Don’t Give Up on Finding a Treatment

In the last week, four people have told me that while they are comforted to know that other people have similar experiences with headaches and migraines, they are saddened to learn that their headaches may never go away. This is distressing as one goal for this blog is to encourage people to keep seeking relief.

It’s not as impossible as it seems. While I haven’t found a magic bullet for myself, the vast majority do find a successful treatment. Even after you feel like you’ve tried every possible treatment, you have probably only scratched the surface. There are so many drugs and drug combinations that no one has tried them all (including Paula Kamen and me).

Most folks with headache define success as having their headaches disappear. Doctors have a different understanding. A treatment is successful if a person’s headaches are reduced in frequency and intensity by 50%.

Don’t get angry yet. Many people become headache-free, some don’t. No matter how much education and knowledge a health care provider has, they aren’t mechanics. Unlike a car, uniform results aren’t possible. The human brain and body are too complex to expect that.

But you can get relief. Be aggressive, but give new meds time to work — which may be as long as three months. See a headache specialist, not just a neurologist. If he or she is dismissive, tells you your headaches are all your fault, or that there’s nothing left to try, see a new headache specialist. Take supplements that have shown some success for headaches (under the supervision of a doctor).

Visit a sleep specialist, even if you feel like your sleep is fine (advice that I need to follow myself). Getting good sleep can go a long way toward easing headaches. Talk to a nutritionist. Not necessarily about an elimination diet, but about giving your body the fuel it needs. Try massage and essential
oils. Take yoga classes that don’t focus on sweating and breathing hard, but on taking care of your body and nurturing yourself.

You will get discouraged. You will be exhausted. You will be frustrated. Keep trying; wherever “there” is for you, you’ll make it.


Discombobulated After Seeing Naturopath

Yesterday started off with a wonderful yoga class, followed by a fall-off-the-edge downturn. I saw (yet another) naturopath yesterday.

The main selling point of alternative and complementary medicine is treating the “whole person” instead of the illness. I’ve never wanted so much to be a collection of symptoms.

The best question of the visit: What was your life like when your headaches turned chronic? Gee, I was in junior high/early high school. It was obviously the happiest, most well-adjusted time of my life. HA!

How did I deal with the stress at that time? Umm, I slammed doors and listened to loud music. How else do kids that age cope?

Then came the tears. I get it, OK? Crying is healthy. You can’t heal until you process every little part of your life to bits. Any questioning I’m resistant to indicates something I need to work through.

I’m usually an active participant in this. But my head hurt and I was exhausted. I wanted to go to bed, not talk about my deepest insecurities. Tears and sadness are the antithesis of migraine abortive.

It’s not even that I dwelled on the issues after the appointment. I just felt crappy and drained. My attention span was shot. Blogging, working on eBay listings and reading, all activities I’d been excited about earlier in the day, were out. Instead, I took comfort in garlic and basil gnocchi and a movie.

Today I stayed in bed for an hour after I woke up, but managed to gather myself up. I took a long bath, read and ruminated on this post. I was excited to get on with the day. Thirty minutes later, my head hurts and I’m dizzy and tired.

I’m going to go “home” for a while and add some Dave Matthews Band in for good measure. (Funny that part of my coping strategy of nearly 20 years ago has a similar component to my current methods.)


Yoga’s Not What You See on TV

Yoga is a significant self-care tool I use to manage my headaches. But how I define yoga now is very different than how I viewed it two years ago. It’s not about twisting yourself into the pose you see on the cover of Yoga Journal, no matter how much it hurts, or getting a “yoga butt.” Well, it can be about those things, but not if your goal is to nurture yourself.

There are more types of yoga than you can possibly imagine, only one of which requires baking yourself at 100 degrees. Before settling into practicing variations of Iyengar yoga, I tried a couple of “athletic” (for lack of a better word) styles. I’ve since discovered that the “relaxation” I felt after those classes was in fact exhaustion.

Whatever style you choose, finding a good teacher is crucial. Unfortunately, there’s no quality control on yoga teachers. Just like choosing a doctor or therapist, you have to do your research and suss out the right teacher and style of yoga for your needs. The primary task is finding someone who knows enough about physiology to keep you safe. The number of teachers who don’t have this knowledge is astonishing. Your teacher should also know what poses are helpful and harmful for headaches.

