Friday, November 11, 2016

Wake Up and Take a Stand for love: Who’s with me?

Some people I love voted for Trump. Family and friends. And I don’t mean random FB friends. They don’t fit the Trump profile. They are not all white. They are not misogynists. They are not evangelical Christians. They are bright and well educated. They love their daughters. Yes?! They have daughters. And, yes, that stumps me, too!

And, yes, I am well aware that you may be re-evaluating who you think I am because I know and love some people on the #trumptrain. Especially now. Now that I and almost everyone (else) that I know and love is some combination of shocked, devastated, heartbroken, scared and/or F-cking furious.

To clarify, I didn’t grow up in the Blue Coast Bubble. I grew up in the opaquely saturated red state of Oklahoma. Clearly, the lens is pretty different there. So as comforting and convenient as it might be to label “them” as hateful, bigoted, crazy misogynists, the truth is not that simple. Because the truth is never that simple.

I will not speak for them – cannot speak for them. But I have spoken with some of them. (They are definitely not all interested in talking politics with me.) I cannot agree with them but I can understand them. Because I dared to listen to them without ASSuming I was better or smarter than them. I cannot say that I entirely understand their positions or that I am swayed by them. I can say that I feel less devastated and more hopeful because I was able to have a civilized conversation with a Trump supporter as the election results were rolling in. In realtime.

Like a lot of us, I was anxious on election day. I cried when I voted. Normally, crying is not really my thing. Let’s agree on one thing: there was nothing normal about this election cycle. When I got home around 6pm, I immediately turned on the computer to see what was happening in the election. I had had a nagging concern that had been developing over several days. Brexit kept coming to mind. The polls might have been way off. My Blue Coast bubble was about to burst. Interesting feeling to be shocked and not surprised all at once. I was in multiple WTF text conversations with friends because I couldn’t bear to be alone in it. A girlfriend called in confused horror: What is happening? We talked for a while, listened to the news, texted our friends, pretended to be fully present as we distracted and consoled ourselves with our oh, so easy multi-tasking technology. Because the news was presenting some increasingly not-so-easy-to-digest information.

And then I did something really stupid. I sent a text to a friend in Florida. “fucking florida.” Like blaming Florida was gonna make me feel better. Like engaging my Trump-supporting friend in this particular moment was gonna be constructive in any way. Banter turned into talking points, heading South in a hurry. Not surprisingly, we don’t even agree on the facts.  So I called him, not sure he would pick up the phone. He did.

Honestly, past experience told me this conversation was going to go badly and end abruptly. But I was desperate to make some kind of sense out of it.  I wanted someone who voted for him to give it to me straight in that way that you can only bear to hear from someone you really know well. I needed a heart-to-heart. And I got one. When I really needed to believe that we are bigger than our differences, I got exactly what I needed. For two hours, we talked and we listened. And we talked and we listened. Without a moment of raised voices or cheap shots, we heard each other.  Not just heard each other.  Felt the source of our mutual concerns. We hung up the phone and I listened to Trump’s acceptance speech. And I cried. Again.

I am heartbroken. Not only for the people who are afraid of losing Obamacare, afraid of losing their LGBT – and to be clear, human! – rights, afraid of losing women’s rights, planetary rights… I could go on. I am heartbroken that I had no real idea of the pain and suffering of the #trumptrain. I am heartbroken for the impoverished mentality of a wealthy nation. I am heartbroken for a nation of people who don’t feel safe to express themselves in civilized ways. I am heartbroken that fear won. For now.

For now, I am awake. And I am so clear that anger and fear lead to hate in equal measure. No one gets immunity. The only thing I know for sure is that impossible conversation on the night of the election was made possible because we both knew that we were in a fragile state; we both knew that we had no option but to listen with kindness or come unraveled. And we revealed to our selves the deeper truth that we ARE bigger than our differences, that love trumps hate. We have to grow up and wake up. We cannot go back to sleep.

I know some people are really angry and scared and sad. And that’s understandable. Others don’t get it at all. And - tough news – that’s also understandable through their lens. No one can ever make you wrong about your feelings. And that’s universal. We can’t swipe left and make it go away. We can’t #Calexit. We are not moving to Canada.

As a nation, I know that we are better than this. As an individual, I am taking a long, hard look at how I am better than this life I am living…. Not in an egoic I’m so great or above it all kinda way. Rather, I am asking the questions: What does my best self do? How do I quell my own anger and fear? How does love respond? What is for the greatest good? Where do I need to do better? What part of me needs to grow up, wake up and stand up? What does positive action that unites us even look like?

Who’s with me?

