MM is. 71-year old female, married, with 2 grown sons. She suffers from hypertension, pre-DM and has had both knees replaced. She does not drink alcohol, reports "eating well," and says she feels healthy "sometimes." She stretches at home, has taken up yoga (at my studio as well as local Senior Center), and sometimes rides her stationary bike at home. She reports sleeping well, however, also reports that she wakes up usually around 2am and 4am to use the bathroom, but says she feels rested in the morning. She says she generally feels a "slump" in the afternoon around 3pm.

MM reports a "6 or7" on a scale of 1-10 for stress, saying that it's usually dependent on her husband and older son. She says they both tend to increase her stress levels because of their "lack of common sense." She says when she feels stressed, she sometimes goes into a quiet room, closes her eyes and relaxes. She reports feeling tension mostly in her upper shoulders and neck. MM comes across as a very kind and gentle soul, and suffers from a fear of dying. She has consistently mentioned ruminating about being "next in line," and it's clear that this plagues her.

MM reports gaining the most joy from her grandchildren and family. She says her husband is her "best friend," even though he adds to her stress. She says, "there is a lot of history here," referring to his background with addiction and recovery. She has a large extended family, and a great relationship w/ both her sons and their families and kids. She babysits her grandchildren often, and reports loving having that role and relationship with them.

MM reports not being religious and claims she has "earned her wings w/ God" referring to everything she had gone through with her husband and his addiction and recovery.

MM has a delicate sense of self. She attributes this to having grown up with a mother who neglected her needs due to MM being one of 7 kids in her family. Her mother did not favor her and MM was left to her own devices often. She appears to be the kind of person who is always doing for everyone else, and neglecting her own needs. She is aware of this and part of our work together is to develop her "voice." She also reports enjoyment in doing puzzles in order to keep her "mind sharp."

Satya: discussed Satya w/ MM, one of the Yamas (ethical guidelines) in the Yoga Sutras of Patanjali. We talked about how Satya encourages us to live with integrity and speak honestly—both to ourselves and others. Practicing Satya means aligning our words, thoughts, and actions with our authentic self. It’s not just about being truthful, but doing so with kindness and awareness, especially when our truth has an impact on others.

Santosha: discussed the meaning of Santosha, one of the Niyamas. Suggested that we dive deeper into the meaning and practice of Santosha (contentment) in our sessions moving forward in order to develop self-acceptance and peace with who we are, and where we're at in this moment.

1. Arthritis and Knee Replacement R/L: Placed blanket under knees to add additional padding when on hands on knees. Client reports being able to do most things and will let me know if it's giving her knee problems during the asana part of our sessions.

1) Research also shows the benefits of yoga for adults living w/ arthritis in terms of improving their physical activity levels and overall physical wellness.
2) Research shows reduction in pain and stiffness in those suffering from knee OA and participating in yoga.
3) Research shows improvement in the psychological aspects of a persons wellbeing when suffering from OA and participating in a yoga program.

Moonaz SH, Bingham CO 3rd, Wissow L, Bartlett SJ. Yoga in Sedentary Adults with Arthritis: Effects of a Randomized Controlled Pragmatic Trial. J Rheumatol. 2015 Jul;42(7):1194-202. doi: 10.3899/jrheum.141129. Epub 2015 Apr 1. PMID: 25834206; PMCID: PMC4490021.

Lu J, Kang J, Huang H, Xie C, Hu J, Yu Y, Jin Y, Wen Y. The impact of Yoga on patients with knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials. PLoS One. 2024 May 16;19(5):e0303641. doi: 10.1371/journal.pone.0303641. PMID: 38753745; PMCID: PMC11098307.

2. Hypertension: In our session, I was mindful to avoid any poses or breathwork that could elevate my client’s blood pressure, such as inversions, breath retention, or vigorous pranayama. Instead, we focused on gentle, grounding movements, supported forward folds, and calming breath techniques to help regulate the nervous system without strain. Every aspect of the session was tailored to prioritize safety, ease, and relaxation in order to promote the reduction in blood pressure.

Tyagi A, Cohen M. Yoga and hypertension: a systematic review. Altern Ther Health Med. 2014 Mar-Apr;20(2):32-59. PMID: 24657958.

• 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.