New post on alteayoga.es

Hey lovelies.  I am trying to move over to alteayoga.es.  So, any new posts will go there first.  Here is a link to something I wrote this morning.  Toodle-loo.

https://alteayoga.es/2017/11/07/the-mysterious-path-of-the-yogi/

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New Term starts 12-Sept-2017

Yoga at GOA
Yoga at GOA

Hey people, sorry it’s been a while.  The summer term has gone swimmingly and I’ve been kept busyingly busy!.  Classes were sometimes full to overflowing, sometimes empty to the point of silence.  But, the 90-days of consecutive classes is drawing to an end. And, of course, I have got my fingers in the pot, planning for next term.

Firstly, I am going to take a few days off teaching.  Last class is this Friday, 1-Sept-2017.  Then, until Tuesday 12-Sept-2017, rien de rien.

From 12-Sept-2017, I will offer a five-days-per-week teaching schedule. No class Sunday or Monday, but every other day, yes.  Start time is 9:30, pricing model remains the same:  7€ first class, 6€ the second one in the same week, 5€ for the third and so on.  Weekly cost for all five classes is 25€, and there is no monthly fee.

So, I hope to see you there. Not for me, but for you.  Yoga has special, magic powers and my most sincere wish is that everyone reading this could feel that blissfulness at least once.  No, yoga won’t change the world:  only activism and engagement can do that.  But yoga can change your inner world and that might be a good starting point.  Om.

Turn around….

I have been giving classes at GOA for nine months now.  Every day is a privilege.  I honestly can’t believe how conducive that room is towards the inner experience of yoga.  The sea beyond, the salty, iodine-rich air, the birdsong…wait…birds?  Where are the birds?  Oh, yes, look at those windows at the back of the room.  What?  They open?  Sliiiiiide.  TA-DAH!  And thus we discovered the hidden treasure of GOA upstairs!  The gardens of the Edificio SKI behind us.  Mature trees, well-kept gardens, fresh shady corners, a shimmering swimming pool.  What more could one ask for, honestly?

Warriors in Warrior Pose
Warriors in Warrior Pose
GOA views
The view to the front.

I call it Krishna tricks.  The idea that you don’t know what you don’t know and that many times what you discover is humorous, tricky.  When I first came across the concept of the Trickster God (and this concept exists in many diverse cultures), it changed my relationship to the Divine.  I had been raised with the idea of the schoolmaster God – judgemental yet forgiving, but somehow always out of reach.  The trickster God likes to remind you of his presence by letting you in on the joke.  Just when you think you know something, you realise that you know nothing at all.  And so you retain the beginner’s mind, a childlike innocence.  Not all is said and done, not all is known, nothing is set in stone, especially not your personality traits or character, whatever you might believe that to be.  Life becomes a lot more fun when you think it’s conspiring to make you laugh…

Krishna played some tricks in the yoga room last week.  He reminded me that what is behind is just as important as what is in front.  He reminded me to open that back window and to look through it.  JSK.

NY Time Opinion: Yoga teachers need a code of ethics

I agree completely with the author of this piece.  As a teacher of Viniyoga, I am ashamed that there has also been a scandal in our lineage, although not mine directly.  I won’t publish details here, but it is easy enough to dig up.  Notably, the person involved is back teaching, without apparently having to atone for his indiscretions. For me, his alleged bad behaviour does not detract from the essence of the teachings of his father, TKV Desikachar and grandfather, T. Krishnamacharya.  However, I do believe that the organization that promotes the teachings of Viniyoga ought to be strong enough to discipline even the direct descendent of its founder.   Anyway, here is the link.

Daily Yoga Classes at GOA, Altea

It’s shaping up to be a busy summer.  Nothing like doing yoga every day.  Since it’s going so well for me over at GOA Altea, Lau and I have decided to collaborate on a a new project:  yoga campus 2017!  Basically, it is a daily yoga class and healthy breakfast deal.

Yoga bliss
Yoga Bliss

We understand that the summertime is for chilling.  But, we also know that there are people out there who know that relaxing is not only about wine and lying in.  Strange is it may sound, we believe that there are people out there who like to awaken early, with a clear head, and care for themselves with exercise, breathing and positive thinking.  How do I know that such people exist?  Because I am one of them!