Leslie Kazadi, C-IAYT, ERYT-500

Monday, July 18, 2016

Diving into and out of Panic
at the Great Blue Hole

We’ve all panicked from time to time, to some degree or another. When it’s over something harmless, like waking up late, it’s the stuff of comedy.  Think Hugh Grant’s character, Charles, in “Four Weddings and a Funeral.” Funny because we can all relate. You realize you missed the alarm and you have alarming thoughts doused with expletives, rushing around as if you could make up for lost time. Only to realize you are running around in circles. Hijinks for observers.  Being late, after all, is not the end of the world.

Not so funny is an actual panic attack. Until you’ve experienced it, it’s really hard to grock. This does feel like the end of the world. Like a heart attack. As in, I can’t breathe, I think I’m dying attack. Typically, they come seemingly “out of the blue.”

Diving the Great Blue Hole in Belize doesn’t really fall into the out-of-the-blue category. It’s a 130-foot dive with a brisk, 3-minute descent time that allows you 8 minutes of meandering underneath a wall of 40-foot stalactites next to a 400-foot, deep-blue, eerie abyss. Made famous by Jaques Cousteau’s naming it one of the top 10 dives in the world, it’s a bucket-list badge of honor for divers. It is not for the faint of heart or beginner diver. Or logically, for a moderately experienced but out-of-practice diver like me.

Yet there I was in Belize with my bucket list. I had to do it. Despite nobody I knew going with me. Despite my long respite from deep dives. And let’s just say, despite my better judgment.

I’m excited and nervous as I wait on the pier for the water taxi to take me to the dive shop. It’s uncommonly still. No breeze – which is bizarre because it’s always breezy in Belize. This means the 3-hour boat ride to the Blue Hole will be smooth. This means getting into the water at the Blue Hole will be easy. This means I can relax.

At the dive shop, the staff seems calculatedly nonchalant.  Someone tosses me a mask and declares from 6 feet away that it is a perfect fit. My previous snorkeling excursions earlier in the week were not so lucky. They don’t bother to offer me a wetsuit, though everyone else has one. They seem a little too relaxed. “You don’t really need one. The water’s warm. This one should fit if you really want one.” I try on the wetsuit with purple and pink stripes, another good sign. It fits. The staff keeps repeating how easy the Blue Hole dive is. All seven of the divers are excited and nervous. No one thinks it’s an easy dive. None of us have done it before. I feel comforted that we are all metaphorically in the same boat.

As we near our destination, the dive master gathers us around and goes over the basic safety routine – how to clear your mask and your ears, universal hand signals, air supply. He reminds us that we have a second, emergency regulator to breathe through. Between reminders of how safe the dive is, he warns that we have to go single file and stay at his depth. He warns us that there will be no stopping and that if you have a problem and have to go back, you are on your own. “We can’t sacrifice the group for one.” Ummmm…. What?! “The dive is really safe… there is only one thing that can be a problem - nerves.” Only. One. Problem.

I fidget with my equipment. I make sure the BC (buoyancy compensator) will inflate. This is what keeps you from sinking to the bottom. If you sink to the bottom at 400 feet, you are not coming back up. Period. Once you dive below 50 feet, you start to sink rapidly without the BC. I check the regulator, literally the pipeline to your air supply. I check the air gauge. I remind myself that I am brave.  I’m the second one to jump into the water. I do the 2-foot dive below the surface test as instructed. There’s only one problem.

“I can’t get enough air from the regulator,” I say, taking the regulator out of my mouth.  And so it begins. The rapid-fire, rabbit-hole rationale that begins and ends with: This is a big mistake! Before I got into the water, I checked to make sure the regulator was working. But I didn’t actually breathe out of it to make sure it was working correctly. I don’t know this equipment. I don’t know these people. The resort didn’t recommend this outfit. Nobody in this group gives a flying f*ck about me. What if my mask doesn’t really fit? My mask didn’t fit when I was snorkeling the other day and I spent the whole time clearing it with my eyes burning. I can’t do that at 130 feet. What if I can’t clear my ears? I couldn’t free dive to 15 feet without my ears hurting the other day. And I could not clear them. This is crazy. What if I can’t clear my mask or my ears at 100 feet? I can’t go straight back up because then I’d have to go to a decompression tank. You can’t go straight back up anyway because you are diving on a diagonal underneath limestone after 50 feet. How would I find my way back? What EXACTLY does sacrifice one diver mean? What do you mean, “You are on your own”? Where IS a decompression tank? I can’t fly to it because you can’t fly after a deep dive. What exactly are those rules again? What if I can’t breathe at 100 feet? What if there are hammerheads? Why had I been hoping to see a hammerhead (shark, that is)? I am crazy?! I can’t breathe NOW! I don’t think I can do this. What the actual f*ck was I thinking?! This is a big mistake!

