmonary disorder and became oxygen- and steroid-dependent for respiratory management. She was also placed in an assisted living facility by her family because of frequent falls due to leg weakness. I was her home health PT. She was compliant with her exercises but wasn't really walking more than a couple of steps because of extreme fatigue. Also, she suffered from several osteoporotic fractures from "hugs" from her family. She was really upset by this because she felt like she was crumbling from the inside out. The pain from the osteoporotic fractures and the immobility from not walking and being pushed in her wheelchair by staff further eroded her overall health. She died in her sleep—with no major medical cause—several weeks after I discharged her.
So you might be wondering, could yoga have helped J? I believe that if it had been a part of her activity regimen when she started her walking and exercise class that it would have. Yoga could have helped J with her sense of physical and emotional loss as she lost her independence and her home. Guided strength training for specific bone strengthening positions might have slowed her progressive osteoporosis. Unfortunately I will never know for certain because her care was limited by her HMO insurance company and I was only given four visits and told to "get her back onto her feet."
In my more cynical moments I am disgusted by the public degree of privilege that American yoga seems to support. The visual images of perfect woman and occasionally men shine from the glossy covers of popular mainstream yoga magazines, with headlines urging pursuit of the “perfect yoga body” and touting delicious organic recipes, not to mention hyping over-the-counter supplements for “health” or lovely yoga fashions to enhance your practice of yoga.
So when the accolades of the wonders of yoga are constantly cited sometimes I can’t take it. But then I remember B.K.S. Iyengar and how he really did bring yoga to the people and how he did make it accessible to everyone. I also remember that yoga is more than asana—that it truly is a credo on how to live your life for the greater good.
So in this spirit of inclusivity and my own belief that the best way to deal with health challenges is through personal empowerment, I am starting a new beginner-level yoga class focusing on bone health called Yoga for Healthy Bones, both to honor J and to support my general yoga students who, as they are aging, are being diagnosed with bone loss from either osteopenia or osteoporosis. This class will provide camaraderie, creating a community of mutual support as well sharing, which the class members can engage in if they so desire. There is nothing better in self care than learning what worked or didn't for individuals with similar diagnosis. And, most importantly, this will be a venue where people can practice yoga without fear of hurting themselves.
So in this spirit of inclusivity and my own belief that the best way to deal with health challenges is through personal empowerment, I am starting a new beginner-level yoga class focusing on bone health called Yoga for Healthy Bones, both to honor J and to support my general yoga students who, as they are aging, are being diagnosed with bone loss from either osteopenia or osteoporosis. This class will provide camaraderie, creating a community of mutual support as well sharing, which the class members can engage in if they so desire. There is nothing better in self care than learning what worked or didn't for individuals with similar diagnosis. And, most importantly, this will be a venue where people can practice yoga without fear of hurting themselves.
I am personally very impressed with the work and level of dedication that Dr. Loren Fishman has provided for his patients through his ongoing medical study on the efficacy of yoga in building bone density. This class will incorporate some of his basic principles of bone stimulation as well as focusing on many of the safe beginner level standing and seated poses for osteoporotic individuals. If you live in or are visiting the San Francisco Bay Area, come and join us on Sunday afternoons from 4:00-5:30pm at the Yoga Room in Berkeley, California (see yogaroomberkeley.com).
