BOOK REVIEW: The Way of the Iceman by Wim Hof and Koen De Jong

The Way of The Iceman: How The Wim Hof Method Creates Radiant Longterm Health--Using The Science and Secrets of Breath Control, Cold-Training and CommitmentThe Way of The Iceman: How The Wim Hof Method Creates Radiant Longterm Health–Using The Science and Secrets of Breath Control, Cold-Training and Commitment by Wim Hof
My rating: 5 of 5 stars

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Wim Hof is often presented as a freak of nature. If you’re flipping through the science channels, you might see a segment that shows him subjecting himself to extremely cold temperatures with no ill effects. This book is an attempt by Hof, and co-author Koen De Jong, to counter the proposition that he’s some sort of mutant (or—worse–that his demonstrations are cons) by offering a method by which anyone can achieve the same feats. It should be noted that long before Hof and YouTube came on the scene, there were people [notably Taoist and Tibetan Buddhist monks] performing similar acts.

Hof’s method (called the “Wim Hof Method” or WHM herein and in this book) consists of three components: cold training, breath exercises, and commitment building. The book explores this three-legged stool from both the scientific and practical dimensions. There’s one chapter on each of these elements that describes what it does to the body and how it contributes to well-being, and later chapters both describe what scientific studies have found so far and outline the approach by which the reader can explore the WHM on their own.

There’s a lot of front matter in this book (two forwards, a prologue, and an introduction), but the book more-or-less consists of seven chapters. The first of these is a mini-bio of Hof. It describes a fascinating event in Hof’s youth in which he was exposed to cold, as well as his travels to India in an attempt to find a yoga teacher. [As is the case with most people who come to India seeking to find that quintessential guru—i.e. a half-naked, weather-beaten, and forehead paint-streaked classical guru—he found that he had to wade through a sea of charlatans and shysters while never finding the true masters who are likely hidden away in caves in the Himalayas. Note: this is not to say that one can’t find excellent yoga instruction in India but it’ll likely be by someone fully clothed and not someone smoking pot on a ghat in Varanasi.] This resulted in Hof taking an experimental approach in which he studied the effects of various activities on himself (and such experimentation is what he advocates for others as well.) It should be noted that Hof didn’t invent this method from scratch—e.g. the breath component is based on Tibetan Tummo meditation.

As mentioned, Chapters 2 through 4 explore the three components of the WHM, i.e. cold training, breath exercise, and commitment building, respectively. These chapters describe the science of how these three elements generally (as opposed to a later chapter that describes studies in more depth) act upon the body. The commitment section describes a number of arduous feats such as climbing Kilimanjaro in a T-shirt and shorts, but also describes the role of diet (with particular emphasis on the fast-5 diet which is similar to, but not precisely, what Hof came to practice organically.)

Chapter 5 dives more deeply into the science than does the preceding chapters, and focuses on the studies in which Hof has participated in his attempt to facilitate a better understanding of his method.

The penultimate chapter suggests what the WHM might do for people in various classes, including: healthy people, athletes, and people suffering from various physical and mental ailments. With respect to the latter, there is discussion of exemplary cases as well as the possible means by which the training might act.

The final chapter is a brief outline of how the WHM can be put into practice by readers. There is also a sample log by which practitioners can chart their experience.

There are a range of graphics including line diagrams and photographs. Most of the photographs are inspirational shots of Hof in action, but there are diagrams and other graphics used to convey scientific ideas. There’s a recommended reading page as well as a works cited page. Both lists are small and confined to a few key sources of information, with the latter being the more scholarly works. There is also a glossary that may prove handy for some readers.

This book is illuminating and many stand to benefit from it. I found the approach of the authors to be sound; it’s basically “see for yourself.” This book could easily have been a sales brochure, and in some ways it is, but the fact that it emphasizes the science and the suggestion that the reader try the practice lends credibility. I’d highly recommend this book for anyone who wants to expand and explore the limits of their capability.

