What does a professional yoga teacher do after he permanently loses his voice? Yoga, of course.
“You don’t have asthma,” my doctor confirmed, “you have this,” pointing to the x-ray and an almond-size tumor blocking 75 percent of my windpipe. “This is a very big deal.” For him or for me, I wondered, hoping not for him. If a well-respected Ears, Nose, and Throat surgeon was unnerved, my future looked grim.
My eyes moistened as I realized my partner and I might have to cancel our winter yoga teacher training—a tough blow for all the participants and, with my co-director and me being full-time yoga teachers, to our livelihood. “Catch a cold and you could die,” the doctor warned, tapping the ominous white growth on the x-ray.
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Putting My Yoga Practice Into Practice
Few things bring lessons from yoga class to life better than being t-boned by a calamitous injury or illness, or confronting any kind of life-changing obstacle.
Five years and four throat surgeries later, teaching yoga and Buddhist meditation classes despite having a paralyzed vocal cord and nominal speaking voice, I remain healthy and upbeat and every day learn something unexpected about embodied spirituality.
Take the yoga term “madhya,” for example. I’d used this Sanskrit word for more than 20 years of teaching without giving its significance much thought. Madhyas are effulgent pauses, like those occurring twice within each breath when we’re neither inhaling nor exhaling, or after each roll of the ocean’s tide or swing of a pendulum. In the pregnant lull of a madhya, the divinity of the Universe is revealed, or so I had been told and taught.
Now, because of a tumor, I understand why madhyas, arguably, are the whole point of yoga and other ancient wisdom traditions. While on a hospital gurney, squeakily rolling toward an operating room for the first surgery, I held my partner Camilla’s sweaty hand and realized I was gifted a brief respite between pre-surgery struggles with near suffocation and the post-surgery challenge of breathing through a trach tube. In that hospital hallway, I felt for the first time the profound calm of a madhya. Yes, I might die, I thought; I might lose my voice and beloved business and never again gaze into Camilla’s beautiful brown eyes. But during that still point while lying on the stretcher, I felt love—and for a timeless moment I was at peace.
That’s not to say there haven’t been challenges. Camilla has assured me over the years that my hoarse, barely audible whisper makes me sound like Batman, yet the reality is decidedly less sexy: I can’t talk on the phone or order at restaurants; I can’t converse with students without wearing a microphone; I can’t answer Camilla when she calls out from another room.
I’ve also learned the yoga principle of aparigraha, the willingness to let go, somatically. It’s a lesson I’ve felt directly in my surgically-reconstructed throat: When I grasp and feel resentment for losing the booming baritone I enjoyed during the previous 50 years of my life, I strain to breathe around my paralyzed vocal cord and lose what little voice I’m blessed to still have. “Enlightenment is not about being perfect,” say the Zen masters, “it’s about being without anxiety over imperfection.” I take that to heart with every breath.
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Discovering the Gift of Illness
When a fourth and final Hail Mary operation several years ago failed to get my voice back, I slumped with self-pity at the hospital’s check-out counter and pondered the pros and cons of drowning myself. Then, I looked up and smiled feebly at a young man who’d suddenly appeared behind me. He leaned heavily on a cane, wore a hearing aid, and appeared to be partially paralyzed from a stroke.
The painful rictus of his mouth could offer nothing in return to my quiet hello. On the drive home, Camilla and I listened to Austin’s great local music on the radio, I winged my free arm out the window, and started planning the next day’s yoga classes. I shook my head with renewed gratitude for life.
As anyone dealing with a physical or emotional test knows, our gifts can come when least expected.
Once, at the beginning of a 90-minute flow class, my microphone squawked with dead-battery static and frazzled into silence. I glared over the students’ heads at our studio clock—just 89 more minutes to go! Though a part of me wanted to curse and hurl the muted headset against a wall, a bigger part chuckled with awe at the Universe’s sense of humor and never-ending use of synchronicities.
Halfway through a yin class devoted to Shiva the Destroyer and “embracing change,” I abruptly realized—duh—I didn’t lose my voice to the throat surgeries, my voice had simply changed into something new. Not inherently better or worse, just different, with its own unique limitations and benefits. When guiding students through yoga nidra body-scan meditations in our candlelit nightcap classes, my amplified whisper proved incredibly soothing. I heard the loud snores to prove it.
