Hip Replacement, Recovery and the yoga of healing

This page will be the very opposite of cool, so if that’s the sort of yoga you’re

 

English: Hip replacement using cementless impl...

English: Hip replacement using cementless implants. 16 days post-surgery. (Photo credit: Wikipedia)

 

seeking, I’m going to save you some time and encourage you to surf on. No hard feelings.

Hip replacements involve walkers and drains and quite often severe limitations, and having had one just prior to my 43rd birthday, I can tell you they feel the subterranean opposite of cool.

But like so many other things in life, the  truth is that while the process is tedious, the problem solved painful and deeply limiting, and the daily recovery mundane and filled with potential frustration, the result and even the path leading to it are cooler than cool, the stratospheric pinnacle of awesomeness.

During the process – the bits leading up to the surgery (a right total hip replacement), the pain and shame and self-blame (I know, what a crock, right?), the fear of all the what-ifs leading into a surgery (a paramedic knows far too much about what might go wrong and how ugly it might be), the recovery (avec le walker, complete with yellow tennis balls), the limitation and then the daunting task of regaining new optimal functioning, I wanted to write, I considered writing, I wrote in my head and in my journal, but I didn’t cross the threshold of public sharing, my blog. Part acceding to shame monsters and part simple self-protection during a time of deep vulnerability, I kept this part to myself – mostly. I did publish a reflection on imperfection and what it means for teachers, probably more revelatory than I’d like, but there all the same. And a few bits and pieces.

Now I’d like to share what I learned about disability, surgery, recovery, hips and yoga in the process.  The overarching message my soul was sending me had to do with challenges and their meaning, ability and self-concept and how stories can heal or hurt depending on how stuck inside us they get.

Here are some facts: I was born with a mild birth defect of my hip joints that made them susceptible to injury, even after the best treatment available in the late 60’s and early 70’s in the US. As a result, in combination with a desperate need for self-mastery born of other unhappy events, I sustained two (yes, I learn slowly) stress fractures of the femoral shaft and neck setting me up for degenerative joint disease. Docs at the time of the first injury told me to stop running (it was my religion at the time) and that I would need a hip replacement by the time I was 30. Figuring I might as well as smoke it while I got it, I kept running and weight lifting like the competitive madwoman I can be, hence the second injury.

Over the past 5 years the pain in my hip from lack of cartilage and bones grinding one another down had led to a pronounced limp, postural imbalance and worst of all, inability to hike or walk very far. Miserable in this one respect, I kept hopping out of ambulances (gingerly, impact was a bitch), practicing and teaching  yoga and avoiding the hip replacement. Maybe I could heal myself. Maybe I could make it one more year. Maybe I couldn’t get pregnant after a hip replacement (turns out, easier because less inflammation in the body). Maybe… I was scared. Scared to go forward, scared to stay put, couldn’t go back. Back to what?

Turns out, I had no idea what it felt like to have a properly working joint. When we moved temoprarily to Silicon Valley for Dear Hubs’ career, my plan was to write and teach. My plan was side-tracked when I was put in contact with a surgeon who was not only wise and kind, but performs the procedure in a way that obviates hip precautions. That’s right: no limitation post recovery. Think about that.

It didn’t take me long to think about it. Having worked hip dislocations enough as a paramedic that I could do it in my sleep, I knew all too well what awaited me in terms not only of limitation, but of consequence regardless of how careful I might be. Some of my patients’ hips dislocated when they stepped from a sidewalk to the grass. A procedure that avoided this? Sign me up!

That didn’t take away the fear prior to surgery: I’d also transported people whose joint appliances had gone wrong somehow – there are myriad ways, as it turns out. I knew of hip sockets gone empty and bodies confined to bed for lack of skeletal support when the implant had to be removed. I had witnessed the surgery when intubating in the OR and knew they would saw off the top of my leg bone, bore it to make way for a 7 inch metal spike and screw a cup into my pelvis. None of that sounded fun.

The anterior approach that Dr. Kliman in Palto Alto used left me feeling like I’d been kicked in the upper quad for about 9 months, but also means they don’t sever a single muscle or disrupt the joint capsule. Translation? Essentially the same risk of dislocation that I had before. I could do yoga, ski, dance, hike, cross my legs and anything else I wanted with abandon. Once I’d recovered.

