Yoga for Parkinson’s Disease

awkward_pose_3-001“Inhale. Raise your arms out wide and overhead.” Charles’ right arm lifted 45 degrees off his hips. His left arm lagged, though it pivoted a few inches higher. His left hand bent at an odd angle. “Can you straighten your wrist to create a continuous line from shoulder to fingers?” He flashed a smile that indicated he knew what I requested, but his hand didn’t budge. Charles was oblivious to it being skew.

This large man in gym shorts and a scrub tee sitting on the edge of a straight chair with his arms cocked like a broken-winged bird was striking Tadasana. Mountain Pose, the tallest of yoga poses. For most Tadasana is an arrow of energy reaching proud to the sky. But for an 82-year-old with Parkinson’s Disease, it looks very different. I noticed that Charles’ arms rose higher than the previous day, if only by half an inch. His effort was genuine. It was a good Tadasana.

I focus on teaching yoga to middle-aged and elderly men with compromised mobility. Some suffer from too many sedentary years and too much food; others have tender backs or nagging sciatica. The most severe, like Charles, suffer debilitating conditions that make everyday movements difficult. Regardless how old and infirm a person is, I develop a sequence of breath and asana he can execute with satisfaction, and then we work to extend mobility beyond that benchmark.

My work with Charles, a native of India visiting Boston for an extended period of medical treatment, highlighted the benefits yoga can bring to people with complex medical conditions. It also illustrated how yoga could be integrated into a comprehensive treatment plan. I incorporated Charles’ physical therapy exercises into our sessions, yet remained focused on the specific benefits of asanas: breath; control; and alignment.

Parkinson’s disease is a progressive movement disorder that occurs when our brain doesn’t make adequate amounts of the neurotransmitter dopamine. Dopamine disseminates messages from our brain to our muscles. Without enough dopamine we have uncontrolled movement. Parkinson’s most familiar manifestation is tremors, particularly in the arms and legs, but the disease can also produce stiffness, slowing movement, changes in speech, and erratic gait. There is no cure. Medications help people control Parkinson’s and exercise is effective in alleviating symptoms and extending mobility.

Any type of movement can benefit Parkinson’s patients. However, activities that incorporate pattern and sequence, like Tai Chi, zumba, and dance, are most effective. Yoga, which integrates pattern and sequence along with breath control, is particularly effective.

Parkinson’s Disease has five discrete stages. Tremors are common during Stages One and Two. Charles was in Stage Three, when shaking often gives over to an eerie calm. Charles stood still for moments before he moved, concentrating on his first step. Then he made quick, tentative wobbles. Once underway, he stepped forward at a steady pace and often accelerated until he encountered some obstacle or needed to change direction. Then he stopped, recalibrated, and began the hesitating sequence again. If I set my foot directly in front of his, Charles immediately stepped over me and continued walking, as if the obstacle added urgency to the message from his brain to his leg.

images-1I had outlined a Parkinson’s-based posture sequence derived from Iyengar, Renee Le Verrier, and literature about yoga for Parkinson’s, but anticipated adjusting it according to Charles’ capabilities.

His son Frank shared Charles’ physical therapy exercise diagrams and expressed concern about his father’s lost leg strength. Although I wanted our sessions to complement Charles’ medical treatment, my emphasis was yoga, so I began with breath.

Charles sat on a straight chair with his knees out straight. We inhaled and exhaled to a regular rhythm. I hovered my palm two inches above his thigh and. “Inhale, raise your right thigh to touch my hand. Exhale, release your foot back to the floor.” Charles maintained his breath, but couldn’t correlate movement. His thigh lifted, slowly, then abruptly fell. It rose again and again with increasing speed until I lowered my hand to his knee and steadied his leg to the floor.

UntitledWe spent fifteen minutes doing toe raises; heel raises; hip flexes. He lifted one leg and crossed it over the other. I focused on consistent breath even when his movements were erratic. We stood. He held the back of his chair. More toe and heel raises, full leg flexes, and knee bends. We ended our half hour by marching in place, one of his PT exercises. After four or five steps, either Charles’ knees trembled or his legs rooted in stillness. It was remarkable how the same sequence would dissemble in such contradictory ways.