Every thought, a dead end.

Someone checks and assures me that the regulator valve is all the way open.  This does NOT make me feel better. This only confirms that there is a problem with the equipment. I breathe through my nose.  I can breathe fine through my nose. I put the regulator back on and still can’t breathe freely. Proof that it’s the regulator.  I take the regulator back out and announce in a tone of voice that says it all, “I’m feeling a little panicked.” Then something really interesting happens. I notice that I also cannot breathe freely on my own without the regulator. I’m confused because I thought that I could, but now the regulator isn’t part of the I-can’t-breathe equation. I am gulping air in through my mouth, not yet realizing this, only aware that I cannot get enough breath and that I don’t think I can do this. I’m on the surface. I can’t breathe. This is what asthma or COPD must feel like. This is interesting. I make a mental note that this is going to be interesting later, followed by a note that I ASSume there will be a later.

The dive master is standing on the boat and pronounces, “You are panicking.” (I think but now realize I am not 100% sure that I said that out loud already.) “Stop treading water. You are going to wear yourself out. Inflate your BC (aka your don’t-drop-to-400-feet rescue device). And relax. Just breathe.”

OK. Even then, I appreciated the humor. You wouldn’t think that someone telling you to breathe and that you are panicking would be helpful. And we all know how maddening “just relax” is. But for me, it was a moment of insight. I had been absolutely unaware that I was treading water. I was some combination of confused, embarrassed and amused that someone was telling me how to breathe… even as I couldn’t. I recognized that I have been working like mad to stay afloat. Maybe that’s why I was out of breath. Maybe it was nothing. Just relax. I inflated the BC. It pressed into my ribs and exaggerated rather than ameliorated my I-can’t-breathe status.

Then something magical happened. I recognized that this can’t be true. BC’s do not inhibit breath. Scuba equipment does not make people sink. I don’t have asthma. I know how to breathe. And I witnessed myself as being in a self-induced, self-deluded panic attack.  Nothing is wrong and I can’t breathe. Now, this IS interesting.

I decided to question my thoughts against what I know to be true.

1.     Mouth breathing can be panic inducing. Sort of a conundrum when you are breathing through a regulator, necessarily through your mouth. The problem is you can gulp in more oxygen than you need without getting the CO2 that is required to get the oxygen to your tissues, and in particular to your brain. This is a classic case of less is more. I choose to breathe through my nose while I sort it all out as I’m floating on the surface.

2.     I have a rational mind and a fact checker in my brain. It’s always running in the background. Sort of a PITA at times, but my best and only friend right now. If I can talk myself into panic, I can think my way out.

3.     If you can speak, you are breathing. Period.  Good to know, right? If you can’t breathe, you will pass out so your autonomic nervous system will reset your breathing. If you are on land, this is also good to know. In the water, not so much.

4.     I understand the nervous system. Panic is just my nervous system in fight/flight/freeze. It’s beneath the surface of consciousness. Three elements are at work subconsciously deciding if the situation is A) malevolent or benevolent; B) “permanent” or transitory; and C) out of or within my control. If I can wrap my brain around the idea that the situation is benevolent, transitory and within my control, I will relax. Awesome. I’m already starting to feel in control.

5.     Nothing in nature is malevolent. (We can argue this point ad nauseum but for now, it’s my story so play along.) Everything is transitory. (ditto) Besides, I know exactly how long the dive is, to the minute.

6.     If I start clearing my ears and my mask from the get go, I can’t possibly get out of my depth with this. If I’m good at 30 feet, one depth down, I will know from past experience that I am good at 130 feet. If I’m not, it’s a straight shot up with no repercussions for resurfacing from 30 feet down. I can choose to bail if I need to.

7.     I will know as soon as I get under water that if I can breathe at 2 feet that the regulator IS working. Then I can also breathe at 130 feet. I know I can change my mind. I am in control.

8.     I remind myself that I am absolutely mesmerized and at ease under water. I do not suck air. I do not panic. I can trust myself.

9.     I am brave. THAT is real.

Meanwhile, the dive master is in the water. He looks at me and says, “You are first after me.”  It’s go time. I remind myself that I can change my mind. Then I deflate my BC so I can get below the surface. And my regulator and my breath are absolutely fine. And I AM mesmerized and at ease. I kept repeating - like a mantra - clear your mask, clear your eyes, take slow breaths, stay with the dive master. And before I knew it, the 3-minute descent to the gigantic, limestone stalactites is over. We have arrived at the 130-foot depth.  I can breathe. I am fine.

