Each week as I prepare to teach the Yoga for People with Cancer class, I seek some inspirational words. I'd decided that we'd visit and revisit Tree pose in all its iterations, from lying to long sitting to static tree to moving tree to a pre-savasana resting tree, each time finding a new kind of balance. This poem, written by Ilan Shamir, really struck a chord with me and so here's playful blog to share with you. As we transition into spring, let's celebrate the catkins on the hazelnuts, the swelling buds on the maples and our own roots and growth!
Advice from a Tree
Stand Tall and Proud
Sink your roots deeply into the Earth
Reflect the light of your true nature
Think long term
Go out on a limb
Remember your place among all living beings
Embrace with joy the changing seasons
For each yields its own abundance
The Energy and Birth of Spring
The Growth and Contentment of Summer
The Wisdom to let go like leaves in the Fall
The Rest and Quiet renewal of Winter.
Feel the wind and the sun
And delight in their presence
Look up at the moon that shines down upon you
And the mystery of the stars at night
Seek nourishment from the good things in life
Earth, fresh air, light
Be content with your natural beauty
Drink plenty of water
Let your limbs sway and dance in the breezes
Remember your roots
Enjoy the view!
Menopause. Hot Flashes. Uncomfortable, disturbing, nauseating, fuzzy brain, disturbed sleep....hot flashes are listed as one of the most negative aspects of our peri to post menopausal years. We begin to feel like Goldilocks, desperately seeking a "not too hot, not too cold, just right" kind of world.
75% of women have hot flashes during their menopausal transition. Moderate to severe hot flashes typically last 7 to 10 years on average and less frequent or severe (either end of the spectrum) can last even longer. Let's talk about how you can influence the frequency and intensity of hot flashes, sleep and feel better!
We enjoy a breadth of temperatures in our lives before surgical (full hysterectomy), chemical (induced by medication) or natural menopause....we can be too warm or too cold and simply put on or remove a layer of clothing and stay comfortable. This is due to our clever hypothalamus, the part of our brain noticing and controlling thermoregulation. When it sense that we're becoming too warm or cold, it send signals to our organs, muscles and hormonal systems. They collectively respond to bring our internal core temperature back to normal. With menopause, the range of acceptable fore body temperature is drastically narrowed. We become more sensitive to external temperatures so much that we experience a sense of panicking with crisis messages zipping around, causing blood vessel dilation, sweating, wakefulness, peeling off of clothing/blankets....the list is long!
Why now? There are a number of theories including declining estrogen theory, elevated noradrenergic activation (stress) theory, east vs. west (consumption of phytoestrogens) theory, stress-coping theory, perception of menopause theory and thyroid dysfunction masquerading as menopause symptom theory. Estrogen does 400 jobs in our premenopausal body each and every day. We have declining estrogen with menopause, reducing support to our hypothalamus, making our threshold to heating much more sensitive. Simply adding estrogen sounds logical, but isn't an answer for women who are sensitive to estrogen (a history of estrogen related cancers), nor for those who are estrogen dominant (actually have low progesterone in relation to their estrogen). This is a condition that is more common in recent decades due to chronically high stress hormones that creates chronically low progesterone in relation to our declining estrogen. It's all in the balance.
We need stress hormones in our lives in order to wake up each morning, but again, not too much stress. With our reducing estrogen, we handle stress less well after menopause due to altering of our neurotransmitter activity. Rather than thinking that we've become wimpy, we now know that our stress response is more sensitive through menopause due to physiological changes! Those of us who dread menopause or fear aging, those who are stressed by daily life (financially, physically, relationally, emotionally), those who have suffered trauma and those who smoke and/or are obese are likely to experience more frequent, intense and long lasting hot flashes.
Triggers for hot flashes include caffeine, dehydration, alcohol, smoking, sugar, hot foods (spicy and temperature), stressful situations, stressful thoughts, sleeping in a hot/unventilated room, wearing too many clothes/blankets, focusing on/worrying about hot flashes/aging and not prioritizing restoration time (like quietude, meditation, prayer or nature walks). Hmmmm......notice any patterns for you?
