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Strong is the new sexy!

I’m feeling strong today, and hoping you are too! This was one of my biggest fears as I traversed all of my cancer treatment; that I would never be able to get back to full strength. I grew up with two older brothers, and always looked up to them and wanted to be like them, so I was pretty tough from a young age. I never wanted to hear that there was anything that I couldn’t do, or that I was too weak because I was a girl or because I was small. Fast forward to age 40, when I got my first big dose of learning that there are some things you really can’t just muscle through. Cancer treatment is insanely humbling, as the changes to our bodies and the effects of the treatment are profound, and no amount of stubbornness or toughness can change that. It’s just a fact. And we must learn to accept that these changes are a part of the treatment that was necessary to try to save our lives. Not that we have to like them. But acceptance is important to our peace of mind. Instead of staying angry or sad at the new condition of our bodies, we can accept that this is what was required, and throw a little love to our bodies for doing the best they can to heal and carry us through.

But wait! It gets better from here. Acceptance doesn’t have to mean we resign ourselves to staying there forever. Acceptance means recognizing that this is a necessary step on the path, and resisting it or hating it just makes it that much more unpleasant. So a deep breath and quiet acceptance of each step is important. But what comes next is up to us! Mahatma Gandhi said “Strength does not come from physical capacity. It comes from an indomitable will”, and I feel this so deeply. I believe that it is this indomitable will, this gentle persistence, this fire deep in the pit of our bellies, that can help us pull ourselves back up after the effects of cancer treatment do what they must.

Of course there is some physical aspect to strength. Yoga asana practice has been so essential in helping me rebuild the physical strength that I lost during cancer treatment. Sadly, these treatments do sometimes have direct effects on our muscles, nerves, and other tissues, leaving legitimate damage and weakness. But with proper approach and patience, most of us truly can recover much, if not all, of our physical strength. And even if we have permanent damage to certain nerves or muscles, we can learn to strengthen surrounding muscles that can compensate for the others.

Yoga also teaches us softness, and to gracefully navigate the balance between our strength and this softness. Yoga does this by really making us tune in to our bodies and feel when we have the strength to push forward and when we need to back off or rest. As we become more and more in touch with ourselves, we re-develop a deep trust in ourselves and our bodies. Cancer and cancer treatment can really destroy that trust, leaving us feeling betrayed by our bodies and disconnected. Yoga helps to restore that connection and that trust. And this, I believe is where our indomitable will comes back into play. Much of strength lies in believing in ourselves, in trusting that we can do something, that we can handle whatever comes our way. Even in times when we feel weak or are struggling with some of these side effects, if we can dig down and find that indomitable will, we will muster the ability to keep going and try again. Yoga helped me to rebuild trust in myself, to re-establish that connection, where I could believe in myself again and know that I would get there. And that I would get there safely by continuing to tune in and proceed with my practice while maintaining that balance so I didn’t have to fear injuring myself or my various scarred body parts. Fear of injury can be a real roadblock in rebuilding strength or resuming activity after cancer treatment. So this reconnection and rebuilding of trust in ourselves and our bodies is imperative in coming back.

This is one of the main reasons I developed this website. To help others who are going through their own breast cancer experience to safely and cautiously begin a yoga practice and find a way to reconnect to their strength in body and in mind. To start slow and easy and foster this connection with themselves and their own bodies, to regain trust, and to overcome those fears that they simply can’t or that they will injure themselves if they try. And then once each individual starts to feel comfortable, my hope is that they then have the tools and the belief in themselves that they can continue their journey of yoga or other activities in whatever way they want. They can continue to practice here with us, OR they’ll also feel comfortable doing yoga anywhere, without feeling limited or fearful, trusting their own bodies and knowing how to modify the practice if needed to care for themselves in any yoga class. Obviously we’d love to have you continue to practice and grow with us here, but we also recognize that it is important to participate in your own communities, in live classes with your friends and loved ones. So once you feel comfortable, go see what all is available. And if you have any doubts or concerns, let me know and I’ll see how I can help.

So wherever you are in your cancer and yoga journey, be patient and understanding with yourself. Really try to tune in and feel what is going on in your body so you can develop that connection, balance, and trust again. Find your indomitable will. And believe you can do it! You are strong beyond measure.

BTW the pose in the pic is tittibhasana, or firefly pose. Funnily enough I have the strength for this one, but not quite the flexibility. It is a work in progress, just like I am!

Namaste

Are you caught in the epidemic of busyness and stress?

Are you busy all the time? Are you stressed out? What does stress feel like to you? What effects does stress have on your body, your mind, and your health? I’ve been thinking about this topic a lot, as I am preparing a talk on the topic for the Tucson Cancer Conquerors’ Soul, Strength, and Spirit day, which is coming up soon! I’m very excited to be a part of this program, btw.

