Varicella by Peter Acker, MD, FAAP

      David was the last of us to contract chicken pox, but he got it the worst.  My older sister picked it up at school, passed it on to me and finally, probably about the time I had scratched off the last of the crusts from my skin, he came down with it.  He must have been less than one, since I, two years older, have no recollection of this.  I just know that for years my parents would recall how sick he got and how worried they were.  He had been born prematurely and from day one, my parents worried about him.  Just a skinny little thing, covered with pox, my dad would recall from time to time with a grim shake of his head.  In my early childhood, I didn’t have a clear notion of what chicken pox was.  I imagined for a time it was some sort of culinary dish like chicken cacciatore or chicken a la king.  This kind of misunderstanding was typical for me, a middle child benefiting from what I later liked to call benign neglect as I was buffered on one side by a preternaturally verbal older sister and on the other by my sickly younger brother who together managed to soak up most of the parental attention.   I was free to concoct my own versions of things in dreamy solitude.  Worried attention, on the other hand, had a rather toxic affect upon my younger brother, I think, who grew up to be a robust, talented, but extraordinarily anxious young man.

       We shared a bedroom throughout a good deal of our childhood and for the most part it was a harmonious situation, though of course we did have our occasional squabbles.  He had what was probably some sort of vocal tic that would manifest just as he was settling into bed.  As I read on the adjoining bed, short little grunts and sighs would emanate from his side.  I learned to merely grit my teeth since complaining to him, just made it worse and my parents, I was sure, would take his side.  Later he decided that the light of my lamp bothered him and I would retreat to another room.  He would emerge after some minutes claiming that a faint light under the door was preventing him from sleeping and I would withdraw to a far end of the house.  For a scrawny little thing, he wielded a lot of power.

     As I grew older, I developed protective mien toward my brother.  In college, we talked often on the phone.  Usually, I could gauge his mood in the first millisecond or so.  Frequently, he would start with sort a brief vocalization, sort of a throat clearing then a long pause and then slowly at first he would pour out the various things that were on his mind.  I would listen, make an occasional encouraging comment and finally I would hang up the phone feeling totally spent.

     In one of those conversations, he confided to me his growing conviction that he was gay.  I immediately assured him that I was fine with it, but at the same time, I was yet again gritting my teeth, wondering how my poor scrawny younger brother, covered with pox, could deal with the world as a gay man.  For some time, I carried this revelation in solitude.  Gradually, the circle of those in the know grew and some years later we were able to enjoy a friendly if not entirely relaxed Christmas at Dad’s (my mother had had since passed away) with David and his black male lover.

      In 1982, I began my internship in pediatrics at Bellevue Hospital.   The work was grueling, but fascinating.   My brother, in the meantime, had gone to the Studio School not too far away laying the foundation for a painting career.  Will he ever choose something easy, I wondered at the time.   He supported himself by working as a typesetter at the Nation magazine and painted tirelessly in a loft that he had bought in a pregentrified of area of Brooklyn and which he shared with his boyfriend.   I remember being amused that my artist brother owned property before I did, the doctor.   His work habits were fueled by an intense nervous energy.  He carried a sketch pad with him everywhere.  We would on occasion travel out to the country together to visit our father and I would laze around while he would spend virtually the whole weekend tramping around with his easel. 

     David sometimes invited my wife and me to elaborate dinner parties in his loft.  He would hover over the stove carrying on multiple conversations with his guests, usually artists and writers, while frenetically tasting, adding ingredients.  His salads, in particular, were the product of endless additions of minute amount of spices and herbs.  I marveled at all the talents that were emerging and began to feel a tad envious as I compared my conventional life style to my brother’s bohemian bonhomie. 

     In 1981, the CDC reported a cluster of 5 homosexual men with pneumocystis carini pneumonia.  Initially the disease was known as GRID or Gay Related Immune Deficiency.  As it became increasingly recognized that more than 50% of cases were not gay related, it was changed to Acquired Immune Deficiency Syndrome.  At Bellevue, we began in the fall of 1982, to see young children with unusual infections.  I remember one infant in particular who was my patient.  Despite all our efforts, she got sicker and sicker.  Drawing blood or replacing an IV in her became a dreaded task for all involved and I remember struggling sometimes up to an hour, ungloved in what was typical during that halcyon era and afterwards scrubbing off all the blood from my bare hands.  Only in retrospect, did we recognize that she represented one of the first cases of pediatric AIDS, usually contracted at birth.  Two years later, a pediatric AIDS clinics was set up at Bellevue. 

