Pilates Breathing vs. Mindfulness Breathing

I have written about both Pilates and Mindfulness lately, as both are areas I have been pursuing in my quest for optimal health.  I discovered a dilemma between them the other day.  It concerns how I breathe, an activity that I am quite fond of, and plan to continue to do until the moment I die.  I have been reading the book Full Catastrophe Living by Jon Kabat-Zinn, one of the big names in mindfulness.  One of the basic ways of meditating involves focusing on your breath. Kabat-Zinn recommends diaphragmatic breathing, or belly breathing.  In this type of breathing, you relax the belly, letting it rise and fall with each breath.  He states that this type of breathing allows the lungs to expand more and to take in more air with each breath, and is slower and deeper than chest breathing. 
In Pilates, the focus is on strengthening the core muscles, mainly the abdominal muscles.   To do this, we are instructed to 'pull the belly to spine', and to 'keep the abdominal muscles engaged' (or pulled in) throughout the exercises.  Breathing is an important part of Pilates, with specific breathing patterns. Keeping the abdominal muscles pulled in while doing the exercises can be a challenge at times.  Strong abdominal muscles support the torso and organs, decrease strain on the back, and provide structure from which the whole body can function better. 
When I am doing my water walking exercises, I often remind myself to pull in my belly, as I do in Pilates.  (I do Pilates and water walking on alternate days, generally doing each twice a week).  This morning, I started to do that, then I thought about mindfulness, and hence, my dilemma. Should I pull in the abdominal muscles to strengthen them, or should I relax them to allow my lungs to breathe more fully?  Both have their benefits.  I was watching my kitten this afternoon (as I often do, because she is so cute), and noticed that her belly rose and fell when she breathes.  This appears to be the more natural way of breathing.  
Here is what I have decided.  When I am exercising, doing both the Pilates and the water walking, I will pull my belly in, because one of the goals while exercising is to strengthen my muscles.  At other times, I will let my belly relax.  This way, I will get the benefits of both  

Agree to Disagree

A couple of days ago, we had an altercation at the pool where I exercise.  I was in the current channel, which is an oval area where the water is chest deep, and there are jets that propel the water in one direction around the oval.  We can walk either with the current, or against the current for extra resistance.  There are classes, where an instructor tells us what to do (forward, backward, sideways, knees high, skipping, and many more variations of movement around the oval. 
One of the instructors has been out for knee surgery, and the coverage of her classes has been sketchy.  So a number of us were there for a class, and there was no instructor.  No big deal.  We knew what to do, so we proceeded to do the various exercises, each in our own pace and order.  A woman on Oxygen got into the current channel towards the end of the hour, with a companion, who walked behind her, holding the Oxygen tank up above the water.  I wasn't sure how safe that was, but I was thinking of going over to her and commending her for continuing to exercise, despite her need for Oxygen.
A couple of the other people were doing stretches, standing along the wall, as we always do at the end of the classes. This woman went up to each one of the people along the wall, and told them they should not be there, that this area was for water walking, and if they wanted to do other exercises, they should go elsewhere. Neither of the two women she said this to stood up to her, I think they were too flabbergasted (I love that word).  I went over to her, and told her that usually there was a class at this time, and that the instructor had not shown up, so we were doing the class without her, and what these women were doing was part of what we do in class.  The woman with the Oxygen loudly and sarcastically stated, "I know what they do in those classes, but there is no class.  They shouldn't be doing this here."  I tried to point out that this was class time, and these were class exercises, but she continued to loudly state her case, that these people were in the way of people who wanted to walk in the channel (they weren't, there was room to go around them), and they were going to cause someone to fall (only if the other person wasn't watching where they were going, in which case, they, themselves , causd the fall).
I walked away, as did the others in the class who were there.  We could see very clearly that she was not going to listen to anyone else.  It was not worth my breath to try to talk reason to her.  In my mind, I agreed to disagree with her, and dropped the subject  Other than thinking about writing this blog, I did not spend much time thinking about this incident.  There are all kinds of disagreeable people out there, as well as agreeable people with whom I (or you) will disagree.  Give the situation the attention it deserves.  In this case, not much.  No one was harmed, and by letting people or incidents like this get to you, you are giving them more power than they really have.
The expression 'agree to disagree' is very useful.  It can come in handy in situations like this, as well as when the person or situation does matter.  We do this all the time, such as my friend who is a Democrat married to a Republican, or another friend who has 2 children, one who went to Ohio State, the other to Michigan (long time rival universities).  Agreeing to disagree is also useful when one person says "But I told you yesterday....", and the other person says "No, you didn't".  If two people view a situation differently, or remember it differently, in most cases one won't convince the other.  Rather than fighting, just agree to disagree.  Unless it is a vitally important decision, it seldom matters if everyone agrees.
If you are living with chronic pain or chronic illness, you likely don't have extra energy to waste on disagreements that don't really matter.  Some people like to argue.  If that is you, then picking fights with others who like to argue can be a form of entertainment.  I don't want to waste my time or energy this way, so be aware that if you try to get into an argument with me, I won't take the bait.