Sadly, stress seems to have become an integral part of our lives and our culture. Some years ago, the WHO (World Health Organization) declared stress the health epidemic of the 21st century (of course that was before Covid). But this just underscores the seriousness of this problem. Stress isn’t just some minor annoyance. It is a serious problem, with real consequences for the health of our bodies and minds (tons more on that in the talk). And while stress affects everyone in our culture, having cancer and dealing with treatment, follow up, fear of recurrence, and treatment side effects can just raise the stress game to a whole new level. I’m not going to get into all the details here today, but I do want to address one aspect of this epidemic of stress, also sometimes referred to as the epidemic of busyness. And that is that we DO have some control over how stressed we allow ourselves to become. And by default, then, the power is ours to change that if we want to.

You know how much I love Eckhart Tolle, who said “It is possible to be busy without stress. If you find it is not possible for you, it is better to be not busy at all”. There are a few important points wrapped up in this quote. First, it may seem hard to believe that we could possibly be as busy as we are without being stressed. They just go hand in hand, right? Maybe not. We all know people who seem to do 1,000,000 things, do them all effectively and effortlessly, and never seem flustered or overwhelmed. So some people can do it. What do those people have, because I want some?!

Second, Tolle points out that there are many of us who may not be able to continue to be that busy without tipping our delicate balance over into the “stressed” zone. No shame in that. There are probable many more of us in this category than in the first one. But we must learn to see it, to feel it, to be honest with ourselves, and admit it. It is only then that we can begin to do anything about it. If we just keep running mindlessly through our lives, busy and overwhelmed, stressed to our breaking points, and refusing to admit that there is anything wrong, we cannot get better. So as always, self-awareness is so key.

And his final point is that we can choose not to be so busy. Just because everybody else is doing it, and it has become almost a badge of honor in our society to say “Oh, I’m sooooo busy” whenever someone asks how you are doing, doesn’t mean that you should strive for that. Maybe we don’t need to take that second job (if we cut our expenses, could we do without it?), or all that overtime, or to be on so many committees, or take on that volunteer work, or so many social engagements, or spend so much time scrolling facebook. Maybe we need more quiet time, sipping coffee or reading a book. Just looking out the window, strolling around our gardens, and just BE-ing. There is a funny meme that says something like “she was just sitting there, doing nothing, just breathing and relaxing, like a total psycho”. But I believe that our bodies and our minds really need that kind of time to decompress, to heal, to balance. When was the last time you just sat around, enjoying yourself, and didn’t let yourself feel bad that you weren’t “accomplishing” anything?

So busyness and stress are big problems. What can we do about it? First, we have to really tune into ourselves and understand how we, individually, are doing. This is svadhyaya, or self-study, in yoga philosophy. Are we truly handling our level of busyness with ease, and thriving? Or are we secretly suffering, stressed, depressed, anxious, or even with physical problems like irritable bowel syndrome, that might be exacerbated by our stress? Be honest. I used to be super tough, and truly believed I was doing just fine, in spite of my busy lifestyle. I wasn’t. And it isn’t easy to admit, but we have to face it if we want to make any positive change. Pretending to be fine, while the dangerous effects of stress are smoldering in your body is no good place to be.

I’ll talk more about the next steps in a future post and in lots more detail in our session at TCC October 2! For those of you who are TCC members, see you soon!

Namaste

Do you feel at home in your own skin?

“The journey of yoga isn’t about mastering the poses. It’s about finding the feeling of being at home in your own skin” – Kino MacGregor

I don’t usually post these progress over time collages, but I thought this one might be helpful in illustrating a few important points as we all continue to progress in our yoga journeys.

First, this might not look like much progress at all! It is pretty darn subtle. And it is 3 years of slow continuous effort in scorpion forearm stand (aka vriskikasana in pincha mayurasana). What you might notice is that my back is bending ever so slightly more over these 3 years, and my feet are coming slightly closer to my head, due in part to the deeper backbend, but also due to more opening of the hip flexors (front side of hips) and quadriceps, which allows the legs to stretch further back and down. Eventually, the feet are supposed to reach down and touch the top of the head. Obviously I’ve got a long way to go before I’ll reach that point. Maybe 3 more years? Maybe 10!

So the first point is that the practice of yoga is a journey that requires slow, continuous effort over long periods of time. We can’t expect our bodies to just pick up these abilities with one or a few months of half ass effort. We really have to commit some time and earnest energy to give our bodies and minds time to adjust and develop. This brings us to my second point, which is that in order to be able to commit to slow steady progress, we must learn to practice non-attachment. This means that we aren’t so attached to the specific goal of touching our feet to our heads (or whatever other specific pose-related outcome we might be striving for). If we were, we would give up after we weren’t able to check off that box in some period of time. I sure wouldn’t still be working on touching my feet to my head. I might just say, “well I don’t think my body can do that one”. And the truth is, maybe my body never will do that one. And that is ok. But I am certain that I am gaining strength, resilience, patience, and love for myself each time I try. As Kino says above, yoga isn’t about mastering certain poses. It isn’t about collecting certain accomplishments, or checking off the boxes after each pose we learn to do. It is about so much more. It is about everything we learn along the way. It is about realizing our strength and our tenacity and our capacity to continue to try again and again, even when we fall. Even when things are hard. Of course, it is ok to have some goals in mind, so that we have something that we are working toward. But we must recognize that whether or not we ever arrive at that goal isn’t the measure of the success of our practice.