     That era in some ways resembled America pre 9/11.  Though the AIDS crisis intruded upon our consciousness far more slowly than the terrorists attack upon the World Trade Center, there are, I think, some real similarities: the sense of an undetectable enemy, a similar kind of fear. AIDS changed our feeling of safety and brought an abrupt halt to the notion of sex without consequences which had blossomed on the college campuses of the 60’s and 70’s after the advent of oral contraception.   Potential lovers were scrutinized suspiciously in the same way that air travelers uneasily eye fellow passengers of Middle Eastern appearance.    Unlike chicken pox, which mounts a frontal assault upon our respiratory tree and then quickly fans out through the blood stream establishing gaudy beachheads in the skin and mucous membranes, the AIDS virus is the ultimate bioterrorist, sneaking into our bodies undetected, biding its time in patient preparation for its assault on the immune system.  In the case of chicken pox, the body’s immune system steadily fights off the infection and the pox marks which initially look like dew drops on a rose petal as they are poetically described in medical textbooks, become cloudy, and then burst leaving a crusted bump.   The patient practically always recovers fully, but yet there is one similarity to the AIDs virus: the varicella virus does not completely leave.  It nestles in the ganglion roots of the spinal nerves establishing a redoubt where it remains dormant, kept in check by a vigilant immune system.

     As it turned out, David was aware of the cluster of cases in Los Angeles before I was.  I prided myself that I kept up with the medical literature, but I missed that report.  The gay community, on the other hand was already humming about it.  He called me that fall, his voice cracking, and there was that long pause that I hadn’t heard for years.  He was frantically worried that he had contracted the gay disease. Over the next few months, it was like old times: late night calls and nervous ruminations.   Looking back on it today, I cringe as I recall my repeated reassurances.  Don’t worry, I counseled, my assured tone fueled by my confidence in the power of my medical knowledge: a confidence that, as is commonly the case among doctors, reached its apogee towards the end of my internship.  Only later, did I come to appreciate the pipeline of information from the gay community that David was privy too, which proved to be a much more reliable source about the nascent AIDS epidemic. Gradually, he calmed down, and by the Spring of 1983, he rarely brought it up and was deeply consumed for preparations for his first solo art exhibition.  On the wards at Bellevue, our conversations turned increasingly to speculation on what was causing this mysterious disease.  As David calmed down, I began, in secret, to worry.

     It was a good two years later that David called me to tell me that he was laid up.  He had an attack of shingles.  He related this to me calmly, mildly complaining that the pain was interfering with his painting schedule.  I feigned an equal casualness as I strained to keep my own voice from cracking.  After hanging up, I stood there and my wife entered the room astonished by the tears streaming down my face.  Varicella, benign varicella, had reared its ugly head after 30 years of slumber in the dorsal roots of David’s thoracic spinal nerves producing a band of blistery eruption which snaked round from one side of his back to near his navel.  Shingles, results from a reactivation of the varicella virus in the spinal nerve.  While merely a temporary, albeit painful, affliction for the elderly, for the young gay male, it is a harbinger of much worse things to come, because it is a sign that the body’s immune system is starting to wane.  Since there was no blood test for diagnosing AIDS at that time, this was the first incontrovertible sign that he had a problem with his immune system.    Once I learned he had shingles, the last vestiges of denial fell away and I knew. 

     Some months later I dropped by on one of my regular visits to his loft and found him stretched out on his bed, breathing a bit heavily and with what seemed to be a slight bluish cast to his face.  He waved me closer with a smile before going into a paroxysm of coughing.  Just a bad cold, he told me and I managed to convince myself that he was not breathing rapidly and that the lighting was a bit funny.  The next day, I came again and this time I brushed away his protestations that this was a cold and convinced him to go to his doctor.  His doctor took one look at him and dialed the hospital.  While waiting for the hospital to pick up, he turned to look at me and I thought I saw a recriminating look on his face.  Why had I not been more alert to the clear signs of respiratory distress that any intern could see?  By that evening, he was in the intensive care unit at Columbia Medical Center on a ventilator.  He showed remarkable strength and dignity while flat on his back with a hose sized tube ensconced in his trachea.  He wrote frequent notes on a little pad with the same frenetic energy that so characterized him. He wrote “I’m optimistic” among other things and was careful to equally divide his attentions among the circle of friends and relatives around his bed.   I remembered his almost disabling anxiety when he thought he might have AIDS and marveled at how well he coped with actually having it.  