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BOOK REVIEW: The Science of Breath by Swami Rama et. al.

Science of BreathScience of Breath by Swami Rama
My rating: 4 of 5 stars

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This is an oldie, but a goody. The first edition came out in 1979, but as its intent is to provide an overview of the anatomy and physiology of breath for yoga practitioners, the fact that it doesn’t access the bleeding edge of respiratory science isn’t all that detrimental.

This short book consists of four chapters. Two chapters are by the famous yogi Swami Rama, and the other two are written by medical doctors. The first chapter is an introduction to breath from the yogic perspective. It both explains why it’s so important to understand and work with breath and introduces the mythic physiology (prana, nadi, chakra, etc.) that has historically been used to explain pranayama (breath exercises.)

The second chapter is written by Dr. Alan Hymes and it explains the mechanics of respiration. While Chapter 2 focuses on the anatomy of breathing, it begins with an explanation of cellular respiration to introduce the role of breath in powering muscles. There is a fine explanation of the operation of the diaphragm and the intercostal muscles in breathing.

Chapter 3 is written by Dr. Rudolph Ballentine, and it delves into the role of the nose and nasal cavities in respiration. Breathing through the nose is emphasized in both yoga and many other systems of breath training (e.g. the Buteyko and Wim Hof methods.) This is because the nasal cavities perform many useful functions such as moisturizing and warming air, capturing pollutants, and extract heating and moisture from exhaled breath. Besides exploring nasal anatomy and physiology, Dr. Ballentine describes jala neti shatkarma (nasal cleansing with salt water) and nadi shoudhana (alternate nostril breathing.)

The final chapter, written by Swami Rama, mostly describes various techniques of pranayama (breathing exercises) and related practices bandhas and mudras (locks and seals in which bodily parts are contracted or constricted.) However, the chapter begins with a mix of physiology and mythic physiology. That is, it explains some topics not addressed earlier–such as the interaction between the nervous and the cardiovascular systems as well as chakra.

My standing complaint about books that weave together science and pseudo-science is mitigated a bit herein. My problem with putting these ideas together is that it can be difficult for the reader to determine what concepts reflect reality and which offer models to help one visualize energy. However, except for the last chapter, this book does a good job of keeping these ideas separate. The chapters by the medical doctors present the science with minimal intrusion of unscientific concepts. Swami Rama does present science and mythology together, but not so much scrambled together in a confusing mish-mash.

Chapters 2 through 4 use a number of graphics to help present the material. In the middle chapters these largely consist of line drawings to convey the relevant anatomical features or physical actions. The last chapter adds photographs to demonstrate relevant postures. There is a page of recommended readings, but it’s more of an advertisement for other books put out by the Himalayan Institute than the recommendation of books on the science of breath.

I found this book to be educational. It packs a lot of useful information into a concise package and is readable to a layman. I’d recommend it for yoga practitioners and others who are engaged in breath work.

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5 Reasons to Write Poetry

We’re a week into National Poetry Month. I’ve posted a few poems with more to come, but here I’ll reflect upon the benefits of writing poetry. Some may point out that this is one-sided because the pantheon of poets is littered with opium addicts and suicidal depressives. I read a BBC article citing research showing poets were 20 times more likely to be institutionalized than the non-poet population. I maintain that those bards were broken from the beginning, and that there’s another side to the story.

 

5.) Poems are puzzles, and puzzles make you problem-solve. This may be more true of structured poetry than free verse, but a poem wrangles words into a relationship designed to create a desired outcome–often an emotional state. With structured poetry one faces a tight puzzle that’s constrained by syllable counts, the relation of stressed and unstressed beats, or rhyme schemes. But even free verse cuts away everything that dampens a desired resonance. That’s done by a series of strategic choices.

 

4.) Poetry aids emotional management. A study by UCLA researchers found that poetry writing dampens the activity of the amygdala (the brain’s bringer of fear) and, of course, gives the pre-frontal cortex something to do (besides creating catastrophic scenarios–which is its go-to occupation under stress.)