Begin by keeping a hot flash diary for a week. When do they come? How severe are they? How long do they last? Which of the triggers can you align with your hot flashes? Each woman is unique and it's up to you to sort yourself out. Be your own personal sleuth.
Some general guidelines are: Address one personal trigger per week from your list, beginning with your toughest personal challenge. Stop and congratulate yourself, knowing that the balance of the list will be easier. Learn and practice calm breathing by doing the following: breathe in for a count of four and out for a count of four. Keep going for 5 minutes, building up to 10 minutes, repeating 2 - 4x/day. Lose 5 pounds; repeat if needed. Begin a gratitude journal, noting 3 items each day that you're grateful for. Controlling your controllables is your first step! You'll sleep better, fell better and enjoy life more.
Words from people who have or have had cancer…..
Cancer. 1 in 2 men and 1 in 3 women will experience cancer in their lifetime. It is now recognized as a manageable disease. Simply, cancer is one word for many different diseases in which some cells go rogue, just won't quit when they are supposed to, then multiply. Our immune systems are supposed to catch these wild ones.
The following are the pearls of wisdom comes from the people that I've been privileged to meet in my clinic or in our Yoga for People with Cancer class.
1. You've got the power. Listen to your intuition, your mind and your body while making the many big decisions ahead of you. You'll be getting to know and handing over some degree of power to medical professionals and making challenging decisions. Check in with yourself with kindness and gentleness. Seek support from your MIPs (most important people).
2. Recognize that you are still you. Many people describe a loss of identity as they search for one cause, one action/habit/behaviour/situation that is the root cause of "their" cancer. Try thinking of cancer as a mystery….one cell mutated and the immune system didn't catch it. No ownership, no causation. Not your fault.
3. Sit a while. Be aware of your thoughts, ideas and sensations, the good, the bad and the ugly. Ask for what you need and for what you want. Some call this experience "sitting well with discomfort" rather than denying its presence or letting it completely take over. Learn to be aware of how you're coping with cancer, your treatments and how they're affecting you.
4. Give yourself space when all the medical attention is over. This may sound odd, but many people report feeling quite lost when, after far too much intervention, there is suddenly none. No doctor visits, no specialists, no tests, consultations….then what? There is a period of waiting for you and your medical team to see how your body is responding. It can be a scary and lonely time. Talk to those people with whom you can be vulnerable and open or seek an appointment with your GP and/or a counselor.
5. Oh, those comments. "You look great!" "How are you, really?" or avoidance. Many people, from good friends and family to acquaintances, have no idea how to interact with someone with cancer. Some want to reassure or offer their stories, opinions and internet "wisdoms". Those with cancer have said: simply be present, listen, "be normal", have other topics of conversation (besides cancer), go for a walk together, remind us all that there is beauty in life outside of tests, surgery, radiation, chemo and side-effects world!
6. And sometimes, the "side effects" go on, and on, and on…… For some people, cancer doesn't end with the end of treatment. Hormonal or targeted therapies can last 10 years, create sudden onset menopause and give both women and men hot flashes. Retesting can be every 3, 6 or 12 months and be terrifying. Just attending doctors appointments and hospital tests can evoke fear. There may be side-effects from chemo (like peripheral neuropathy), radiation (like scar tissue) and surgery (loss of part of you) that change you for a lifetime. The people around you may assume that you're "done the fight", expecting you to bounce back. They may not recognize your challenges. Describe cancer related fatigue (and how it's different from garden variety "tired") and cancer related cognitive dysfunction ("chemo brain") to those near you. Help them understand your present experiences to help them be more compassionate and understanding. And know that your body is really talented, wants to restore and almost all side-effects reduce in intensity in time.
Here we are in a new decade where cancer is considered a manageable disease. Who knows what brilliant insights we'll have in understanding cancer prevention, diagnosis and treatment!
