Ten Strategies for Bouncing back from Surgery, Part 2

Eighteen months ago I had a double mastectomy for breast cancer. This has been my fourth surgery in 24 years, and of all the surgeries I've had - see Part 1 - this has been the easiest recovery yet. In my previous post I mentioned five things to do to prepare for surgery, assuming you're lucky enough to know ahead of time. Sometimes that can't happen. But if you haven't done those things, now might be a good time to implement them. Below are five strategies that really helped me bounce back from this last adventure.

6) Enjoy taking it easy, and let others help you!  Relax - what a concept! As a self-employed person, I rarely take more than ten days off a year. What a girl has to do to get three weeks off, huh? How about a double mastectomy? LOL! The point is, if you're recovering from surgery, don't fight it. Enjoy the time off. Read books, watch movies, do nothing. Just Be. And don't feel guilty or worry about it. Let people help you. It gives them a good feeling. Relaxing will help your body heal.

7) Start moving right away. (In hospital, they will make you do this.) At home, you can start by taking some full, deep breaths that expand and lift your ribcage on the inhalation, and let it drop and relax on the exhalation. Do this lying down, seated, and standing. Stretch like a cat when it's  been curled up a long time - you know, where your toes spread and your muscles contract and vibrate. Even if this makes muscles that have been cut suddenly hurt, don't worry about it. It's getting blood to those muscles that helps them heal.

8) You have a new body. It's changed and it will feel different. Be kind to yourself. This is a tender time.  Don't be afraid of this - even if you're now missing parts, or have new parts. Try to cultivate an attitude of curiosity and inquiry rather than aversion and hostility.

9) Be real. If you're a type-A energizer bunny, lower your expectations a bit. For God's sake, your body has just been cut and invaded! Give yourself a break. You're probably going to overdo anyway, so back off already. You'll slow yourself down with setbacks if you push too fast. If, on the other hand, you're a slug, then you need to move more than you want. Movement circulates blood and lymph and helps the body heal. Capisce?

10) Prioritize during your recovery time. As you start to feel better, you'll find yourself staring at a pile of bills, laundry, and other tasks, but you won't really be up for much. Put aside time in small bites, like fifteen or twenty minutes to deal with a bill or a phone call, then rest. You're taking time off, remember?

Surgeries are not often experiences we're delighted to have, but they can be uplifting experiences. A surgery may save your life, give you renewed capabilities, or buy you time. These are all gifts. If you enjoyed reading this, pass it on to a friend. If you've recently undergone surgery and need some help getting back your physical strength, contact me.

Ten Strategies to Prepare for Surgery, Part 1

In the last 24 years, I've had four somewhat major surgeries: two bowel excisions and resections for Crohn's disease, an ankle tenosynovectomy, and 18 months ago, a double mastectomy without reconstruction.

I guess you could call me a comeback kid - if "kid" applies to someone fifty-three years old. :-))  With each surgery and rehabilitation, I've learned some very important lessons.  Here are Ten Steps to Bouncing Back. The first five deal with before the surgery. If you have the luxury of planning a surgery, these are important. If you don't, think about not being able to take care of these in an emergency and get busy. Preparation wins this battle.

1) Create an exercise program that appeals to you that includes strength and resistance training, stretching, and coordination and balance challenges and stick to it. Even twenty minutes a day - five minutes for each of these skills - will pay enormous dividends the day you find yourself incapacitated from surgery.

2) Consult with a Naturopath or Nutritionist. Some supplements should not be taken before surgery, like Vitamin E, because it can cause bleeding. Plenty of supplements can help with the healing process after. Alternative medicine is being used more and more in conjunction with allopathic (western) medicine. Get a team together: acupuncturist, massage therapist, chiropractors can all help get your body in could shape before, and get you back on track after.

3) Line up help form friends, partners, family for the first week or two after your surgery. Try not to rely on only one person. My partner was a dream and totally there for me, but it made him feel better having my sister there as well. Many hands make a light burden. Let people know ahead of time so they can prepare. Have people bring food so you and your caretakers don't have to cook all the time. People really do like giving a hand.

4) Get the down and dirty info on your procedure and condition. I know - this can be scary. But it's better to know and be prepared so you can make the best decisions for yourself.