Chronic Illness/Chronic Pain Support Group

The first session of my new Chronic Illness/Chronic pain Support Group was Wednesday.There were four participants, plus me.  Three of the people there already knew me from the Akron area Sjogren's Support Group that I helped found, and that I co-lead.  At the Sjogren's group I am the 'education chairperson', or as I like to call it, the 'science officer' (I guess I watch too much Startrek). I often share little tidbits or longer presentations on topics related to living with Sjogren's.  I take it as a vote of confidence that these people have already seen me in action, and wanted more.  The other person there was one of my husband's patients who has chronic pain.
Each session will have an education/discussion segment and a creative portion (art, craft, writing- no experience necessary). The creative portion will support the education portion in some way.  I get to combine several aspects of my life together doing these groups. I am a psychiatric Occupational Therapist, a big part of my job is teaching coping skills.  I am also an artist in a variety of media.  I think the creative portion will provide a number of benefits. Focusing on a task can take the mind off of the body for a while.  Learning new skills helps build self esteem.  Some of the participants may discover they really enjoy a particular media, or are really good at it, and want to pursue it on their own, giving them a new hobby or outlet.  People can interact and socialize while they work, and maybe make some new friends.  And last, but not least, its FUN!  The other aspect of my life that applies is that I have lived with chronic pain and illness for over 20 years, so I know what it is like.
I think the first session went very well.  First we introduced ourselves to each other, and I introduced the concept of the group.Then I talked about journaling, the benefits, how-to's, and a variety of types of journals.  Then we made our own journals, starting with a packet of bound pages and other materials.  We actually did bookbinding, ending up with journals bound in our choice of covers, including a ribbon to mark the page we are on.
I think this support group is unique in its format. I don't know of any other programs that combine the creative and didactic together as I am doing.  Most support groups focus on coping with a specific illness or issue, and some end up being 'bitchfests, where people complain about their lives or problems.  While having someone who will listen, and who understands what you are going through is important, I want my group to focus on coping and living our lives to the fullest, despite our issues.  I am not a trained art therapist, so what I do is not art therapy, but in some sessions we will talk about our art in similar ways to art therapy.  I believe that the two segments will add to each oher and make a stronger and more interesting program. 
My group is the first and third Wednesdays of each month, 4:30-6:00 pm, at my gallery, SherylsArt Gallery, 3241 Oakwood Drive, Cuyahoga Falls, OH.  The cost is $15 per session, to cover materials and supplies.  If you are in the Cuyahoga Falls/Akron area, come join us.  Otherwise, look for support groups in your area.  People who have been through similar issues can be very supportive.
 

Gluten-Free Versus Gluten-Lite, Take 2

About three weeks ago, I wrote about my plan to try eating gluten free for a month and then eat gluten to see how it affected me.  I was tested for celiac and it was negative, but I have heard that even without celiac, a gluten free diet can be helpful for people with Sjogren’s Syndrome, Fibromyalgia and hypothyroid, three of the ‘challenges’ I live with.  So the results are in -sort of.  

One thing I noticed is that I have gone from using 2 prescription-strength Pepcids a day, and still having problems with acid and reflux, to using only one Pepcid a day, with few problems.   

On Friday, one of my husband’s patients (he is a psychologist) brought him some homemade chicken noodle soup.  I decided that, since I had gone 4 weeks without gluten, this was as good a time as any to put my system to the test.  How ironic that I was having chicken soup, usually thought of as a cure-all, to see if it would make me sick.  **A note to my husband’s patient- This is not a comment on your cooking.  The soup was delicious.  The test was how my body would react to the gluten in the noodles.  And react it did.

We ate the soup with English muffins for dinner. Within a half an hour, I developed a stomach ache.  It was gone in the morning, but came back when I ate half of a bagel for breakfast.  I had half of a sandwich on rye bread for lunch, the stomach ache continued.  ENOUGH!  My body shouted.

In my previous post, I speculated on whether I would need a strict gluten free diet, like a person with celiac disease needs, or, since I do not have celiac, would a ‘gluten lite’ diet suffice?  True confession:  the diet I followed this past week was not completely strict.  I did not eat anything with blatant gluten ingredients, but I did eat a few things that were labeled ‘packaged in a facility that also packages wheat’, so there may have been some contamination.  I also ate oatmeal for breakfast most days.  Oats, themselves don’t have gluten, but they are sometimes grown in fields that alternate with wheat, so may have some contamination.