My dear friend and yoga teacher Kelly Pretlow, pictured above, has written the following article about doing just that. It’s long, but overflows with helpful information.

What to Look For in a Yoga Teacher

As a Certified Purna Yoga teacher and long-time practitioner, I am delighted by our culture’s growing interest in this ancient art and science. More and more people are exploring yoga for its wealth of healing knowledge as well as the profound guidance it offers for personal and spiritual growth. Due to this popularity, there has been a marked increase in the number of yoga classes being offered – in studios, gyms, community centers and even hospitals.

What many students may not know is that there is no national standard for yoga teachers. Nationwide, yoga teacher training programs range from 26 hours (YogaFit) to over 1,700 hours (Purna Yoga); most programs come in at around 200 hours of training. This means that you, the student, must decide what you want in a teacher and if the teachers you are considering meet your needs – on physical, mental, emotional and spiritual levels.

In this article I will share an insider’s perspective of what to look for in a teacher so that you can enjoy a safe, quality, effective yoga practice for years to come. The first thing to understand is that a good yoga teacher is different from a yoga demonstrator or a yoga model.

A yoga teacher acts as a guide on your journey of self-discovery, healing, acceptance, growth and, yes, more supple hamstrings. They will assume a reasonable degree of responsibility for your physical, mental, emotional and spiritual growth and well-being while you are in their class. For these reasons, you should use the same caution and care in choosing your yoga teacher that you use in choosing any other health care provider.

Before you jump right into your search, it will be helpful for you to define your reason(s) for practicing yoga. In my studio, most students begin an Intro to Yoga 8-week Series because they have heard of the general physical benefits of practicing yoga – improved balance, increased flexibility and strength, better sleep, etc. Many newcomers also say that they are interested in the spiritual aspect of the practice and wish to learn more. Still others have specific issues (injury, chronic illness, a vague sense of “dis-ease” with their bodies or their lives) for which yoga was recommended by a friend, family member or health care professional.

Your personal reason does not have to stay the same over the course of your yoga practice. Just as you change and grow, you may find that what brought you to yoga (lower back pain, for example) is not what keeps you coming back months or years later.

How do I Choose a Style/Tradition?

Yoga is an ancient art and science that, over the years and in the hands of numerous practitioners, has made its way around the world in many versions. Each style you see today is the result of someone’s passion for this practice. There is no “right” yoga, but there is a yoga that’s right for you!

If you’ve defined your reasons for practicing, as suggested above, then allow those reasons to guide you as you choose which style of yoga seems right for you. Sign up for more than one class of a particular style in order to truly get a feel for its essence – one class is not enough to give you a good sense of what to expect on a regular basis.

In general, the major styles that are widely available today are:

  • Anusara: Practice focuses on three areas: attitude, alignment and action
  • Ashtanga: Classes consist of a physically demanding set series of poses designed to heat the body and release excess energy. The pace is usually quite vigorous.
  • Bikram: Classes consist of a 26-pose routine practiced in a sauna-like room (heated to 105 degrees with about 60% humidity).
  • Hatha: Hatha is the umbrella term for the physical practice of yoga postures (asanas). This term is commonly overused, being applied to any style of yoga that does not follow a specific school/tradition. If someone says they teach Hatha yoga, ask for more details.
  • Iyengar: Practice focuses on proper alignment of the body in each pose. Props are used to ensure safety and efficacy of the poses until such time as the student no longer needs them. Iyengar yoga is one of the most popular styles in the U.S. today, and many other styles include Iyengar alignment principles.
  • Kripalu: Practice focuses on enlightenment and consists of three stages: willful practice, willful surrender and meditation in motion.
  • Kundalini: Practice focuses on unleashing the Kundalini energy and includes postures, breathwork, vegetarian nutrition, hydrotherapy, chanting and meditation.
  • Power Yoga: This is basically an Americanization of Ashtanga. It is a physically demanding practice consisting of sequenced postures and continuous movement.
  • Purna Yoga: A holistic practice that engages the body, mind and spirit. Asana draws upon the alignment focus of Iyengar yoga. Meditation focuses on opening the heart center.
  • Viniyoga: Focus is on breathwork and function over form in asana practice.