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Camilla and I often tell our students, “The 90 minutes you spend on a yoga mat are really for the other twenty-two and a half hours of the days.” Two years ago, after teaching a class devoted to heart-opening poses like Camel and Wheel, I felt a strange tickle deep in my throat: The vagus nerve near my larynx, severed during my first surgery, instantly came back on line. Though still hoarse, the volume in my voice went from quasi-mute up a few game-changing decibels to Tom Waits territory, and has held steady ever since. When I shared with Camilla what happened, she smiled knowingly and said, “It was the heart-openers.”
Over the past five years of coming to peace with my throat, my favorite deity has been Lord Ganesh, the elephant-headed “remover of obstacles.” With his conspicuously broken tusk, he reminds us that imperfection is inevitable and that we all have the instinctive ability to transform our challenges into blessings.
“There is a crack in everything,” the late great Leonard Cohen crooned Zen-fully, “that’s how the light gets in.” We sometimes become most alive, most excited about the mysterious machinations of the Universe, when we are given an obstacle: whether we suffer from chronic back pain, plantar fasciitis, or we lose the ability to speak; whether our hair turns gray, our politicians become less blue, or our financial status goes from black to red.
What is your broken tusk here to teach you?
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Why Isn’t Yoga Covered By Health Insurance?
The short answer is, it’s complicated.
We spoke with John Kepner, executive director of the International Association of Yoga Therapists (IAYT), and Courtney Butler-Robinson, stress management specialist and yoga therapist for the Dean Ornish Reversal Clinic at Saline Heart Group in Benton, Arkansas, to find out why yoga therapy is largely uncovered by health insurance companies. Dean Ornish, MD, made headlines in 2010 for convincing insurance companies that yoga and meditation, when combined with proper diet and exercise, could reverse heart disease. To date, yoga therapy is covered only under the Ornish Reversal Program for heart disease, but some affiliated clinics, such as Saline Heart Group, are beginning to offer cancer care.
Yoga Journal: With all of its proven benefits, why is it so hard to get yoga covered by insurance?
John Kepner: That’s the big question. IAYT is a self-regulated organization—it’s all voluntary. We have standards and an accrediting body, continued education, certification, and an enforceable code of ethics, but we don’t yet have a certification exam. All professional health fields have some kind of exam. IAYT has just launched that effort, and I expect it will take another two years to complete. Those are necessary but not sufficient pillars when you’re talking about insurance. In most cases, but not all, insurance coverage extends to licenced health care fields.
Courtney Butler-Robinson: We are a wellness center and offer different programing. We recently extended into cancer care. The Ornish Reversal Program is the only program I know of where the whole thing, including yoga therapy, is covered by Medicare. Oftentimes, people who have cancer or have been given chemo will end up with heart problems, and in that case, we can often bill under that.
JK: One of my personal goals is yoga therapy insurance coverage for people recovering from cancer care. Their bodies have been wrecked by chemo. They need something to bring body and mind back to well-being. There’s a lot of research showing yoga can help with that. IAYT is connected with the Society for Integrative Oncology, which is seriously exploring yoga now.
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YJ: How do you see this goal coming to fruition? Will insurance-covered yoga therapy be siloed by illness or ailment, beginning with cancer and heart disease?
JK: I just don’t know. We are feeling our way. As mentioned, the Society for Integrative Oncology has two committees looking to yoga. For now, they are working independently of us, although we communicate with them. We are also developing a way to have insurance cover yoga therapies by health condition. My personal thought is that cancer is a good disease to start with. There is a lot of research and general sympathy. Heart disease is already addressed by the Ornish program.
CBR: I think Ornish will get prostate cancer covered in the next five
years. We just need to prove to insurance that this therapy will save them money.
JK: There are plenty of creative possibilities for financing yoga therapy in a health care setting beyond insurance. I wrote about it in 2005, but it’s still relative today. Anyone interested can look to my paper, “Financial Support for Yoga Therapy: A Montage of Possibilities,” published in the International Journal of Yoga Therapy.
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