Friday Q&A: Collapsed Lung

Front View of Heart and Lungs

Q: Got a friend (a smoker) who ended a camping trip in the mountains (probably around 6K feet) by getting a collapsed lung. His wife got him to the hospital and all is well--he is even back to enjoying his electronic cigarettes (says it is not really smoking!) Anyway, I was thinking of using this as an opportunity to (finally) get him to try breathing meditation, Yoga/Tai Chi—but the lung thing has me worried. This was spontaneous with no obvious indications of why it happened or if it will happen again. He does nothing half-way, this guy, so if I get him doing deep-breathing exercises he will be going for the max. Is there a danger of the collapse happening again or can we use deep breathing to strengthen his lungs?

A: Thanks for writing to us about your friend’s condition. As always, the information I will share is of a general nature and in no way a prescription for how you will want to work with your friend. But I hope the following discussion will give you more information to work with as you try to help your buddy. 

Let’s start with the condition that your friend developed. He has what is called a spontaneous pneumothorax (SP), when air gets in between the lungs and the space around the lungs—not a natural state of affairs—resulting in a change in air pressure inside the chest cavity, with the air pushing on the lung.  The lung subsequently collapses a little or a lot and leads to chest pain and shortness of breath of varying degrees, depending on the size of the collapse. With a small, uncomplicated collapse, the person's lung may quickly heal on its own.

Although pneumothorax can occur for no obvious reason, as a cigarette smoker, your friend would be at higher risk for this right away. Known causes of SP include a chest injury, underlying lung disease or ruptured air blisters (blebs). According to the Mayo Clinic website, the following are risk factors for the development of SP:

• Gender. In general, men are far more likely to have a pneumothorax than are women.
• Smoking. The risk increases with the length of time and the number of cigarettes smoked, even without emphysema.
• Age. The type of pneumothorax caused by ruptured air blisters is most likely to occur in people between 20 and 40 years old, especially if the person is a very tall and underweight man.
• Genetics. Certain types of pneumothorax appear to run in families.
• Lung Disease. Having an underlying lung disease, especially emphysema, pulmonary fibrosis, sarcoidosis and cystic fibrosis, makes having a collapsed lung more likely.
• Mechanical Ventilation. People who need mechanical ventilation to breathe effectively are at higher risk of pneumothorax.
• History of Pneumothorax. Anyone who has had one pneumothorax is at increased risk of another, usually within one to two years of the first episode. This may occur in the same lung or the opposite lung.

Before I address the value of yogic breathing techniques for SP, I do want to mention a potential downside to yoga and SP. There is one report in the medical journal Chest about a pneumothorax arising in a yoga practitioner who had been doing the pranayama technique called the Bellow’s Breath, which is a fast breathing technique of inhaling and exhaling. Fortunately, this is a very rare occurrence; but you would likely want to avoid that and similar breathing techniques for quite some time after the person’s lungs re-inflate and they get the go-ahead from their doctor to return to normal activity. And in the case of our above SP person, they are at an increased risk of a recurrence of a pneumothorax, so you will need take care.

So what do I think would be a reasonable approach of yoga breath techniques for SP? We do know from a few studies done in India that yoga practices, including pranayama, can be helpful for other lung conditions like asthma and emphysema. That means yoga has been used safely in other people whose lungs that don’t work quite right. To me, this is very encouraging about the overall safety of yoga for lung diseases. One possible unwanted result of someone having a SP might be a reluctance to take even a normal inhalation due to fear of a recurrent collapse. However, practicing a gradual increase in the length of the inhalation and exhalation while monitoring for pain or shortness of breath could effectively re-establish a person’s pre-SP breathing ability. And if you encouraged the breathing to have a gentle quality on both the inhale and exhale portions of the breath cycle, you could also eventually improve the overall deep breathing capacity of your student.

It would likely be important if your student has a type-A personality to observe his breathing while you teach him the technique to verify that the breath is not aggressive in any way.  If you yourself do not do a lot of pranayama in your own practice, I’d really recommend that you find an experienced teacher to work with your student.

As things progress, your friend may be able to do the modern three-part breath that is very commonly taught in all levels of yoga classes in the US (you start by imagining you are filling the belly first, then the lower chest second, and finally the upper chest last, but in one continuous breath without a pause). It is also possible that once a good three-part breath is established, teaching a very mild form of ujjayi breathing could be helpful. Ujjayi mimics the effect of using a device called a spirometer that is used in a different lung condition called atelectasis, which is more a problem inside the lung’s tiny air sacs the alveoli, not a result of a collapsed lung specifically. Again, I’d have the student create a very quite ujjayi sound as you monitor  his work for a while to ensure he is keeping it on a more gentle level.