 

3.) Poetry helps build better prose. Some writers will be more concise and others will be more graphic, but there’s always a benefit to be had. I found a NaNoWriMo blog post that tackles this topic nicely, so I’ll just link.

 

2.) Poetry activates attentiveness. This is especially true of a form like haiku, which consists of natural observation unembellished by analysis or sentiment. However, all poetry styles require one examine the world intensely enough to see the old anew. This post may be of interest on the topic.

 

1.) Poetry can access the unconscious. As a practice, I often just put pencil to paper write whatever comes without intervening or directing my conscious mind. Yes, most of it’s crap.  Or not even crap–more like gibberish. But when I go back through these later on, phrases often jump out at me as interesting or evocative, and these often find their way into the heart of actual poems. This is a particularly beneficial practice when one is stuck.

5 Hyphenated Yogas That Miss the Point of Yoga

The laissez-faire and easy-going yoga community has spawned some phenomenally ridiculous mergers. I have “yoga” as a term on Google News, and almost every week I get fed a new example. I’m not saying every new approach to yoga is bad, but there’s one disturbing trend–i.e. the distraction yoga.

 

In the title, I refer to “hyphenated yogas,” but what I’m really ranting about is “distraction yogas.” A distraction yoga is one in which an element is brought into the practice so that one doesn’t have to keep one’s mind on one’s breath, alignment, and / or mental state. (Because who wants to think about that shit when one can be thinking “Wow, that kitten sure is cute.” or–believe it or not–“This beer has hoppy undertones.”)

 

Now before I get accused of hating puppies or beer, let me point out that nothing could be further from the truth. What I’m ranting against is the notion that you can marry any two good things and make a great thing. If you don’t believe me, please allow me to dip my nachos in your banana split. See, there are plenty of things that are awesome independently that make abominations when forced together.

 

I’ll include links as I go, lest you think I made this stuff up for hilarity’s sake.

 

5.) Beer Yoga: This is one of the most recent and intriguing distraction yogas. I’m not saying that one needs to follow a strict Vedic approach to life to practice yoga, but–come on–could you stop drinking for a couple hours to pretend your body is a temple (or at least that it’s not sitting in a trailer park with the windows busted out.) Unless “calf slaughter-yoga” catches on, it’s hard to imagine a less yoga-like practice than consuming intoxicants during the practice of yoga. By the way, there’s also a marijuana yoga, but I’ll lump these together as intoxicant yogas.

beermug

 

4.) Goat Yoga: This is one of many “animal yogas.” Like the others, the point is to have cute creatures around. How it’s supposed to help one’s yoga, I can’t fathom. Actually, I can fathom the suggested logic, probably something to do with calming and engendering feelings of compassion and well-being. But, ultimately it’s distraction by cuteness. Note: you can also do yoga with cats, dogs, horses, and probably river otters.

goatyoga-461x346

 

3.) Karaoke Yoga: Talk about distraction–nothing better than pounding music and reading a prompter to keep one’s mind off that ache in one’s hamstring.

karaoke_yoga

 

2.) Rave Yoga / Club Yoga: This might be a cheat because it’s similar to the previous one on the list, and I’m trying to lump these together so as to not be too repetitive. However, it’s not exactly the same, and is the perfect example of a distraction yoga. (There’s also Harmonica yoga and other musical yogas, but I won’t double-dip anymore.)

bombay_yoga-2e16d0ba-fill-735x490

 

1.) Tantrum Yoga: It wasn’t easy to determine whether I’d include this one or not. On the one hand, it’s not a distraction yoga in the sense that the others are. On the other hand, it takes the award for being least yoga like on the grounds that it’s not about dispassionately witnessing one’s emotional state but rather feeding one’s negative emotions. Note that I don’t group laughter yoga into the same class. I’m not sure whether laughter yoga is beneficial (or to what degree it’s a yoga), but I know that many people benefit from it because it bolsters positive emotional states.