What Makes a Qualified Teacher?

Every style of yoga has its own guidelines for becoming a teacher. When I realized that teaching yoga was my calling, I decided to take the time to mold myself into the very best teacher I could be. The first standard I set for myself was that I wanted to have a certain number of years of personal practice and experience as a student before I even attempted a teacher training program. Now, years later, I stand by that decision as one of the best I made in my journey to becoming a yoga teacher. It takes time to truly feel and recognize the cumulative effects of a yoga practice. One must be steeped in a long-term practice in order to effectively guide others in their journeys.

Here are some things I believe are integral to the making of a truly qualified teacher:

Education & Training
In general, anyone who chooses to teach yoga does so out of a desire to help people. There is no lack of good intention amongst yoga teachers, but often there is a lack of substantive education. The more physically involved the style of yoga, the more the teacher must understand anatomy, kinesiology, physiology and asana.

Some styles have their own certification process (such as Anusara, Iyengar, Purna Yoga or Viniyoga). This makes it easy to research your teacher’s background because you can go to that style’s homepage and read about the teacher training program. Most teachers are happy to discuss their yoga background and plainly list their education and experience in a bio. If a teacher you are considering is reluctant to talk about their training or downplays the importance of training that may be a sign to look elsewhere for a qualified teacher.

Continuing Education
Beware the teacher who has no teacher! It is my belief that teachers have a responsibility to themselves and to their students to seek continuing education. For some of us that means pursuing more advanced or diverse certifications. Others satisfy this responsibility by attending on-going classes with a senior teacher, going to yoga workshops/conferences or traveling to India. Still others delve into the ancient texts, seeking new understandings of the guiding philosophy of yoga. Whichever method your prospective teacher has chosen, their demonstrated commitment to furthering their growth is a fundamental aspect of being a good teacher.

Personal Practice
Just teaching is not enough to deepen one’s yoga practice or understanding of the effects of the asanas on the mind, body and spirit. A teacher must have a personal practice – whether it’s daily or a few times a week – in order to maintain a certain level of discipline, proficiency and self-care. A teacher’s personal practice is a sign of dedication not only to their art but to the discipline of yoga as well.

Teaching yoga is a very demanding occupation for which one must maintain optimum health and wellness. Regular yoga practice at home is a key component in assuring one’s “fitness” to teach.

The number one thing on a teacher’s mind should be safety. If you feel unsafe (physically, emotionally or energetically) with anything your teacher presents in class, respect your boundaries and speak up! As teachers, we strive to help our students grow past their perceived limitations and learn to trust their bodies. This sometimes means that we challenge our students to do things they don’t believe possible. At no time, however, should a teacher push a student into something that is not safe or respectful of that particular student’s abilities or state of mind.

Do you resonate with your prospective teacher? Is your teacher someone you enjoy spending time with while in class? As important as training is, you must enjoy your teacher’s company or you probably won’t like their class. Ask your friends or family members for recommendations. Don’t be shy about contacting a teacher to ask questions or dropping by a studio to look around. I strive to make myself approachable and available not only to my current students, but to prospective students as well. Ask a teacher to meet for tea and come prepared with a few questions.

“Real” Life
You cannot judge a teacher by their yoga poses. Of course teachers should be able to demonstrate proper postures, and you want a teacher whose proficiency is higher than yours, but flexible hamstrings don’t make a better teacher any more than they make a better person. A teacher’s lifestyle choices and general outlook are a better gague for their efficacy as a yoga teacher than anything else. If a teacher has a great class personality, for example, but their personal life, finances, or relationships are a wreck, it’s a good sign of imbalance and upheaval.

The energy of upheaval can (and probably will) seep into the classroom atmosphere. Sure, we’re all human and we all have times when things feel overwhelming (illness, accident, etc.), but the manner in which we deal with life’s challenges reveals the kind of person we truly are. Yoga teachers make an implied commitment to live by and honor the yamas and niyamas (the ethical precepts of yoga) and must be wholeheartedly dedicated to becoming better people. If your teacher thinks it’s all about the “yoga butt,” you may want to look elsewhere for one who understands the deeper practice of yoga.