     Most people survive their first episode of pneumocystis, but David did not.  I asked his doctor about this, and he did not have a definite answer.  Years later, I learned that subtle genetic differences probably account for the variable outcomes.  We had a memorial at a gallery in Soho.  We stood, surrounded by his paintings and many of us in turn stood up to talk.  As I approached the front to take my turn, I thought how strange for me, a doctor, to be giving a talk in a Soho art gallery. There was one other doctor in the crowd, his doctor, a specialist in infectious diseases from Columbia. Several years later I read an article about the AIDS epidemic in the New York Times Magazine and saw that David’s doctor was prominently mentioned as a pioneer in the early treatment AIDS.   Towards the end of the article I learned to my astonishment that he himself had recently succumbed to the horror of the disease that he had been close witness too as a treating physician.

 ******

      In 1989, my then two year old daughter, Jessica, came down with chicken pox passed down from her older sister.  It was a fairly typical case and on Sunday morning of Memorial Day weekend, the lesions looked like they were mostly crusted over.   Late that afternoon, her fever returned, but now was much higher than it had been at the height of her illness.  Within a few hours I noticed a faint rash, appearing like mild case of sunburn.  I snuck into my study and quietly looked up toxic shock syndrome.  I closed the book, convinced that I had succumbed to that age old malady of med students of seeing in themselves whatever disease they happened to be studying and I calmed myself down.             It was my wife, using a mother’s instincts, who truly recognized the severity of what was transpiring.  I placed a midnight call to one of my partners and together we drove to the medical center.  It turned out she did have toxic shock syndrome, which is a rare complication of chicken pox.  She was in the hospital for a week or so, but completely recovered.                  

     David’s paintings are hung throughout our house interspersed with Jessica’s, who has become an accomplished painter.    I watch her move quickly, about the kitchen and I catch a glimpse of small round scar between her eyes, the only remnant of her bout with chicken box.  She leans over a salad she is preparing, making familiar minute adjustments.  She fixes me, with a look.  “Dad, what’s a matter, you’ve never seen anybody make salad before?”

The Yoga Therapy by: Kathryn Merrifield

Two years have lapsed since I attended a yoga class at Yoga Sanctuary in Mamaroneck.  Thanks to a Groupon, I returned on Thursday to find Ellen Patrick, certified yoga therapist, teaching Yin Yoga.  Ellen had taught me a lot about alignment – so much so that I was able to continue my Vinyasa and Ashtanga practice due to her expert instruction that had me release my clenched shoulders in Down Dog and put the effort into my more relaxed upper back (between my shoulder blades).  Tiny adjustments make a big difference.

Lately, my left hip has been nagging and unable to right itself out of what I determined via x-ray, to be some kind of tissue-related pain, something that I intuitively understood after sustaining years of injury to my body as a side effect of the sciatic pain that reduced me to a hunched over and crying pregnant woman six-and-a-half years ago.  It eased with the help of chiropractic care, specifically through Active Release Therapy from the Optimum Health Center in Mamaroneck.  Chiropractor, Seth Pearl, ran this second facility (to the main office in Scarsdale) but has since closed that site and consolidated his holistic practice to I-Have-No-Idea-Where.

I’ve consulted with Mamaroneck Acupuncture about this hip injury and received a home exercise program from an orthopedist.  Acupuncturist, Dr. Henry Wu, helped but only diminished the pain -  the exercise instructions remain in a stack of papers in the stacked papers area of my house.

Ellen Patrick seems to have provided the assist needed with very simple stretches and the use of a foam roller – I own one of these, but the trick is just knowing how to use it for maximum benefit. 

“So much more than a yoga studio, The Yoga Sanctuary offers Yoga, Yoga Therapy, Pilates, and Massage Therapy.  An oasis for vitality and tranquility, we offer our students various tools that will help to reduce the stress in their lives and enhance their health and well-being.  Anchored in ancient traditions and validated through modern science, the services we offer are designed to empower and influence each individual's life in a more positive direction.
 