5) Set your affairs in order!  Do you have a Living Will? This tells your doctors what you want should you be become unable to communicate, as in coma. Do you want to stay plugged in indefinitely? Do you want hydration only? Tube feeding? You get the picture. Most hospitals have these forms handy. They need to be witnessed though. And you will need to appoint someone to take responsibility for you and advocate for you if you're not able, so get a Durable Power of Attorney. Have you made a will? Wills and Durable Powers of Attorney can be downloaded from Stevens-Ness (http://www.stevensness.com/store)  for a small fee. Before my surgery, I bought a small notebook and listed all my bank accounts, numbers, passwords, utility accounts, landlords, etc. so that if I kicked the bucket, my dear ones wouldn't be left with a mess. It gave me peace of mind and them as well.

Stay tuned for the next five pointers on how to bounce back!

Breaking Holding Patterns: What's Keeping Us from Freedom and Spontaneity?

In the body, as in life, often what begins as an adaptive response to a stressor becomes a habit or holding pattern. This expresses itself in several ways. Chronic pain and tightness; a feeling of impingement, ungroundedness, unevenness, clumsiness, chronic fatigue. This physical imbalance may be expressing a psychic or emotional imbalance, a trope or tendency to think, lean, or act in some habitual way. These tendencies and habits prevent spontaneity and may actually be the culprits that keep us repeating patterns of relating, and finding ourselves facing the same issues again and again. Habits expressed in chronically tight areas may take years to uncover, explore, and resolve, but the time and effort are well worth it, and the journey can be as satisfying as the resolution.

Rigid (left) and Collapsed (Right) postures from Emotional Anatomy, by Stanley Keleman.

Ask anyone what makes humans stand upright, and most answers include some direct or indirect reference to gravity. Most people think of gravity as a force that must be “fought” in a continuous struggle in which - obviously - we are bound to lose. And the postures which express this belief are generally along a continuum between rigid holding or collapse - see photo, above.

We forget that what goes down, must come back up; and forgetting that rebound, we get stuck in holding patterns that keep us either up, or down. The effort involved in staying put is greater than that which would allow for a rebound, or for a continuous flow between down and up. This flow - imbued now, rightly so - with an almost mystical reverence - is nothing other than a continuous energy exchange.

Like the medieval Tarot symbol of the The Star, in which a woman holds two pitchers from which there is a continuous flow back and forth - when we are “in the flow” we partake of stream of energy which makes all effort seem effortless. This is because when we don’t hold on, we neither block our receptivity, nor our outpouring of energy, and there is a continuous refreshment.

 Three Steps to Connecting

1) The first step in finding the flow is acknowledging that it exists. A surfer stepping into the ocean is not in doubt that there will be waves. A key point here is trust. If you miss a wave, there will be another. That’s the nature of Ocean. Getting lost in regretting a missed wave, or nostalgically replaying a wave captured - either of these states will assuredly result in missing the next wave. This is a practice in continually letting go and staying alert and relaxed in the present. In the present is all the information you need.

The waves keep coming!

2) Next, noticing where you are and what’s happening opens you to receive information. Whether standing or sitting, notice where you are receiving support. Support is continually there in any point of contact. Support exists even from something you are holding. Changing your relationship to the point of contact so that you are “receiving” it, not pushing it away, changes the energy flow between you and it. The point could be the ground, a chair, a steering wheel, a weight or cup, a person’s hand. This awareness is a place where you are relating to everything through your senses, both inside you and outside you simultaneously.

Support exists even from something you are holding.

3) Realize that the intention to rest into the point of contact is what creates support. Resting is not collapsing, but a subtle relaxation into the feeling of the contact. Relaxing increases sensation, that is, neuromuscular feedback. Muscles are wired in both directions; by allowing your weight to ‘fall’ into a surface, you create an automatic push back - that’s gravity. This is rebounding and creates reciprocity and flow.

Energy is flowing in all directions, down, up, out, in. He is in Equipoise.

Quads: To lift the leg with, or not?

Invariably, almost every dancer has received some version of this admonition when lifting their leg: "Don't use your quads!"

Quadriceps group: Vasti Lateralis, Intermedius, & Medialis plus Rectus Femoris.

Since the action of the quadriceps muscle group - the four major muscles on top of the thigh - is to straighten the knee and lift (flex) the leg in front of the body, how in heaven's name are we supposed to subvert nature and lift our legs?