Even in the weeks leading up to the replacement I was exercising about 2 hours a day, when you include dog walks, yoga and gym visits. Because the quadriceps muscles are stretched quite to their limits for joint access, the post surgery window requires nearly total rest so that the muscles can recover and regain their functional shape. Clearly you don’t want to be abed the entire time – the body would seize up. But my limit was around the block with a walker for nearly a month. Then two, three… up to five blocks. For a full three months, no yoga asana, no weights, no craziness, no abandon. Two miles were my max limit. And even swimming was verboten until the scar had fully healed. I was a basket case. And not a well-woven one.

When the three month mark hit, I was ecstatic… then deflated. Turns out, my hip had been so non-conformist from the very beginning that having an anatomically “correct” appliance in there was a wholly different experience. It was wonderful – riding bikes made sense for the very first time in my life! – and my muscles had to re-learn everything. Add to that a degradation in my sense of balance, an inability to lead up stairs with my right leg and feeling like I was learning to live again. I was re-weaving my basket.

As I write this, my surgery was 1 year, 1 week and 3 days ago. I’ve had my first year surveillance X-ray and all is hunky dory. I can lead up stairs with my right leg, my balance is restored, I can walk – I revel in walking and hiking – miles without pain.

I do not run, jog, do plyometrics (jumping exercises), carry a heavy pack or do anything that could wear my appliance out more quickly than regular living. I can do Sun Salutations with ease again (that just happened a couple of months ago) and understand so much more the yoga of pain, of limitation and of modification. I will never tell another yogi that what feels aligned in their own body is not aligned because it’s not symmetrical to my eye. I will never push a student’s limb into the place that looks right to me. I listen deeply to what my students tell me feels right in their bodies and invite them to explore alternatives, or sometimes to simply go deeper into where they are.

It turns out my limitation was a great gift, but one I had to struggle with mightily until I wore myself out enough to listen to what it was teaching. I still listen and am still learning from the experience. I enjoy more rest now than ever before in my life. I care less about deadlines, consequences and what other people think. I care more about the integrity of movement, work, meaning and expression and know that these win out every time.

I’ll write more about modifications, asana, practices and meditations that helped me and arose from this experience. They all come down to this: be still, even with pain. Pain really doesn’t entail suffering; we can make suffering without pain and skip suffering with pain. In the stillness, listen. Listen into sensation, past judgement (your own), past fear and trust what comes to you. Even when it seems simple. Too simple. Just follow the inner teacher.

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Focus, concentration, things that masquerade as them and spiritual bypassing

Seal of Good Practice as it appeared in 1958

Seal of Good Practice as it appeared in 1958 (Photo credit: Wikipedia)

Practice is called “practice” because it is just that. The mechanism by which yoga and meditation practice work on us is repetition despite fluctuating desire and facility, and this repetition is called practice.  And you’ve no doubt heard and experienced that the point of showing up day after day, desire or no, and despite how easy or hard it is on any given day, is that we are practicing for life.

Meditation is described in yoga by the sixth and seventh of the “Eight Limbs” described by Patanjali. Dharana and Dhyana together describe meditation: concentration + focus. Concentration is the ability to stay present to the field of awareness, while focus is the ability to select and moderate that field. Focus, put simply, is the ability to choose your object of meditation while concentration is the ability to remain with it.

Meditation Sticker

Meditation Sticker (Photo credit: Sanne Schijn)

Dear Hubs and I often refer to one another’s quirky abilities  – you know, the character traits and capacities that can be endearing or annoying depending on how you relate to them – as special secret super powers. Organizing and focus are two of mine.

Any superhero will tell you that their super power can also create their biggest problems, and is usually the repository for the bits of experience they want to avoid. So how can a mere mortal avoid the pitfalls of special secret super powers if the chicks and dudes of flight and steel can’t avoid them?

So perhaps I shouldn’t have been surprised the other day when my laser focus and persistent concentration were revealed to me not as super powers, but the armor with which I gird myself and fend off the demands of body and home.