So, to recap, you could gradually reintroduce the three-part breath. Once that is safely accomplished, you might add in some gentle ujjayi to the three-part breath. And with all beginning breath teaching, I’d recommend starting off with the student lying supine to learn these techniques. To be on the safe side, avoid holding the breath at the top of the inhale, and also the bastrika and kapalabhati forms of pranayama.


 —Baxter

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Unity Farm Keets (Guinea Fowl chicks) Available Now

Our Guineas have been remarkably fertile this Summer and we'll have 100 babies available for purchase.   They're $4 each.

Guineas are tick eaters and will rid your yard of many undesirable insects.   You will need a coop to keep them safe from predators at night.

Our first hatching of 20 is extremely healthy and we'll have another 30 hatching this weekend.

Although chicks are shipped in general, our experience is that the process is extremely stressful for them.    Anyone wanting guineas should contact us at khalamka@gmail.com for New England (Sherborn, MA) pick-up.  Here are the details:

Straight Run (M/F) Hatched 8/20/2013
Pearl Gray (standard dark color)
Pearl Gray Pied (white chest)

Colors possible (Pearl Gray, Pearl Gray Pied, White, Lavender and Lavender Pied)
2nd Hatch on 9/3/2012
3rd Hatch (last for the year) on 9/18/2013
All will be well feathered by the time cold weather arrives

$4 each or 10/$30

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Book ReleaseYoga Sparks'uot; by Carol Krucoff

by Nina

Just a brief announcement today that one of our guest bloggers, Carol Krucoff (see Yoga May Be the Best Activity for the Elderly), has released a new book! It is called Yoga Sparks: 108 Easy Practices for Stress Relief in a Minute or Less.

Baxter reviews the book in the September 2103 of Yoga Journal Magazine, which is currently available.

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Building Unity Farm - Preserving History

Since Sherborn's founding in 1652, the land of Unity Farm has been adjacent to the town center.  In the past, the property has been a dairy, sheep paddocks, and part of a much larger farm.   As I've cut trails through the property I've uncovered old tools, old timbers, and numerous rock walls.

Along the Unity Farm Marsh trail are two particularly interesting sights - the Sherborn Powder House and the Old Dug Well/Windmill.

The Powder House
The Powder House for Sherborn was built by the town in 1800 so that gun powder could be removed from the public meetinghouse where it had been stored, much to the relief of concerned citizens.  James Bullard was appointed keeper and the building was constructed in a meadow overlooking the lane behind his house at 33 North Main Street.  Although the actual building was demolished in 1857, the site of the Powder House is on our property.    The circular foundation is still in place and the rocks used to build up the walls are lying adjacent to the foundation.   An ash tree has grown up inside the former building.   Today, railroad tracks cross Powder House Lane in Sherborn, so the Powder House is no longer publicly accessible.      I've cleared the area, connected it to our trails and will be adding National Forest Service-like signage to it soon.

The Old Dug Well
About 100 feet south from the Powder House is an old, hand dug, brick-lined well.   When I first found it, the well was filled with 5 feet of mud, wood debris and midden.   What do I mean by midden?   As I began to excavate the well, I found 10 old milk crates, hundreds of pounds of old unmilled lumber, rusted iron tools, and an old menu board, pictured below.    Although fragments of the menu board are missing, it appears to announce "Great Steaks" like the "Powder House Tenderloin", Sirloin, Round, etc.  The lettering appears to be from the early 1900's.   I've asked Historical Society members about the well and steak sign.  Their only guess is that it might have been related to the old train station on Powder House Lane (no longer there) that used to be the major transportation hub in Sherborn.

Next to the well, an old windmill (blades shown above) provided the energy to pump the well water uphill to sheep grazing meadows.

Since the well has now been restored to be a fully functional water source, I built a cover for it from 6x6 and 3x5 lumber.   We do not want wandering deer (or wayward teens) to fall into the well.   Our Great Pyrenees may not be as communicative as Lassie if Timmy falls into it.