My next experiment will be whether my body can handle small amounts of gluten.  Yesterday, we ate at Cracker Barrel, a favorite restaurant of mine.  I asked them about gluten free foods, they said that they don’t claim that any of their menu is gluten free.  I chose items that are less likely to have gluten:  grilled trout, corn, hash brown casserole and coleslaw.  I did not ask for my food to be cooked separately, as a strict gluten free person would require, and I even ate a half of a corn muffin, which was made with some wheat flour.  I did fine.

My plan is to eat mostly gluten free, any products which are primarily grain, such as bread and pasta, I will stick with gluten free. But I will allow myself to use products with a small amount of gluten, such as my favorite mustard. Someday, I may try a strict gluten free diet, to see if it helps me even more, but for now, I am going to stick with ‘gluten lite’. That is the best of both worlds (at least for me).

Pilates

In my Pilates (pronounced puh-LAH-tees) class yesterday, it occurred to me:  I have not yet written about Pilates!  Pilates was started in the early 20th century by Joseph Pilates in Germany.  It is an exercise system that especially works to strengthen the core (abdominal) muscles in the body.  When these muscles are strong, the rest of the body is more supported, and can function better. All movements are controlled and smooth, with emphasis on keeping the abdominal muscles pulled in the whole time.  Breathing is done in proscribed patterns, exhaling on exertion, and for some exercises, multiple breaths in, then multiple breaths out.  Though some of the exercises are difficult for me, I always feel looser and taller when class ends, and I have more energy.
In class yesterday, our instructor said, as she often does, "If it causes discomfort, don't do it."  My first thought was "Everything causes me discomfort."  I caught myself, because I am trying not to focus on negative thoughts.  So I reinterpreted what she said to mean "If it causes excessive discomfort, don't do it."  Even for a healthy body, some discomfort is acceptable, and muscles don't develop as much if you always keep them in their comfort zone.
For bodies like mine, which hurt no matter what, it is important to learn its signals. I know that with certain exercises I can push through the pain, and I will feel better afterward, others I need to back off.  Some days I push more than others, depending on how I feel that day.
One of the things I really like about this instructor is that for many of the exercises, she will give a variety of options of difficulty.  This allows each participant to do the exercise at a level appropriate to their own needs and abilities, and also gives us permission to back off if we need to.  Not that we really need the instructor's permission, but many people think they do. I sometimes start an exercise at a higher difficulty level, then switch to a lower one part way through the series, as my body requests.
There are a number of things that can be gleaned from my experiences with my Pilates classes.  First, it is important to know your body, what it can and can't do, when to push and when to back off.  Listen to your body's signals, and stay alert to them, they change often.  If something causes excessive discomfort, or you know you will have to pay too much for it later, don't do it. 
Second, all of us need exercise, look for classes or other opportunities that are right for you.  If you are lucky, you will find an instructor like mine, who gives options, and encourages everyone to work at their own level of comfort and ability.  If not, learn to adapt the moves yourself.  The basic rules for adapting something is: 1. Figure out what you are trying to do.  2. Identify why you can't do it the regular way (too fast, too intense, too long a time, etc.). 3. What can you change to eliminate or decrease the problem issue? (slow it down, less intense, shorter length of time, reposition so your body is more supported, etc.) 4. Decide which option to try, if that one doesn't work, try another).  For more on this topic, read my post, 'Adaptation 101'
Third, give yourself permission to do what you need to do, no matter what others around you are doing.  This goes for all areas of life, not just exercise. You don't need anyone else's permission to take care of yourself.  You live in your body- You are the only one who knows how it feels, and the  one who must look out for its needs.
I know there are many people with Fibromyalgia who go into a flair from the slightest extra exertion.  For you, exercise is important, but go very slowly, and increase at very small increments over a long time (your doctor or occupational/physical therapist can guide you on this).  I am lucky in that I don't have this problem.      

Five Ways to be Mindful

I know I have been writing about mindfulness alot lately, but it has been on my mind (pun intended).  One of the blogs I follow, 'Beyond Meds', wrote a post 'Five ways to be Mindful', based on teachings of Jon Kabat-Zinn, who developed mndfulness meditation for stress management.  Here is a summary of that post:
1. Consider what's right with you.  We tend to focus on what is wrong with us, and that keeps us stuck. “Until you stop breathing, there’s more right with you than wrong with you,” says Kabat-Zinn.  Every day, thank your eyes for seeing, your feet for carrying you from place to place, etc.
2.  Love yourself unconditionally.  Don't wait until you lose that weight, love yourself as you are, now.
3. Live in the present moment.  Live as if this moment truly matters, and you can really enjoy the creamy smoothness of a piece of chocolate, or the little interactions you have throughout the day.
4. When life gets tough, don't take it personally.  When problems occur, it is hard not to blame yourself, and to get stuck in the 'if only' mindset.  Instead of dwelling on the past, take responsibility by asking yourself what are you going to do different right now to move forward?
5. Put the 'being' back in human.  We are so busy doing, we don't take the time to just be. Just sitting and contemplating is what separates us from the nut gathering squirrels. It is a great stress reliever, too.