When the mix of focus and concentration is out of balance, it’s pretty easy for me to catch myself using these capacities to live in my head rather than whole body and to snap at people who ask me to change the range or object of my focus. When Dear Hubs came in to ask how I’d like to be served breakfast, I’d become so absorbed in my focus that I snapped (not a proud moment, to be sure).

Like Gollum with the Ring, I had mistaken the object of attention for the value.

CG depiction of Gollum created by Weta Digital...

CG depiction of Gollum created by Weta Digital for the Lord of the Rings film trilogy (Photo credit: Wikipedia)

The object is only valuable for what it reveals about the field of awareness in which it resides.

Using my special secret super power as a shield from the world, I was so far in my head I had ceased to feel hungry, notice my posture and breathing or respond to the person I admire most in the world as the wonderful human being he is.

The balance of focus and concentration is part of what I need to practice when I arrive on the cushion or mat. My personal tendency is to fall into over focus, which can be a sort of spiritual bypassing, when we use our practices to escape the world rather than find equanimity in it.

How do the components of meditation show up in your day-to-day world? Have you ever noticed that you “leave your body” during your day-to-day life? How do you use what you learn on the mat and cushion to adjust how you relate to your work and love?

Yoga heals

I’ve recently made a new blog friend who shares his healing over at I am Gerry 

and he asked me a simple and deep question. I want to share part of that answer with you, here. The question is, simply, “Do you think yoga can help me?”

My resounding answer is “Abso-freaking-lutely!” The depth comes in how it helps and why I know this and what we’re really talking about with “yoga” here.

Yoga is movement with attention originating from your breath. Start with the breath. “Breathing in, know you are breathing in. Breathing out, be breathing out.”  This simple meditation can initiate profound healing processes. While I was preparing and recovering from my surgery last year, I had strict orders from the doctor about not exerting, squatting, lifting, bending or really having any of what I’m used to thinking of fun. I still did yoga. How? I reclined on my bed or on my mat and I practiced this simple meditation. Often it led to subtle, small movements that released tension and patterns and led to changes in my breathing pattern. Simple. Small. Powerful.

Yoga is not merely a series of postures you take while doing something else that somehow magically cure what ails you. You cannot look up a “back care routine” that will address your specific problem, nor a “menstrual cramp routine,” “weight loss routine,” nor any other “routine.” The reason is in the name. Routines aren’t for individuals. Routines are, well, routine. You certainly can and might look up “hip pain yoga” and find many routines, the reading and pondering of which will reveal things to you about the structure and function of that joint, of specific poses. Note poses that are repeatedly mentioned, look up your target issue in Light on Yoga‘s index. But know and remember that your body and situation are unique and not only do they really deserve, but you flat-out needindividual attention. If you’ve done enough yoga to have an internal sense about what feels healing, that attention might just be yours. Even experienced practitioners, however, benefit from consultation with other experienced practitioners. Why?

A yoga class.

A yoga class. (Photo credit: Wikipedia)

Yoga’s purpose is to dissolve knots of habit and tendency. Sometimes it’s just plain faster to ask someone not caught up in your habits of thought and movement for help. Sure, you could practice on your own and over time the process would create healing. But why isolate yourself when you can reach out and receive what might be a bolt of stuckness-dissolving lightning from someone not playing with the same deck?

Why am I so confident yoga is healing, period? For reasons of principle and experience. Yoga works directly with the transformative processes that create and shape our body-minds. Have you seen Arthur Boorman’s story? If you’ve missed this one, go see it now. This is no urban legend. This disabled veteran walked again after a diligent, often painstaking practice of yoga. But I’ll bet he didn’t enter into it expecting to be “cured” in a week. My experience with clients who succeed in finding new function is that they engage their practice for the way it effects their lives every day, and the regularity that engenders leads to what appear to be miracles.

Healing doesn’t always look like what we’d like it to. Healing sometimes means greater peace, joy, changes in expectation and yoga is not a cure for everything. The mindset that yoga can “fix” us grows from a binary mindset of brokenness and leads to the insidious hidden goal to be fixed. Which means that if you are imperfect (read: living, breathing human) the yoga hasn’t “worked.” Are near miraculous changes in function possible? Abso-freakin-lutely.

