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Since the start of the pandemic, my emotions have swung like the pendulum of the hydroxychloroquine efficacy/inefficacy for COVID-19 debate. The highs and lows can be extreme.  Stress has always been a part of my life, but it magnified with the recent events in our world. I was troubled by how best to: 

• manage my practice and telemedicine 
• keep my family and myself safe 
• decide whether to send the children to school in the fall 
• educate my children about social injustices 
• help my 87 year old mother

If my husband asked the simple question, “What’s for dinner?” I became very upset; the non-COVID death toll was about to rise by 1 in Dallas that day. In psychiatry classes, we learned about coping mechanisms to help with stress; some people use humor, others go into denial, but the most successful ones are those who empower themselves. 

Dr. Lenny Calabrese had cited the benefits of mindfulness meditation to improve immunologic health and sharpen mental acuity. I had seen benefits in my patients, but never could do it myself.  How can people meditate and strike a pose when there is so much to worry about?  Stress-eating seemed so much more comforting! 

When my neighbor and yoga instructor, Deedre Morales, held a neighborhood session, I begrudgingly went. Four months into this practice, I;ve discovered yoga has made me more level and stronger physically and mentally.  I am sharing Deedre’s suggestions that you can easily incorporate into daily life. Try these movements, and share them with your patients.  No equipment needed; it takes less than 15 minutes.  Remember, habits form on average after 66 days. -- Kathryn Dao, MD
 

Why Rheumatologist’s Need Yoga Now 

by Deedre Morales

In uncertain times, more than ever doctors need yoga. You have been dealing with an added level of stress and may be noticing more anxiety in your patients. The ancient practice of yoga provides several tools to empower you.  

So what is yoga, really? 

The word “yoga” comes from the root “yuj,” which means “to yoke” or create a union. The goal is to unite the mind, body, and spirit through Poses (asana), Controlled Breathing (Pranayama), and Meditation (Dyana). The following routine easily can be done by rheumatologists and their patients.  These are my favorite, accessible exercises to revitalize and strengthen the entire body.

1. Cat/Cow Pose: to achieve emotional balance, while strengthening and stretching the spine and hips. It requires coordination, posture and balance. 

To begin, come onto all fours, keeping your knees about hips width apart, beneath the hips. Spread your fingers out nice and wide, keeping wrists beneath the shoulders. On the exhale, round your spine, bring your chin in towards your chest and tuck the tailbone. Inhale as you arch your spine and look slightly upward, extending your tailbone upward. Do this movement at least 5 times and work on joining the breath with the movement. Synchronize breath with movement. 

                            Cat: Exhale                                                    Cow:  Inhale

2. Forearm Plank: to strengthen the core muscles; a variation of the dolphin pose.  One of the toughest poses because it targets many muscle groups at once. 

Assume a push-up position, and align your shoulders over your wrists. Drop to your elbows and rest on your forearms with palms down. Extend your legs behind you and balance on the balls of your feet.  Avoid arching your low back while tightening your abdomen and squeezing your gluteals. Keep your legs straight to engage your hamstrings and quadriceps. Don’t forget to breathe.  Beginners, alternate between holding and resting on your knees for 10-30 seconds. Repeat 3-5 times.

3. Tree Pose: improves your concentration, balance and coordination and strengthens your entire leg. Best to do often so you can catch yourself when you feel “off-balance.”

Begin standing with your arms at your sides. Distribute your weight evenly across both feet.  Shift your weight to your one foot. Bend the contralateral knee and bring the toes close to your standing leg. You may keep the toes on the floor while you find your balance. It helps to fix your gaze gently on one, unmoving point in front of you. Once focused, start moving the foot higher onto the shin.  Do not rest your foot against your knee, only above or below it. Adjust your position so your hips align; then, press your palms together in a prayer position at your chest, resting your thumbs on your sternum. Inhale as you extend your arms overhead, reaching your fingertips to the sky. Hold for up to one minute. Release the pose slowly so as not to fall.  Repeat on the opposite side.

4. Meditation by breathing: The mother of yoga and a favorite to do throughout the day. The best part - you can do it anytime - anywhere! Gain clarity, relax, generate kindness and more.

Sit comfortably (on the floor or in a chair). Take slow deep breaths through your nose. Take time to mindfully notice your breath entering and leaving your nostrils. Bring your hands to your knees. With each inhalation, touch your thumb to a finger, starting with your index finger and then progressing to the 3rd, 4th and 5th fingers. Breath in and then mentally exhale the words: Peace - Begins - With - Me as you touch each finger with your thumb. This divine practice calms the mind and brings us into the present moment. 

I hope that you can find a few minutes in your busy day to try these simple postures and focus on yourself. I would suggest starting with two or three sessions per week. For more information or questions, visit my website deevineyoga.com. Namaste.