Unique to The Yoga Sanctuary, is our Yoga Therapy progam, which addresses the needs of students on the physical, physiological and psychoemotional levels.  Our highly trained and certified yoga therapist, Ellen Patrick, E-RYT 500, provides group and individual instruction providing for issues ranging from lower back pain to Multiple Sclerosis to anxiety and depression.”

http://www.yogasanctuary.net

Your Sandbox is my Sawdust by Kathryn Merrifield

 Woke up this morning thinking about the days that I spent with Dad – weekends with him at The Palm Restaurant – not entire weekends – but those Saturday nights we would drive east on Santa Monica Boulevard and arrive there almost by magic, pull up to the valet, walk under the valet overhang – black background with the palm tree logo in gold shining through.  Someone taller and in a black coat pulled at the large black door handle and ushered me and my two brothers onto the sawdust-coated hardwood floors, past the coat check and cigarette machines.  Past the buzzing conversation at the pretty, mirrored bar where, I’m sure, my father’s Chivas Regal scotch was set among the other pretty bottles behind the dark and shiny bar – the top of which was at least a foot taller than my young self and remained taller, and larger and intimidating despite my growth to a towering five feet, three and a half inches. 

Greeting us at the door was Chi Chi then Tony at the host podium and the walls covered in the character portraits of every star that ever entered that place or had died famous or, quite often, topless or with a hat or a cane or a distinctive jawline.  It was an education to me and to my two brothers – that one lady lounging by the palm tree, blond and barely clothed, characterized outlined in black like a comic book character is round an perfect.  Piercing eyes identified the men like heroes and swarthy, childless, unattached singletons. 

But a lobster was brought to the table and we were taught to put it to sleep by stroking the back of its neck before it was plunged into a boiling vat of water to cook while our clams casino and half and half (battered and fried onions and homemade potato chips) were served.  Dad ate the green guts but called it something else.  There was melted butter and lemon and a bib.  But, my brothers and I often ate meat instead.

It’s not a typical story.  Not just the meat part, I mean.

Neither is the story about the time my brothers told me to go into the men’s bathroom to see the odor-killing disk in the urinal they used for target practice before I got a quick look then got my fingers slammed in the door.

A screaming girl at the bathroom doors and kitchen entrance was interesting, to say the least.  We were often the only children patronizing The Palm Restaurant.

I miss that place.  Sawdust slipping under my feet, like it belonged to a bunch of adults grinding at the wood floors toward the same satisfaction children toil dig out and in a sandbox.

Easing Grief with Yoga - by Kathryn Merrifield with Jennifer Swain

“Yoga is an internal practice.  The rest is just a circus.”  

- Light on Yoga by B.K.S. Iyengar

Some time ago, I wrote an article about yoga and my experience with grief – the passing of my father who encouraged me to start taking yoga after injuries that made me stop cycling and running – two of my favorite pastimes that slowed me down and calmed me and made me write more effectively and clearly.

I realized with that short essay, that yoga has a strong connection to my emotional expression now.  I found that I came to my mat feeling like my head was caught up in a tornado and ended my practice with a realigned spine, the air passing easily in and out of my lungs, and my shoulders normally set below my ears (where they had crept with stress). 

Caught up in the idea about yoga as a vehicle to grief relief, I began talking to my yoga friends and instructors about it, and found that a woman from class that I had seen but barely knew, had written an essay on the subject to complete her yoga certification.  That person was Jennifer Swain, and her husband, Michael, passed away in 2008 after a fight with pancreatic cancer.  She spent one and a half years in a cancer ward while he received treatment. During that time, she explained that her body went through changes reflecting what unfolded for her emotionally as she coped with letting go of her husband and watching her two children, then sixteen and fourteen years old, do the same for their father.

After Michael died, she began what she describes as a rigid exercise schedule of running, swimming, walking the dog very early in the morning.  She would need to move the moment she woke up. During that time, she also began taking yoga at The Wainwright House and The Rye YMCA – both Astanga and Vinyasa classes. 

One of her yoga teachers, Lois Wald Ps.D., a clinical psychologist turned good friend, reminded her that, “it’s okay to slow down and allow yourself to feel what’s going on.”

Like many athletes new to yoga, the tendency is to look at yoga like another form of exercise – to muscle through the postures.  From my own experience, repetitive injury is the best lesson in the body’s limits and the need to attend to form, rest and movement.  It seems to be the only way I learn.  Like Jennifer, pain got me to the mat and to the soft landing place that yoga has to offer – a place of surrender.

Jennifer settled into a consistent yoga practice.  The result of that was not the immediate relief of grief, but rather the release and surrender to it.  Slowly, she blended the other forms of exercise with yoga then began teacher training through Kaia in Westport, Connecticut.

“I never would have done this had it not been for the death of my husband.  Not that I’m at all grateful for that, it just is the way it is.”

Grief or grieving is the human process of dealing with loss. Emotional suffering is a natural response to a loss of any kind, but especially the loss of someone or something to which a bond has been formed. We form attachments to a relationship, a pet, our health, a job, a relationship, or a financial situation but in all probability we will lose one of these things.

