Specific Therapeutic Yoga asanas can help to reduce pelvic pain and lower extremity swelling associated w/ chronic pelvic congestion syndrome and lower extremity edema due to long term endometriosis complications.

Goal: The goal is to help my client learn certain poses in order to reduce pain and swelling due to chronic endometriosis and pelvic congestion syndrome. The metric used to determine efficacy will be a pre- and post- questionnaire (week 1 and week 4) outlining how 2 specific symptoms of her condition rate on a scale of 0 - 6 in relation to how it effects daily activities, job performance, etc. Assessment questionnaires will be included in the follow up plan. The plan will run over the course of 4 weeks meeting once a week for 30-60 min.

Name: Tricia N. Age and DOB: 47 Mailing Address: n/a City, State: Cranford, NJ Phone/Cell: n/a Email: n/a (Optional) Marital Status: Divorced (Optional) Children? If so, how many?: none When you’re feeling your best, can you describe how you feel? Current Medications: Spiralactone. Armour Thyroid (30mg), Vit D3, Folic Acid, Mg, B12, Sensitol (for insulin resistance), FemGuard (contains Black Cohosh, Ashwagandha, B12) Significant Medical History: PCOS, endometriosis, hypothyroidism, IVF (unsuccessful), Pelvic Congestion Syndrome, lower extremity edema due to Pelvic Congestion What brings you to Yoga Therapy? To reduce pelvic pain associated w/ endometriosis complications and to reduce stress associated w/ lifestyle.

I envisioned working with this client on a weekly basis for approx 30 min every Friday. The sessions are scheduled and implemented via Zoom and done right when the client gets out of work on Friday afternoons.

The session begins with a brief centering in order to ground and relax the client after a stressful day. The centering helps to draw the clients awareness back to herself and to start to detach from the stress of the workday.

Once the client is settled, 5-8 min of Pranayama are done (Nadi Suddhi or Dirgha) in order to relax the client further and allow her to ground into the following asana practice (the main goal of the sessions) and to also work on expanding her breathing as the client has a strong tendency towards a shallow breath.

From here I lead the client through a series of asanas that specifically target the pelvic region to help w/ reducing pain and creating stretch and length through the pelvic region as well as increase circulation through the lower extremities. The asana portion of the session lasts about 20 minutes. Specific poses used include Supta Baddha Konasana, Balasana, Ustrasana, Restorative Bridge pose, Waterfall, Lizard and Pigeon.

The session ends w/ a brief quiet meditation and chanting OM together.

The branches of Yoga used are mainly Hatha Yoga with a sprinkling in of Raja Yoga (during our discussions and time getting to know one another). The Hatha branch supports the use of asana and pranayama in order to relate to the key teaching and the overall goal of the sessions.

The Raja Yoga component was mainly during discussions as the client has a strong tendency to overwork - we discussed Ahimsa and starting to think about non-violence to oneself. I strongly encouraged the client to start carving out a few minutes a day to devote to meditation and some gentle stretch work to feel better overall. This portion was not a part of the Key Teaching, but just happened organically.

This particular client is someone I've known for many years in a professional setting. This made it a little easier on my end in the sense that I know her medical background, we have a comfort around one another and it was seamless.

I think she got a lot out of the sessions (in fact, we're continuing them outside of the TCA) and she really has a deep belief in various healing modalities outside of Western medicine in order to treat various medical, mental and emotional issues.

I would advise my client to continue a daily meditation practice (Dirgha and Nadi Suddhi) of at least 10 min. I think these types of pranayama are best for her, her personality and her current medical condition.

I would also advise her to continue w/ me weekly as well as to incorporate some of the asanas I taught her into daily use even if it's just for a few minutes daily.

I also advised the client to read Yamas and Niyamas for a deeper understanding of the teachings (at her request).

Yes I applied the intended plan (and prob a little more). The desired goal was achieved and I believe the client benefitted greatly from the sessions. I do think that keeping these various modalities will be important for this client her entire life as her condition is chronic and will need to be managed. I also believe that once permitted, having these sessions life versus via Zoom will benefit her greatly in terms of making any needed adjustments w/ alignment or props.

I did not really have to adapt anything in the plan other than the start of our sessions were a little tricky. This client tends to be a big talker, and getting her to settle down and relax was a challenge. I think learning how to really get someone to settle into their space, bring their awareness inward and embrace the sessions w/ comfort and safety might be one of the most challenging aspects.

I also learned that when faced with yoga therapy clients, it will be likely that many issues need to be addressed and knowing what to address, how and when will be a challenge as well. I look forward to working w/ more clients in the future and creating more detailed plans.

I think considering it was my first experience approaching a client as a Yoga Therapist, all went very well. As I mentioned in a previous question, I really look forward to the time when these sessions can be done in a live setting with a more therapeutic vibe and where we're able to adjust clients, adjust their props and make it a really rich experience.

• Nally-Tricia_IYTh-Assessment-Form-TCA.pdf
• Nally-Tricia_IYTh-Intake-Form-TCA.pdf