During our first week we established a warm-up routine, incorporated his PT exercises, and added new poses. Charles couldn’t get up and down from the floor, so we concluded sessions with supine twists and savasana on his bed. I massaged his legs and feet. His muscles were taut despite not being able to move them as he desired.

The second week, we extended our sessions to 45 minutes. Charles’ movements became more controlled; sometimes they even corresponded with his breath. One day, after Savasana, I eased him into a sitting position. “Can we do yoga breathing?” he asked. Before I could answer, he brought two fingers to his nose and initiated Nadi Shodhin, alternate nostril breathing. Then he stiffened his belly and began percussive Uddiyana breath. After twenty or thirty quick exhales he brought his hands over his eyes and let out a trio of Om’s. Charles never explained where he learned these breathing techniques, but we established a new way to end each session.

At the beginning of our third week Charles wanted to move his reclined poses from bed to floor. I was concerned about getting this 190-pound man onto the carpet, and even more concerned about getting him back up. But his initiative was strong, so I tailored our standing series to prep for lying down. I discovered that Charles could raise his hands full overhead if he moved his arms forward rather than laterally. We practiced squats, albeit shallow ones. We moved into Halfway Lift, first with hands on thighs, then hands on shins. Using his chair as an aid, Charles descended to his knees and got into Table Top. He struck Cow/Cat and maintained his balance through gentle forward shifts. Finally, Charles lowered all the way to the floor, rolled on his back and grinned at his success. The firm surface improved his floor exercises. Getting back up took more than a minute as he shifted to a seat, knelt to Table Top, and pressed against his chair to stand.

Every day Charles greeted me with a smile, proclaimed he was stronger, and demonstrated that conviction. I came to expect continuous improvement. Then, in the middle of our fourth week, his smile faltered and his movements were slow. He stumbled moving into Table Top. I broke his fall. He rolled onto his back. Then he laughed.

Untitled“Why do you always laugh?” I asked about his odd reaction to anything that proved difficult.

“What else can I do?” He shrugged his large, awkward body, raised his eyebrows, and chortled some more. After his floor postures Charles took a long savasana and I gave him a gentle massage. I supported his sitting position for our final breathing with my legs. The vibration of his Om’s resonated through my shinbones.

I discussed the change with Frank, who explained the doctor’s had taken Charles off his Parkinson’s medications to test his functioning without them. I was glad to understand the reason for Charles’ sudden dip, and marveled at how close our body chemistry is linked to our abilities.

For the next week, every day was different. One day Charles was strong, executing all his poses and working from the floor. The next day he was so fatigued he remained in his chair. Frank reported improvements in other aspects of Charles’ health attributed to reduced drugs, so we continued to explore how to regain balance and strength with his new regimen. Eventually Charles spent more time standing and, on good days, executed his entire sequence.

Rotational movements were very difficult, which made sense since moving in multiple planes is complex. I introduced seated and standing twists, lateral movement synchronized with breath, and angled steps with a torso shift to open the centerline of his body. Charles turned in a circle by shuffling through dozens of tiny weight shifts rather than taking discrete steps. I slowed his movement down, encouraged him to place one foot with one breath, and he learned how to turn a full circle in only six steps. The number six became our threshold limit. Whether straight or in a circle, Charles could not maintain a steady gait beyond six steps.

We practiced yoga five times a week for six weeks until Charles returned to India. Six weeks is insufficient time to make definitive claims for yoga’s influence on a Parkinson’s patient’s health, movement, or disease progression. Due to Charles’ age and advanced disease stage, much of what we did was a hybrid of yoga, elder fitness, and physical therapy. It is difficult to separate the benefits of our yoga from Charles’ drug regimen and physical therapy. However, Charles, Frank and I can each attest to improved balance and strength. Hopefully, more controlled scientific studies will be done to reinforce and refine the link between yoga and Parkinson’s. In the meantime, the anecdotal evidence is strong that regular yoga can be a powerful adjunct to medical treatment.