The Blue Hole is a collapsed cave, so that the normal sway you experience underwater is absent. It is virtually still. Except there is a curious, constant stream of tiny slivers of limestone silt shimmering all around. There is almost no sea life in the crystal-clear water. The stalactites are nothing like the sparkly, pointy, icicle-shaped ones I have seen on land. Instead, they look like something out of Dr. Seuss. They are enormous, round, ropy-shaped and neutral-colored sculptures that go on forever. As we glide alongside them, it is an uncanny juxtaposition – the massive, solid-stone tapering structures piercing the spacious chasm of the translucent blue sinkhole. It is an unbelievably ethereal experience.

Back on the boat, we are all elated that “We did it!” I feel incredibly grateful that I changed my mind. I freed myself from fear and opened up to experience what was actually happening. And what actually happened was a magical adventure I will never forget.

It was an incredible re-mind-er of the real goal of yoga as an awareness practice. It allowed me to go off the mat and into a whole other magical world. It gives me the tools to be brave. Granted, I didn’t have a full-blown take-me-to-the-ER I-think-I’m-dying panic attack. It only lasted a couple of minutes, thanks to the firm observation of the dive master. His reality check cued me into my body and out of my insanity - as in I was out of my mind and in a fantasy of frightening thoughts. This is the essence of mindfulness: recognizing thoughts, questioning their veracity, feeling the impact of thoughts on the body, and shifting attention to feeling the experience of the moment.

I know that full-blown panic attacks may not be helped with suggestions to relax, breathe and stop panicking. I know that I only got a glimpse of how crazy-making, isolating and scary panic attacks can be.  I have a lot of students who get panic attacks. And one of the things that makes them difficult – the panic attacks, not the students?! -- is their mysterious arrival.  Out-of-the-blue, out-of-control anxiety and the inability to track its triggers or its source.

There are short-term strategies, while you are riding out a panic attack. Here is a great article with a simple acronym, AWARE, and simple – not easy! – steps on what to do and how to BE in the midst of an attack:

There is a saying, “Panic is not a long-term strategy.” Super not helpful, right? Yoga IS a long-term strategy for panic attacks. Panic is an out-of-body experience; yoga is a get-in-your-body practice. Panic is an isolating experience; yoga is a community activity. Panic takes your breath away; yoga connects you to your breath. Panic makes you feel out of control; yoga teaches you self control. Panic can be caused by stress; yoga reduces stress. Panic is steeped in fear; true yoga is imbued with love.


Yoga. Breathe. Love. Live. Your bucket list is waiting! and so is your yoga community! 

Leslie Kazadi

Saturday, July 16, 2016

What my Motorcycle Crash taught me about My Truth.

Nothing like a brush with mortality to discover what you really think.  I had decades ago abandoned my belief in a God that plays favorites, The One that decides who gets to be homecoming queen or who wins the game, The One you can pray to or bargain with when the shit hits the fan.  Or The One who punishes you, thus creating the shit-hitting-fan situation that you deserve.  Instead, I adopted the yogic Atman philosophy that we are infinite souls traversing the universe in an ephemeral body.  Oh. So. Ephemeral.

So when I was riding my motorcycle, cruising down PCH at 50 miles an hour and a car was clearly about to make a u-turn right in front of me, I had an astonishing number of thoughts in those fleeting seconds before what I knew to be an immanent crash. 

“Holy Shit!” was the first…

… followed by anguish at my folly for thinking I was a safe rider so I wouldn’t crash, that I would be okay riding a motorcycle in LA.  Obviously, this wasn’t going to be okay.  And, in fact, I was certain nothing was ever going to be okay again.  But I quickly shifted gears, literally.  No time for denial and deals.  I surrendered to the reality of the moment and did my best to mitigate the damage. This is happening. Soften into it. Seriously? Seriously. I did not pray… just to hedge my bets.  It never crossed my very busy mind.  I was probably doing about 30 when I slammed into the car and flipped into the air, slamming my helmet once on the hood and then again on the ground after what seemed like an abyss of time floating in the air.   I skidded along the gravel presumably on my back? But there is a lapse in memory or consciousness because  I was already sitting when I got my bearings and had my next thought. 

Wow!  I’m still here. 

AND I’m sitting up.  My knee must be destroyed because the pain is excruciating. So that sucks.  And I’m not too sure where I am, so that’s not so great. (I do have the wherewithal -- or more likely survival instinct – to pretend like I have my holy shit together.) But in my first moments before all the details of the physical world truly registered, I had an utter sense of clarity that regardless of my physical situation, which was not looking so good, that “I” was still okay; that everything – whatever that is – was going to be okay because “I” am not really my body anyway. 