tantrum

 

Now, one may have noticed that there are many seemingly strange (hyphenated) yogas that I haven’t mentioned. I haven’t said a thing about surf board-yoga, stripper pole-yoga, or acro-yoga–and I specifically excluded Laughter Yoga from the wrath of my rant. That’s because this isn’t a rant about people being innovative or non-traditional, it’s about people missing the point of what yoga is supposed to be (i.e. a means to quiet the mind.) I don’t know whether I can see myself doing yoga on a surf board or a stripper pole, but I’m certain that one has to give it one’s full attention–it’s not about finding a distraction to make yoga more palatable to hipsters.

BOOK REVIEW: Light on Pranayama by B.K.S. Iyengar

Light on Pranayama: The Definitive Guide to the Art of BreathingLight on Pranayama: The Definitive Guide to the Art of Breathing by B.K.S. Iyengar
My rating: 4 of 5 stars

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This is B.K.S. Iyengar’s A-Z guide to breath and breathing exercises (pranayama.) It’s meant to do for pranayama practice what “Light on Yoga” did for asana (postural) practice. That is, it presents all the classic techniques, offers variants to meet individual needs, and provides the background necessary to put pranayama into the context of a balanced yoga practice.

Let me begin by discussing the book’s organization, and this book is organized to the n-th degree. There are parts, sections, chapters, and even the paragraphs are numbered (though–near as I can tell–the latter serves no purpose for a typical reader and may be more for the help of the writer and his assistants. It does create a somewhat biblical scheme, so maybe it was assumed there would be a need to quote this guide “chapter and verse,” as they say in Bible study.)

The bulk of the book consists of the first of two parts, and Part I is divided into three sections. The first of those sections is “The Theory of Pranayama,” and it puts pranayama in the context of yoga’s entirety. If you’ve read other B.K.S. Iyengar titles, much in these nine chapters will be familiar (e.g. discussion of the eight limbs.) However, chapter 4 offers a nice description of the anatomy and physiology of respiration. There are many anatomical drawings and diagrams in it to help convey the complex information. There’s also additional information about the traditional Indian notions of breath encapsulated in the concepts of prana, nadis, and chakras.

Section II is entitled “The Art of Pranayama” and it covers those topics necessary regardless of what technique of breath exercise one is practicing. It includes seated postures, mudras, bandhas, inhalation, exhalation, retention, etc. This section, too, has nine chapters. The final section of Part I describes the various techniques of pranayama. The chapters of this section are arrayed in lists, and they systematically build from the basic technique towards more advanced variations (e.g. by inserting retentions.)

Part II covers meditation (dhyana) and the corpse pose (savasana.) With respect to the former, it suggests how one’s body, mind, and sense organs should be conducted in the act of meditation. In the case of the chapter on corpse pose (after cross-legged seating position, this being the most common position for practice) there’s an extensive look at the details of that pose.

There are a number of helpful features incorporated into the book. In addition to the drawings mentioned in Chapter 4, there are black-and-white photos throughout to clarify the textual instructions. There is also a glossary of Sanskrit terms and an Appendix of courses of pranayama (i.e. recommendations as to how to sequence breathing techniques for optimal results with guidance as to how many sets or repetitions of each to use.)

My major criticism is one I’ve offered about previous books from this author and others. There’s a muddle of science and mythology that makes it hard to know how much weight to give particular instructions. It may be that a given piece of advice (e.g. a contraindication) is based on repeated observations of the physical or mental effects, or on a sound understanding of anatomy & physiology. In which case, it makes sense to heed such advice. However, advice can also be based on myths and the desire to preserve a way of thinking about the human body which is wholly unsupported by evidence. In which case, if one has no dog in the fight to preserve egos, it makes sense to disregard said advice. I suspect the vast majority of statements of what to do (or not to) fall into the first category, but some may fall in the latter, and it’s not easy to tell which is which.