As the rest of Kino’s quote reads, the journey of yoga “is about finding the feeling of being at home in your own skin”. And THIS is what I really thought about when I put together this photo collage of me practicing my scorpion in forearm stand. As I was looking at the pictures, I realized that you really can’t see the biggest difference in this posture over these 3 years. And this is often the case in yoga. There may not be big changes happening on the outside, but profound changes are happening on the inside, and they are actually the more important ones. You can’t see it, but I can FEEL it. The biggest difference in this posture is that I now feel so much more comfortable in the pose. Several years ago I could get up into a forearm stand, partly just out of brute force and stubbornness, but now I feel truly at ease in this position. I can breathe easily, and spend some time here, working slowly on the shape, feeling each part of my spine, my neck, my hips, and my legs. I can actually tune in to what my body is doing, where I need to engage and where I need to relax, and what happens when I explore those movements. Instead of feeling strained and uncomfortable, I feel at ease, graceful, and at home in my own skin. Even though my feet don’t touch my head. Of course I’ll keep working on it and maybe one day they will. Or maybe they won’t. But in the meantime, I’m so grateful that I finally realized it just doesn’t matter.

So next time you step onto your mat, remember that the practice of yoga is a long and gentle journey, that it isn’t about “perfecting” any specific shape or pose, but instead about how you feel as you are practicing, and what you learn along the way. Challenging ourselves on the mat teaches us to truly tune in to ourselves, to our bodies and our minds, as we practice. And as we tune in more and more, we learn to embrace and work with what we have, rather than fighting or struggling against ourselves or trying to be something that we are not (like flexible in the spine for me LOL). In this way, this practice teaches us to be at home in our own skin. This is the true measure of the success of this practice. And AHHHHHHH, what a feeling!

Interestingly, navigating a cancer experience can teach us similar lessons. We learn that we can’t force that year of herceptin to go any faster, or that we can’t expect everything to be perfect once we get that “final” surgery, or that we’ll be done and feel back to normal once we finish xyz treatment. Often things are delayed, complications arise, or plans have to be adapted and adjusted to best take care of our health. Maybe we have to re-evaluate our priorities and bow out of some obligations that we no longer have the energy for, or some friendships fade away as our needs change. So we have to learn to be patient, to let go of our expectations and not torture ourselves if things don’t go just as we had planned. Instead, we can try to take the opportunity to tune in to ourselves, to listen to what we really need, to be loving and understanding with ourselves and know that we are learning and healing as best we can. When we do this, just as in yoga, we can feel the struggle release a little, we can find some grace and ease in the midst of this truly challenging time, and we are at home again in our own skin. And AHHHHHH, what a feeling!

If you want some help developing your yoga practice or need any guidance, please let me know. I’d love to see if the practice of yoga can help you find your own AHHHHHH moments.

Namaste

Relaxing into our most vulnerable spaces to find freedom in breast cancer recovery


Y’all have heard me talk about how I find backbends particularly challenging. But at the same time, I find them tremendously freeing and opening, meaning after I practice a deep backbend, I feel like something that was previously stuck is becoming unstuck, and I feel this rush of relaxing energy buzzing around my body. In other words, I have a love-hate relationship with backbends. But the love part is growing stronger with time and practice. 

There are a lot of reasons why backbends can be challenging. For one thing, we never backbend in normal life. We are always bending forward, maybe now more than ever with our technology driven lifestyle. We bend forward looking at our phones, working at the computer, sitting on the couch watching netflix, not to mention while cooking, eating, reading a book, driving our cars, and tying our shoes. We very rarely bend backward. So the feeling is just foreign, which translates to scary and uncomfortable for many of us. Not only are our spines not used to it, but the soft tissues on the front side of our body aren’t used to it. The muscles of the abdominal wall and front of the pelvis/hips can be tight, and feel overstretched in backbends. And for us breast cancer survivors, we often have tremendous tightness on the front side of our chest and shoulders related to surgery and/or radiation, and this makes backbending even more challenging. We might also fear falling over backwards in a backbend, afraid that we are not as coordinated or in control of our bodies in these positions, so we can’t catch ourselves if we fall. 

So what do we do when we are scared or we feel uncomfortable? We tense up our muscles and we hold our breath, both of which make us even less flexible. Next time you try a backbend, see if you can notice muscles tensing up. Perhaps in your back, your glutes, your hips, or your shoulders. I know they do for me. I have to remind myself to get out of my own way. To breathe deeply. And to relax. When I am able to do that, I find so much flexibility that I didn’t know I had, and this is where I find that opening, that un-sticking, that freeing up of previously obstructed energy flow. And I think this is what Iyengar means, when he says “There must be relaxation in full extension”. If we are to get the full benefits of backbending postures, or spinal extensions as we call them in yoga, we must learn to relax, even in the midst of these uncomfortable and challenging positions.