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Interview – Architecture by Moonlight

haiti-001The MIT Alumni Association produces a podcast each month that highlights an alumni’s book. This month features Architecture by Moonlight. Thanks for Joe McGonegal and Brielle Domings for drawing insights between my MIT experiences of forty years ago with my recent endeavors. MIT Podcast Interview

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Let Pilobolus Build the New World Order

vitruvian_man-001I attended an incredible workshop this week; WBUR Cognoscenti published my thoughts about letting the improvisational dance group Pilobolus show the world how to lead, follow, and all get along.

Since Cognoscenti doesn’t pitch events, the awkward poser can recommend that you witness Pilobolus this weekend at the Citi Shubert Theater in Boston, hosted by Celebrity Series. It will be a memorable performance, and perhaps reveal new ways for us all to move together.


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Two Lookin’ Atcha

usa-001The refrigerator shelves were almost empty. My middle-aged brain couldn’t concoct a breakfast from leftover chili, half a dozen eggs, kidney beans, two day-old rice, diet Cherry Dr. Pepper, and a jar of strawberry jam. Until I realized the meager pickings held everything I needed to jump-start my day with a Denco Darlin’.

Denco’s Cafe anchored the corner of East Main and South Jones in Norman, Oklahoma for over 35 years. Rumor has it the original Darlin’s satisfied men’s cravings of a different sort in the upstairs rooms of the commercial block tight to the railroad tracks. But by 1972, when my high school buddies and I frequented Denco’s after a long night, Darlin’s were a legitimate menu item.

Main Street Norman swells to 100 feet wide where the street grid shifts to accommodate the crick in the Atchison Topeka and the Santa Fe tracks. The rest of town aligns with a compass grid and the University of Oklahoma campus. Forty years ago the grid shift separated downtown’s gun shops, pawn shops, and boot shops from the campus’ malt shops, head shops and fern bars. Working cowboys had no business near OU, and vice versa. Except late a night, when everybody showed up at Denco’s.

Neither laborers nor fraternity boys, we were oddball high schoolers better at math than football. We opted out of Norman High to attend University School, a pair of Word War II outbuildings on OU’s neglected North Campus; misfits in a town where football rules in the generation before Big Bang Theory made geeks cool. We didn’t drink or smoke much; still our heads nurtured a rebellious buzz. We grew our hair long, tried to grow beards, listened to American Pie, and played bridge ‘til dawn several nights a week. Around four in the morning, hungry and giddy, we drove through blinkered lights and angle-parked my parents’ Torino wagon between mud-caked pick-ups and flashy GTO’s.

imgresDenco’s was open twenty-four hours, though I don’t believe anyone frequented the place in daylight. Wee morning was prime time; daybreak men in working jeans cradled mugs of hot coffee, late-night partyers in paisley shirts nursed burgeoning hangovers. We found a booth and ordered our Darlin’s. The food was cheap. The air, laced with cigarette smoke and stale beer, was free.

A Denco Darlin’ with Two Looking Atcha came in a shallow metal plate, like a miner’s pan, filled with elbow macaroni, a ladle of chili, a handful of shredded cheddar, and two sunny-side eggs. The food was piled high but never overspilled the edge. Grease held the assembly in place. One morning I tried to extract a unique noodle from my meal without success and therein grasped the principle of covalent bonding.

Just before swallowing the last of my chili and slurping my Coke I realized that sleep had slipped off my agenda. I’d motor straight through to my 11 a.m. shift at Safeway. Sacking groceries for eight hours on no sleep wasn’t fun, but it wasn’t hard either. My buddy Mark’s eyes were half-closed; he was expert at sleeping through the day. Larry was wide-eyed as me. Konrad, our quartet’s philosopher, retained an inscrutable look. He extracted a toothpick from the jar on the table, inserted it along his upper gum and pronounced, “My teeth feel like they’re wearing sweaters.”

Denco’s closed a few years after we graduated from high school. Attempts to recreate Denco’s have failed. The streets of downtown Norman still run at an odd angle, but these days that’s the only thing unique about them. There’s not much cow town left. Denco’s is a law office.

University School closed in 1973; my graduating class was the last. I’m Facebook friends with my high school pals, but only Konrad stills lives in Norman. We went on to college, then graduate school. Two of us became physicians. We married, raised children. Two of us divorced. The renegade spirit that led us to Denco’s proved more rebellious in our imaginations than in our deeds.