So hum.

For the first time, I knew I wasn’t full of shit when I told my yoga therapy students, “You are not your situation.”  I actually believe it.

The truth is, we are all the light of awareness that transcends any situation.

Leslie Kazadi

Monday, May 16, 2016

In Stitches: What I Learned from my Hysterectomy

In Stitches:  What I Learned from my Hyster-ectomy

It wasn’t until after my hysterectomy that I realized how many useful things I did not know about the surgery and recovery until I experienced them… and not for lack of searching.  With 600,000 hysterectomies performed annually in the US, there’s a good chance you know someone who will have one this year.  Here’s my hindsight advice.

Know your options.  After you do your research, ask questions.  Bring a friend, take notes and/or record your consultations. Invest in a second opinion or find a doctor with more experience in less invasive procedures.  Realize that you are hiring them and you want the best person for the job.  Because I had a large fibroid outside of my uterus, it would have been easier for the surgeon to have an “open procedure” with a larger incision as opposed to a laparoscopic incision.  I chose the surgeon who is The Guy for laparoscopic uterine surgery in my area.  But if you’ve ever had surgery or talked to anyone who has, everyone will tell you their surgeon is The Guy.  Knowing other doctors and friends had recommended My Guy was comforting.  Yet & still, after removing my uterus laparoscopically, the team couldn’t break up the large fibroid (because it had calcified?!) so they made a four-inch incision to get the fibroid out.  Having both types of incisions in the same surgery, I can attest to the fact that laparo is much less painful with a much faster recovery than the open incision. It’s worth fighting for if it’s at all possible.

As little as you can, as much as you need.  As a yoga therapist, this is my philosophy on using yoga props.  As a human being, it is also my philosophy on removing body parts. I was lucky to have a supracervical procedure; ie, saving my ovaries and cervix. Your options might be different. But if your doctor suggests prophylactically taking extra parts, saying you don’t really need them, do your research, know your family history, and make the best decision for you. I reminded my surgeon in pre-op (meaning right before I was wheeled into surgery) that I very much wanted to keep my ovaries and cervix if at all possible, though I understood there were no guarantees.  He flippantly responded that the cervix is not really important.  I wondered to myself if that would be his position if we were sleeping together.  “Nonetheless,” I insisted, “I want to be clear that it’s important to me.”

Know what's important to you. Acknowledge that it's a big decision and a highly personal one that only you can make. You may get input from well-meaning friends. I did. But once you've made your decision, advise your friends to forever hold their peace.  In my world full of yogis and alternative healers, people are anti- western medicine, anti- prescription drugs and definitely anti- “optional” surgery.  I am, too.  I spent about a year from the time my gynecologist stated, “Once you have your fibroids removed, you will feel better in a week than you have in years.”  What in the world was I waiting for, you may wonder.  But it’s a little more complicated than that.  (What isn’t?!) Should I try to save my uterus and risk new fibroids?  Should I have my cervix removed to prevent cancer?  Ditto the ovaries?  Am I ready for men-oh-pause?  Is it really that bad or should I live with it? I researched a lot, asked friends, consulted Eastern and Western doctors and did a lot of soul searching.  Once I was clear on what was right for me, I made a very clear boundary that the time for comments and suggestions was over.  I had made peace with my decision so they needed to forever hold their peace as well.  I had to cut a few people off mid-sentence. I stopped going to an alternative healer who disapproved of my decision. You need to be surrounded with support.

And speaking of (core) support, plan ahead.  Before any surgery, getting as strong as you can in advance will serve you well in your recovery.  You will want to be strong  not only in your core muscles, which will be out of service for longer than you will want, but also in your legs, arms and back body to compensate for your MIA core.  And even though no matter what you do, you will have no stamina after any major surgery, it will come back faster if you cultivate it before surgery.

Avoid the rabbit hole of pre-surgery jitters.  Whatever you do, realize that internet forums are filled with people with worst-case scenarios.  You will NOT be reassured by anything you find there. If you accidentally find yourself on one, change the channel immediately.  And no matter how tempted you might be, the night before your surgery is not the time to consult the internet.  Watching “Jack the Ripper” isn’t such a wise choice either.  (What WAS I thinking??)  Turn off your computer and plug in your earbuds with the most peaceful music or meditation you have.  Definitely play it in the morning, in the car and in the pre-op. Take it into surgery if you can.  If you’re like me, your surgical team will think you’re joking and/or crazy and won’t allow it. But definitely have someone there to plug you into it post-op.