I would recommend this book for students and teachers of yoga. It’s a good reference for one’s pranayama practice.

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BOOK REVIEW: Altitude Illness by Stephen Bezruchka

Altitude Illness: Prevention and Treatment (Mountaineers Outdoor Expert)Altitude Illness: Prevention and Treatment by Stephen Bezruchka
My rating: 5 of 5 stars

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I picked this book up after my third, and most recent, trek at high altitude. On each trek, I felt the altitude at some point along the trail, but the most troubling and persistent issue for me has been sleep disruption—what I learned in the book was called periodic breathing. That was one of several useful lessons I learned from this book.

Altitude illness is an odd affliction. There’s a clear logic to what is happening inside your body. There’s a lack of sufficient oxygen to get said oxygen distributed throughout your body by way of your body’s business as usual operations. Homeostasis is out of whack, and the body does a number of things at once to rectify the problem. Because of this, in practice the ailment is actually a range of disparate illnesses that can seem to act in an arbitrary manner. Different people feel altitude in different ways. Some have no problems if they acclimate a few days, but others hit a ceiling beyond which they can’t travel no matter what. One’s level of fitness has little to do with how well on acclimatizes. For some, like myself, it can be a nuisance, but for others it can turn into a threat to survival in a flash.

This book is a concise introduction to altitude illness that covers: acclimatization / adaptation [ch. 1], the various forms of altitude illness [ch. 2], prevention [ch. 3], diagnosis [ch. 4], treatment [ch. 5], the effects of altitude given common preexisting conditions [ch.6], and a guide to preparing for a high altitude jaunt [ch.7.] In addition to the chapters mentioned above, there are two final chapters that make for nice features. Chapter 8 presents case studies of various true instances of altitude afflictions. The cases not only make for interesting reading, but also may help one connect the dots as to what is happening with oneself or someone in one’s party. The last chapter is a frequently asked questions (FAQ) collection that helps to summarize and restate issues addressed in the main chapters. The FAQ may also help one find needed information more quickly, rather than having to flip through the entire book while someone is having trouble.

There are some graphics in the book. Most of the graphics are photos of high or extreme elevation environments—and mostly the latter. (fyi: The book calls 12,000 – 18,000 feet [3660m to 5490m] high altitude, and over 18,000ft [5490m] is extreme altitude.) There are also several tables and a line drawing or two. There’s a short bibliographic section that is nicely divided into two sections, one for health care professionals and the other for lay readers.

I found this guide to be useful and well-presented. It’s well organized, concise, and easy to navigate (bullet points are frequently used to good effect.) This is the kind of book that is meant to help you get to the information you need quickly. There’s not a lot of use of the narrative approach beyond the case study chapter and a few anecdotes in the chapters to liven the discussion. I don’t mean to make is sound dry, but it’s a book with a purpose and that purpose isn’t entertainment. The lack of extraneous information and the keeping of blocks of text small is a good idea for this kind of guide. Having said all that, it’s quite readable by a layman. Jargon is explained and there is a glossary. (There are only a few medical terms—e.g. edema (fluid build-up), ataxia (incoordination), and syncope (fainting)that one needs to be concerned with repeatedly.)

If you will be traveling at altitude (and remember that may not be high or extreme elevations, some people have problems at as low as 6000ft [1800m.]) I’d highly recommend this book. I’d further recommend one re-read it on subsequent high elevation travels. It’s a short book and is broken up into tight subsections.

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BOOK REVIEW: Siddhartha’s Brain by James Kingsland

Siddhartha's Brain: Unlocking the Ancient Science of EnlightenmentSiddhartha’s Brain: Unlocking the Ancient Science of Enlightenment by James Kingsland
My rating: 5 of 5 stars

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Kingsland builds his niche by connecting the dots between the teachings of the Buddha and scientific discoveries about meditation and mindfulness. There are many books that tell the life story of Siddhartha Gautama from various perspectives (e.g. famously the books by Hermann Hesse and Karen Armstrong.) There are also a number of books reporting the science of meditation (e.g. Herbert Benson and Sat Bir Singh Khalsa.) However, it’s not so common for the subjects to be overlapped.