Yoga for People with Cancer classes are held on Mondays at 10:00 at The Yoga Room at 1204 NW Blvd. in Creston. First class is free and come as you are…no special clothes or equipment, no previous experience or fitness level, just you and a sense of humour!
Constipation. If your back passage (bowel release and anorectal action) isn't working well, nothing else in your pelvis (bladder, intimacy, pelvic organ support and core strength) will be working well. So, brace yourself, let's talk constipation!
Do you enjoy a consistent, full, complete and satisfying bowel movement every morning? BMs should be a minimum of every 2 - 3 days and a maximum of twice daily. You should never need to rush, have skidmarks in your undies or lose stool without you knowing or before you're ready. Ever. The stool should be firm but not dry or very cracked, smooth but not sticky and medium sized to pass with comfort. It should be brownish, of a consistent smell and without mucous or blood. It shouldn't be painful to release your stool nor should you bear down. Hemorrhoids can come with pregnancy or stress, but shouldn't be persistent. You should be able to travel or change your routine without upsetting your BMs. Your bowels are meant to digest your food and drink, transfer nutrition to your body, then get rid of the waste. It's a beautiful system!
How does it actually work? When you take that first warm drink in the morning, the sphincter between the esophagus (food tube) and the stomach sends a signal to the rectum that today's food is en route. Yesterday's waste is nudged along the colon, down the digestive tract and into the rectum. The sphincter at the end of the rectum opens up. Counterintuitive? Stool has just landed and it opens up to take a sample. It checks if it's gas, liquid or solid. If it's gas, it nudges you. If it's liquid, it slams shut and gives you to signal that you need to move! If it's solid, it shuts firmly and gives you the message, "Time to go to the toilet". Don't delay. It nudges, you calmly go.
Toileting habits are important. Sit comfortably and relax. Your knees should be slightly higher than your hips, supported on a stool or block. Breathe into your belly and sense your pelvic floor softening, descending, and the sphincters opening up to let stool pass. If you have the urge to push, don't! Just breathe into your belly and do a bass hum, low growl or pursed lip outbreath to protect your pelvic floor. Keep allowing your system to release and let go. Don't stop the stool until your body says you're done. Then belly breathe again, rock your pelvis and enjoy a few moments of quiet. When you're sure you're done, do a few gentle pelvic floor squeezes to help clear the anus so that wiping is gentler and more complete.
You can support your digestive system. Keep hydrated, drink mostly water, and enjoy a drink of warm water with tooth-brushing to help your stool stay hydrated overnight. Be cautious with fibre, adding a little at a time. Pay attention to the foods that your body finds a problem - what makes your stool too solid and/or what makes it too loose? What gives you gas? You're unique, so learn about you. Support your system with a heated wheat bag and a massage. Help your system release its waste products after all the work it's done for you. Depending on your issues, there are specific techniques, stretches, breathing patterns and habit changes that will help you enjoy lovely BMs that support your health.
If you have specific problems with your bowel release, a pelvic physiotherapist provide you with with an internal and external assessment and treatment plan just for you. Your digestion, bladder, pelvic organ support and intimate life will thank you!
Pelvic pain is complex and has many faces. We've talked about Painful Periods, Endometriosis and now we're going to tackle Bladder Pain Syndrome.
Bladder Pain Syndrome may have begun like this: You had a urinary tract infection that just didn't go away. You felt urgency to void. You felt pain just above your pubic bones (where your bladder lives), in your perineum and/or in the urethra (the tube from the bladder to the outer world). When urinary tract infections became chronic, the old thinking was that the interstitium (bladder lining) was inflamed, ergo the outdated name "Interstitial Cystitis". Bladder Pain Syndrome is far more complex, the name far more descriptive.
In 2018, we know the onset of BPS is more like this: Your bladder thinks that it's under threat…..a grizzly is at its door. Your bladder may have suffered at some point in your life, perhaps when you were a child (Chronic infections? Withholding voiding? Difficulty with bedwetting?). The part of your brain that worked with your bladder remembered this sense of distress. Later on in life (with puberty, onset of intimate relations, stressful situations, baby having, an accident or menopause), your bladder had "flashbacks" and kicked into that difficult memory. Your immune system pitched in, bringing on an immune response and inflammation. Your bladder nerve endings and the nerve pathways to the brain were woken up. Your tendons, muscles and fascia tightened up in order to protect the area.