Back to my refrigerator circa 2014. Although I was missing two key ingredients for an original Denco Darlin’ – no noodles, no cheese – I could toss together a reasonable facsimile. Instead of eating nutritionally appropriate poacheIMG_0574d eggs on dry toast, I got out the skillet, poured too much oil in the bottom, scooped in chili, beans, and rice, and mixed it with a spatula. On a separate burner I greased the griddle and fried two sunny-side. When the whites bubbled, I glided the eggs over the chili. Two bright yolks shimmered atop the oily stew. The entire mass slid onto my plate. I ate it up fast.

Fried food is like memory; its distinct flavor has a short half-life. I sopped up the last of the grease with bread. It tasted as good as I remembered, though I couldn’t feel sweaters on my teeth. Some insights are only available to young men who’ve been up all night.

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Architecture by Moonlight

haiti-001Architecture by Moonlight: Rebuilding Haiti, Redrafting a Life, is available through Amazon, Barnes & Noble, and University of Missouri Press.

Please join me at an author event around Boston, and attend a remembrance at the Cambridge Public Library on January 12, 2015 – the fifth anniversary of the earthquake.

Check for updates and additions to book events.

Boston Area Events for Architecture by Moonlight – November 2014

ProductImageHandlerWednesday November 5, 2014  7:00 p.m.  New England Mobile Book Fair  82 Needham Street Newton Highlands, MA

Sunday November 9, 2014  3:00 p.m. Book Ends Winchester 559 Main Street Winchester, MA

Friday November 14, 2014 3:00 p.m.  Harvard Book Store  1256 Massachusetts Ave Cambridge, MA

Tuesday November 18, 2014 7:30 p.m. Interview on NewTV by BJ Krintzman  Comcast Ch. 10, RCN Ch. 15, Verizon Ch. 34

DATE CHANGE – Thursday November 20, 2014 7:00 p.m. Calumus Bookstore 92 South Street Boston, MA 02111   Reading with LGBT community focus

Boston Area Events for Architecture by Moonlight - January 2015

Thursday January 8, 2015  7:00 p.m.  Porter Square Books  25 White Street Cambridge, MA

Monday January 12, 2015 6:30 p.m. Cambridge Public Library 449 Broadway Cambridge, MA  Reading and remembrance to commemorate the fifth anniversary of the Haiti Earthquake

CANCELLED – Tuesday January 13, 2014  7:00 p.m. Trident Booksellers & Cafe 338 Newbury Street Boston, MA




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Frivolous Intentions

awkward_pose_3-001I’ve been practicing CorePower Yoga for a year now, which means a year’s worth of Intention. Making an Intention in yoga class was new to me. At first it felt forced. Then I got into the spirit of Intention and began identifying people who could use a bit of extra energy. Neighbors suffering from illness, folks struggling with life decisions, friends who could use an extra boost – people I would pray for if I believed in prayer. Sometimes I conjured cosmic, Buddhist sort of Intentions like world peace and universal wisdom. Rarely I sent my Intention inward to myself; a sure sign that I was troubled.

Some teachers suggest Intentions. They ad lib a few palliative words or read an inspiring quote. They have good – intention – though their suggestions never align with my own headspace.

imagesA few weeks ago, when nothing seemed particularly better or worse in the world or my position in it, Intention came up fast during yoga sculpt and I had nothing in mind. Have fun! Rang through my head. What? I did a mental double take. That is no kind of Intention. It’s silly and ephemeral. But nothing significant would occupy my head, so, Have fun! it was.

When we were in an extended high plank and the teacher invoked our Intention to spur us on, I smiled. When she commanded that our Intention bring us through hamstring curls the fact that I wasn’t having fun – yet – made me laugh. When she brought us back to our Intention during savasana I decided that the prospect of having fun had energized my yoga that day.

images-1Since then, frivolous Intentions have become commonplace. Some days my Intention is to have fun; other days its to dance, have more sex, or party. My yoga is more carefree, buoyant. Perhaps someday my Intentions will address the world’s major ills directly. For now I enjoy musing about song and dance and having fun. Which may do more for me – and the world – than any somber Intention.