There’s a reason that this middle path hasn’t been more widely studied. While Buddhism is arguably the most science-friendly of the major world religions, there’s always a gulf between spiritual and scientific thinking. The writer has to figure out how to chart a course through rocky waters. Books appealing to spiritual seekers are likely to come across as insubstantial fluff to the scientifically minded reader, and books appealing to skeptics are likely to feel materialistic and cold (and, perhaps, naive) to the spiritualist. The Buddha’s teachings about the need for the practice to be experiential, rather than faith-based, offers a unique opportunity to tread this tightrope. Furthermore, the Dalai Lama’s willingness to facilitate a dialogue between science and Buddhism has been crucial as well. One can easily set aside controversial issues like reincarnation and karmic law as they aren’t essential to the value of mindfulness.

The book consists of twelve chapters. The chapters generally begin with a story or teaching from the life of Buddha, and then go on to investigate the relevant lesson in more detail with particular emphasis on any relevant scientific discoveries that support said teachings.

The story of Buddha begins in a wealthy, high-caste household with young Siddhartha Gautama being kept from seeing the effects of aging, illness, and death. When the young Siddartha, nonetheless, sees these things, it is a powerful introduction to the concepts of impermanence and suffering that will play a central role in his future teachings. Chapter 1 starts this introduction and also offers an overview of the book. Chapter two continues it. In Chapter three, Kingsland describes a little of the known history of meditation, though its origins are lost to time.

Chapter 4 is entitled “The Second Dart” and it discusses the Buddha’s teaching of the same name—the second dart being one’s mental reaction to an event (i.e. the initial dart.) Chapter 5 investigates the question of whether there is a self—and, if so, of what manner. A core idea within Buddhism is that the self is illusory.

Chapter 6 gets to the heart of the matter by explaining the mechanism of mindfulness meditation and what has come to be known as MBCT (Mindfulness Based Cognitive Therapy)—a secular approach to the use of mindfulness to improve well-being. The next chapter tells the story of how a group of fire worshippers came to follow the Buddha after he made clear that everything (their senses, thoughts, and emotions) were aflame with craving, hatred, and delusion, and that springboards into a discussion of how mindfulness is used to reduce craving and addiction.

Chapter 8 tells the story of an attempt to kill the Buddha via an angry, drunk elephant, and the Buddha’s thwarting of the plot by way of calm and compassion. As one might have guessed, the chapter is about moderating emotions, just as the Buddha controlled his fear before the elephant.

Chapter 9 takes a jaunt into evolutionary biology to question how the mismatch between what humans evolved to do and what we do in the modern world causes mental illnesses and how mindfulness can help mitigate the problem. Chapter 10 is about metacognition, or the ability to observe and reflect upon our own mental experience—i.e. thinking about thoughts. Chapter 11 is about cognition and decision-making, and the role that meditation can play in improving our performance in this domain. The last chapter discusses the Buddhist conception of death and enlightenment. It isn’t until this point that there’s a major divergence between the Buddhist and scientific viewpoints. There is a discussion of the Buddha’s teachings emphasizing that belief in ideas from on high is not so important as experience.

Six of the chapters (2, 4, 6, 8, 10, & 11) are concluded with guided meditations to offer the reader an introduction into the basics of mindfulness. These are simple practices that many readers will already be familiar with in some variant or another. (e.g. breath awareness, bodily awareness, and mindful eating.)

There are only a few graphics (e.g. maps and diagrams—mostly of the brain) but there is no need for additional graphics. The book has references annotated.

I found this book interesting and thought-provoking. It uses the stories of Buddha as well as some stories from the present day to make the reading more engaging and approachable. The discussion of scientific research is easy for a neuroscience neophyte to follow.

I’d recommend this book for anyone interested in learning more about the science behind Buddhist practices.

