Sunday, September 29, 2013

Going with the flow

One of the things that separates wellness from fitness is the goal. Wellness, generally, has a goal of working with the individual to find what their optimal state of health is and finding the practices that will support that. Fitness, on the other hand, tends to have pre-set goals based on an athletic ideal, and the individual pursues practices towards those goals.

The two are not mutually exclusive. A person can utilize the tools of fitness (gym machines and workout regimens) to work towards wellness (goals based on their own current and optimal health states). While the fitness industry has gotten better about it, though, there does remain an echo of the "no pain, no gain" mentality. Certainly some of the newer extreme workouts appear to embrace that philosophy. A wellness approach, however, encourages listening to the body's messages, including if not especially pain.

I've learned, over the years, to distinguish between various forms of pain. Is this pain from ongoing inflammatory issues, pain from pushing my muscles to their limits, or pain that likely means an injury? I can usually tell. Sharp, shooting pain is a pretty clear stop sign, or should be. Any nurse would surely tell their patients as much, but how good are we at listening ourselves?

I can only answer for myself, and that answer is "not very." I injured my Achilles tendon over a month ago, but since the initial sharp pain backed off relatively quickly, I didn't treat it very aggressively. I'd baby it if it "acted up," but otherwise, I just kept on with everything I had been doing. I wasn't rolling on the floor screaming, so I couldn't have torn it, right?

Wrong.

Seeing athletes suffer a complete or near-complete tear of the Achilles conditions us as viewers, even viewers who should know better, to think of it as an all-or-nothing injury. It's possible, though, to tear this very wide tendon just a bit. Apparently this is what I did, and tomorrow I'll finally get firm diagnostic info on the extent of the damage.

As of my last entry, I was all excited about working with the Kuan Yin Standing Qigong practice and trying to keep yoga as part of my regular practice as well. The wake-up call that I had actually torn my Achilles tendon made me have to sit back and re-assess my practice. Nothing I was doing caused it to hurt, but then, it didn't hurt at all first thing in the morning. By the end of the day, though, it was getting either fatigued or inflamed or (most likely) both, so perhaps I wasn't dong it any favors by starting my day this way.

Over the past couple of weeks, I've shifted to working with Seated Qigong practices instead. Until I learn exactly what is contraindicated, I'm not attempting any cross-legged variations, but these flows work when seated with feet resting on the floor as well. Part of me remains frustrated at not being able to continue with the practice I had been developing, but "going with the flow" is part of Qigong, and listening to the body's needs and adapting accordingly is part of a wellness approach.

As far as yoga, it has plenty of seated and supine or prone asanas to choose from, and so I've found myself working more with those as well. Again, listening to what the body actually needs as opposed to what some ideal in my head suggests I "should" be doing.

That, apparently, is the lesson I need to be working on at the moment. How about you? Have you experienced changes in your body that have required re-thinking your wellness practices? I'd be interested to hear others' experiences.

Tuesday, September 10, 2013

Qigong

Qigong is a type of energetic meditation-in-motion that I had learned a bit about years ago but hadn't practiced in quite some time. I've been working with it recently, though, and I'm finding it very helpful in setting the tone for the day.

It helps that I stumbled across a couple of YouTube videos that demonstrate a very gentle flow that takes less than 20 minutes.

Kuan Yin Standing Qigong Part 1

Kuan Yin Standing Qigong Part 2

This flow is part of a type of Qigong called Sheng Zhen, or Unconditional Love. There are also flows named after other religious figures, such as Jesus and Mohammed, as I discovered when I got hold of the book about this type of Qigong. I like this idea very much, as it shows an honoring of the beauty to be found in various paths.

One thing that is not shown in the above two vids is the zhongtian movement that is meant to start and end each flow, and this is the thing I find particularly useful for coming back to a grounded calmness in the midst of a busy day. It takes less than a minute to use this movement (though if at work, it might be best to duck into an area with some privacy), and once you are used to doing the movement at the start and end of a flow, then using the movement by itself helps to recall that sense of peace and equanimity.

If you click on the link to the vid where Master Li describes the movement, he goes into several layers of meaning to the movement, and whether you think of the surface meaning of cleaning mind, body, and soul or the deeper meaning of connecting heaven, earth and self, again, it's a fairly simple way to reconnect.

Having rediscovered how much I enjoy Qigong and having newly discovered this form, I find I am practicing it nearly daily. At the same time, I find I miss working with Yoga on a regular basis. Finding the balance between the two is going to be the challenge. Perhaps one when I get up and the other before bed? We shall see.