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Take Your Time: Results from Yoga Practice

by Nina

Horses Grazing by Brad Gibson

It's a running joke in our family that when Brad gets impatient with me—because I often do various household tasks a bit slower than he does—he says to me, "Take your time!" He swears that Bill Murray said this repeatedly in the movie Caddy Shack, but when we watched it again recently, no one actually ever uttered that line. Regardless, I always reply, "You take your time."

But many worthwhile things really do take time. For example, if you want to cook a really good meal instead of eating fast food, you need to shop for fresh ingredients and prepare everything from scratch. And if you want to turn a new acquaintance into a close friend, you need to spend a lot of time together, getting to know and trust each other. The same is true for seeing results from yoga practice. Obviously, one Downward-Facing Dog pose doesn't instantly make your arms stronger, though with regular practice, it definitely will increase your strength. And it also seems obvious that if you want to reduce your stress levels, you'll need to practice stress management regularly over a period of time.

So it was very interesting for me to hear about a recent study at the Feinberg School of Medicine, Northwestern University, that looked at the effect of exercise on insomnia. One of the findings as reported by Gretchen Reynolds in the New York Times post How Exercise Can Help Us Sleep Better was:

"After the first two months of their exercise program, the exercising volunteers (all of them women) were sleeping no better than at the start of the study. Only after four months of the program had their insomnia improved."

Yes, it took four whole months of regular exercising to bring improvements. That's quite a bit of time, don't you think? The women in this study were not practicing yoga for exercise, but it's likely that using yoga as a form of exercise to help with insomnia (something I definitely recommend) might take a similar amount of time. And it also makes sense to me that if you are practicing yoga for insomnia (see Yoga for Insomnia, Part 1) by using stress management techniques, you should also give that some time (though some people report that doing breath practices in the middle of the night produces immediate results). So be patient.

In general, the time you invest in your yoga practice—whether you are practicing for your physical health, your emotional health or both—is what brings the payoffs. After all, yoga sutra 1.14 tells us that equanimity is attained only through steady, dedicated, attentive practice:

Long, uninterrupted, alert practice is the firm foundation for restraining the fluctuations of the mind. —trans. by B.K.S. Iyengar

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Nocturnal Leg Cramps and Yoga

by Baxter

Recently while reading through one of my Family Medicine journals, I came across an article that caught my interest due to the frequent complaints of some of my students.  It was on nocturnal leg cramps.  Yes, quite often my students will ask me what they can do to address these ill-timed leg cramps (as if there is any good time for a leg cramp!).  I’ll get into what we know about the nocturnal leg cramps (NLCs) in a minute, but what caught my eye in reading was the recommendation for treatment:

“Limited evidence supports treating NLCs with exercise and stretching…”

Now, they don’t specify yoga, but as we all know by now, modern yoga would fit the bill. This treatment was recommended before any mention of medications, which is quite unusual for these journal articles.  It is usually the other way around—meds first, non-drug options mentioned last. This gave me a great sense of hope that modern medicine is beginning to grasp the benefit of starting with non-drug treatments for some conditions!

So what are these NLCs and how common are they? Well, according to the American Academy of Family Practice, they are super common, with up to 60% of adults reporting they get these kind of leg cramps.  They are described as recurrent, painful tightening of muscles in the legs, usually the calf muscles. And the NLCs can contribute significantly to insomnia. The exact cause in not known, but they hypothesize that the cramps are probably caused by muscle fatigue or nerve dysfunction, as opposed to low levels of blood electrolytes like sodium, potassium and such, or from other abnormalities.

Just to flesh out the symptoms of NLCs, they are painful and incapacitating, like no walking while they are occurring! They last an average of nine minutes per episode, and the first bout can be followed by hours of recurrent episodes and residual pain. Even though the calf is the most common muscle affected, cramps in the feet and thighs are also fairly common. Sufferers describe them as a spasm, tightening, twinge, strain, or a muscle seizure. And they are usually in one leg, and can cause the limb to move.

Folks with other conditions are sometimes more likely to have NLCs, such as those with vascular diseases, lumbar canal stenosis (narrowing of the spinal cord channel in the lower back), cirrhosis of the liver, patients on hemodialysis, and those who are pregnant, to name a few. Certain medications are also associated with NLCs, such as estrogen, Naprosyn and others. So, definitely check that out with your family MD if you start having them. NLCs are different from other conditions that might seem similar, like restless leg syndrome, claudication (cramps due to vascular narrowing of blood vessels in legs that occur with walking), myositis (muscle inflammation), and peripheral neuropathy (which has many causes).  So you do need to get checked out with your doc to rule out these other conditions, which may not respond to yoga so favorably.

