Unshakeable Serenity
One of my favorite statements written by BKS Iyengar is found in his commentary on sutra II.1, where he defines kriya yoga. Kriya yoga means the actions or the means of yoga, and it consists of three principles: tapas, burning zeal in practice, svadhyaya, self study, and Isvara pranidhana, surrender to something greater than ourselves. These three practices purify the body, breath and mind, and are beautifully summarized as action, reflection and devotion.
The quote that so moved me is this:
“By following the precepts of kriya yoga, all aspirants may learn to live in unshakeable serenity regardless of circumstances.”
I remember distinctly reading this for the first time and thinking, I absolutely do not have that! I react to circumstances! I am not serene! I then experienced a strong inner feeling that this great master was telling me that this did not have to be my fate. It felt very direct, as if he were telling me personally that another way of living is possible. That quote has given me great solace in many situations. It reminds me that I cannot control circumstances or outcomes, but I can learn to respond instead of react. I can cultivate a stable and calm mind, so that when life throws curve balls, I can adapt with resiliency, creativity and even with joy.
I know that I have not achieved unshakeable serenity, but I have learned that through yoga practice, I can move in that direction.
Many of you know that I am facing a major surgery. I am doing my best to practice being in a state of calm presence, while maintaining an optimistic view that the outcome will be positive.
While teaching at the studio over the next couple weeks, I want to focus on the students and on yoga rather than on my medical situation. I don’t mind answering your questions, but I thought it would work best to use the blog to share details about my lymphedema, the surgery, and my recovery process. So, for those who want to follow my healing journey more closely, this blog will be the place to go.
Lymphedema
I am having surgery to treat lymphedema in my left leg. Lymphedema is swelling caused by insufficiency of the lymphatic system, often caused by lymph node removal during cancer surgery. I have had this condition since my cancer surgery in 2012, but it was mild and manageable. However, since I broke my first metatarsal in 2023, the condition has grown worse. Having tried all therapeutic means available, I have decided to have a series of surgeries. The first of these will be on Monday, January 26. It is a major surgery and will require that I convalesce at home for one month.
I have been self-treating my lymphedema since I broke my foot three years ago. After a trip to Montreal in April, I noticed that my swelling was much worse, and that my leg felt hardened. I started physical therapy in June and continued with it all summer. The therapy consists of a technique called manual lymphatic drainage, where the therapist uses her hands to move the lymphatic fluid. The PT also helped me to get better compression garments, and to get insurance coverage for a pump that helps promote lymphatic flow.
Lymphedema Surgery
I did not image that I needed surgery. I thought that was only needed in cases where the limb was grossly enlarged. What I learned by meeting with the surgeon is that the stage of lymphedema is not determined by the size of the limb, but by the quality of the tissue. When swelling has been present for a long time, the skin begins to harden, and the underlying tissue becomes fibrotic.
As the doctor explained to me, once this happens, there is no amount of compression, exercise or weight loss that will change it. That built up tissue must be removed by liposuction. Once the excessive fluid and fibrotic tissue is removed, it acts as a jump start for the whole lymphatic system, even in the other leg!
In most cases, the removal of the fluid and fibrotic tissue will leave loose skin. Because my leg is not that big, I did not think I would need skin removal. But a nurse has explained to me that with the skin removal, my leg will look better, heal better, and have reduced risk of infection. It is the standard of care. It means that I will have a long scar down my inner leg. I was not expecting that, but it is just another element to accept in the quest for better lymphatic flow.
I thought I would be very reluctant to have this surgery. It is invasive, painful, and requires a long recovery. But once my husband Cliff and I met with Dr. Wei Chen, our view completely changed.
Dr. Chen is a world-renowned micro plastic surgeon who is on the forefront of innovation for lymphedema surgery. People come from all over the world to work with him here at the Cleveland Clinic. I feel very fortunate to be working with him. It is somewhat of a miracle that I have a January surgery date, as I was told I would have to wait until September. Because the procedure is so intense, they only do the upper leg. I will have the lower leg done in September.
Then we will wait to see how I respond. The third possible surgery is the most amazing one. In this procedure, using 40 times magnification and a suture 8 times finer than a human hair, Dr. Chen connects lymphatic vessels to veins, so the veinous return of blood to the heart helps the lymphatic fluid to move as well. Cliff and I watched a video of this procedure, and it is amazing. This is the least invasive of the three surgeries.
I should say that these procedures do not mean that I will no longer have lymphedema. They are not a cure. But there are some very positive outcomes that we can expect. My left leg will likely be returned to close to normal size. The lymphatic flow will improve, which should reduce swelling. It is very likely that I will still need to wear compression, but I will probably be able to shift to a lighter, more comfortable garment. My hope is that the procedures will also help prevent the condition from progressing over time. Finally, having these surgeries will give me peace of mind, knowing that I have done all I can to respond to this situation.
Preparing to Heal
To prepare for the upcoming surgery, I have read about the fantastic outcomes Dr. Chen has achieved with other patients. This gives me confidence and reduces fearfulness. I am also visualizing the surgery going beautifully, and imagining myself healing quickly and completely.
To support this inner work, I am using a wonderful recording for Successful Surgery created by Belleruth Naparstek of Health Journeys, now available at Hay House. I highly recommend this site if you need support to cultivate vibrant health and radiant well-being. You will find recordings with imagery and affirmations for stress, cancer, insomnia, and much more.
My work for now is to get everything in organized for the yoga studio to continue for a month without me. I am deeply greatly to my yoga friends and colleagues who have stepped up to cover my classes. I am also trying to get in the best shape I can, get lots of sleep, and get myself mental and emotionally ready to surrender to the wisdom and experience of Dr. Chen. I know he will take excellent care of me.
I will end with a wonderful quote sent to me by a dear friend. It is from Rob Walker in his Substack, The Art of Noticing. When his work related internet access was down for 36 hours, he wrote;
“Specifically, once I actually accepted the situation, I decided to embrace it. I re-envisioned my situation as a tiny sabbatical.”
This made me smile, as I had already begun thinking about ways I could make my month at home more fun and interesting. I am sure I will enjoy plenty of reading and television. But I realized it could be a wonderful time for yoga philosophy study, Sanskrit study, pranayama and meditation practice – a sabbatical. I am looking forward to seeing how I can use the time not only to heal my body, but also to uplift my mind and spirit.
Thanks for listening! I am guessing that my next post will be after the pre-op appointment with Dr. Chen on January 21.
With love and gratitude,
Karen
