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How disability complicated my relationship with yoga and changed how I talk to my patients

How disability complicated my relationship with yoga and changed how I talk to my patients


How disability complicated my relationship with yoga and changed how I talk to my patients

When I graduated from physical therapy the second time, my therapist was much more pragmatic than the first one had been. The first time I went to physical therapy was immediately after leaving the hospital. I had cancer and needed several surgeries to remove the tumor and the surrounding malignant tissues. Then I had a stroke after one of these procedures, literally adding insult to injury.

My left arm was paralyzed, my left leg was tired and weak, and my face drooped on one side. Despite all of that, I was still young and relatively healthy. My potential for recovery was incredibly high, so my therapists were convinced that I’d do very well. They celebrated my tiniest improvements and insisted that I focus on a distant and idealistic future: me after cancer, after stroke, with two good hands, two strong legs, and a straight, beaming smile.

I went back to physical therapy two years after my illness. I had proved my first set of therapists right to some extent. By then, my mouth had straightened and my leg had almost totally recovered. My arm and shoulder were another story. They could move again, but slowly and awkwardly. The muscle tone had increased over time leading to stiffness and a constant aching pain. Most significantly, my left hand had lost most of its sensory function and would never recover it. I mentioned the pain and stiffness to my neurologist, and she sent me straight back to physical therapy. Things improved a little bit, but as weeks passed, it became clear that I’d need more than just PT to manage it.

“You know,” my therapist said, scowling as she entered notes into her computer, “you might want to think about taking a yoga class. That arm isn’t going to get much better.”

I bristled.

Woman rolling up yoga mat
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I’m a physician, so I’ve done my share of doling out advice about healthy habits and lifestyle changes.

I’ve talked about low fat diets and leafy greens, taught techniques to improve sleep, decrease stress, and increase physical activity. The one thing that I hadn’t suggested to my own patients was to try yoga. I gave my PT the same skeptical look and half-hearted nod that my patients had given me time and time again when I’d recommend a lifestyle change—I had absolutely no intention of going to yoga class.

Occasionally a health fad sweeps the nation, and suddenly every other person you know is claiming that it cures everything from obesity to ADHD. When my friends, family, and well-meaning strangers found out that I had cancer, they suggested that I try a number of these remedies to treat it. I was told to eliminate sugar and red dye, to go vegan or paleo, to eat more blueberries to get rid of inflammation. Colonics would rid me of toxins, they said. Essential oils would help with the sadness, they claimed.

After my surgeries and after the stroke, when I walked with a slight limp and my arm was still at its weakest, I started getting suggestions about exercise. Cross fit and Soul Cycle and even pole aerobics. But yoga was the one recommended to me most often. I heard miraculous stories about how it made people fit and strong, how it cured depression and back pain and asthma. If yoga could do all of those things, my would-be advisers reasoned, then surely it would work for me.


I knew that people were trying to help, but their suggestions quickly started weighing on me. There seemed to be an undercurrent beneath the advice: I was a broken thing that needed to be fixed. Or worse, that I could fix myself but I simply wasn’t trying hard enough.

The more time passed, the stronger that feeling became—especially once I started to look healthy and “normal” again. If I mentioned my mobility issues or asked for some kind of accommodation, I was often met with looks of shock, confusion, or disbelief. Some people wanted more details and asked probing questions about my hand and my illness. Others shared their own stories about disability—I am forever grateful for those people. However, some others eyed me critically. They made unsolicited suggestions for improving my mobility, always getting to yoga eventually. They didn’t seem to listen when I told them what would and wouldn’t work for me.

Woman receiving physical therapy in the hospital
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I completed my second round of PT and incorporated the therapist’s recommended exercises into my daily routine. My shoulder loosened a bit but the pain persisted. I went to a pain clinic where I got injections in my neck, shoulder, back, and upper arm every three months. I tried patches, pills, creams, and massagers—nothing seemed to work. My sleep got worse. So did my anxiety. I was in my neurologist’s office waiting for another follow up appointment when I noticed a brochure on the table. A new yoga studio had opened nearby and offered special classes for PT graduates in addition to their regular schedule. The people in the pictures looked so happy, so healthy.

It took two months, three attempts to sign up, and continuous support from a chronically ill yogi friend before I actually stepped into the studio for my first class.

I shuffled to the back of the room, hoping to hide behind more seasoned yogis. Unfortunately, only two other women showed up and they looked just as bewildered as I did. The teacher was placid, personable, and impossibly fit as I imagine many yoga teachers are. She didn’t ask us why we were there or ask us to share about our respective medical traumas. She smiled and started class. She showed us two or three modifications for each pose, encouraged us to take breaks as we needed them, and offered assistance when we struggled. And oh did I struggle. I spent half of the class trying not to fall and the other half of the class cursing myself in my head. This was yoga and it was kicking my butt. I don’t know what I was expecting but it wasn’t to end up shaking and drenched in sweat twenty minutes in. The teacher smiled. I’m convinced that she could read minds. “Don’t think about what you look like,” she said. “Don’t think about what you can’t do. Just focus on what brought you here and do what’s best for your body.” My shoulder ached. I moved on to the next pose.

Group of women in a yoga class
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Yoga is not a miracle drug. It did not cure my cancer or heal my brain. My shoulder still hurts. I still have anxiety. I cannot be fixed, but I am not broken.

What yoga has done for me is help my body and I coexist with each other.