Once you have been diagnosed, you will obviously want to do something to diminish the number of attacks or completely prevent them. A yoga asana approach would include practices and poses that bring movement and stretching to the lower legs, as well as practices that quiet the nervous system, as nerve dysfunction is one of the purported causes of NLCs. I’d start by reclining on the back and doing Thread the Needle pose (Sucirandhrasana), also known as Eye of the Needle or Figure 4 pose. Focus on circling your ankles as well as flexing and extending your foot at the ankle joint.

From there, I’d take one leg up into Reclined Leg Stretch pose. Start with the strap on your heel pad for a few breaths, move it to the arch of your foot for a few breaths, and finally place it on the ball of your foot and more actively pull down with the strap as you push up with the heel of the foot. This last variation will likely give you the most feeling of stretch in the calf muscles, which include the superficial gastrocnemius, the deep soleus, the posterior-lateral peroneus longus, and the posterior-medial tibialis posterior.

Many of the standing poses will bring some stretch to your calves and feet, especially the back foot in poses like Warrior 1 and Pyramid pose (Parsvottanasana). But even Warrior 2, Triangle pose and Extended Side Angle pose (Parsvokanasana) will provide a little stretch to the area, and might be better starting poses for newer students with lots of tightness in that calves. Wall Calf Stretch (a modified version of Warrior 1 with the toes of your front foot touching the wall and either hands or forearms on the wall) really isolates the calf muscles nicely, too. There are other poses that will have some nice benefits for the calves as well, like versions of Childs pose that will bring some stretching pressure and compression from the thigh bones and body down onto the calves and lend to some widening of the muscles. So throw a few Childs poses in the mix. And you can fulfill the “exercise” part of the recommendation by doing more active flowing practices, which will encourage warming and improved circulation to the lower extremities. And finishing off with some supported inversions like Legs Up the Wall or Chair Shoulderstand will release increased blood pressure from the legs for a bit, which could have a lovely calming effect on your legs, as well as your nervous system.

Pranayama practices that quiet the nervous system, like extending the exhalation (perhaps a 1:2 ratio of inhale to exhale) and others would be of great benefit, as would a body scan meditation, where you encourage all of the muscles of your body to release deeply.  Such a meditation could be done just prior to bed to prepare you for a good night’s sleep. There are, of course, other options you could include, but this will get you or your students started if nocturnal leg cramps are disturbing your rest. Let us know if you have a favorite calf release that I did not mention. We love your feedback!

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Building Unity Farm - The Guinea Fowl are Born

It's August in New England and although everyone in healthcare IT is consumed by Meaningful Use stage 2, ICD10, ACA, the HIPAA Omnibus Rule, and various compliance initiatives, it's also the time we try to take a few hours off before the busy Fall.   Although I'm not taking any vacation this year, I have reduced my writing schedule (hence fewer blog posts this month) and spent more time at Unity Farm.

This week our first 20 guinea fowl hatched and the keets (the name for young guinea fowl) are running around the brooder, eating, drinking, chirping, and sleeping.

Here's how we did it.

Guinea fowl are terrible parents.  They lay eggs in a community pile and one female incubates them all.   Unfortunately, they tend to lay in the forest near fox dens, fisher cat habitat, and coyote trails.   We've lost several females this Summer but luckily found the nests and gathered the eggs before they were too chilled to be viable.

We placed them incubators at 100F and 50% humidity.   The gestation period of a guinea is 26-28 days.

Automated egg turners slowly moved the eggs for the first 23 days.  Then we laid them flat in the incubator, making it easy for the chicks to peck through the shells.

On day 25, one of the larger eggs started to roll, crack, and chirp.    A few hours later, a piebald keet was born  (Keets come in pearl black, white, grey, and piebald).

On day 26 and 27, the rest of the eggs popped like popcorn with little keets running around the incubator.   About an hour after birth we moved them to the brooder, a larger space kept at 100F with ample food and water.

Three of the 23 eggs did not hatch (hence the expression don't count your chickens before they're hatched), which is typical for game birds.   After verifying that there were no signs of movement, I carefully opened the 3 unhatched eggs and found that all  had developmental issues and an early demise.