I know a lot of people who rent houses for holidaymakers in summertime.  Very often, these are three and four-bedroom houses, and the groups that share them are ten, maybe twelve people, children included.  Now, being in a large group for any length of time is tiring.  I have seen time and again the sunburnt, sleepy faces of mums and dads on holiday.  I know that some of those people will relish, absolutely delight in the idea of a quiet hour for themselves in the morning, to stretch and breathe and reconnect with their inner essence. Believe me, yoga changes the prism through which one views the world.  So, set your alarm for 8:30, get on over to GOA by 9:00 any morning in July and August 2017 and come practice yoga.  Don’t bother eating first, yoga is best practised on an empty stomach anyway. Breakfast is served afterwards, with your VIP card, attractive pricing and lots of care and love.

Need more info?  Comment below, like Alteayoga on Facebook, or just mail me on alteayoga – at – gmail – dot – com.

Namaste and a great big Om.

-Rachel

PMPS: Post Mastectomy Pain Syndrome

Introduction  

om
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Among breast cancer patients, a common complaint is numbness or tingling in the upper-inner arm.  This is called neuropathy and is often down to damage to one particular nerve:  the intercostobrachial nerve.

ICBN

The intercostobrachial nerve (ICBN) is connected to the brachial plexus and innervates the axilla, medial arm and anterior chest wall.  The brachial plexus is a group of nerves that originate in the neck and whose basic function is to move the arms.  (plexus definition:  a network of nerves or vessels in the body. an intricate network or web-like formation.)

It is well known that many breast cancer survivors have problems with mobility, strength and sensation in the arm of the affected side.  Today, we are going to talk about the specific complaint of tingling, numbness, pain and loss of sensation in the armpit and the inner arm.  Here is an image, lifted from the pdf whose link is in the references section, that illustrates perfectly the areas of skin that are innervated by the ICBN.

icbn skin innervation
Area of skin innervation by the ICBN

PMPS

Intercostobrachial neuralgia, also known as Post-mastectomy Pain Syndrome (PMPS) is estimated to occur in about 33% of breast cancer survivors. I can’t find reference to whether these are 5-year remissions,  or longer or shorter intervals, but 33% seems to be the agreed upon figure, and this is for PMPS that persists for longer than three months after the breast surgery.  There are other nerves involved in PMPS, but it appears that the the ICBN is the main nerve affected in most cases.  Thus, some people say it is more correct to refer to Intercostobrachial neuralgia.  However, as that doesn’t exactly roll off the tongue, let’s stick to PMPS and try not to think about PMS (ouch!).

Why does it hurt?

 

axilla dissection
Axilliary lymph node dissection.

The origin of the pain is either:

  • nerve damage during surgery, or
  • scar tissue around the nerve.

Surgery in the axilla is usually to remove lymph nodes, and these are deep to the ICBN. Here is an image of the technique that is used to remove lymph nodes.  I lifted it from the medscape article that is cited in the references section.  Radiation therapy (RT) tends to damage nerve tissue and promote the formation of fibrosis, is also a cause of the PMPS.

Here is a wonderfully concise description of the surgical reasons for PMPS:  

“The most commonly cited theory of chronic postoperative pain in breast cancer patients is the intentional sacrificing of the intercostobrachial nerves. These sensory nerves exit through the muscles of the chest wall, and provide sensation predominantly to the shoulder and upper arm. Because these nerves usually run through the packet of lymph nodes in the armpit, they are commonly cut by the surgeon in the process of removing the lymph nodes.” (http://www.cancersupportivecare.com/surgerypain.html)

I tried to understand what a “lymph node packet” might be, as this isn’t a term that we use in MLD speak.  I think that it is a surgical term for the bundle of lymph nodes that is excised.  [An article unrelated to PMPS and ICBN contained this phrase “We prospectively assessed 61 pelvic lymph node dissection specimens (packets) in 14 consecutive patients undergoing radical cystectomy.” ]

What to do?

As usual, when we use yoga therapy for breast cancer rehabilitation, we must respect limitations.  Firstly, PMPS won’t be cured by practising yoga.  But, it can be helped.  Secondly, there is variability in the extent and severity of pain and impairment to range of motion.  So, adopt a personalised approach and be patient.  Use simple, slow movements with breath synchronisation to achieve optimum results.  If you are a yoga teacher, you probably believe in prana.  I certainly do, and no matter how scientific the tone of my posts, I will absolutely vouch for the healing effects of good prana circulation.  So, when teaching, keep your students focused on the practice, not on the results.  Also, use your own healing energy and direct it towards them.  Wish them well.  Ask for guidance and the blessing of whatever guiding energy you believe in.  

Here are a few suggestions for sequences that you can integrate into your own practice and bring some flexibility and mobility to the chest and inner arm region.  Note that all sequences mobilise the brachial plexus in general.   

ICBN PMPS sequences
ICBN PMPS sequences

 References