The act or unconscious attachments we have to believing things will stay the same can lead to an almost unnatural response to changes and losses in our lives. Responses to grief vary from person to person and there is no evidence that there is one right way to respond. The stages of grief have been outlined in five distinct stages:  denial, anger, bargaining, depression, and acceptance.

Grief is complicated and varies greatly from person to person. The grief of an adolescent may be different from the grief of an adult. The loss of a parent, sibling, spouse, child, or marriage can all bring with them different sets of behaviors.

Jennifer and I found common ground sharing the ways yoga helped us through grief:  the loss of her husband and the loss of my father six years ago.  The loss of anything, really.

When I lost my father to cancer six years ago, I began reading a book about grief as a way to connect to the process and understand what I would go through.  It was not the first time I that someone I loved had died. There was only a wide open patch of nothing.  Reading about death and grief, helped me realize that all I could do was to be patient with the process - be patient with my anger, exhaustion and sadness at the loss of a conflicted father-daughter relationship.  Almost every day, for the last two years of his life, we talked on the phone.  Often, the longest conversations between us occurred when I was driving to and from yoga or swimming.  It was similar to Jennifer’s experience in that cancer ward.  But different because of the distance.

Exercise has always been a reliable safety valve to me, a release to otherwise detrimental stress.  Admittedly, I sometimes rely on it too much.  Jennifer found, and I did too, that yoga integrates the mind and body purposefully winding breath around movement.  At the very least, you must breathe. Any yoga instructor will tell you that it is perfectly acceptable to attend class and lay on the floor in savasana and simply breathe.

The breath, or Prana, is the restorative link that connects the physical body with the spirit. The simple act of pranayama calms the mind and warms the body.  It requires surrender to breath.  Pranayama calms the panic and overactive mind that can accompany loss or death of a loved one.  Trauma depletes us physically, mentally and emotionally.  The emphasis on the breath in yoga is the link to a spiritual realignment of the body and mind, both of which suffer a state of exaggerated imbalance through the process of caretaking and death.

 “You can’t make a career out of grieving,” either, Jennifer said.  We sat down for the second time to talk about this essay.  She quoted a Chinese proverb:  “You cannot prevent the birds of sadness from passing over your head, but you can prevent them from making a nest in your hair.”   Also true.

My favorite yoga instructors, the ones that seem to integrate the teachings into their own lives, and live, breathe and speak it, have a way of setting intentions for a particular practice with a reading or acknowledgment of the present:  the chaotic or subdued energy of the season, the extreme heat, the frigid cold.  The combination of meditation and asana revive the body as well as the mind. The teachings from the yoga sutras feed the wandering mind by giving it something to grasp.  It is what loss needs. The focus on the present and the acceptance that things are always changing, combined with the wisdom of the yoga traditions, are enormously helpful. The perspective that yogic teachings have on death and dying are so contrary to western beliefs but are also soothing and helpful to the experience of loss.  Death is part of life. 

Vairagya, or non-attachment is one of the main teachings of yoga. If we can embrace the almost counter-intuitive concept that things are in a state of constant flux with results both good and bad, we can begin to think about death differently. This is not to say that we will be free of the pain that accompanies loss, but we can alter our perspective of the event and transform our response to meet the changes.

The inevitability of death is integral to the human experience. But, to the living, any death is hard to deal with, especially if it’s either sudden or violent or entirely contrary to what makes sense according to merit or age or immense love. The use of yoga in concert with other channels toward healing can help open the body and the mind to accept the harsh reality of loss and transition, whether it’s talking to a friend, a clinical psychologist, or an individual, or group of people (formal or informal), who have experienced a similar loss.

An asana practice clears the channel for grief to pass through.  Yoga will not save its practitioner, but rather soften the passage of painful emotion.  Postures done with props, specifically blocks and bolsters, can open a body held rigid in the throes of sadness. The asanas (poses) need to be less strenuous - grieving itself expends energy. The practice should be geared to rejuvenate and heal.

Supta Baddhakonasana (Lying Down, Bound Angle):  Lie on your back with a bolster under your spine, beginning close to the earth so as to feel grounded and safe. Poses begun on the floor will engender safety and grounding.  It is a reassuring place to start when life off the mat becomes chaos.

Supta Virasana (Lying Down, Hero):  Sit on the floor between bent knees, spreading about eighteen inches apart, and place a bolster under the bottom so as not to stress the joints. This pose can be used for meditation and pranayama (breathing). 