My experience is that yoga heals. In my case T’ai Chi + yoga. After a rollover car accident in 1992 I was diagnosed with a bulging disk in my neck and experienced numbness, pain and loss of function. Docs said I’d walk with a cane for the rest of my life and recommended surgery. Having been in the doctor’s sights many times before, I knew to be wary. I deferred and sought healing elsewhere. After years of T’ai Chi practice I returned to yoga. After several years of both I had reason to be scanned again. No evidence of the injury on imaging. I knew I felt better, that my body had healed. The tests gave evidence to others. I’ve seen the same with clients over and over again. And have experienced a similar trajectory over the last year while recovering from my own surgery.

Will yoga help. Yes. How? Breathe in, breathe out. Consult. Research. Connect to your own wisdom. Choose and be diligent. Yoga heals.

Yoga of hidden goals, redux + applied

There’s a beautiful book launch today over at Curvy Yoga, where the name of the game is “body positive yoga,” which you might hope would be a redundant phrase.

For that reason, I was fascinated with the interview Roseanne highlighted in her blog post over at It’s All Yoga: a quick (11 minute) chat about photo-shoots, body image and loving life with Kathryn Budig of ToeSox ad fame.

NiNJA a'SCAREDY CAT

(Photo credit: aJ GAZMEN ツ GucciBeaR)

Budig sounds like so many of us reflecting on our vulnerability and body image (deeply intertwined) and a million yogis who depend on their practice to sculpt their image of a yoga body. The interview (11 minutes) didn’t allow for deep exploration of the junction where external and internal judgment meet, much less our collective concept of “goddess body” (can anyone say Venus of Willendorf?)

Deutsch: Venus von Willendorf

Deutsch: Venus von Willendorf (Photo credit: Wikipedia)

I guess that what this short conversation reveals is that there are many possibilities rattling in our collective consciousness.

What the juxtaposition of this book launch and this interview say to me is that there are plenty of hidden goals rolling around in many of our assumptions about yoga, bodies, health and beauty.

Brava for Guest-Jelley (most especially today) and for Budig for putting it out there, for Roseanne over at It’s All Yoga for asking the question.

The yoga of hidden goals that rearrange your life

Rearrange

Rearrange (Photo credit: Wikipedia)

Svadyaya, self-study, is one of the guiding practices or values of yoga, one of the niyamas, and is often taken to mean the study of texts or of the breath.

Studying habits and patterns, though, can make tectonic shifts how you live your life. This kind of study, though, has to be courted; it can’t be undertaken on a schedule. You have to be ready when the text opens itself and clear enough to see what it’s telling you.

Yoga, you’ve heard over and over, means “yoking.” Yoga is the union of seeming opposites – sun & moon, light & dark, active & inactive, inbreath & outbreath, effort and surrender. Yoga also happens when we’re able to see how opposites intersect in our own bodies, lives and psyches and not take sides. Like that moment when you realize that you really can be happy for someone else and sad for yourself (or visa versa) at the same time, and they’re not like matter and anti-matter, canceling one another or causing your very substance to blink out of existence from the seeming contradiction.

“Yoga” refers to the internal logic of life. When you begin to listen to your life and view it from a place of expansive consciousness, it gets a little Joseph Campbell on you. The deeper reality that allows the seeming contradictions to co-exist begins to surface like artifacts in the desert after a rain and the thing that’s always bugged you about how you live your life, react to stress or talk to yourself in between the words you say out loud becomes utterly clear, obvious and undeniable, like a skeleton bleached under the sun on a vast landscape of air and sky.

Only when you make space for these seeming revelations (the truth has been there all along) can you begin to see how your own internal logic has been using all your well-planned, deeply cherished goals to weave its own fabric from your life.

This is the reason I come to the mat. Not because this will happen on any given day, or because I can make it happen or force understanding where, right now, there is only longing. But because without this time alone, quiet, in movement and stillness, the internal logic of my life – the thing that’s trying to work itself out, the call that I can almost hear in everything I do, the voice that might be calling out for help and for care, or might be driving me forward – won’t surface through the sands of time, won’t be heard, made scrutable and understood. Without taking this time, the voice in the desert continues calling, unheeded, unheard, mistaking itself for alone.