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Old Schwamb Mill

usa-001Veer off of Mass Ave onto Lowell Street in Arlington, take the first right on Mill Lane, walk a hundred yards and step back 150 years. That’s when  Old Schwamb Mill, custom oval frame manufactory began creating the most beautiful picture frames in the world, and where the original equipment still operates in its Civil War era building. My friend Bob and I happened by last Tuesday and enjoyed one of the most memorable tours of my life.

At one time seven mills operated along the Mill Brook, which originates in Arlington’s Great Meadow and parallels Massachusetts Avenue through Arlington Heights, Arlington Center, and East Arlington, before joining the Mystic River. These days, most of the mills are remembered only by the names of bulky condominium buildings, but the Old Schwamb Mill was saved from the wrecker’s ball and was listed on the National Register of Historic places in 1971. Today, it is a working museum, open to the public two days a week.

IMG_0971The Schwamb Mill has made oval picture frames – frames that now hang in the White House and Buckingham Palace – since 1864. It’s hard to know which is more impressive, the four rotating frame jigs that allow a craftsman to create beautiful molding profiles in perfect ellipses of any axial proportion, or Dave, the keeper of the mill for the past fifteen years who dropped everything he was doing to give us a leisurely tour.

IMG_0972The wood frame building is little changed since the Civil War. The rough floorboards, exposed columns and beams, though well maintained, have never been updated. The dark interior, highlighted by sharp light through six-over-six pane windows, is full of workbenches, profile templates, molding samples and well-worn hand tools. Along the south wall, where the natural light is strongest, three frame jigs are permanently bolted to the floors, ceilings, and walls, with cast iron supports. Belt and pulley systems turn the jigs. They were originally driven by water, then steam, and only recently by NStar.

Dave explains how the oval frame jigs work. The pulleys rotate a huge axle, maybe 10” in diameter, that spin a wide, flat plate. Two other iron plates are attached to this, at right angles to each other. They can be held at a fixed distance from each other yet slide independent of the main element. A large slab of wood is fixed to the outermost plate. When the main axle turns, the inner plate spins in a circle, but the outer plate, and the wood attached to it, spins in an ellipse, with the major and minor axes determined by the distance fixed between the two sliding plates. It’s ingenious and durable; the machines are more than a century old.

Oval picture fraIMG_0966mes are made from four pieces of hardwood, each one-quarter oval, that are rough cut into thick arcs but have precise finger joints. This rudimentary shape is back screwed to the jig. A heavy iron stand sits to the left of each jig, at the single precise height that is perpendicular to the frame at every point of the ellipse’s irregular turn. Dave pulls an overhead wooden lever the size of a paddle. The belts roll, the plates spin, the wood base and rough frame rotate in what appears to be a wobbly motion, but that movement is precise at the location of the chisel stand. Dave takes a chisel, and with steady hand lays it atop the stand. He gouges a clean, crisp line along the spinning oval.

IMG_0968It takes about eight hours to make a frame: two hours to cut the four pieces of hardwood into a rough oval and finger-joint glue the edges; an hour to set up the jig once the glue is dry; two to three hours to shape and sand; a final hour for an oil finish. Old Schwamb Mill sends frames out that require gilding and other custom finishes.



We piqued Dave’s interest with enough questions that he invited us downstairs to see the big daddy jig – capable of spinning an oval frame with up to three feet of difference between the mIMG_0969ajor and minor axes. Screwed to the template was the largest frame Dave’s ever made – a six foot by four foot oval commissioned by the Harvard Museums. He’d already finished and delivered one; the second was in the final stages of chiseling before final sanding. The size of the walnut frame presented numerous challenges. It had to be built out of eight pieces rather than four, the jig needed additional reinforcing because the template was so big it racked as it swept through a full twelve inch variation in each direction. (The sliding plate offset is one-half the total difference in the axes; a two-foot differential requires the jig be set with a one-foot space in each half-rotation). The mammoth frame is an incredible piece of craftsmanship.

The Old IMG_0970Schwamb Mill builds about thirty custom oval frames a year, a tiny percentage of what they made when the mill employed more than twenty people in the 1870’s. An oval frame online costs about $40; one from Old Schwamb can cost ten times that. But the point of buying an Old Schwamb oval frame is not to just to encase a photo, but to own a piece of handcrafted history.

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