Saturday, August 24, 2013

Music and Wellness

One of the things I like to make a lot of use of, both in my own wellness and in working with my residents, is music. I have often found soothing music helps folks with dementia wind down after dinner and before bed, seeming to reduce sundowning-related distress. (It tends to help the staff, too!) For myself, I've found that certain music is better for certain times of day than others.

I have four main playlists on my phone/mp3 player: Gear Up, Wind Down, Rock Out, and Dancetastic. Some songs end up on more than one list, but the goal is to have a different overall feel to each playlist to fit its purpose. Generally, my objective is to shift my mood and energy in a particular direction as I drive from one location to the next.

The Gear Up playlist is what I tend to play on the way to work, and it has songs I find both energizing and motivational, including (but not remotely limited to) Sting's "Brand New Day," Elton John's "Crocodile Rock," Panjabi MC's "Jugni," Led Zeppelin's "Good Times, Bad Times," and MC Yogi's "Be the Change," which is my latest favorite.

Wind Down is exactly what it sounds like: the playlist for when I need to settle down after work or school. It's not super-super relaxing, as I still tend to play it while driving, but much more focused on mellow and soothing than upbeat and inspiring. Songs on this list include Madonna's "Cherish," Pink's "Dear Diary," Blue Gillespie's "Making Sound," and more MC Yogi with "Shanti (Peace Out)."

Rock Out would probably be more aptly named "Road Trip," as I mostly use it for when I am driving long distances and not all the songs would typically be classified as rock. Adam Lambert's "Strut," for example, has the type of driving beat that is needed for long stretches behind the wheel, but is more pop than rock. AC/DC's "Shoot to Thrill" and Metallica's "Fuel" (the live, full orchestral accompaniment version, thank you very much), and Joan Jett's "I Love Rock 'N' Roll," are a bit more obvious.

Dancetastic is, well, dance music. I like to go out dancing after work, and shifting gears from "work mode" to "dance mode" is definitely helped by listening to some Lady Gaga (e.g. "Just Dance"), J-Lo ("Let's Get Loud"), John Barrowman ("I Gotta Feeling") or The Wanted ("Glad You Came").

The point is, for a busy nurse (or busy anyone) on the go, music is one way to make sure you're nurturing yourself and recharging during drive time that can otherwise be draining. I included the song examples and links because I think people often associate music that's intended to be holistic-wellness oriented to be all wave sounds and flute music. You know the type I mean. And that's exactly the music I use during a Reiki session. But there are other ways to use music to support wellness, and yes, that can include Metallica.

Saturday, June 22, 2013

Nutrition and the Chakras

As someone who practices both Yoga and Reiki, I also have an interest in the chakra system. As a nurse, I find it particularly meaningful in the way that the seven major chakras or energy centers in the body largely map onto the plexuses, major nerve branchings along the spine.

There is, unfortunately, a lot of drek to be found when looking for info on the chakras. I steer my Reiki students towards Anodea Judith's books. Wheels of Life is probably the best and most thorough introduction, and The Sevenfold Journey is a great workbook to go with it. I do also check out other books as I run across them and as time allows.

Most recently, I stumbled across The Inner Peace Diet. While I'm not sure I buy into all the book's claims, it does have some excellent-looking recipes. I don't have the time to prepare the week-long menus the book sets out, but I do like the idea of using food as a way to bring attention to and nourish the chakras.

When I teach Reiki III for Master Practitioners, I do it a bit differently than I've seen others do. I teach it over 12 weeks, and the first 8 are spent reviewing Reiki I and II topics in more depth as well as an intensive journey through the chakras. Week one, we work with the sushumna, the column of energy running parallel to the spine and along the seven major chakras. After that, we take one chakra per week alongside some of the basic Reiki topics. One suggestion I've often made to students is to include foods during the course of that week that resonate with the chakra in question.

The easiest way to do this, especially in warmer weather, is to incorporate fruits and vegetables that are the color associated with that particular chakra. I'm teaching a Reiki III class now, and last week ended up being a lot about tomatoes and strawberries and red bell peppers, for example. This week, we've got carrots, oranges, cantaloupe, peaches, and sweet potatoes, and I may even try making the pumpkin primavera recipe from The Inner Peace Diet. There are other chakra-related recipes on the net, several of which look interesting. But when life gets busy, keeping it simple can be the best way to go.

