• 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.

Downward facing dog at the wall, with hands on chair seat or at kitchen sink; client’s choice. Timed up and go sequence as his energy level allows. Lie down supine on the floor with support under head and bolster/rolled blanket under knees, practice full belly breathing and extended exhale, then conclude listening to soothing instrumental music of choice. This is orientation allows the force of gravity to counter kyphosis and cultivates rest. Look at/read Michael J. Fox quote daily.

Center, ground, arrive. Fatigue questionnaire. Client score, “presence of significant fatigue.” Full belly breathing with awareness and feedback. Seated spinal warm-up and neck joint freeing movements, focusing on integrating breath with the movements. Significant limited ROM on right side of neck, DBS wires on this side. Chair pose at the wall with block and blanket behind head. Gently press head into block/blanket for proprioception. Downward facing dog with hands on chair seat. Used strap across hip creases to allow fuller axial extension and relieve pressure on hands, wrists, and shoulders. Counter to excessive kyphosis. Relax, Pull Up, and Lighten Up verbal cures for postural alignment. Lighten Up cues very effective. Client asked to lie down on the floor at this point. He was too tired to do any more. Short soften and release guided relaxation and resting to quiet instrumental music.

Client reports his lower neck and upper back haven’t felt this good in a long time. Verbal cues are frequently difficult for the client to follow. Proprioception in head and neck area is improving. Demonstrating and some somatic sensory facilitation give the client sensory feedback to understand verbal instructions.

Very old patterns/samskaras have been established. Change is foreign, takes a while to comprehend how to do things differently and adjust to make change. Self-compassion would benefit the client, and it is challenging for him. Self-criticism is well established. Opportunity to introduce pratipaksha bhavana and an acceptance practice.

There was a five week lapse between sessions. I need to continue to repeat practices with the client to make them familiar to his body and mind. Demonstrate patience, acceptance, and non-judgement. The client is feeling the benefits of the practices, even after a short sequence. His mood continues to lighten at the end of a session.

As per care plan as client’s energy level allows.
Include practices from 05/24/24 and
Standing toe tap practice.
Timed Up and Go.
Breathwork to energize, ‘Ha’ breath kriya repetition.