Even more than the physical challenges associated with backbending (front body tightness, muscle tension, spinal stiffness), we can also be challenged by some mental or emotional roadblocks. The front side of our body is the sensitive side, the vulnerable side. And just as animals protect the front, or belly/throat-side, of their bodies in an attack or battle with another animal, we seem to instinctively know that we need to protect the front side of our bodies more than our back sides, which are more durable and resistant to injury, owing to our bony spine, ribs, and large back muscles. So when we bend backward, we can feel this profound vulnerability, as we open up our soft front side to the world. Even though we know nobody is going to jab a spear through our belly in the yoga studio, we still feel exposed and vulnerable, and this adds to the discomfort. Compound that with our self-consciousness about our breast cancer scars, our reluctance to show those to the world, and our fear that those areas might be weak or fragile, and backbends are just all kinds of difficult.

But this is what the practice of yoga is about. Not only will backbending practice release the tightness in our chest and shoulders, strengthen back muscles, improve posture, optimize bloodflow to the spine and surrounding tissues, and make us feel physically better. At the same time, we are training ourselves to do things that are challenging, and we are slowly learning to be able to do them with ease and grace, using the strength of our minds and our breath to carry us through. Learning to open, rather than retreat, in the face of vulnerability and fear. Learning to trust ourselves and tune in to our resilience, even in our most difficult moments. And it is here that we discover we are powerful beyond measure. That no challenge, be it breast cancer treatment or other serious life trauma, can close us down. Instead, we relax into the backbend, shining our hearts, our breasts (or scars as it may be), and our bellies out into the world, vulnerable, but confident in ourselves, and free.

Backbend on, yogis! You can do it, and you’ll thank yourself later.

Namaste

Do you have anything weighing you down in your cancer recovery?

You wanna fly, you gotta give up the shit that weighs you down. Wow, I love this simple, direct, and real truth from Toni Morrison. Do you have any shit weighing you down? Sometimes it is even hard to see it, because we so accept, and even embrace, it as a part of who we are. Of course, all of our emotions and thought patterns and behavioral habits developed for a reason. We were trying to protect ourselves from something, or trying to adapt to or cope with a difficult situation. So all of these things have their role and their place and time in our lives. I’m not saying we should shun them or block them out or forcibly suppress them, pretending to be someone that we are not. Because honestly that doesn’t work very well either. But if we can recognize any unhealthy or unwanted shit that we are carrying, that is no longer serving us in any positive way, then we can recognize when we are ready to just let it go. As they say, awareness is the first step toward change. So we must first spend a little time looking honestly and deeply at ourselves. In yoga, this is called svadhyaya, or self-study. Within self-study, we must also remember compassion and non-judgement, being understanding with ourselves and why we developed whatever shit we developed. But then, with the light of awareness and a little loving kindness, we can decide if it is time to release it. And ahhhhhh, the freedom we feel when we are able to let go of that shit and fly!

What kind of things might be weighing us down? It could be different things for each of us, of course. Maybe anger at this cancer. Maybe fear of what may come. Sadness at the change in our bodies. Frustration at the loss of things we used to be able to do. Maybe disappointment in a loved one who was less than understanding or said the “wrong” things. Maybe a feeling of hopelessness that we will ever get back our strength and vitality. Maybe impatience at this slow healing. Maybe we have distanced ourselves from others to try to protect them, so we feel a little alone. Maybe we’ve got the why mes? Maybe we’re stuck in sick mode and afraid to let ourselves feel better. Maybe you have none of these? Maybe something else? All of these are perfectly normal and expected responses to the challenges of being diagnosed with cancer and all that follows. And we have every right to feel them. But we can also choose whether or not we want to stay there. Whether or not these are responses that are helpful to us feeling our best, and really re-learning how to enjoy our lives, in spite of our difficulties.

So once we are aware of all of the things we are feeling and how we are responding, and we have identified one or more that feel like they are weighing us down, then what? Not much actually. In the light of this awareness alone, in this space of mindfulness, where we notice the thing with understanding and non-judgement, that negative emotion or habit naturally loses its grip on us and begins to diffuse on its own. We begin to notice when it arises instead of letting ourselves get swept away in it. And then, a spaciousness arises where we have the clarity and the opportunity to choose an alternate response. One that feels better to us. One that is more in line with where we want to be. We may not yet be ready to give up all of our shit. Sometimes we need to just sit with it a while before it serves its purpose. But with awareness and self-study, you’ll know when you are ready to let it go. And there we find our freedom. Our healing. And our recovery. May we all give up that shit and fly!

Namaste friends

Btw this posture is called flying pigeon. It requires open hips, some arm strength, core strength, and a bit of practice. It is challenging, but also fun and empowering! Let me know if you want to try to start working on some fun arm balances. I’d be happy to help!

Find your calm in the eye of the cancer storm

Anybody else love Neil Young as much as I do? He is my all time favorite musician. The Grateful Dead are a very close second. I was listening recently, and this song, “Like a hurricane” came on. I have always loved this one, but it took on a new meaning when I started thinking about it, rather than as a lovely tribute from one individual to another, but instead as addressing each and every one of us. Because truly, we all DO have a calm place inside of us, the eye of the storm so to speak, no matter what kind of hurricane, typhoon, or other shit show might be going on around us. Sometimes it is really difficult to see, feel, or know that this calm eye still exists, especially when the storms of our lives get really intense or complicated. But we must remember that it is always there, always available to us, this refuge from the storm, this place of peaceful stillness. And then we can train ourselves to easily enter in.