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BOOK REVIEW: Low Back Pain ed. by Jeffrey N. Katz, M.D. [A Harvard Med School Guide]

Low-Back Pain: Healing Your Aching BackLow-Back Pain: Healing Your Aching Back by Harvard Health Publications
My rating: 5 of 5 stars

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This guide is one in a series put out by Harvard Medical School. It’s the second one that I’ve read, and I found them both to be beneficial reads. The first was on the health benefits of tai chi chuan (a Chinese martial art / system of health exercise [qi gong.])

Harvard Medical School’s willingness to report findings about unconventional approaches and self-care was part of the appeal of this book. When I first developed lower back problems, I went to the doctor, was diagnosed with arthritis via x-ray, and all I got was an offer for pain killers. To me this was much like going to the mechanic because the check engine light came on, only to be told that all they could do for me is unplug the pesky indicator light. At any rate, that’s why this kind of book can be useful, because one can’t always expect a given doctor within the modern medical establishment to be on top of treatments not involving drugs or surgery. This isn’t to denigrate those options, often times they are the best or only option, and they are covered in this guide as well. However, back pain is one of those rare areas in which sometimes the best option is outside medical norms. Much as many doctors hate having information thrust in front of them by patients, at least Harvard Medical School may garner more respect than a WikiMD post. There’s even a box talking about the mind-body connection, and options in that domain.

Low back pain is both extremely common and often still poorly understood. That’s because there are so many problems that can cause similar symptoms. [I guess this shouldn’t be a surprise because our pelvis had to rotate through evolutionary changes to take us from quadrupedal to bipedal. It makes sense that our nerves and blood vessels might be routed in such a manner as to cause troubles.]

While this guide is short, it does take on a range of issues, including: who’s most at risk, how the spine works [and doesn’t], what the basic categories of back injury are, how one’s specific ailment may be diagnosed, how to evaluate treatment options, what one can do on one’s own to help heal a problem back while preventing future injury, what medicines may be prescribed, what surgical options may be offered, and advice on facilitating a recovery.

As far as ancillary features are concerned, there are a number of line drawings. This artwork is generally either anatomical drawings used to show how the spine works or is injured, or show exercises that one can use to strengthen the back. There are a few pages each of resources and glossary. The resources are not so much printed resources (there’s only one of book, and that one is authored by the editor of this guide,) but rather organizations and even websites.

I found this guide to be informative and helpful. I would recommend it for anyone who has low back problems, or who might benefit from learning more about them (e.g. yoga teachers.)

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BOOK REVIEW: Piriformis Syndrome by Loren Fishman, M.D.

Piriformis Syndrome: Diagnosis, Treatment, and Yoga: Pain in the ButtPiriformis Syndrome: Diagnosis, Treatment, and Yoga: Pain in the Butt by Loren Fishman
My rating: 4 of 5 stars

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This short book (<50pp.) describes piriformis syndrome, what causes it and how it’s diagnosed and treated. Piriformis Syndrome is a malady in which a nerve is pinched by the piriformis muscle. Because of the way pain (and other sensations) radiate, it’s not necessarily easy to differentiate this syndrome from a low back injury. However, the descriptions of the specifics of this condition, and the test used to diagnose, it may give one insight as to whether one is looking in the right direction for the cause of one’s butt and leg pain.

One nice feature of this book is that it explains how yoga can be used both as part of the treatment regimen and as a preventive measure. The yogic treatment consists of just four classical postures of Hatha Yoga: Janu Shirshasana (head to knee pose), Parivrtta Trikonasana (twisted triangle pose), Matsyendrasana (a simple twisting pose named for a sage), and Parivrtta Parsvakonasana (twisted side angle pose.) However, yoga teachers who have students who’ve been diagnosed with this condition will find it nice that the book gives modifications and clarifications pertaining to use of the postures to help such people.