The outcome? You may develop a hypersensitive, overactive, inflamed bladder. As your bladder fills, it naturally stretches. That tight and inflamed bladder isn't so keen on stretching, sending a threat message to the brain. Your bladder naturally fills to 500-ish mls., but with BPS it can become painful at only 100 mls.. The bladder may also not welcome urine due to the inflamed lining, so you may feel a sense of urge to get rid of it…now! If you experience these feelings for more than three months, your brain begins to focus on the bladder, becoming attentive to all bladder sensations from a little urine to moderately full to urgency to pain! The natural voiding reflex and habits become distorted over time and your bladder forgets how to feel the "Oh, I'm getting full…..I'll have to go to the loo soonish, but no rush" sensation. The rising tension in the pelvic floor creates more problems. Toilet time naturally involves releasing the pelvic floor along with opening of your sphincters in a lovely dance. With a tight pelvic floor, your urine stream may become slow, interrupted, painful and incomplete. Intimacy may become painful. You may have an accompanying challenge with bowel release (not constipation….it's the letting it go part that becomes slow and/or painful). Your stress system and brain become alerted over time and this increases your perception of pain; it attaches it to your emotional state. If you haven't slept, are having a bad day or have stress, you'll feel BPS more than you would have otherwise. It's just all so connected.
What can you do about it?
Find a pelvic certified physio. You'll be asked about how your bladder functions, how often you void, how it feels before, during and after voiding, how your bowel works (loading, comfort, movement, frequency), pelvic floor function, deep core function and how your life is working (your nutrition, sleep, understanding of pain, pelvic systems and stress management). Your internal and external pelvis and deep core will be assessed. Research has shown us that your pelvic floor needs to be calmed down in its hypertonicity (tension), pain and function or the dysfunction and pain in your bladder won't change. You will be taught pelvic floor releases with breathing patterns, general and specific stretches and perhaps the use of a wand (a pelvic trigger point tool for you to use). An elimination diet is helpful, but no two women with BPS have the same dietary triggers. Eat food that agrees with you. Get good sleep and downtime. Find and manage your stressors. Bladder Pain Syndrome can be managed well. You can experience a cascade of wonderful changes when you take charge of your own health.
"That time of the month" may bring on cramps, bloating, food cravings, unpleasant moods, loss of energy for some women. Consistently painful periods are NOT normal, so please ask for help if that is your experience and learn some ways to ease your discomfort!
Stress can increase period pain, make you skip or lose your periods altogether. When you're stressed or in pain, your breathe at the top of your lungs, just under your collarbones. Breathing deeply and fully into your low lungs creates rhythmic abdominal and pelvic movement. It's a natural massage, moving your organs like seaweed dances in the ocean in response to waves. Slow, relaxed deep breathing promotes relaxation, enhances your mood, improves your concentration and simply feels wonderful! Use your breath to make a simple, accessible and lovely change.
Here's how: Ly on your bed with a pillow under your head and another under your knees. Let you body release and relax. Place one hand on your chest and the other on your low belly, making sure your elbows are supported on the bed. No effort! Now, breathe in slowly through your nose. Let your belly lift, your low back arch, your pubic bones descend towards your feet and your hips release. Your lower hand will have lifted and your upper hand will stay quiet on your upper chest. Now just let the air seep out of your nose, exhaling without effort. Let is be as slow as you're comfortable enjoying. Count a slow 4 counts in and at least 4 or more (to 5 or 6?) out. Repeat. Enjoy.
Release Your Pelvic Floor
When our body experiences pain, it may respond by tightening up and holding back. Periods, when completed with ease, are about letting go! Our pelvic floor can get in the way of releasing our flow by becoming tight in response to pain. Begin practicing release of your pelvic floor by sitting on a big ball or over an upholstered sofa/chair arm. Breathe into your low belly, feel your pelvic floor open and release…….use this technique when you're in your painful cycle and you will find more ease with your flow.