Cancer can be a particularly difficult storm to navigate, with so many different waves of challenge coming at us from all directions. From the shock of the diagnosis, to the fear of the unknown, to the physical challenge of all of the treatment, to the mental and emotional upheaval, to worry about our families and our livelihoods, and the ever-present concern for our futures and more, being diagnosed with cancer truly is a freaking hurricane. But we don’t have to let ourselves get swept away. Importantly, we also don’t have to run away from this storm, forever trying to hide underneath something, getting as far away as we can, or just blocking it out. Nor do we need to exert tons of energy trying to fight against its relentless power. Instead, we can learn to find and tune in to our own calm center, even in the midst of the storm. Just like in the movies, where they drop cameras down into the eye of the violent twister and find a place of unbelievable stillness, we too can drop in. We can allow ourselves to just BE in the midst of our situation, without straining against it, without trying to stop the winds, and instead just settling in to our own tranquil center.

We can use so many tools to help us get there, like our breath, our meditation, and our yoga practices, which all train us to more easily drop in to this inner space, where we find peace, comfort, rest, and rejuvenation. And the great thing is that we can use these practices over and over again, as much as we need them. Because the truth is that these storms often flare up again, and we might again begin to get blown off track. This is completely normal and part of the experience, but as we gain more proficiency with our tools, it is easier and easier to catch ourselves and drop back in.

And it is from this place of calm stillness that we can find clarity, courage, strength, ease, and joy, regardless of what is going on outside or how difficult our challenges might be. So in this brilliantly poetic imagery from Neil Young, take a deep breath, look deeply at yourself, and see that you may be like a hurricane, but that there is always calm in your eye.

Namaste friends

ps Please don’t mind my dirty feet! It had been raining this day and the patio was all wet. You can see Vato looks a little dirty too, but he tried to scoot out of the picture! 😉

Exercise truly is medicine in cancer survivorship

If you follow my FB page (Yoga with Leona), you saw that I recently posted an awesome interview that Dr Leslie Waltke (of The Recovery Room) did with Dr Kathryn Schmitz on the importance of exercise in cancer survivorship. If you haven’t had a chance to watch it, please do (https://www.facebook.com/lesliewaltkept/videos/386294369484336). They are both brilliant and dynamic leaders in their fields, each working for many years in different aspects of exercise in cancer. Dr Waltke is a physical therapist with many years specializing in cancer rehabilitation, and creator of the best practices in cancer physical therapy, and teaches physical therapists and other medical specialists from around the world how to best work with cancer survivors. Dr Schmitz is an exercise physiologist, a leading researcher in exercise oncology, has directed many of the important scientific studies looking at the benefits of exercise in cancer prevention and cancer survivorship, and co-developed the guidelines that we now use to recommend exercise in cancer. So these 2 are powerhouses! And their experience and work are so beautifully complementary to one another.

Exercise seems so simple that it is hard to believe that it is as powerful as it is. The benefits of exercise in cancer survivors are truly staggering. Not only does exercise help us feel better (improving fatigue, overall quality of life, sleep, lymphedema, physical function, depression and anxiety), but it also has been proven to reduce the chance of our breast cancer coming back AND to reduce the chance of us dying from breast cancer (for those who meet the recommended 150 minutes per week of moderate intensity exercise vs those who do not exercise)! Read that again. And those reductions in risk of recurrence and death are not small. Different studies report slightly different numbers, but the reductions are generally in the range of 40-60%! That is a huge difference, and is as much or even more than the benefit associated with some of our traditional treatments. I’ll write another blog about the proposed mechanisms by which exercise has these amazing benefits (otherwise you’d be here all day reading just this one!).

As I always say, we can’t control everything that happens in our cancer journey. And it is really important to learn to let go of our need for control so that we can establish some peace. However, there are some things that we can control. And how we move our bodies is one of them. No matter where we are in our cancer journey, we can work on moving our bodies, and try to strive for that goal of 150-300 minutes of moderate intensity exercise per week. If you do more vigorous forms of exercise as well, the minutes required are lower. How do you define “moderate intensity”? They give a perfect and simple guide in the video, which is that moderate intensity is any exercise that gets you working hard enough that you can still talk, but you couldn’t sing or speak in long, complicated sentences. In other words, your body should be taxed enough that it affects your breath, but not so much that you can’t really talk at all (that would be moving into the “vigorous” realm). So whether that means brisk walking, dancing, tennis, or vigorous yoga, get those minutes in!

Importantly, Dr Waltke and Dr Schmitz talk about the fact that what is moderate intensity for one person might not be moderate intensity for another, so we all need to evaluate the level of our exercise for our specific situation. AND, moderate intensity may look very different even for the same individual, at different times through their treatment. For example, the week of your chemotherapy, just getting up and walking to the mailbox or doing a load of laundry may constitute moderate intensity, while 2 weeks later when you have recovered a bit, you might need to walk all the way around the block one or a few times to get into that moderate range. So it is important to know that this will be a moving target, and that is ok. Also know that sometimes you may need to exercise in shorter periods, for example just 5-10 minutes several times per day, rather than 30-60 minutes all at once. This is a place where yoga philosophy and training ourselves to really tune in to our bodies, to study ourselves, to be flexible and compassionate with ourselves, and to use our energy rightly is so important. We can’t be so attached to some specific exercise goal (ie I must walk 2 miles 3 times a week or whatever) that we wind up hurting ourselves, and taking steps backward. So really listen to your body, adjust as needed, and just do your best. Learn to push on days when you feel up to it, and to back off on days when you need to. Eventually you will build strength and the exercise will get easier and easier for you. You will feel empowered, and you will also be much more in tune with yourself and your health.

