The client has many physical challenges. Most recently she was diagnosed with a torn right rotator cuff. Physical therapy after diagnosis caused her more pain than without it. The PT was ineffective, so she stopped after about five sessions. Her left leg appears longer than the right (possibly impacted by the scoliosis,) affecting her gait. Tremors in right leg are brought on by prolonged standing. She has a history of a L1 ruptured disc that required surgery with a difficult, long recovery. The residual pain from her back surgery, spinal stenosis, and arthritis result in chronic pain. Her toes are rigid resulting from surgery to correct hammer toes. The edema around her ankles and lower legs is aggravated in warmer, summer months. Restless leg syndrome can awaken her in the night. Occasional migraines typically brought on by dips in barometric pressure. She has been told that she has a high pain tolerance by several of her doctors.
By taking a gentle yoga class three times a week and exercise walking regularly, the client has a consistent, balanced exercise routine. She has a massage twice a month that eases her muscular pain.
Her son and daughter-in-law live next door, giving her a comforting sense of safety, security, and connection.
The client’s breathing is full and easeful. Full belly breathing, fluid through the throat, mouth, and nostrils. Expansion and contraction around whole trunk with the breath. She is lively, alert, and calm; Her speech is clear and coherent. Refreshed upon waking in the morning, her energy level wains in the afternoon. She organizes her days around her energy levels, being more active early, then quieter later in the day.

The client is fully engaged in conversation and activities, focused and alert. She is intellectually curious, an avid reader, doing puzzles, and writing poetry. She has a regular meditation practice, usually in the afternoon or evening: either focusing on the third eye, or a variation of a Subud, Latihan meditation practice; sometimes incorporating movement, gestures, and humming.

When speaking about her close friendships, she began to cry as she recounted a time in her life when she and her husband cared for a dear friend who had been abandoned by her husband, experiencing deep depression, including suicidal thoughts. It is her tendency to emotionally support her friends and family. She has experienced loss of many family members, friends, and the loss of her husband who had been her life partner since her teenage years. Tender grief seems just below the surface of her strong character. Listening to classical music is soothing and uplifting for her. Her recently adopted kitty brings her much joy and is a welcome housemate.

The client attends weekly Sunday services at a local Unitarian church. “Very liberal.,” she states. Her home has expansive views of the surrounding forest and mountains from which she derives much pleasure and inspiration.
Spiritual support plan. Continue to be curious and learn from the client.

Patanjali’s Yoga Sutras. Sutra 4.5 Although the activities of the individual minds may differ, one consciousness is the initiator of them all.
Yoga philosophy/wisdom teaching integration Become Each Being, Chapter 77. The Book of Secrets. Osho. Meditations 106 and 108. 106. “Feel the consciousness of each person as your own consciousness. So, leaving aside concern for self, become each being.” 108. “This consciousness is the spirit of guidance of each one. Be this one.” OR Tonglen meditation practice.

• Yoga for Pain management. Prosko, Shelly, Breathing and Pranayama in Pain Care. Yoga and Science in Pain Care: Treating the Person in Pain.
• Measurement Tool.
McGill Pain Questionnaire. McGill Pain Questionnaire Online Calculator with Print/Save Results Feature https://www.mdapp.co/mcgill-pain-questionnaire-calculator-467/
OR
Wong Baker Pain Scale. https://wongbakerfaces.org/instructions-use/
• Rotator cuff and shoulder conditioning program. Created by the American Academy of Orthopaedic Surgeons (AAOS.) https://orthoinfo.aaos.org/en/recovery/rotator-cuff-and-shoulder-conditioning-program/

Looking forward to talking during mentor meeting.

• 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.