Start with a hot water bottle or heated wheat bag for 15 - 20 minutes in a restful position and quiet place. Cover yourself with a blanket. When you're all warmed up, remove the heat and, with the heel of your hand, massage your own belly, picturing a clock. Find the "time" on the clock that needs special attention, keeping the massage gentle, slow and consistent. You might need 10 - 15 minutes to massage, then 5 more minutes to repeat heat. This stimulates blood flow, mobilizes your fascia and organs and distracts the pain nerves from being cranky.
Yoga is a way of learning to breathe, release, strengthen, move and approach life with ease. Some of the yoga poses that relieve period pain are Child's Pose, Knees to Chest, Forward Fold, Cat-Cow, Windshield Washer Spinal Twist and Savasana.
An experiment of one: Try by adding 2 yoga "classes" (at home or in a class) per week for 3 months. Employ low belly breaths, releasing your pelvic floor, heated tummy massage. Keep track of your periods for 3 months. Benefits may include: reduced cramping intensity and length of time, less moodiness, more regular periods, lighter bleeding, less bloating, less tender breasts, better sleep, improved concentration and a more relaxed experience. Find ease in your monthly cycles……they'll be a monthly experience for most of your life, so find what works for you!
POP, Not the Fizzy Kind!
POP, Pelvic Organ Prolapse, is experienced by almost 70% of women, yet fewer than 28% of us know what it is! Let's define it, unravel its causes and Most Importantly, learn how to assess, stabilize, prevent and reverse POP.
What is Pelvic Organ Prolapse? The International Uro-gynecological Association defines POP as "the bulging/herniation of one or more of the pelvic organs (uterus, vagina, bowel and bladder) into or out of the vagina." POP occurs when the muscles, ligaments and fascia (a network of supporting tissue) that hold these organs in their correct position become weakened. POP is common because its causes are so common: pregnancy, labour and childbirth, aging and menopause, genetics and family history, obesity, chronic cough, chronic constipation, heavy lifting (work or play), hypermobility (naturally stretchy people) and pelvic surgeries (especially hysterectomies). Often the impact on supportive structures earlier in life (i.e. pregnancy) that create prolapse will not be functionally obvious until menopause. That's why being assessed for POP at any time in a woman's life is so helpful…..it is usually preventable!
How would you guess that you have POP? Women describe heaviness or a dragging sensation in the vagina or pelvic floor, a lump or bulge in the vagina, aching discomfort in the pelvic region, urinary or bowel problems, a dull backache or sexual problems. These symptoms often worsen with activity or simply as the day goes on. Bladder and bowel problems involve incomplete emptying, feeling the need to bear down or use manual help to finish the job on the toilet. If the bladder prolapses on its own, it can create chronic bladder infections. This is due to kinking of the bladder neck before you've completely emptied leaving just enough urine behind to brew up another infection. POP must be assessed functionally, graded, on repeated testing and with an understanding of the deep core system and breathing patterns. Our bodies are supremely clever at recruiting "help", but often those patterns of recruitment cause further dysfunction.
What can you do about POP? Reversing POP is a new and exciting world in Pelvic Physiotherapy. We used to think that surgery was the only option…….a challenging surgery and one that is oft repeated due to structural failure as life's activities challenge the repaired structures. In a recent study in Vancouver, 79% of prolapse surgeries were cancelled after 8 weeks of pelvic physiotherapy, thereby avoiding the risks inherent in surgical intervention.