I repeat: have someone there! The day of your surgery, you probably want your most kind-hearted friend with you as your hand holder. You also need a spokesperson.  Or what I affectionately termed a support team of what the f*ckers.  That friend who doesn't know when to keep the peace and maybe isn't the best hand holder? THAT is your best advocate. If you need to be in the hospital, you need someone with a louder, clearer, more emphatic voice than you will be able to muster saying, I don’t care what the clock says, protocol says, or who you need to call, we need X and we need it NOW! You also want someone holding your hand while this is going on. No matter how fiercely independent or just plain fierce you ordinarily are, you will be on drugs in a hospital gown unable to do much of anything on your own (because as soon as you can, you are outta there!).  So the only person seeing yourself as fierce is you.  Your fierce, inner warrior will serve you in your healing, but in getting what you need in the hospital… not so much.

Don’t be a hero. Your inner warrior should not be stoic! When I awoke from surgery and was asked to give my pain a number—which I learned was a requirement of hospital staff before administering narcotics—I actually thought:  well, the worst possible pain of a 10 would be having my legs and arms shot off, so I don’t want to exaggerate.  So even though I was in significantly more pain than I had ever experienced in my entire life, I said a 6.  If you are in so much pain that you can barely speak, it’s probably not a 6.  Three—count ‘em—shots of Dilaudid (aka synthetic heroin) later, I finally felt the pain subside.  But I didn’t learn my lesson there.  I continued to minimize the pain number as I imagined how horrific pain could be, but that tied the staff’s hands in giving me more pain meds.  It wasn’t until my second day post surgery that the nurse pointed at the very large white board that had been directly in front of me all along, detailing how the pain scale worked. If I wanted more narcotic pain meds, I had to give her a high enough number to warrant the drugs.  Your team of WTFers - who I recommend be sober - can help you with the math on this.

Just as pain is nothing to sneeze at, sneezing is nothing if not painful!  You want to avoid sneezing at all costs.  There is a sneezing center in your brain that sends a “tickle message” before you sneeze.    Luckily, there is a trick to prevent yourself from sneezing.  Just press your finger on the groove between your upper lip and nose, aka the philtrum, to suppress a sneeze.  This trick also works to suppress your sense of smell, which will come in really handy if you get nauseated by smells since the only thing worse than sneezing would be vomiting.

Post surgery, what’s missing?  Despite a bizarre combination of pain, numbness and swelling, I immediately felt a sense of space where I had had a grapefruit-sized fibroid outside of my uterus (technically, “pedunculated”) removed.  I didn’t have as much sensation of my uterus being gone in the beginning, but then, it wasn’t calcified and feeling like a rock in my belly.  And for enquiring minds, the six ligaments that attach your uterus to your pelvis are left behind.  Sloppy?  Maybe, but it’s less digging around to clip them at the pelvis, and that’s a good thing.   The stability they provided to your pelvis is gone.  Your bladder was more or less resting on your uterus.  That support is also gone.  If your cervix is gone, that is also a structural support MIA.  (Now is a good time to remember all the benefits of the surgery.)  It’s also a good time to get really clear about all of the muscles that support your core, which include the deep muscles of your back, abdomen, psoas and especially the pelvic floor.  The stronger they are pre-surgery, the sooner they will wake up afterward.  And you are going to need them more than ever.

Be ready to move way before it seems reasonable. Remind yourself that movement is required for healing because it’s the last thing you will want to do.  When I was wheeled into my hospital room, I was told I needed to start moving, starting with sliding myself off the gurney and onto the bed.  I thought the nurse had to be kidding.  But there she stood with her arms crossed and I realized she wasn’t.  I wanted to explain that I was a yoga teacher, that I was all about healing through movement.  But in that moment, savasana seemed more appropriate.   It took me a couple of minutes, literally, to slither onto the bed. I immediately discovered that rotation (twisting the spine) was the most challenging/painful movement for me. Remember that the more you move, the sooner you can go home.
What you don’t know can hurt you.  It’s astonishing how much you need your abs to do almost anything and how painful it can be.  I was shocked to realize that although the hospital staff was very attentive and knowledgeable re medications and procedures, a la western medicine, that they were clueless about body mechanics and muscle engagement.  Their well-intended instructions for me to get myself out of bed were ridiculous.  You need to use the electric bed to full advantage, bringing the head of the bed, and thus your upper body, as upright as possible and taking the bed as low to the ground as possible before getting up.  Bend your knees and put your feet on the bed and use your arms – which will engage your abs to some perhaps painful degree – and slowly swivel sideways, keeping your feet on the bed. Step one foot at a time onto the rail of the bed like a ladder unless you are lucky enough to have legs that will reach the floor.  And if your feet won’t touch the ground, demand a stool or something to stand on because any time your legs are dangling, you are going to wish they weren’t!  When you sit in a chair, have support behind you so you don’t have to use abs and hip flexors to hold you up because that would elicit more pain.  Also have support under your feet and do not let them dangle.  Let yourself stoop at the hips and bend at the knees initially when you stand and walk for less pressure on your incision.  Do not allow cameras in the room unless you have a very good sense of humor.