Enter the next myth: "Lift from underneath."  Another miraculous subversion of nature, whereby the hamstrings, the long muscles group behind the thigh whose action is to bend the knee and extend the leg behind the body, are now supposed to do what the quadriceps do - a kind of anatomical inversion.
(check out this blog: http://www.danceadvantage.net/leg-from-underneath/)

These well-meant and sincere corrections from excellent teachers confuse dancers. Let's be clear: you cannot dance classical ballet without using your quadriceps since the function of the quads is to straighten the knees and lift the legs. Nor can the hamstrings, which, in a front leg lift, must lengthen in order to permit the leg to go up - and those with tight hamstring know this because the tighter the back of your leg, the lower your leg will be when you try to lift it - serve as leg lifters.

I think teachers are trying to describe a subjective sensation: that a leg lift does not come from muscling or tensing the front of the legs, but from a feeling of release in the back of the legs. This release creates a feeling similar to a rush of wind under a skirt - a sensation of lifting from underneath. It might be more helpful to try to describe this than to perpetuate confusion and cognitive dissonance with inaccurate statements about the function of muscles.

View of hamstrings, rotators, IT band from the back.

These inaccuracies simply point to the fact that teaching dance is difficult. We try to put into words subjective feelings and sensations in order to evoke those sensations in dancers. Still, it behooves us to be precise. Make no mistake: Quads straighten the knee and lift the leg, along with hip flwexors and ilopsoas, to the front and also to the side. But they don't work alone to do that, and a lot of other actions are happening at the same time involving the core & the standing leg, so perhaps better to say: "Don't over-focus on the quads and lifting the leg. It's as important to feel a sensation of lengthening down into the floor while floating the rib cage above the hips."  Well - here we are again in sensation land! See what I mean? (For more on topics like these, please visit my colleague, Monika Volkmar, on www.danceproject.ca)

Beyond the Barre: Why dancers need cross-training.

I want to talk about ballet training beyond the barre. Of course the barre is where it all starts, but it cannot end there for many reasons. First because doing barre is not dancing, it's a preparation for dance, but many dancers get stuck there, in a fixation on perfection and perfecting technique. Second, because in fact, just using barre work to train the body is no longer enough. This  may be controversial still for some teachers. So I want to spend some time explaining why I've come to this view.

The exercises ballet dancers perform at the barre are a series of very specific movements, shapes, and coordinated sequences that form the lexicon of classical ballet choreography. They include a kinetic and verbal vocabulary requiring flexibility and strength in extreme external rotation as the impetus for every single gesture. If performed correctly, this builds a body that contains a great deal of kinetic power in the implicit coil of the spiral called turnout.

Training is all too often aesthetically driven, not anatomically nor kinaesthetically driven. This means dancers are trying to make themselves look right without reference to whether something feels right, or without a reality-based accurate view of their physiology.  Herein  lies the root of most future problems.

At the very least, training beyond the barre informs dancers intellectually and experientially about their physical anatomy - how it works based on functional reality and not aesthetic ideals. Paradoxically, when the body is functioning optimally, movements are always balanced and graceful.  In other words, an optimally functioning body is beautiful.

When a dancer becomes overly preoccupied with their appearance in a mirror, breadth and depth of sensation is muted in favor of heightened visual feedback. This visual preoccupation, because its focus is so narrow, is often completely distorted, producing a negative feedback loop. Force of will used to accomplish a desired line creates tension, which interrupts freedom of movement. The result is a dancer working against themselves, which can be likened to when the immune system begins to attack the body.  For more on this subject, check out my colleague, Monika Volkmar's excellent site www.danceproject.ca) To be continued......

Welcome to The Spacious Body

Our body is constantly changing, breathing form: matter, spaciousness, consciousness dancing.

Our experiences of this living body are vastly diverse and run the gamut from extreme freedom to extreme limitation, from a feeling of dull inertness to alive potency or prowess. The same body can feel these extremes from one moment to the next. Our perceptions are constantly shifting. The Buddhists are fond of saying Form is Emptiness and Emptiness is Form. But what does that mean?  To me, it means that Form creates emptiness, and Emptiness creates Form, for without each other, each would be virtually meaningless.

This blog will be a place to explore these and other ideas.