Coping, Exercise, Symptoms

Migraine Reprieve Ends: Welcome Back, Nausea

Is it normal for a visit to the grocery store to make someone want to throw up? Namely, me. At the Whole Foods downtown. Granted, a huge hot food section, lots of stinky cheeses, and two kiosks of made-to-order Asian food makes it particularly smelly. But still.

My head may be in less pain, but the nausea has returned full force. Clearly the my migraines haven’t retreated, only the pain. I actually developed the aversion to eating a few days ago, but the over-the-top nausea just kicked in.

Being honest with myself, I know that my “good week” wasn’t as grand as it seemed. It meant an extra good hour each day with an awesome day and a half on Tuesday and Wednesday. After walking less than a mile yesterday, my body felt as if I’d run five. The gentle yoga practice I did upon returning home increased the exhaustion. All the signs of an impending migraine were there whether I wanted to pay attention to them or not.

Now my head is sore to the touch (allodynia) and tears are streaming from my eyes (a sure sign for me that a migraine is coming). I didn’t ever consider that the effects of reducing my neck and shoulder pain were longterm. Even so, I hate when the good times end.

As usually happens, Hart missed my low pain, high energy days. I’m going to try to eat some lunch and relax for a bit. Maybe the migraine will let up before I pick him returns from work.

Exercise, Treatment

Less Neck & Shoulder Pain Equals a Happier Head: The Joys of Massage, Menthol Muscle Rub & Yoga

My neck and shoulders are finally loose enough to reduce my migraines and headaches. (Knock on wood.) After years of trying to treat them with no success, I assumed my neck and shoulders were destined to be tight.

After four months of intense, frequent massage and myofascial release, I feel like a new woman. The benefits have become so evident in the last week because I’m finally doing some regular yoga practices and am smearing my back with menthol muscle rub nightly.

No dibs and dabs for me — this is a heavy-duty layer of sticky, smelly menthol balm. I fight the chills for the first 30 minutes I’m in bed and the smell is migrating from our bedroom to the hall. No matter, I really do feel better.

I had some success with Woodlock Oil a year ago, but backed off when I learned that artificial menthol is made with turpentine. Since then I’ve searched in vain for a product with naturally occurring menthol — not that there’s any way to really tell. Clearly, I’ve given in. (I just realized that I could contact companies directly. I may not learn much, but it will be more than I know now.)

I try to do some chest, neck and shoulder focused yoga stretches each morning and before I go to bed. The stretches are so helpful that fitting them in my day is no longer a chore. The best part? The effects are immediate.

Now I’m looking for a good muscle balm. What do you recommend? I’ve tried:

  • Biofreeze: My favorite so far
  • Sombra: My massage therapist used this yesterday; not greasy or too stinky.
  • Jason Mineral Gel: Doesn’t smell to bad, but smeared like crazy
  • Safeway Generic: Smeared on the side of my face and irritated my eyes all night

Cinnamon muscle balm is a great option if you don’t want to smell like menthol. Just know that I may scream and run the other way if I smell you.

I only have a week of relief under my belt. Who knows if it will continue. Even if my migraines eventually thwart the benefits, my muscles no longer being bound up is at least a blessing to my back.

Many thanks to Linz who recommended myofascial release, my lovely yoga teacher Kelly, and the fabulous acupuncturist and massage therapist I’ve seen. If you’re in the Seattle area and interested in seeing any of my healthcare providers, send me an e-mail for contact information.

Books & Products, Exercise, Treatment

Gentle Yoga for Migraine (and Headache) Relief

Gentle yoga postures and breathing techniques may ease the intensity and frequency of migraines, according to a study in this month’s issue of the journal Headache. I didn’t need a study to tell me this, but supporting evidence is always good. While the study didn’t look at tension type headaches, I have no doubt that yoga is still beneficial.

Gentle is the operative word. Classes focused on working out, which I refer to as yogacise, will likely worsen a headache. For this reason, I avoid Ashtanga, Bikram, Vinyasa and power yoga, as well as anything offered at a gym. Finding a good yoga teacher is paramount.

Restorative yoga is a godsend during a severe headache. It’s easy and relaxing yet invigorating. “Active relaxation” is how Judith Lasater, a leader in the field, describes it. Her book Relax and Renew is a fantastic introduction to restorative yoga. Many yoga studios offer classes — ask around or Google restorative yoga in your area.

Breathing techniques were an important part of the study. Unfortunately, the abstract doesn’t say which techniques were used, but I imagine relaxation was the focus. You can learn a lot about breathwork online, but it’s more complicated than it may seem. Again, a lot of studios offer breathwork classes, which is often refereed to as pranayama.

If the cost of continuing classes is overwhelming, consider taking a
few private classes. An hour-long session runs about $60 (in Seattle),
but it won’t take many to learn how to practice at home. Nearly every teacher offers one-on-one sessions.

There are some crucial things to know if you decide to try yoga:

If you have a migraine or headache at the time of your practice, never do an inversion, which is any posture that raises your heart above your head. Blood (and energy, if you’re into that) rushing to your head during a headache or migraine will make it worse. For some people, doing inversions at all can trigger a headache. For others, inversions can help prevent future headaches.

Always tell your teacher if you have a headache. Your practice must be modified to avoid inversions or any other posture that may exacerbate your headache. Teachers are used to such requests and will be able to give you alternate poses. If not, I suggest finding another teacher.

It’s strange that the study’s lead author is in a Zoology department, but I agree with the results, so I don’t much care. How’s that for blatant disregard of my advice to evaluate medical studies carefully?

Kelly Pretlow, my dear friend and yoga teacher, kindly demonstrates a twist in this photo. Maple Leaf Community Yoga is her north Seattle studio.


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.

Coping, Exercise

Motivating Yourself to Exercise

Even if you swear off New Year’s resolutions, thoughts of exercising may still nag at you. Not only because it is something everyone should do, but because it’s a vital component to managing migraine and CDH.

Feeling terrible is an obvious roadblock, but motivation can hinder you more. ExerciseFriends may help you overcome this obstacle. The free site helps you find people to exercise with in your neighborhood or you can simply chat with others online. The partner search includes profiles and ages of possible buddies. You can narrow your search to males only, females only or both.

Making a commitment to exercise with others is almost impossible for me. I have to cancel more often than not, so the forums seem to be a better option. My best motivation was when I checked in with a friend who I talked to almost every day.

We don’t talk as much anymore, so ExerciseFriends may be another place to say, “Yes, I exercised today. I met my goal of walking X miles.” The current posts don’t really lend themselves to this, but starting a daily role call type thread would serve the purpose. Even if no one else posts to it, the public reporting can kick you into gear. In fact, whenever I convince myself to walk next, I’ll start a thread on the support forum.