The 20 keets that hatched are amazingly active, large, and robust.   Our batch of keets last year arrived in the mail and we had quite a lot of attrition.  There are definite advantages to hatching your own poultry.

Animal husbandry is hard and Guinea Fowl can be challenging, as illustrated by this great article in the Atlantic.

At 4 weeks, we'll move the guineas to the coop, but keep them from free ranging until 12 weeks.  We find that 2 months in the coop gives the guineas a chance to mature and be able to defend themselves agains predators.  It also firmly establishes the coop as their home and they'll return to sleep there every night as adults after a day in the forest.

We've gathered nearly 100 guinea eggs from forest nests and all are in our incubators.  Although we can keep 50 or so in our coop and sheds, we'll sell the others to local farms.   Given the significant increase in tick-borne disease across the country. we believe that guinea fowl, nature's most efficient tick eater, will be very popular with homeowners in the rural areas west of Boston.

Guineas have become such a regular part of our lives that I cannot imagine a day without them.  Looking out my home office window, I expect to see the guineas running by on their quest for food and camaraderie.

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On Vacation

Take Back Your Life by Melina Meza

Yoga for Healthy Aging will be on vacation for the next week. We'll return to our usual five posts per week starting on Monday, August 26. Have a good week off, everyone!

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Friday Q&A: Multiple Sclerosis

Q:I am curious about how yoga might be used to benefit someone with a diagnosis of Multiple Sclerosis (MS).  I have heard about it, but am not sure how to proceed.

A: Thanks for checking in about this. I am surprised we have not addressed this to date, so I am happy we will go over it today! After I did my teacher training in 2001, one of the first workshops I ever attended was down in the South Bay, where a well known teacher from Catalina Island, CA named Eric Small was teaching a weekend workshop for the National MS Society on “Yoga for People with Multiple Sclerosis.” In my previous incarnation as a full-time family MD, I had cared for a few patients who had the diagnosis of MS. But honestly, it was their neurologist that really addressed their MS and its symptoms more than I did. If only I had known then what I learned from Eric back in 2001, I would have had some very powerful tools to address this serious condition. And, boy, was I learning from the right person. Eric was diagnosed with MS as a young adult and had a pretty severe first episode, which made it hard for him to even walk without the aid of crutches.  Fortunately, he attended one of BKS Iyengar’s first classes in San Francisco in the late 60s and was taken under the master’s wings and taught how to work with his condition using yoga practices. Eric has rarely had any additional symptoms, a rare story with MS, indeed.

For those of you out there unfamiliar with MS, it is the most common neurological condition that leads to work disability in younger adults. Two-thirds of people with MS are diagnosed between the ages of 20-40, and although it is not a cause of premature death, it does often lead to significant disability. The theory behind MS is that the body develops an auto-immune response to the protective sheath that surrounds the nerves in the brain called myelin sheath, attacking it as if it were a virus or bacteria. Not only does this lead to scarring of the myelin, but it can affect the underlying nerve as well. The result is that communication running down the damaged nerves slows or stops, leading to all kinds of unwelcome symptoms, like muscle weakness, spasticity, lack of coordination, loss of balance, gait difficulties, tremors, swallowing trouble, speech disorders; numbness, tingling, burning, or pain; blurred vision, double vision, blind spots or blindness; bowel and bladder problems like urgency, frequency, retention, incontinence and constipation; as well as vertigo, depression, or emotional labiality; and short term memory loss and impaired concentration are the most common cognitive signs. This is a staggering array of symptoms, and because no two MS suffers will have the same constellation of symptoms, it can take a while to even get to an accurate diagnosis of MS.

There are a few different patterns for the affects people experience, and I am going to suggest that if you want to know more about that, check out the National MS Society website. But let's say that in many cases the symptoms will intensify for a while, referred to as a relapse, and at times they will diminish for a while, called remission. One of the main complaints from those with MS during a relapse is fatigue and heat intolerance. They often note fatigue arising in the late afternoon, and symptoms worsening if the environment is hot or if they overheat with activity. This is a perfect point of entry for yoga, especially quieter poses, restorative practices and breath work.

Viparita Karani (Legs Up the Wall Pose)

Although we have mentioned yoga’s benefits before, the MS society notes the following as particularly relevant in dealing with the huge list of possible symptoms that MS folks may experience: breathing becomes deeper and more regular; circulation increases, for better distribution of O2 throughout the body; flexibility increase; muscles and joints are toned; internal organs are massaged; and a general feeling of well-being arises. And since fatigue and heat intolerance are the most limiting factors to the MS student, the breathing and restorative practices are extremely beneficial for managing these symptoms and you might start out learning these for your benefit or teaching these first for your student with MS (see Mini Restorative Practice).