Another very interesting challenge that they discuss is what to do for the person who really doesn’t like to exercise. First, they encourage us to explore lots of different types of exercise. There really are so many things we can do. From walking, to dancing, to swimming, weight lifting, yoga, aerobics, zumba, hiking, rowing, and walking your dog. Most people can find something they like. But if you truly can’t, then just buckle down and do it anyway! We all have to do some things we don’t like, right? But we do them anyway because we know they are important or good for us. I mean, do you really like brushing or flossing your teeth? But you do it anyway, right? Getting our exercise in truly is important, in so many ways. Aside from all of the benefits discussed above specific to cancer survivors, there is also extensive literature in the general population for the role of exercise in prevention and treatment of everything from heart health to blood sugar/diabetes, arthritis, and dementia. There are just so many reasons to get our bodies moving!

Please check out the website for the Exercise is Medicine/Moving through Cancer program for more information, great graphics, links, and references (https://www.exerciseismedicine.org/support_page.php/moving-through-cancer/).

Namaste friends

Yoga will optimize your coping strategies in cancer survivorship, greatly improving quality of life

If you’ve been following for a while, you’ve heard me say many times that yoga is SO much more than just the physical practices/exercises (asana). The full practice of yoga is a holistic mind-body practice for harmonizing our whole being, including guidance for thought patterns/behaviors, breathing practices, concentration, and meditation, along with the physical practices (click here for more info https://yogawithleona.com/2020/09/15/the-8-limbs-of-yoga-in-cancer-survivorship/). This whole mind-body program not only gets our physical bodies healthier, stronger, and more flexible, but also helps our minds to work with more clarity, balance, peace, and joy (and thereby less anxiety, tension, agitation, or confusion). How does it do this?? By training us in practices that not only tone our bodies, but that cultivate healthier mindsets, coping strategies, mental resilience, and tools to better manage our emotions. And just like anything, the more we practice all of these mind-body techniques, the better we get at them, and the more they become our baseline condition, making life and all of its challenges simpler and easier.

Let’s face it, cancer is the shits. I mean it. It is not easy. I recently learned that a cancer diagnosis is actually defined as a type of trauma in the DSM-5 (the book health care providers use to categorize mental disorders), and there is a whole literature on the traumatic experience of cancer. It literally rocks our worlds, threatens everything about our lives including our lives themselves, and puts us through innnumerable intense challenges of body and mind. I hear so many survivors (in active treatment or beyond) saying things like “Will I ever feel normal again?”, “Will this dark cloud hanging over me ever pass?”, “Why can’t I get back to my fun former self?”, “I can’t stop feeling sad and frustrated”, “My body is wrecked and I’m so down on myself”, and “Nobody around me understands”. But then, on the other end of the spectrum, some women seem to breeze through this awful experience, minimally affected, confident, active, and unscathed. So why the difference? Of course, there are clear differences in our bodies and how they handle treatment, and so some women suffer more severe side effects than others. Not to mention that our cancers are all different, so the treatments themselves vary as well. But some of this difference, I believe, comes from how we cope and the attitude that we bring to the table. From the lense through which we see this cancer experience. We all have different coping strategies that we have developed throughout our lives, from early childhood through adulthood, and all of our experiences along the way. These different patterns for how we cope and deal with stress have been studied extensively in cancer survivors, and have been shown to correlate with many outcomes, including overall quality of life, mood/depression/anxiety, fatigue, and even pain. Examples of different attitudes or coping strategies include: acceptance, positive refocusing, refocus on planning, positive reappraisal (attaching a positive meaning to a negative event in the context of personal growth), fighting spirit, catastrophizing, anxious preoccupation, helpless-hopelessness, rumination, and blame (self or others).

These coping strategies and attitudes, of course, are not fixed. They can be changed, but it takes some recognition and some effort. We have all developed the strategies and attitudes we have for a reason, likely related to trying to protect ourselves in some prior challenging situation. And in no way do I mean to suggest that our suffering is our own fault, for being the way that we are. I only mean to say that this is an area where we have some control over how our experience goes. We can learn to cultivate the healthier, more adaptive strategies and attitudes, and thereby help ourselves struggle less with the situation. For example, one can see how catastrophizing is one of the maladaptive strategies, and how it just leads to more anxiety and distress. Why would we want to keep doing that to ourselves, if we can see it and learn to change it? On the other hand, refocus on planning helps us to rationally consider what next steps we need to take to get through, giving us some sense of control and easing anxiety and fear of an unknown future. Similarly, acceptance (as opposed to ruminating on “why did this happen?” and struggling against things we cannot change, like the fact that we have this cancer diagnosis) brings a sense of peace and calm to our minds, allowing us to see with more clarity and less emotional reativity. You can go on and on, and investigate each quality and understand how it might have positive or negative impact on your state of mind, and your overall quality of life. Maybe take a few minutes looking at that list of coping strategies/attitudes and see if any of them sound like things that you commonly do in the face of stress or difficulty. Or specifically in the context of your cancer. Do you see them as helpful or harmful? Are there any that you would really like to down-regulate? Or any you’d like to get better at?