For more on each of these points, read the post by Beyond Meds.  It is a very different way of thinking and focusing than most of us are accustomed to, and one which I think is worth practicing.

Staying Warm in the Cold

I had a task I needed to do out in the garage that would take me a couple of hours to accomplish.  Here in Northeast Ohio in January, that means being out in the cold- I think it was a high in the low 20's (F) today.  That got me thinking about how to stay warm in the cold.  I tend to be cold when other people aren't, so I have a good supply of long johns, etc.  Before going out to the garage, I put on an extra pair of socks, long john pants under my regular pants, an extra sweatshirt, and earmuffs.  I came in every half hour or so, and had an insulated mug of hot tea to sip on.
In general, the best way to dress for staying warm is in layers, so if you get too warm you can take off a layer, and put it back on when you get cold again.  The layer closest to the skin should be something that wicks the moisture of sweat away from the skin, and dries quickly.  Being wet and cold can lead to hypothermia, and possibly frostbite.   Silk is good, as are a number of synthetic materials.  Cotton used to be the preferred fabric for next to the skin, but cottton absorbs and holds the moisture, keeping it in.  My personal favorite is Cuddl Duds, which are smooth and silky feeling, and thin enough to wear under other clothes without adding bulk. I have both the long sleeve shirts and the pants. I also have socks that I wear under my regular socks in winter, called Gobi Liner from Wigwam, that are thin, wick away moisture, and help my feet stay warm.  I even bought a couple of pairs for my older son, who lives in Boston, rides his bicycle everywhere, and whose idea of fun is a 100 mile bike ride.
On top of that layer, I often wear a turtle neck long sleeve shirt, which keeps cold air from blowing down my neck.  I am glad I am not very fashion conscious, because most shirts these days expose too much skin for my comfort. 
The next layer should be something that traps and holds body heat in, such as fleece or wool.  Some people wear a down or fleece vest, which keeps the body's core warm, but I have found that I need long sleeves.  If my arms are cold, all of me feels cold.  When I am indoors, this is my outermost layer.  If I am going out, I add another layer that will insulate and keep the body heat in, and rain/snow/wind, etc. out.  Depending on the weather and how active I will be, this ranges from a windbreaker to a down jacket.  If my ears get cold, they hurt terribly.  I like to wear earmuffs, or a more recent find for me are those fleece headbands.  I wear them when I am outside even if it is 55 degrees.  Each coat or jacket I own has a fleece headband in one pocket and a pair of gloves in the other pocket.  Mittens are actually warmer than gloves, because the fingers help keep each other warm.  I have mittens available for the coldest days, but it is easier to do things in gloves.  
When I am sitting inside our apartment, I often feel cold.  I have a nice, snuggly fleece blanket I like to drape over me.  When we first get to our cabin in the winter, it is often around 40 degrees inside.  Once we get everything brought in and the food put away, I wrap my electric blanket around myself and read until the place warms up.  My cat likes both the fleece and the electric blanket, and often stretches out on my lap, adding extra warmth for me. 
As you can see, keeping warm is very important to me.  When I am cold, my muscles tense up, which increases my pain level.  Keeping muscles warm helps them to relax, and decreases pain. 

The Mindfulness Solution to Pain

Several times I have written about mindfulness and how it can be used to help reduce pain. Mindfulness involves a level of awareness of ones surroundings that is uncommon in our busy lives. While driving, we plan what we will say at the meeting when we get to work. At work, we think about what our child said this morning and what we will make for dinner tonight. We live our lives in the past and future, inattentive to what is occurring in the present moment.


Mindfulness involves noticing the feelings, sensations, sounds, etc. surrounding us in the present moment, and accepting them as is, without judgment. The dog barking next door is neither bad nor good, it just is. The same goes for the pain you are experiencing, though it may take some practice to be able to accept this. Part of learning to be mindful is learning to meditate, where you focus on one area, such as your breathing. I have tried to meditate off and on, but I have never gotten into a habit of meditating regularly, which is the only way to gain real benefits from it.

I found a book at the library that I hope will be helpful in this area. It is The Mindfulness Solution to Pain, by Dr. Jackie Gardner-Nix. I have read the first three chapters. They talk about understanding pain, what mindfulness is, and basic meditation. One thing that caught my attention was the similarities between the words medication and meditation. Medication has a ‘c’, for chemicals, and meditation has a ‘t’ for thought. Both have their place in controlling pain.

This book suggests stopping reading after the third chapter, and practicing daily meditation for a couple of weeks before moving on. Since this is a library book, I am not going to do that, but I am going to try to start meditating daily. I did it for 10 minutes today.  That's a good start.