My shoulder still hurts, but maybe a little less now. My arm is still stiff, but it is stronger. There are still moments when I flash back to the intensive care unit where I was stroked out, strapped down, and terrified. That old panicky feeling creeps up and threatens to choke me. I close my eyes and focus on my breath.

I still don’t suggest that my own patients try yoga when they’re in recovery—at least not right away. If nothing else, illness has been an excellent teacher. I’ve learned so much about what it means to have a disability, how to be a better physician, and how to work more empathetically with patients. Every therapy isn’t for everybody, so it’s important to listen to disabled people, learn each person’s wishes and goals, and figure out what works best for them. Knowing that I could be the first or the fiftieth person to suggest any kind of therapy (including yoga) means that I had better know whether it’s even feasible for them before I start talking. If I think that yoga may help a patient and they agree, then that’s when we can have a meaningful discussion about how to practice safely.

I may never be able to do a handstand or even much of a pushup. That’s okay. I am stronger in ways that I never thought I could be. I will probably always be annoyed every time a new health fad becomes popular, 150knowing that at some point someone will suggest that I give it try. I’ll probably give them that same skeptical look and half-hearted nod and then grudgingly—but invariably—return to my yoga mat.

The post How disability complicated my relationship with yoga and changed how I talk to my patients appeared first on HelloGiggles.

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Flu Vaccine Is Safe for Hospitalized Patients

PASADENA, Calif. — Hospitalized patients who received the flu vaccine had no increased risk of outpatient visits or hospital readmission within seven days of discharge, according to a Kaiser Permanente study published today in Mayo Clinic Proceedings.

The study also showed that vaccinating hospital patients did not increase the risk of fever or rates of laboratory evaluations for infection. It also showed that the vast majority of patients who were not vaccinated during their hospital stay remained unvaccinated for the full flu season.

“We know rates of inpatient flu vaccination are low, often due to physician concerns that the vaccine could complicate healing or delay hospital discharge,” said Sara Y. Tartof, PhD, MPH, study lead author, Kaiser Permanente Southern California Department of Research & Evaluation. “Our findings demonstrate that not vaccinating patients during a hospitalization may be a missed opportunity. Right now, only 28 percent of patients not already vaccinated prior to hospitalization are being vaccinated before they leave the hospital.”

This study builds upon previous research that showed surgical patients who received the flu vaccine during their hospital stay did not have increased risks of complications or delay in discharge compared to surgical patients who were not vaccinated during their stay.

The flu is a highly contagious respiratory infection that can cause serious complications, hospitalizations and, in some cases, even death. Some people — such as older adults, young children and people with certain health conditions — are at high risk for serious complications if they get the flu. In addition to recommending annual flu vaccination for people ages 6 months and older, the Centers for Disease Control and Prevention recommends hospitalized patients who are eligible receive the flu vaccine before discharge.

This retrospective cohort study looked at the electronic health records of more than 250,000 patients ages 6 months and older who were hospitalized in a Kaiser Permanente hospital in Southern California during any of three flu seasons from 2011 to 2014 with admission and discharge dates between September 1 and March 31 of the following calendar year.

Researchers found:

  • 71 percent of patients vaccinated during their hospital stay were vaccinated on the day of discharge.
  • 74 percent of those who miss the opportunity to vaccinate before or during hospitalization remained unvaccinated throughout the season.
  • No increased risk of hospital readmissions, outpatient visits, fever, or clinical evaluations for infection among patients who received the flu vaccine during their hospital stay.

“This research backs up what many physicians have known intuitively for some time: Giving patients the flu vaccine while they are hospitalized is convenient and, most important, safe,” said Bruno J. Lewin, MD, a family practice physician at the Kaiser Permanente Los Angeles Medical Center. “Unless there are contraindications, physicians should have no hesitation to vaccinate patients with the flu vaccine while they are hospitalized.”

The study was funded through the Vaccine Safety Datalink by the Centers for Disease Control and Prevention.

Other authors of the study include senior author Steven J. Jacobsen, MD, PhD; and Lei Qian, PhD; In-Lu Amy Liu, MS; Hung Fu Tseng, PhD; Lina S. Sy, MPH; and Rulin C. Hechter, MD, PhD, of the Kaiser Permanente Southern California Department of Research & Evaluation; and Bruno J. Lewin, MD, with the Southern California Permanente Medical Group.

Vaccine research is an active area of study at Kaiser Permanente.

About the Kaiser Permanente Southern California Department of Research & Evaluation
The Department of Research & Evaluation conducts high-quality, innovative research into disease etiology, prevention, treatment and care delivery. Investigators conduct epidemiologic research, health services research, biostatistics research, and behavioral research as well as clinical trials. Major areas of study include chronic disease, infectious disease, cancer, drug safety and effectiveness, and maternal and child health. Headquartered in Pasadena, California, the department focuses on translating research to practice quickly to benefit the health and lives of Kaiser Permanente Southern California members and the general public. Visit kp.org/research.

About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 12.2 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to kp.org/share.

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Baby shark and friends enjoyed the healthy treats from staff.

Baby shark and friends enjoyed the healthy treats from staff.

Dressed as superheroes and movie characters, keiki visited General Surgery, Cardiology, Food & Nutrition and other departments to take in the hospital’s Halloween decorations and meet physicians and staff in costume. Five young patients who were unable to leave the pediatrics floor received a special delivery of Halloween treats delivered to their rooms by staff members.

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About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 12.2 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: kp.org/share.

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