In the medical mental health world, we use something called Cognitive Behavioral Therapy (CBT) to help us identify and examine our thoughts/beliefs/attitudes, and then change them as needed to improve emotional regulation and optimize coping strategies. This type of therapy has been studied in breast cancer survivors, and found to help a number of things including sleep, fatigue, anxiety, relaxation, positive mood, and others. If you are really struggling, ask your Dr if you might be a candidate for a referral to a therapist to help you in this way.

In a prior blog introducing the idea of the 8 Limbs of Yoga, linked above, I describe an awesome TED talk in which a psychotherapist referred to yoga as “the original cognitive behavioral therapy”! Because just like in CBT in a therapist’s office, yoga helps us to look deeply and honestly at ourselves, to see how we react and how our minds and bodies respond to those reactions. Then yoga helps us by guiding us with ideas on more adaptive ways of seeing and thinking, and then asking us to practice those techniques over and over, until we begin to incorporate them. In doing so, yoga is truly a transformational practice. It not only improves our bodies and how they work, but with some effort and study, yoga can change the way our minds work, leaving us with healthier attitudes, thought patterns, habits, and coping mechanisms. Yoga trains us in some of the very things that CBT teaches, such as acceptance, positive reappraisal, trust, non-attachment, etc. This is why all of my yoga practices have a theme, an idea or mental practice to go along with the physical practice. And why I write so many blogs on such topics. Because I believe, especially for us cancer survivors, yoga’s ability to improve our minds may be even more important than the amazing benefits it carries for our bodies.

So yes, cancer sucks big time. That’s a fact. But we don’t have to let it suck the life, the fun, the love, and the joy out of us. With a little attention to our mindset and how we approach the experience, we can adjust our sails and traverse the suffering with so much more ease, minimizing side effects and optimizing our mood, quality of life, and overall experience. Why not give it a try?!

Namaste

Breast cancer treatment is a pain in the armpit!

If you follow my FB page, you know I recently took about 6 days off from my yoga practice because I was traveling for my husband’s birthday. I often still practice when I travel, but for some reason on this trip, I just wanted it to be about us relaxing at the beach together, and I didn’t want to have to interrupt our time with my yoga practice. It felt great and we had a lovely time, and I actually wrote a short post on FB about how it is good, sometimes, to take a few days off for perspective and reflection on your practice.

Well, after we returned home, I remembered why I usually don’t take more than a day or two off from my practice. Ouch! I have felt, on and off since my mastectomy and full axillary node dissection, some strange nerve pains in the underarm, the side of my chest wall, and down into my upper inner arm. The pains range from a vague numb discomfort type sensation (like after your foot goes to sleep because you were sitting on it) to pins and needles, to sometimes a deep burning sensation like a hot poker is sticking into me, or even a very sharp searing/tearing sensation, like the muscle or skin is being ripped apart. The last one is really weird because I will be able to tell that I am clearly NOT overstretching anything or causing enough tension to result in that tearing sort of feeling. Sometimes it happens when I am sitting completely still! So clearly, these are all nerve sensations, related in some way to nerves that were damaged at surgery, maybe are trying to grow back, or to the development of neuromas (nerve overgrowths, in this case benign and related to trauma to the nerve). This syndrome is called Post Mastectomy Pain Syndrome (PMPS), and refers primarily to this nerve pain in the breast, chest wall, shoulderblade, underarm, and even down into the arm. But PMPS also often includes pain related to lymphedema, capsular contracture, shoulder dysfunction, or other downstream effects of breast surgery (mastectomy or lumpectomy), axillary node sampling, reconstruction, or radiation. Because it can occur with surgery other than mastectomy, it is sometimes called Post Breast Surgery Pain Syndrome instead.

Shockingly, PMPS occurs in as many as 50-60% of people who undergo these types of surgeries, so if you have it like me, you are in good company! Some things make it more likely, including full axillary node dissection (as opposed to sentinel node), implant reconstruction, and radiation. Interestingly, younger age, depression and anxiety, poor/passive coping strategies, lack of cognitive flexibility, and underlying other pain syndromes are also risk factors for PMPS. And protective factors, such as resilience (defined here as a person’s ability to maintain relatively stable, healthy levels of psychological and physical functioning even when exposed to highly disruptive events”) have been correlated with lower levels of PMPS. So how long does it last? To differentiate this from normal postsurgical healing, PMPS is defined as pain that persists beyond 3 months after surgery. Many women with PMPS will have slow improvement in pain over time, but a sizeable percentage will still have pain years later. In fact in one study of women reporting PMPS, nearly half of them still had symptoms at 9 years of follow up.

