Inside Yoga 323 (10/7/2022)

Getting better can be a slow and frustrating journey, but do we allow for this? By and large, we don’t, instead we view recovery – whether it is from illness or surgery – as something which should be quicker. As a society, we have forgotten about convalescence which was historically – that is, up until the late 20th century – a natural part of what is called “getting better”.

I had surgery at the end of May (see previous blog about pre-op, https://www.yogabristol.co.uk/2022/05/29/jigsaw-of-life/ ); and I finished my last blog with a cliff-hanger: that surgery would happen the next day. Well, the good news is that it was not cancelled, as my first attempt at surgery was, and according to the surgeon, as I lay in the post-op ward clouded by a post-anaesthetic haze, I think he said it went well! And I was to remain at home for two weeks and rest.

There were two distinct stages where my mind-set changed, from pre-operation thinking, that I need to get back to work asap, to the post-op thought that only recovery matters. This was helped by the surgeon making it clear that it was TWO weeks off work.

Being self-employed I did not need a sick note; I just had to be strict with myself, no work and just rest. I was good at the resting part, mainly because I was wiped out by the surgery! But as I monitored my surgical wound and its swelling, what I didn’t count on was my worrying mind; day-case surgery is so quick, by the evening I was home, and with no planned follow-up, it was easy to feel a sense of not knowing whether the body is healing as planned (I didn’t have a nurse regularly checking and reassuring me that all is well!). I am aware they say we know our body but that doesn’t stop our mind planting doubts!

I had an official NHS leaflet about my procedure, with timeframes of recovery: seven to 14 days of this; and several weeks of that. So how was I doing? My rational mind saw the big picture and was content to wait and see, making a time frame of at least 6 weeks – this sounds like several does it not? But at times, my emotional mind created havoc, with too many questions and doubts, triggering anxiety, which really did not help recovery!

And yes, before you ask, I practised yoga (gently in the first few weeks!), meditation, and restorative positions, like lying with legs up the wall, and others techniques which really helped get rid of negative thoughts and feelings. Until the next doubt!

As I now approach week six since the operation healing is going well; and after about four weeks I did get follow-up appointment with the surgeon which was reassuring, though it might have helped reduce my worrying if I had been told this would happen when I had the operation! We really don’t like uncertainty! Plus, I will look back in a few months and (hopefully) say it went to plan and all is well!

There is a reason why I am sharing my experiences, because during my recovery one of my yoga students told me about a new book called Recovery: The Lost Art of Convalescence, by Dr Gavin Francis.

I have just read this book, and its relevance to my experience is spot on. Francis, who has worked for more than 20 years as medical practitioner, mostly as a GP, and written several books, has written a short (about 84 pages) but succinctly put argument that we have forgotten the importance of recovery and convalescence.

He writes that “it’s curious that the words ‘recovery’ and ‘convalescence’ are generally absent from the index of medical textbooks.” His book is filled with important observations and insights into recovery and convalescence, or rather the lack of it in our modern world (I should mention, he does make it clear that his book is about the medical world he is trained in, not the host of alternative health techniques that exist).

He comments:  “The medicine I was trained in often assumes that once the crisis has passed, the body and mind find ways to heal themselves – there’s almost nothing more said on the matter. But after nearly 20 years as a GP I’ve often found that the reverse is true: guidance and encouragement through the process of recovery can be indispensable.”

And he adds: “Odd as it seems, my patients often need to be granted permission to take the time to recover that they need.”

Convalescence itself, writes Francis, comes from a word meaning “to grow in strength”. And this can take time, and vary from person to person. There is no exact timetable for everyone or anyone. As he writes: recovery and comparison don’t mix: everyone has a different tempo of convalescence and will require different strategies.

Listening to our own body and learning what it requires is an important part of recovery. “Convalescence insists we acquire a new language of the body, and I encourage people to learn its vocabulary,” writes Francis.

This is not a new idea, but something we have forgotten about. Convalescence was a feature of our healthcare for a long time, from the 19^th century into the 20^th century, the use of convalescent homes and hospitals was more common than these days, where today, as soon as we look ready to be sent home we are!

There is a political side to his argument, as he says “Convalescence needs time, and the value we place on that time ultimately comes down to what our politicians will support.” Because the wealthy can afford to take time off, and perhaps go places to help their healing, but the poorer in society need support with this. He comments that UK payments to support sickness absence are not an unsustainable drain on the state, as is sometimes claimed. “These payments are regularly demonised in the tabloid press, but they make up less than 0.002 per cent of the sum that was paid out to the banks following the financial crash of 2008.”

Being kind to ourselves is an important factor in recovery, as he writes “self-compassion is a much underrated virtue, and the rhythms of modern life are often antithetical to those of recovery…Many of my patients feel a great deal of pressure to be maximally productive so as not to be a ‘burden’”.

He makes the point that “the pressure to be maximally productive is learned early, and it can be a challenge to unpick inherited notions of what constitutes a successful life. But if we don’t modify those ideas, we are unlikely to make time for recovery, or understand the value of rest of and recuperation.”

Many of us would not only agree with what Francis writes, but might think yes, we know this, but how many of us will do anything about how we live, and how we recover?

I could see how I changed my view of recovery: it had stages: the pre-surgery need to get back to work, and a return to normal (does that exist?) as soon as possible, and the post-op urge to recover which started with being impatient and having unrealistic goals; and then the change to acceptance that my body needs time, and it will decide how long, which in my case went from two weeks to at least two months – or perhaps no time frame.

A few years ago I taught an orthopaedic surgeon and after the yoga class we talked about my injured knee (from football I hasten to add, not yoga!), and she explained that a knee can take 18 months to completely recover. This put it into context and threw out the window the 6-week recovery period which seems to be the most commonly cited time frame. And as I sit here typing away, tomorrow will be my six-week period since my operation, and even though I do feel a lot better, I do not regard myself as fully recovered. Healing takes time.

Francis quotes Bengali (Indian) poet Rabindranath Tagore: “in the rhythm of life, pauses there must be for the renewal of life. Life in its activity is ever spending itself, burning all its fuel.”

This is important when it comes to recovery from illness or surgery, but it is also relevant in our daily lives. Burn out, chronic fatigue and just another busy week can take its toll on us. Knowing when to rest, when to do something restorative is important: and naturally, as a yoga teacher, I will recommend some yoga practice, or meditation, whether seated or reclining, a pause as Tagore calls it can be physical inactivity, or something like yoga asanas to help restore our physical and emotional energy levels.

And also, going for a walk, a run, or whatever our hobby might be, can help us recharge. It’s by giving our focus to these activities which can take our mind and body off whatever might be causing the drain on our health and energy levels.

In his book Francis highlights travel as recommended for recovery, because as we have possibly all been told, a change is as good as a rest. He points out that this is not a modern idea, since the time of Hippocrates convalescents have been urged to get away on holiday (or in our modern world, perhaps include day trips here).

And for those of us who cannot just go away, Francis points out that books can “unlock the sick room door to somewhere more expansive and free.” Something I agree with, during the first weeks of my recovery, and also during the pandemic lockdowns, I read several books of fiction; and I continue to read novels every week. Make it part of your routine, because although we might well say we are too busy, it is a question of priorities. Making time to read, to go for a walk, swim or run, or something beneficial can be done if we really look at what is important to our own well-being.

The book is called: Recovery: The Lost Art of Convalescence, by Dr Gavin Francis

A thought for the week: Any questions or comments contact me via the blog reply panel below or email gary@yogabristol.co.uk

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