One of the things people in the US often struggle with is getting enough fruits and vegetables into their diet. That's one reason I find my bentos helpful, as the boxes make it easier (for me anyway) to make these the primary foods in the meals I pack to bring to work or school. I do, however, get into ruts. Taking the "this week is all about [color]" approach also lends itself to branching out a bit into fruits and vegetables I don't always think to include in my diet. Like oranges. I love oranges. Why don't I eat them more often? Well, this week, there'll be a bit more of them.

Tuesday, May 21, 2013

Fitting Yoga In

Last time, I talked a bit about yoga and how I feel it is helpful in supporting not just me but my nursing practice. What I didn't talk about, though, is how the heck I fit it in.

Here's the thing: for a couple of years, I didn't, and then my body decided to tell me what it thought of that. (It was not in favor of this long hiatus.) I had all the reasons why I had stopped lined up. I couldn't find a class at a time that worked with my schedule. There's no room in this tiny apartment. I'm so exhausted after work that all I can do is tumble into bed and sleep till it's time to get up for my next shift.

That last was actually my first big warning sign that I needed to take better care of myself. Outside of active combat (and possibly basic training), I'm pretty sure even the military ensures people have time to recoup beyond just sleeping. How can nurses do any less for ourselves and each other?

Finding a class was challenging. As a second-shifter, neither morning nor evening classes work for me. I'm either at work during most evening classes or not up yet during most morning classes. What I needed was something mid-day, but there really didn't seem to be anything. If I were in a big city, I thought, there might be more options, but not around here.

Then I stumbled upon one single "Lunch Break Yoga" class. Next town over. Going in the same direction as I need to head for work. It couldn't have been more perfectly placed and timed. I've been going for several weeks now, and the instructor has been so helpful in showing me ways to ease my body back into postures it hasn't done in far too long. She is a Kripalu teacher, so the approach and philosophy are familiar.

So there's the first piece: don't stop looking. Somewhere, there is a class that will fit you. It may take awhile to find it, but if this class popped up exactly when I needed it to, I have a feeling you will similarly find one that fits your busy schedule. And finding a class is important, I think, whether you are an experienced yogi/yogini or a brand newbie. Having someone with the training and experience to correct poor form, to adapt the practice to what your body needs, is critical when you're starting out and is still an essential touchstone when you are more experienced.

That said, ideally yoga should be an every day practice, not once a week. There are DVDs and even apps to help prompt you through a flow of poses if you're not at a point where you feel able to construct your own daily practice. I actually have the Daily Yoga (All In One) app on my phone, though I've not really used it yet. It does look helpful in terms of providing cues, though their idea of a "beginner" flow seems a tad advanced to me. I don't know that I would recommend it to someone who is a true beginner. I remember trying years ago to learn from videotapes (yes, back in the Dark Ages), and in my experience it's mostly an exercise in frustration and potential injury. They can be helpful supportive tools but are no substitute for a teacher.

Another approach, a bit more old-fashioned, is to keep a journal. I've been meaning to do so since I started this class. Finally, last week, I picked up a journal and today I started jotting down notes about my practice, postures I want to return to during the week between classes, challenges I encountered, and other thoughts that I want to be able to revisit over time. I'm sure there's an app for that too, but for journaling, I do prefer pen and paper. It took me all of five minutes after class to write it all down. So that was a 45-minute class followed by five minutes of journaling. Not even a full hour total.

I'd love to say that I'll spend that much time each day between now and my next class, but I know that's unrealistic. Ten or fifteen minutes a day, though, should be doable, even in this little apartment.

What are your thoughts on finding space, whether for yoga or any other wellness practice?

Monday, May 20, 2013

Yoga

Another of my favorite holistic modalities is yoga. One of the things many do not realize is that yoga is more than the postures you may see people doing at a gym or fitness center. That is one piece of yoga, known as hatha yoga, which also includes breath work. It's an important component, to be sure, and many people do practice hatha yoga without exploring the other six "limbs" of yoga much or at all.

While I find it useful to consider the whole of the eight limbs of yoga, like most Westerners, I primarily focus on the postures and breath work of hatha yoga and the health benefits associated with them. The style or approach to this that I find the most resonance with is Kripalu. This is probably in part because this was the first type of yoga I experienced, and I found it to be a very gentle "accept you where you are" approach that was far less intimidating for a beginner with some health challenges than, say, going into a heated Bikram class or a vigorous power yoga class. The gentler, more meditative approach I've experienced with Kripalu yoga is also one that I find aligns well with my own purposes in practicing yoga.

