Many in the West see yoga simply as a type of exercise or mindful movement. However, the postures of yoga, also known as Asana, comprise only one of the eight limbs of yoga. In fact, Asana is the third limb of yoga and is preceded by the Yamas and Niyamas, which are teachings on how to live ethically. Within the Yamas and Niyamas, there are five teachings each. The fifth and final Yama is Aparigraha, or non-attachment/non-grasping. For those who prefer positive statements, Jennie Lee describes Aparigraha in her book, True Yoga, as appreciation. Aparigraha compliments the Niyama of Santosha, or contentment.
The Yamas and Niyamas are not destinations per se, but more like a compass directing you toward a more fulfilling and joyful life. Thus, as someone who HATES change and very much likes control/things my way, I will likely always struggle with Aparigraha and Santosha. Appreciation and contentment have been difficult for me for many years, but especially since February 2022 (see COVID is No Joke and The Long Road Home for background).
Clearly, I have gone way too long without a post. I would love to wax on about how this is due to life becoming so full and busy that I simply did not have the time for an update. Rather, I think I’ve been putting it off because writing this requires a level of acceptance I hadn’t previously reached. Posting this update means fully letting go of what I envisioned my life to be like and embracing (however reluctantly) what it actually is. In other words, I have had to work on developing Aparigraha and Santosha.
I have not gotten substantially better. I’ve acquired an alphabet soup of diagnoses: ME/CFS, POTS, MCAS, HSD, presumed CCI, etc. Most of these are considered chronic conditions that I likely had a predisposition for or have existed previously but that were finally triggered by COVID. Showering still requires a seat and it is a really good day if I can get dressed immediately after without a rest period. I currently manage my POTS (a form of dysautonomia that explains why my heart rate was getting so high when I was upright and contributing to a number of symptoms) with salt, fluid, compression garments (when my sensory sensitivity allows me to tolerate them), 4 medications and IV fluids every other day. And that is just one member of the alphabet soup of diagnoses.
For ME/CFS, I try my best to pace and avoid crashing (post-exertional malaise, or PEM). When I am in PEM, it is not only an extreme dip in my energy level, but I develop flu-like symptoms, worsened cognitive/sensory symptoms and often can only get out of bed to use the restroom and maybe eat. I cannot tolerate lights and often need earplugs to tolerate my son’s mere presence in the house. Aside from how poorly I feel when I crash, avoiding PEM is important because, based on the available biomedical literature, PEM results from and/or causes (chicken/egg situation here) neuroinflammation. Thus, repeated bouts of PEM likely cause further injury and damage. The literature also shows a connection between frequency of PEM and long-term prognosis, so expert guidance is to do your best to stay within your energy envelope.
If you’ve read my previous post on my journey since COVID, you might be noticing that I identified both dysautonomia and PEM, as well as need for pacing on my own prior to formal diagnosis. This is common in the ME/CFS world where people typically go years or even decades without proper diagnosis and instead are told to exercise (harmful!) or see a therapist. I am grateful that I was able to identify for myself what was going on and that there are some of the very few experts in this condition here in Salt Lake City. Thus, I had my official diagnoses 7 months post-COVID (diagnostic criteria for ME/CFS require 6 months of symptoms).
As far as Aparigraha (non-grasping) and Santosha (contentment) go, I struggled for months and months to accept my energy limits and repeatedly put myself into PEM trying to do things I used to do. I had to learn the hard way that PEM is not just caused by physical exertion but also by how well my POTS is controlled, the number of sensory inputs I’m exposed to and cognitive/emotional exertion. Currently, the cognitive and emotional stressors are actually stronger triggers of PEM for me than the physical exertion (which is saying a lot for someone who has to use a motorized scooter for most activity that requires walking more than a block). I had to resign from my job and currently cannot even work part-time. The other day, just watching a few hours of continuing education lectures resulted in a higher resting heartrate and lower HRV, objective measures of a body under stress. This was despite watching the videos lying down!
There is, however, so much to appreciate. I’ve learned (mostly) how to manage my “body battery” and was able to avoid PEM after both my dad’s retirement party (which required travel) and my son’s birthday party (think a dozen 3-6 year olds, a “spooky” Halloween theme, and my son’s “Haunted Surprise” which consisted of taking groups of people to his room, turning off the lights and screaming. Talk about sensory overload)! I’ve gradually been able to do more around the house or with childcare. I can drive further than I used to without triggering symptoms. My energy envelope is gradually expanding through targeted and liberal use of rest. I have a wonderful partner who picks up the slack. We have a fabulous “village” that willingly and graciously stepped up when my partner was out of commission himself for several weeks due to illness. I had disability insurance so we have not experienced nearly as much financial upheaval as many dealing with Long Covid.
As difficult as the last 20 months have been, we have been surrounded by so much generosity. As I said early on, I will always be working on Aparigraha and Santosha, but for now, I’ll take where I am, even though it may not be where I dreamed I would be.
Unarmed Mama, MD 