 

Fertile Ground Yoga

Christmas morning when you’re a kid. That’s what today’s like. I’ve been meaning to write about yoga and fertility, yoga and pregnancy, pre-natal yoga and all things yoga and maternal, but the last two years have been so filled with personal hopes, dreams, seeming successes and events I’ve sought not to feel as failures that I haven’t felt qualified or steady enough to share what I know or my experiences, or better yet, where they intersect.

I’ve taken additional training for pre-natal yoga, I’ve taught pre-natal classes and kids classes and, well, let’s just say I have some experience in the matter. When I landed in my pre-natal yoga teacher training class, I was pregnant. I was one of those pregnant women who can’t stop talking about it and whose hormones are like prozac on steroids. It’s good that nothing tragic happened during that short time, because I was seemingly incapable of anything but radiant bliss. I can’t imagine the kind of pain in the tush I’d have been if something truly depressing had asserted itself.

Until it did. But the happening was simultaneous with a drop in hormones, since the happening was a miscarriage. We were stunned. Perfectly dumb founded. But our midwife gave us great hope and assurance, and so we trod on. We saw a fertility specialist – Reproductive Endocrinologist, to be specific, supposedly the best in the SouthWest. Bah! It was like a cattle call with no time for individual variances or questions and a ham handed caricature of a doctor who tried to talk office politics with a trans-vaginal ultrasound wand poking against my cervix and rolling around like a mixing wand in cookie dough. I’m a paramedic and he wanted to talk city and medical gossip. The only information we were interested in had to do with my internal organs and my husband was less than amused.

We did learn that all my specs – hormones, follicles, tube patency &c – were in tolerance and that his contribution checked out, too. So we went back to what we know best, in full faith that magic would strike again in the midst of the hustle and bustle of three dogs, paramedic life, scientist life, writers’ life times two, yoga teacher life and general living life. In the mix were two cross country moves, two fur friend deaths, two surgeries and a couple of years.

We consulted another REI (not the outdoor store, the fertility doc) in our temporary home in Silicon Valley, to be reassured again all was well, not to worry, all in good time. Mind you, I now have a hip replacement and have seen 43 birthdays come and go. As deeply as I appreciate all the stories of friends who became pregnant at 45, I’m doing math. And a 16 year old at 61 is enough to make anyone think twice.

Undeterred, we gave ourselves enough time to return to our desert home, settle back in and find an amazing REI – Dr. Francis Byrn at UNM (for anyone who wonders), who takes time to answer our questions, is tremendously thoughtful and gives us a full range of options . I’m on my third round of Femara (fertility enhancing estrogen blocker that stimulates follicle stimulating hormone) and today, for the very first time, we’re trying IUI (IntraUterine Insemination).

I was like a kid on Christmas morning leaving the office this morning after another of those trans-vag ultrasounds. This one showed follicles the size of golf balls (who KNEW?!? I’d always pictured demure little mustard seeds…) and prompted an intramuscular shot of HCG (human chorionic gonaditropin, used to ensure and promote ovulation) in preparation for the turkey baster this afternoon. The most romantic way of conceiving? Perhaps not, though there is plenty we can do to make the day a celebration. The surest way? Nope, not that either. Turns out, it raises our chances by a mere 5%. But it’s raised my mood and anticipation by 10 times that much. And suddenly I’m ready to talk about fertility, infertility and yoga.

Are my hopes up too high? I don’t know. Are the hopes of the kid who wants a bicycle up too high on Christmas morning? Maybe… depends what’s under the tree. But if the wish is for something wonderful, the process is thoughtful and the alternative something you can only bear if you’ve done what you’re doing now, then I think I’d be foolish not to enjoy the hopefulness, the possibility, the wonderment and put all of that into a prayer. Prayer is never too hopeful. It’s a way of living your life, embracing both desire and uncertainty and of sanctifying the entire mucky, clinical, sticky, pokey, dreamy, mundane and fascinating process.