Knowledge is power.  The one tip the staff provided that was very helpful was to get a pillow (or something with a little more weight is even better) and gently press that into your lower belly for support to ease the discomfort.  Get a medical corset and use it when you stand or walk.  (Or if you have the je nais se quois for an actual corset, forget what I said about no cameras.)  They did not offer me one because I’m not heavy, but I found myself holding my belly in with my hands as I began to walk to prevent my swelly belly from pulling on my incisions.  I ASSumed since they didn’t offer me one that it wasn’t good for healing.  Nope.  They just didn’t think I needed it because I’m skinny.  You will find yourself walking like a robot initially, without the normal spinal rotation and arm swing of a natural gait. Take heart that your body intuitively does this to prevent pain from stretching/engaging obliques  and psoas in particular.  But your arms also steady your balance, so that was enlightening for me.   You will also find yourself walking with a stooped spine and bent knees because if feels better on the belly and requires less muscular effort.  Super sexy, right? This is another good time to remember all the benefits of the surgery. AND it’s not forever.  What is?

Timing is everything.  Notice when your pain meds are peaking.  That’s when you want to get up, take a walk, go pee… these are all ambitious plans post surgery.  This sounds obvious now, but nothing was really obvious to me post surgery.

Slumber party.  Your bowels are the last thing to wake up.  Knowing you need to pass gas or poop is quite a different thing from doing it.  I joked with a physical therapist friend of mine that I might need PT for pooping.  I don’t know if there is an app for that, but there is PT for it.  You won’t need it, but it’s good to know.  Take the stool softeners you are sure to be prescribed.  They work.  And so does Pepcid.

So give it a rest.  Your digestion, that is.  If you get served meatloaf hours after your surgery-- yes, that really happened, at Cedars Sinai, I might add! -- just smile.  You will intuitively understand that laughing is off the menu, too.  And so is anything that is hard to digest.  So if your well-meaning friends bring you soup with beans or lentils or anything gas forming, just keep smiling.  Be gracious.  And give it to your neighbors.  Warm, mushy, boring easy-to-digest food is best.  Even if you love fresh, green juices and protein shakes, my normally easy digestion was not up for these healthy super foods I was used to for weeks.  So even though protein is great for healing, it’s difficult to digest and even digestive enzymes might be hard on your system…. for now.

Back in the saddle.  When I left the hospital, I was advised not to put anything in my vagina for two weeks.  I had to stifle a laugh – painful! – as I asked, what in the world would possess me to put anything in my vagina any time soon?  Apparently, people use tampons for post-surgical bleeding (I had no post-surgical bleeding).  When you do have sex – and you will have sex again!! – it definitely does feel different.  Your uterus contracts during sex, as does your cervix, so there is a sense that something is definitely missing.  But I am happy to report that if you had orgasms before, you will have them again.  And if you still have your ovaries and cervix, the cervix is now a cul de sac, closed up with nowhere for semen to go but out.  (I asked.)

Getting back in gear, aka, driving.  My surgeon told me I would be able to drive when I could bend over and touch my toes while standing.  How many people would have their driver’s licenses revoked if this were part of the DMV test?  This makes no sense since it does not require the same muscles or range of motion as driving.  I could touch my toes two days after the surgery, which I discovered when I dropped my lip gloss on the hospital floor.  It turns out, if you have long, strong hamstrings and spinal erectors (back extensor muscles), hinging at the hips to grab your lip gloss and standing back up is one of the very few things that don’t require any abdominal support.  My surgeon did not believe me when I told him this.  Not surprisingly, telling your surgeon he doesn’t know what he is talking about – on any subject -- is not so well received.  The real question is whether you can bend your hip and knee beyond sitting position and then extend the knee vigorously, in case you need to slam on the brake or accelerator. I was driving in 10 days.  Not coincidentally, I was entirely off pain meds in 7.

Trading places.  I knew I would have swelling in my belly.  I knew my body would leach the protein from my muscles to facilitate my healing.  What I didn’t know was that all of the lean muscle in my body would immediately evaporate.  It was a magic trick – and not in a good way – at least from an ego/visual perspective.  Now my ass was flat and my belly was round.  For months… many, many months.  I wondered if my belly would ever stop swelling, even as I reminded myself nothing stays the same.  Just like everything else, it did eventually change.