Creston has a bounty of options for you:
Pelvic physiotherapy will help you to make the changes necessary including: integrated pelvic floor and deep core muscle training, establishing healthy bladder, bowel and lifestyle habits, and learning healthy ergonomics for coughing, toileting, lifting, sport/exercise and sitting/standing/resting your body through the day. Pelvic Physiotherapy is available at Full Circle Health Centre with Joanne Gailius. An assessment and a few follow-up sessions are usually all that you'll need. Hypopressive training is available locally at Spitfire Fitness with Jenn. Group and individual Pelvic Yoga Therapy is at The Yoga Room with Barb. With your gynecologist, you may be fitted for a pessary, a ring that is inserted in the vagina to hold up the organs. After trying all conservative options, you may need surgery. You'll be ready and able to employ all the skills that you've learned already and you'll have greater benefit from the surgery!
Pelvic Organ Prolapse is common but not normal. Learn about your pelvis, your deep core strength and a strong and healthy body through life's seasons.
Building and Supporting Your Bone Health!
Bone health isn't an "old persons' thing". In 2019, we enjoy living longer, yet we have declining bone health worldwide. 1 in 5 women who fall and fracture will die within a year of their fall; those who survive often experience a loss of independence and reduced quality of life. Fall prevention with a focus on bone health is really important for a meaningful and fun life!
These Quick Facts will help you implement skills that will reduce your bone loss and support your bone building. Brace Yourself!
+ learn to type without looking down at your fingers. Chin in!
Take control of your bone health by building new bone and losing less bone. Next: fall prevention + balance building.
"Sitting is the new smoking" is a trendy phrase right now, yet many of us sit a lot! We sit at work. We sit because our muscles and joints are sore or simply because we're not active. What to do?
Here are some very simple physioyoga rules to help you sit well, feel ease in sitting and help gravity pass vertically through you, not push you forward or backward. Short term sitting is OK. Long term sitting isn't!
Hello Full Circle Friends. I've asked "local" women who work with women to share their offerings on my blog. The first brave submitter is Shona Bohmer who lives and works in Cranbrook.
Here's her story:
What is Restore Your Core™
Restore Your Core™ (RYC®) is an exercise program that uses a whole-body approach to train your core and pelvic floor muscles to be more functional, reflexive, and supportive. Diastasis recti and pelvic organ prolapse safe.
Name: Shona Bohmer
Location: Cranbrook, British Columbia Canada
Social Media handles:
Restore Your Core™ Offerings: Group Classes, Workshops, One on One sessions in person or online via Zoom
Describe your life in 3 sentences.
I’m a married mom of 3 amazing and nearly grown children. I enjoy gentle strengthening and mobility exercises, hiking, mountain biking, and lazing at the lake on a hot day. Restore Your Core™ has changed how I approach everything I do and I’ve turned into a total movement and body nerd!
What inspired you to become an RYC® teacher?
While recovering from a car accident that left me in chronic pain, I discovered my passion for helping women in their own healing journeys. I found RYC® 6-months post-accident and it became clear to me why I was still having pain. My previous fitness choices and compensatory patterns left me unsupported, vulnerable to injury, and delayed my healing. I had been a regular exerciser for decades and had taken countless group classes (crossfit, dance, pilates, yoga, etc.). I had participated in workshops and retreats and, although I had put the time in, I knew very little about the body or movement. As I progressed through RYC® I found myself asking: “Why don’t I know this?” and “Why has no one ever told me this?” I learned so much in the process of healing my body, I felt compelled to share my knowledge.
What piece of advice would you give your pre-RYC® self?
Listen to my body and take time to rest. Pushing through pain or injury doesn’t work!
What makes you a standout RYC® teacher?
I love helping women understand how their alignment, compensations, and breathing patterns can influence their bodies. I support clients in developing the awareness required to improve their movement patterns, which ultimately reduces their pain and symptoms of core and pelvic floor dysfunction. Through this process women feel empowered and able to return to doing what they love. I develop meaningful relationships with my clients and continue to check-in on their progress, answer questions, and offer encouragement. In addition to being a certified RYC® teacher, I’m also trained in therapeutic yoga. I know from personal experience that healing is possible and it’s never too late to start.
Stay tuned to hear from others.....wonder about Hypopressives? Pelvic Yoga Therapy? Core Strengthening classes at the Creston Rec Centre? Let's all share!