There are seven chapters in the book. The first describes the condition and its cause. The second chapter explains the connection between the condition of piriformis syndrome and the symptom of sciatica. Chapter three clarifies the ways in which this condition may be misdiagnosed, and this is followed up by the chapter that shows how it is diagnosed by both physical examination and by imaging technology. Chapter five gives a basic overview of the available treatment options including injections, drugs, physical therapy, surgery, and yoga. The next chapter talks about the state of research. The last chapter explores the yoga asana that can be used to help treat or prevent piriformis syndrome. There are a few graphics. These include line drawings such as of the diagnostic physical exam, and photos of modified versions of the yoga postures.

I’d recommend this book for those who’ve been diagnosed with this ailment, who believe they might have it, but also for yoga teachers who are interested in expanding their understanding of the afflictions of which their students may suffer—so as to be prepared to help them or, at least, not hurt them.

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BOOK REVIEW: Being Mortal by Atul Gawande

Being Mortal: Medicine and What Matters in the EndBeing Mortal: Medicine and What Matters in the End by Atul Gawande
My rating: 5 of 5 stars

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This may be the scariest, saddest, and most necessary book that I’ve read in some time. In it, Dr. Gawande discusses how medicine has proven increasingly effective at extending life, but—at the same time–we are less able to care for the elderly. The traditional approach, in which the elderly move back in with their families (or live independently near them,) often proves untenable. And it’s not necessarily because people are too busy, lazy, or indifferent to put up with granny, but rather that granny is likely to end up with needs that require a professional caregiver—in some cases for virtually every aspect of her daily life. In short, we’ve done a great job of extending life, but often with a sharp dip in the quality of life at the end.

The nursing home was the solution that the health care community came up with when this problem first became apparent. While the nursing home is both necessary and effective for many, for those of sound mind and sound-ish body, the move can be highly demoralizing. People revert from being independent and autonomous adults into a child-like status in which they have little freedom or privacy. Again, if grandpa has dementia or needs to be tube-fed, there’s no way around this, but if he’s just at risk for a fall that might break his hip, then it can be humiliating.

When it comes down to the end, fear of death has led to an unwillingness to ask important questions or even consider what might be just around the corner. This has led patients to keep asking for that one treatment that just might extend their lives—and doctors have been more than willing to allow this. This may be fine in the early days of a terminal illness, but once one has gone through—say–a couple of courses of chemotherapy, the treatment one is likely to get is some trial phase experiment that is as likely to kill one cruelly as extend one’s life—and to the degree that it does extend one’s life one may suffer a set of complications far more miserably than one would in letting the disease kill one. One of the most intriguing study results cited showed that people who took up hospice palliative care (making one comfortable) were found on average to live a little longer than those who kept seeking whatever treatment they could find.

This all sounds like bad news, but the author devotes much of the book to exploring the options that have been put forth in the face of these problems. One of these is the assisted living facility as an alternative to a traditional nursing home. These facilities work for people who are of sound mind and who aren’t too bad off physically. They allow the individuals to live as they might in a condo or apartment, but there are on-sight caregivers and assistance with all the tasks around the house that might prove too challenging for an older person. The other major solution is hospice care. Not that palliative care is new, but it’s increasingly being show to be a preferable option for all concerned. Another important outcome resulted from a major insurance provider’s decision to allow individuals to pursue palliative care while they were still being treated. [Historically, one only had the option of hospice once one had given up on treatment.] At any rate, the intriguing finding was that the insurance company actually ended up paying less because more people signed up for palliative care and those individuals used expensive health care elements like emergency rooms and intensive care units (ICU) less.

While I can’t say that I enjoyed reading this book, I would recommend it for everyone. It’s very readable. The approach is case-based. Dr. Gawande talks not only about his own patients and the patients and caregivers that he interviewed (his practice is not geriatric in nature, so he spoke with several experts), but also about the end of his own father’s life. It’s a short book of about 300 pages arranged into eight chapters. There are no graphics, and endnotes are the only ancillary matter, but nothing else is necessary for this book.

Read it.

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