So for those of us who have this, we gotta learn how to minimize it so it doesn’t limit us or cause us to suffer any more than it has to! Fortunately we do have some control over how we deal with this.

As with most things in medicine, lots of different treatments have been studied, and some may work for some women and others better for others. As you may have guessed, physical exercise has been shown to improve outcomes, including reducing pain, improving function, and improving quality of life. It stretches the tissues, keeps shoulder alignment healthy, improves blood flow, and helps with scar tissue. This is why I think yoga helps me so much. If I stick to my regimen of regular yoga practice, it seems to me that I keep the tissues of my chest wall and underarm nice and mobile, stretched, soft, and elastic. If I don’t move my shoulder and chest wall enough, things seem to get stuck again, and wham! The pain comes back. I’ve been back from vacation for 4-5 days now, and back to my usual regimen of yoga, and the sharp searing pain I was having is basically gone. I need to remember this next time I think I’ll just skip stretching for days on end. As you know from my other blogs, yoga has specifically been studied in breast cancer survivors and shown to improve pain, physical function, mood, and quality of life (among other benefits). So yoga has got to be good for PMPS, and I am a perfect example.

Physical therapy, massage, and acupuncture have also been shown to be of benefit in some women. Medications are often used in severe cases, including nerve pain modulating medications, such as gabapentin. I saw one report of topical capsaicin being of some help. Psychological therapies, such as mindfulness based therapies, cognitive behavioral therapies, meditation, and hypnosis have also shown benefit. Interestingly, yoga incorporates many of these psychological strategies in our practices as well, so you get a double bonus benefit with yoga! And then finally, some surgical approaches and interventional procedures, such as nerve blocks, fat grafting, and targeted muscle reinnervation have been used in some refractory and severe cases.

So that may be waaay more than you ever wanted to know about post mastectomy pain. But since I occasionally suffer with it myself, I thought some of you might also be in the same boat. It is such a strange sensation. It helps me some just to know what it is, so that my fear response doesn’t kick in and start catastrophizing all of the horrible things that it might be. That being said, if you have pain that persists and/or worsens, talk to your Dr about whether you need any imaging, and especially about what options you might have for treatment. Because there are things that can help! And make sure you are moving your body. This is what helps me the most!

Namaste yogis

Learning to love our scars and asymmetries

Just when you thought you knew how weird I was…. there’s more! Did you know I have two different colored eyes? Specifically one of my eyes has 2 wedges of a different color in it, a condition called segmental heterochromia iridis. There are several different types of heterochromia (different colored eyes), and about 0.6% of the population are born with these conditions. There are also acquired types of heterochromia, like from trauma to the eyes (as in David Bowie, who is even weirder than I am). When I was a kid, I thought people with pale blue eyes or dark chocolate brown eyes, or pretty much any color other than what I had, were so much prettier. Now, finally, about 1 month shy of my 45th birthday, I finally realized my eyes are kinda cool.

Sadly, we tend to judge ourselves pretty harshly, and see the beauty in others far sooner than we ever see anything good in ourselves. We have to get better about this. Especially after cancer treatment, when surgery, chemo, radiation, and hormone blockade can leave us scarred and changed. Please click and read this beautiful excerpt from a talk by Ram Dass, about learning to judge ourselves less harshly. https://www.ramdass.org/judging-less-harshly/ I love his analogy of trees, and how different trees grow differently, because of lack of light, or other reasons, and how we don’t judge a tree because of this. We understand why it grew the way it did, and we allow it, and even appreciate that it was resilient and able to grow despite its conditions. Why can’t we be this way with ourselves? I’m beginning to be able to see my scars, not as ugly and asymmetric, but as signs of strength and resilience. I’m beginning to be able to appreciate them, even to have a deep respect for them and what they mean. They mean my body was able to withstand some pretty nasty stuff, and then it recovered and healed itself. It may not look the way it did before, but why would it? The human body is truly a magnificent marvel, and the fact that we can get through these toxic treatments and come out the other side is nothing short of a miracle. I’m trying to develop deep gratitude and love for my body, my scars and asymmetries and weird color abnormalities included.

The second part about the Ram Dass excerpt that I really love is the part about him putting his own picture on his puja table. For those who are unfamiliar, in several eastern traditions, one would normally have pictures of one’s guru or revered dieties on their puja table, and these would be used for prayers and devotional practices. So it is a little unusual to put your own picture there. But his reasoning is beautiful. We could all probably use a reminder to, as he says, open our hearts to ourselves and to understand the predicaments we are in. If we could be as loving and as understanding with ourselves as we are with others, as devoted to ourselves as we are to others, we would find ourselves so much happier and healthier. And we would also be more compassionate and loving with others. A positive feedback loop of love and understanding!

I invite you to take a look at yourself, and really see the glory and the miracle in your body and your spirit. Whatever weirdness you have, and whatever scars and changes you have acquired through cancer or other trials, you are a beautiful force of nature and you deserve your own love, respect, and understanding.

Weirdmaste (the weirdness in me honors the weirdness in you)

btw damn, my eyebrows are impressive, right?! Guess I wished a little too hard for them to grow back. Now I have way too much! I need a lawnmower for those things 😉