Regardless of style, hatha yoga is about using various postures and breathing patterns to bring the body and mind into alignment. Stress, something many if not most of us find a major challenge to health and wellness these days, often seems to arise from a disconnect between mind and body, particularly the need to override the body's fight-or-flight response because neither punching your boss/customer/whomever nor simply running away from them is usually the best plan. We can and do override the fight-or-flight response, but it is less stressful to do so if we have already taught the body and mind to work together rather than at odds with one another.

An example of how this can work is use of the warrior posture, also known as Virabhadrasana, which has several variations: Warrior I, Warrior II, or Warrior III. I have often experienced teachers encouraging the class to enter into this posture and then bring to mind a challenging situation and breathe through the feelings that arise until what is left is a sort of calm resolve. This is one way to train the mind and body to work together when such situations arise, and the practitioner can recall and evoke that sense of calm resolve in those situations rather than allowing stress to take over. The more practice one has at doing this, the more automatic the response becomes.

At the moment, the main way practicing yoga intersects with my practice of nursing is helping me maintain and improve my own physical health. The healthier I am, the better I can do my job, after all. Are you a holistic nurse who includes yoga in your practice of nursing? If so, I'd love to hear how you do so.

Monday, May 6, 2013

Reiki and Nursing

Considering that it was one of the two holistic interventions I mentioned in my last post, and probably the one people are least familiar with, I thought it would be a good idea to elaborate on Reiki as part of holistic care, whether of one's patients/residents/clients or oneself.

Reiki is generally translated as "universal life force energy." The "ki" syllable is the same as one finds in T'ai Chi or Qi Gong, though the rendering in the Western alphabet is different in each case. The healing system of Reiki was developed by Mikao Usui, and while the story not only of how he did so but of how it spread beyond Japan is highly symbolic and mythologized, even Western medicine is beginning to recognize some of its benefits. Those benefits come from tapping into the universal life force that permeates and connects everything in order to bring one's own energy into balance.

That's a bit nebulous for many of the hard-and-fast science types, understandably. It's also difficult to evaluate rigorously, because it doesn't behave like a medication, a surgical intervention, or other easily measurable approaches. You can't see it. The recipient determines whether and how much of it to tap into, in a manner that many have ideas about but no one can prove conclusively, and the effects of how they use it may be completely invisible as well. Some try to argue that because a practitioner can not reliably determine whether there is an actual recipient on the "other end" of a distance session, that this somehow disproves its efficacy. I'm fond of the counter-argument that this is like asking an aspirin whether it is aware of relieving a headache as a means of determining how effective it is.

Here are two opposing examples from my own practice. I've had occasion to use Reiki to help someone manage severe and acute pain while waiting for medication to become available, with incredibly visible and obvious results. I've also had occasion to use Reiki with someone who I could sense was pulling through vast amounts of energy whilst I was seeing no change whatsoever in condition, either in physical or visible emotional state. This person was also near end of life, so I hypothesized at the time that the individual was utilizing the energy on a spiritual level to work out whatever spiritual healing was needed in order to transition from this life, but I can never and will never know. In practice on myself, I have observed that when I perform a Reiki treatment on myself before sleeping, my quality of sleep improves vastly and that has enormous impact on my physical, emotional, mental, and spiritual health.

That's all well and good for Reiki, you may say, but how does it fit in with nursing?  I suppose that depends in part upon your philosophy of nursing. Mine is heavily influenced by Katie Eriksson and Margaret Newman, who both take a very holistic view of people and their care needs, including body, mind, and spirit. (Actually, my personal philosophy developed before I became aware of either of these theorists, but I find that their theories describe my nursing ideals rather well.) As such, I feel that the care I give needs to address all these aspects of a person in order to be complete. That can be rather a tall order.

Often, there is little time in the course of a shift to give the kind of holistic care one would like, but as nurses, we frequently have occasion to place our hands on our patients during various aspects of assessment and care. As mentioned above, it is the recipient who determines if and how much Reiki energy they will tap into, and while there are specific hand placements  (though considerable variation exists in these), all that's really necessary at the most basic level of practice is to place one's hand(s) on or near a person for that energy to be accessible to the client. I have been surprised on more than one occasion to feel the energy "turn on" while re-positioning a client in their bed or wheelchair or listening to their lungs. While my subjective perception of this is by no means necessary for it to be of use to the client, it is reassuring for me to be able to observe that this is available to them even when it is simply not practical to offer a full, formal treatment.

So, now that I've put some of my thoughts on Reiki and nursing out there, what are yours? Are you a nurse who practices Reiki? If so, how do you incorporate it into your practice?