Primarily, he suffers from Parkinson's Disease, which includes slow movements and a limited range of motion. To manage these symptoms and perform daily activities like holding a fork, Mack requires medication multiple times a day.
Osteoarthritis affects his right knee and spine, leading to chronic pain. He feels pain when he extends his neck, right knee pain is severe while using stairs, and lower back pain worsens when he bends over.
Mack has prostate cancer, which is being treated by hormone therapy.
Also, the MRI shows osteopenia in his right hip femoral neck, which is not severe, but it became another physical challenge. A vocal cord issue causes him to whisper when he talks. His movements are generally slow, and his range of motion is limited, though he can walk up to a mile when he feels good. His chronic pain in multiple areas, makes it difficult for him to get up and down from the floor.
He previously used a C-PAP machine to manage his sleep apnea but found it unhelpful. As a result, he continues to report only fair sleep quality.

Mack's energetic state is compromised due to his chronic health, he experiences fatigue due to chronic pain. He also has a challenge in breathing due to asthma and his respiratory system is impacted when weather and air quality are worsened. He struggles with sleep quality due to sleep apnea which also affects his energy level.

Mack's emotional state is affected by his chronic health conditions and the resulting limitations on his lifestyle. He struggles with depression caused by persistent pain, limited mobility, and the overall decline in physical health. He reported that his stress level is moderate, his stress is caused by physical pain, management of his medical conditions and the need to maintain functionality in his life. His social connection is
Okay, he has connections with a partner, daughter, brother, friends, and patients at work, which provide some emotional support.

Mack did not express his religious or spiritual orientation. However, “finding good in people” indicates his desire the connect with others in a meaningful way. He values
the relationships with friends family and communities he belongs to.

His intellectual state is active and engaged in his profession, and he has a continuous desire to learn including biopsychosocial medicine. He likes reading and writing as well.

What?
Jnana yoga: Jnana Yoga involves the cultivation of wisdom and the discernment of the true nature of the self. It emphasizes understanding the distinction between the physical body and the eternal soul or consciousness and enables one to achieve leads to self-realization.

Why?
Mack is experiencing many physical conditions, and depression and stress caused by physical
pain. He said “I don’t feel happy anymore”, this indicates he sees his physical body as his entire self. By practicing this teaching, he can distinguish between physical body and soul, which leads him to find inner peace.

How?
I can use body scan/witnessing practice to separate his pain and become the observer and not be observed nor dictated by physical pain.

The Effects of Yoga on Patients with Parkinson's Disease
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8275425/

The study shows that “yoga significantly improved QoL of PD patients. could improve motor symptoms, reduce the emotions of anxiety and depression, increase QoL, and promote the development of physical and mental health of PD patients.”

Yoga Meditation (YoMed)
https://journals.sagepub.com/doi/10.1177/0031512520945085?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

yoga therapy on quality of life in osteoarthritis of the knee joint
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3193655/pdf/IJY-4-55.pdf

I will begin with JAPA and balancing practice for Mack due to his physical condition, incorporate with body scan and visualization technique then add other asanas if available.

I found this, we talked about it on Wed night, "my hand is injured but I am not injured" suggests a distinction between physical injury and personal identity or well-being. It implies that while a part of your body may be injured or experiencing pain, it doesn't define your overall state of being or identity. In other words, your physical condition or health issue (like a hand injury) doesn't necessarily reflect your entire self or your mental and emotional well-being."

I am planning to apply this to Mack and thinking how.

• Check in, centering, balanced hatha yoga set considering contraindications, relaxation (with imagery as appropriate),
• Balanced pranayama considering contraindications, meditation/centering.
• Include at least one suggestion from Karma, Bhakti, Raja, or Jnana Yoga tailored for this client.