It’s about time.  So maybe two weeks post-op wasn’t the best timing to take a workshop on the pelvic floor.  Or maybe it was perfect.  Nonetheless, there I was hunched over like a senior citizen attending Leslie Howard’s workshop.  I knew she has a bumper sticker “Save the Uterus” and that the whole thing might be a little depressing.  But for me, driving myself to the studio, being amongst friends, and participating (albeit gingerly) in a workshop on finding your core and how your uterus or lack thereof is part of that equation, felt like inner and outer core support.  I highly recommend her workshops and web site for guidance and resources.

How do you know?  I wanted to know when I should start exercising again, when I could go back to work again, when I would have energy again, when I could do a “real” yoga class again.  Unfortunately, it depends.  I started walking immediately, getting out of breath after a block at first.  I succumbed to daily naps, imagining I would get a second wind that never came.  For a few, long months.  I went to my first yoga class a month post surgery, though I still wasn’t really standing up straight.  Getting back to some version of my life was more important than how I looked doing it… which definitely wasn’t pretty.  No one can – or should -- tell you how much to do.  For me, my body would just spontaneously quit when I had had enough. I trusted that.   If you can’t trust yourself with this, find someone who is sensitive and experienced to work with because you do need to move and continue to lengthen and strengthen so you don’t get stuck.

And don’t get stuck with extra or unfair medical expenses.  Know your insurance. Know your rights.  I was very careful and precise with my insurance company, the hospital, pre-op procedures and surgeon about my out-of-pocket expenses. I made very certain that everything was in network.  But the dollar amounts are scary.  I made two piles of mail post surgery.  One was medical bills; the other was insurance reimbursements.  I just let them pile up, knowing they would be coming in for quite some time and that I would have 30 days to pay.  When it seemed like they had all arrived (they hadn’t!), I opened up the reimbursement pile first so I didn’t panic when I saw the bill amounts.  I got a $9,000 bill from my surgeon after my insurance had reimbursed him for the agreed-upon, in-service fee and after I had paid my maximum deductible.  His office offered to give me a discount when I called. They must have ASSumed I didn’t know that it is illegal for him to bill beyond what the insurance pays.  I wrote several letters to various medical providers with reimbursement proof attached, explaining that it was illegal to bill me further and to contact my insurance company with any further communication.  This did the trick. 

And it DID feel tricky.  I wanted all parties involved to be fairly compensated. (My insurance paid out $70,000, which seems more than fair.) And I wanted to be able to go back to the doctor. Like when I felt what can only be described as a thick rope of tissue underneath an incision. What is THAT?  Scar tissue. It is an interesting thing.  We need it to heal initially; then we need to carefully, mindfully, slowly break it down for the next phase of healing. I got some mixed advice re the scar tissue “cure.”  First: Consistently, diligently, forcefully massage the area and after about a year, it will go away.  Second:  After about a year, it will go away.  Really?!  I chose the kinder, gentler route of not f*ing with it, and it was gone within a couple of months of otherwise moving and healing my body.

Are we there yet?  Since I was planning to have the outpatient, laparoscopic feel-better-than-I’ve-felt-in-years-after-a-week surgery, I was a little stunned to wake up and realize my plan had been foiled.  Though I had packed a bag and made arrangements to stay in the hospital just in case, it wasn’t until after my surgery that I truly considered that this was gonna be a way bigger deal than I had wanted to admit to myself. It was only then that I allowed myself to comprehend the sad truth: it takes about a year to recover completely.  

One year later, I could still feel some twinges at times, some vague vestiges of trauma.  As a yogi, I knew neither my strength nor my flexibility were 100% what they were before.  Maybe they never would be. But my belly and butt had reverted to their normal positions; my energy was back; my pelvic pain, rock in my belly and long, heavy periods were gone; I still ovulated; my gynecologist – not the surgeon – reported that my anatomy was beautiful; and I don’t need birth control OR hormones.  So, yes, it may take a year. And, yes, it may even take longer.  After 2 years, I definitely felt better than I did at my first-year mark; definitely stronger with less scar tissue; my hormone levels are way down but my rudder is way steady…. So it’s a slow, steady climb back to a new, steady normal. 

Having a steady, physical practice of some kind is essential to prevent possible long-term complications of bone loss/osteoporosis, incontinence and organic prolapse that can stem from the early loss of hormonal and structural support associated with the uterus. This may also be a sad truth. Or an inspiration - and permission! - to give yourself the time and attention that you know you need to feel vibrantly alive.

Leslie Kazadi

(Repost from 2013)