Because these students also often have some degree of spasticity as well as movement and gait disturbance, the systematic stretching and breath attention of yoga releases tension in the areas affected, while improving circulation and enhancing awareness of the student’s body. Body awarenessaids in recognizing and regulating an individual’s unique MS symptoms. In addition, regular practice will also improve coordination, helping directly with balance issues and helping with transferring.

Many MS students may be using a cane, crutches or a wheelchair some of the time, so you will need to become familiar with using all of the props you can. Chair practices (Chair Yoga) are helpful, but even having poses these students can do in bed will be very helpful if they can not transfer to a chair or the floor easily. So, depending on the individual’s function on any given day, you will either be doing a fairly typical yoga class, a chair yoga class or a very modified class in the wheelchair or in a bed. The key will be to keep things quiet and cooling in general. During times of remission, if there are minimal symptoms, you could try sharing a regular intensity class, as long as heating poses or sequences don’t lead to a flare of symptoms. I’m hopeful these general guidelines will give you a place to begin your exploration of yoga for MS.

—Baxter

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On Teaching Seniors: The Benefits Flow Both Ways!

by Bridget

Wet Handlebars by Melina Meza

While not yet a senior myself, I do teach seniors at the North Berkeley Senior Center. I came to yoga with serious, debilitating back pain—caused by high-speed, over-the-handlebars bike accidents in my teens, and untreated whiplash from several car accidents later on. The gentle Iyengar-style yoga taught at The Yoga Room in Berkeley set me on a path of healing. So, to me, yoga has been a therapeutic, kind and compassionate endeavor—one that has strengthened my back and quieted my mind to an extraordinary degree. Because of this, teaching seniors and working with any physical limitations they may have has been a pretty natural process.

My students at the senior center range in age from late-50s to late-80s. Within the group there's also quite a range of abilities, but there is such a sweet cohesiveness, and a sense of community and support for each other. I try to keep class moving along for the more active students, but everyone is patient when I spend some extra time making sure a new student can keep up. A core group arrives early to set up chairs and bring props into the room from the storage closet, and at the end of class everyone works together to get the room cleaned up, chatting about their interesting, full lives as they go. Last week, one of my students told me that she always feels better after she comes to my class. I paused for a moment to take that in and I realized that I always feel better after teaching it too.

These active seniors are always up for trying something new. I remember the first time I taught a modified inversion – handstand with feet on the chair – an 83-year-old student (after I’d offered an assist and some suggestions for strengthening her pose) stepped down from the chair, looked up at me, and said, “That was FUN!” Of course, handstand isn’t for everyone, and we work carefully up to a final pose. I always offer alternatives, explain potential health hazards, and I often turn poses into “partner poses” just so they can have someone watching and can help each other to remember the details. The partner work also cuts down on the number of people actually attempting a pose at one time, giving me a better chance to keep an eye on the entire room.

While active, eager and ambitious, they also tire more easily than my other student populations. One of my first experiences teaching seniors, I was substituting a class regularly taught by Herta Weinstein. This large class came with an assistant who knew the students well. After I’d led them through nearly half of the ambitious practice I had planned for the hour and a half class, the assistant leaned over and whispered, “I think they need to rest.” I was surprised to realize that the sighing I was hearing was about them wanting a break, not them wanting me to hurry up!

There's never any rush to get it right. That's the beauty of yoga - there is always something new to work on, so you'll never run out of topics to explore, muscles to strengthen and alignment to finesse. My students have reported feeling stronger, better-balanced and more energetic with the addition of the yoga practice. From my perspective, they are all gaining form and body awareness that is gorgeous to behold.

One of my favorite things about teaching this population is their dedication, both to yoga and to the community they’ve developed in the room. Another is that they’re tremendously creative and interesting. I’ve attended piano concerts, photo exhibits, and a Weavers Guild exhibit, all featuring the work of my students. I’ve also attended live performances, eco-movies and co-op dinners with my students, and any time it’s cold you’ll see me wearing a hat crocheted by one of them. My life is so enriched by their presence, and I continue to count working with them among the highlights of my week.

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