There. I got through this first entry on “Fertile Ground Yoga” without using the roller-coaster metaphor. No promises going forward. Why do I call this page “fertile ground” if I’m having trouble having a baby? Because the journey, our emotional, my physical, career, identity changes, our discussions and growth have been the very essence of fertile. Our life throughout all of it, before and I’m sure will be after, is fecund, rich and filled with joy, heartache (which can only happen after joy), texture, meaning and love. Fertility is not how quickly you get pregnant, or how you end up that way. Fertility is a product of attention, commitment, care, showing up repeatedly for yourself and one another, being present even when it’s  not pleasant, loving what you find. Yoga has been an integral part of creating that kind of life for both of us, so our home is fertile ground. No matter what.

I’ll share more specifics, like meditations, asanas and pranayam, here in future posts. Today, I just wanted to tell you about why I’ve decided I have something to share, a point of view and a story to tell.

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Hiking Yoga: What better way to get back to your roots?

The way we newsify things for the sake of entrancing eyeballs never ceases to amaze.  Authors and journalists and editors do it with politics, medical studies and trends in every realm. Yesterday I was listening to The Friday News Roundup and journalist and news analyst Juan Williams, commenting on recent happenings in the American presidential contest, commented something along the lines of  “People remember the truth and political spin won’t erase that.” (I

English: Journalist and correspondent Juan Wil...

English: Journalist and correspondent Juan Williams speaking at Chautauqua Institution in 2007 (Photo credit: Wikipedia)

don’t remember whether he was imputing half truths to elephants or donkeys, he can be trusted to do both when appropriate.) Usually I read Williams as a realist, but I have to say that in this instance I found myself wondering how wide a net he was casting and if he’d read any Orwell (I’m certain, of course, he has. More the wonder he retains his faith.)

What has any of this to do with yoga or hiking or hiking yoga? And have you ever heard of hiking yoga before? Of course you have, if not in name then on your last hike you probably stopped at a spot of beauty and reached for the sky or your hiking buddy to stand in wonder together. The most organic form of hiking yoga.

Blue diamond-shaped sign used to designate hik...

Blue diamond-shaped sign used to designate hiking trails in provincial parks in Ontario, Canada. (Photo credit: Wikipedia)

When I read Taking Yoga on a Hike  this morning I was struck by the mini-history given in the third paragraph:

“This yoga fusion option started in San Francisco three years ago and made its debut in New York City this spring, promising the chance to connect with nature in an urban environment, with stops for yoga along the way.”

Where does the need to pedigree and attribute natural, everyday activities come from except maybe word count? While outdoor and yoga on hikes may not be everyone’s cup of chai tea, folks have been taking yoga hikes as long as they’ve trekked the Himalayas or strapped a yoga mat on an old frame pack. These days I tend to throw my Yoga-Paws in my lighter pack, but it’s the same urge and the same amazing feeling.

The very things that can be complained about in outdoor yoga are the reasons that some of us feel best doing yoga outside: the variability. Sticks and stones  remind you you’re in contact with the earth, bird chirping and dog barking blend together (they only seem different – one more annoying and one more relaxing – because of our reactions), and uneven ground , while challenging balance, adds a tremendous core and functional element. Try doing Downward Facing Dog without a mat and tell me you don’t feel your core in whole new and different way.

I love my early morning and before bed yoga sessions in a flat floored room, on my silk rug with Jonathan Goldman‘s creations streaming from the sound system and candles flickering kind shadows on the visage of Kuan Yin staring down from her museum poster.  But I also love my yoga in the sand, among the cactus and lizards in the foothills of the Sandia mountains, or on the plateaus overlooking

An image of Fajada Butte, Chaco Canyon (New Me...

An image of Fajada Butte, Chaco Canyon (New Mexico, United States). (Photo credit: Wikipedia)

Chaco Canyon… or a thousand other places. These sessions are a meditation, too, albeit with some extra bumps or slants under my feet and hands and perhaps the wave or querying head tilt of another passing hiker (I do tend to choose places where this is less likely to happen). What better intermediate training in watching and caring for your monkey mind in daily life? What more inspiring backdrop? And what better way to groove your own practice?