Janu Sirsasana:  (Seated Head to Knee)  Sit with one leg extended and the other bent and placed into the upper inner thigh and groin.  Gently twist and fold over the extended leg with a flat back. 

Paryankasana One:  Same as Supta Virasana but with one leg extended while the other remains bent and close to the thigh.  Bend at the hips over the extended leg.

Marichyasana:  Sit with the left leg extended, the other bent and pulled into the abdomen.  Bend at the waist and reach the same side arm around the bent knee toward the back where the other hand grasps the wrist of the hand wrapped around the bet knee.  This can reduce stiffness in the back, neck and shoulders, areas aggravated by the stress of grieving.

Ika Pada Rajakapotasana (One-Legged King Pigeon).  Right leg bent with chin parallel to the front of the mat.  Left leg is extended straight behind, toes on the floor, with even hips.  Inhale with one breath, shoulders back and up, then bend over the front leg.  This pose is restorative as the opening of the hips can help release suppressed emotions.

Uttanasana (Standing Forward Bend):  Standing straight, bend at the hips until hands rest evenly on two blocks placed in front of each foot.  This pose relieves anxiety and slows down the heartbeat.

Heart openers will help one to heal and to open up to all the positive things in life. When we grieve we often round our shoulders and pull inward.

Matsyasana (Fish):  Lie on your back, legs extended straight in front.  Push into the elbows and arch the head back. 

Dhanurasa (Bow):  Lie on your belly, legs bent and hands grasp tops of feet.  Legs pull up rather than the arms pull the legs into the body.  The position naturally raises the body off of the floor.

Urdhva Dhanurasana (Wheel):  Lie supine on the floor, knees bent and set hip distance apart.  Plant hands equidistant of shoulders behind the head and push up and into wheel pose where the heart, chest and throat are open.

Poses that require balance may help to restore one’s balance.  They build confidence and create openness to new experiences.

Ardha Chandrasana (Half Moon):  Leg straight and planted on the floor.  Bent at the hip with same side hand on the floor, opposite leg straight (parallel to floor) and opposite extended straight above.

Salamba Sirsasana (Supported Headstand):  Arms bent, hands grasp (in a concave shape) around the crown of the head.  Legs extend straight above. 

Vrksasana (Tree): Standing tall, left bent leg and place foot on inner thigh.  Reach and extend both hands straight above head. 

Crow:  From a squat position, place hands on the floor in front of you, feet together.  Shift weight to the hands and lift feet off the floor, knees in the pockets of the underarms or resting along triceps.

Side Crow:  Variation of crow with legs extended to one side, hands planted in front the same way.

The above represent simple explanations of the poses as they would be photographed, and are not specific instructions.  Asanas should be performed with the consult of a certified yoga instructor together with mindful breathing.

The postures don’t relieve the feelings but the combination of asana and pranayama help access them.  Dr. Lois Wald added, “Holding postures longer than usual fosters a sense of surrender which can allow deeper feelings to emerge.  All you can do is feel it no matter what you try to do or not to do.”

1.     Slowing the breath allows us to let go and simply be;

2.     Relaxes rigidity and tightness in the body that occurs as a result of trauma;

3.     Focusing on drishti (gaze) and breath helps empty the mind of chita (monkey brain);

4.     Mindfulness of the chita allows its release;

5.     The community of like-minded people create a supportive environment – typically, yoga practitioners have an interest in improving themselves.

Yoga itself is not the relief.  “Yoga can help in the transformation of grief from the overwhelming feelings of grief.  The understandable wish is to deny these feelings.  It’s a slow process of learning to feel the grief and incorporate it in healthy ways,” said Dr. Wald.

There is no magic concoction that allows for grief to subside.  Once the feelings present themselves, what do you do with them?  Here are some essential ways that helped us better take care of ourselves:

1.     Talk honestly with someone you trust (friend or therapist);

2.     Get sleep;

3.     Be alone when you need to be alone.

4.     Be with people more than you think you need to be;

5.     Engage in physical activity, apart from yoga, that makes you feel good;

6.     Get outside;

7.     Do the things you love even when you don’t want to – everyone has different methods of self-nurturing;

8.     Be patient.  It will take longer than you think it will to feel normal;

9.     Accept help;

10.  Eat nourishing food.

Injured or not, we just keep breathing and moving… arms, legs and lungs.  That’s all it is.  That’s all of it.

Namaste.