In summary, I would like to emphasize that yoga instruction is not a hobby, it is a profession. As such, the teachers with whom you interact should behave in a professional, respectful manner. By carefully choosing a teacher you will give yourself the gift of an extraordinary learning experience.

If you live in Seattle and are considering taking a yoga class, I wholeheartedly recommend Kelly’s studio, Maple Leaf Community Yoga. She’s knowledgeable, enthusiastic and caring. She takes her work very seriously, but not herself, so her classes are fun, not stuffy or pretentious.


Yoga Provides Relief from Chronic Illness

This won’t be the first time I wax poetic about how great yoga was for me when I felt like my body was broken; but it’s the first time I’ll link to an article where others do the same. I loved how strong and capable my body felt. Similarly, one woman interviewed for the article said that the classes gave her back “a sense of reinhabiting my body.”

Unlike the HIV- and cancer-specific classes described it the article, you probably won’t find a headache clinic that offers yoga classes for patients. Hospitals or health clinics may provide classes for people with wide-ranging illnesses. Even yoga studios who have gentle or restorative classes are likely to provide many of the same benefits. Even if you’re classmates don’t have the same illness or illness at all, there’s benefit to the supportive, non-judgmental environment.

That’s enough of my preaching. Here’s a paragraph from the article to back me up:

“Often [yoga] is something their doctors recommend for the stress-relieving benefits of both exercise and meditation. But many patients find that the sessions, which make them feel more comfortable, also lessen some of their symptoms and the side effects of their medications. And because students exercise alongside others with their same medical problem, the classes also provide emotional support.”


Self-Care or Alternative Medicine?

I’ve blogged a lot about meds and medical devices, but haven’t really discussed “alternative” therapies. There are two reasons for this. The first is that none of the alternative treatments that I have tried have worked for me, so I don’t think to recommend them. The more important reason is that much of the advice of alternative practitioners is what I think of as simply taking care of myself. I do employ many of the strategies of alternative medicine; I just don’t think of them as alternative.

The non-alternative alternative therapies that I try to follow:

Eat simply prepared produce and meat
Frozen veggies make this much easier and Penzeys Spices make it tastier; both make preparation a snap. I also eat a lot of organic produce and organic free-range meat. Living in the northwest give me an advantage with this; organic is easy to come by and isn’t outrageously expensive.

Avoid inhaling potentially harmful chemicals or substances
Since most artificial scents or offensive odors trigger headaches for me, this is pretty easy. Most of my cleaning products are homemade or from Seventh Generation and candles are beeswax or soy. And, as I’ve already complained, I am careful to find home furnishings that don’t off-gas much.

Avoid potentially harmful food additives
Avoid all forms of MSG, nitrates, nitrites, sulfates, sulfites, and artificial sweeteners, flavorings or colorings. This means skipping almost all convenience foods, sauces and dressings.

Exercise and relax
My beloved yoga is out, but I try to take a short walk every day, even if it is just to my favorite coffeehouse (.8 miles round trip!). Meditation is beyond my grasp, but I do try to lie down, breathe deeply and relax all my muscles for about 10 minutes each day. This is usually when I lie down to go to sleep, but I figure every little bit counts.

Use aromatherapy
Maybe essential oils help my headaches, maybe not, but I love smelling lavender, mint and orange. I smell them straight from the bottle, rub them on my temples, burn them with a candle or put them in a spray bottle with alcohol (is that a harmful-to-inhale substance?) and use them as air fresheners.

Don’t mistake me for a whole health goody goody. These are all steps I try to do, which means that I do them most of the time unless I want to go out for dinner, get my shower really clean, take advantage of high energy days or be lazy. But I do feel better when I follow the “rules.” The days I give in to reading a book and eating cookie dough all day are indulgences that I pay for with more headaches.

(P.S. Many of the foods and products I mention are more expensive than conventional varieties. I stock up on frozen vegetables when they are on sale, burn fewer candles than I used to, and remind myself that meds are expensive too.)