Reina maintains an active lifestyle through various physical activities such as walking, pickleball, gym workouts, yoga, and aquarobics. However, she faces several physical challenges.
Reina also deals with IBS-related constipation and celiac disease, both managed with medications like Elavil. Additionally, she suffers from migraines triggered by ripe foods like bananas. She was diagnosed with Mycobacterium Avium Condition six months ago, requiring the use of an inhaler in the morning. Reina experiences persistent pain in her lower back and left glute, which she has been managing with physical therapy for the past two months. She has noticed some improvement in these symptoms, she is less concerned about this now. Reina adheres to a diet that accommodates her celiac disease and does not feel the need for additional improvement in her dietary habits.
Despite these challenges, she maintains a strong social support system, engaging regularly in activities such as yoga, walking, and volunteering at a food bank program.

Her energy levels are highest later in the day, around 5-6 PM, she finds it easy to fall asleep, although her sleep is frequently disturbed by agitated dreams which is a side effect of one of her medications. Reina reported normal breathing with no specific challenges. Using an inhaler to treat Mycobacterium Avium Condition is likely impacting her overall energy balance. Reina sometimes listens to a 12-minute meditation tape for relaxation. Her regular practice of yoga and other physical activities supports her energy flow and helps maintain her vitality.

Reina experiences high stress levels, primarily due to her husband's health issues include muscle pain, fatigue, and the presence of a pacemaker, and loss of family member due to COVID 19.
Reina describes her sleep quality as okay, though it is disrupted by frequent agitated dreams, indicating underlying mental tension. Despite these challenges, she stays close to her family, including her sister and brother, and friends.

Spiritually, Reina does not adhere to a specific religious orientation but values connections with family, friends, and through volunteering. She finds meaning and purpose in these relationships and activities, which are integral to her life and health. She expresses a wish for world peace, indicating a broad, compassionate worldview. Reina feels connected in meaningful ways and believes she understands her purpose of life, which underscores her spiritual well-being.

Reina engages in various intellectually stimulating activities, such as reading, participating in Zoom classes, and playing games like Scrabble and Bananagrams. She is currently learning and teaching pickleball and Bananagrams and has expressed an interest in learning poker and Canasta. These activities reflect her desire for social interaction. Her active engagement in these intellectual and social activities is a positive aspect that contributes to her overall well-being.

Santosha – Contentment

1. Acceptance of Physical Limitations: Contentment encourages acceptance of her current physical state, including any limitations or pain she experiences. This acceptance can reduce frustration and promote a more peaceful relationship with her body.

" My challenges and pains are temporary. Each breath brings new opportunities for healing and growth." This affirmation helps Reina to recognize that her current difficulties are not permanent and that she has the strength to navigate through them, finding peace and resilience along the way.

"This is a moment of suffering. Suffering is a part of our life. May I be kind to myself." This affirmation is for her self-compassion practice.

2 Karma Yoga – selfless service
Reina has been volunteering, she can add reflecting on the satisfaction of contributing positively rather than the outcomes achieved after completing tasks.

IBS Symptom was improved in the yoga/ meditation group compared with the control group using the Severity Scale (IBS-SSS), which measures the severity and frequency of abdominal pain, severity of abdominal distention, dissatisfaction with bowel habits, and interference over the past 10 days.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9889201/

I will include the following asana to improve Reina’s IBS symptoms.
These asanas will stimulate digestive organs, increase digestion, and promote elimination.
apanasana (knees into chest), balasana (child’s pose), supta matsyendrasana (supine spinal twist),viparita karani (legs up the wall), malasana (squat), and supta baddha konasana (reclining butterfly).

• 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.