How to Meditate

With the hectic pace and demands of modern life, many people feel stressed and over-worked. It often feels like there is just not enough time in the day to get everything done. Our stress and tiredness make us unhappy, impatient and frustrated. It can even affect our health. We are often so busy we feel there is no time to stop and meditate! But meditation actually gives you more time by making your mind calmer and more focused. A simple ten or fifteen minute breathing meditation as explained below can help you to overcome your stress and find some inner peace and balance.

Meditation can also help us to understand our own mind. We can learn how to transform our mind from negative to positive, from disturbed to peaceful, from unhappy to happy. Overcoming negative minds and cultivating constructive thoughts is the purpose of the transforming meditations found in the Buddhist tradition. This is a profound spiritual practice you can enjoy throughout the day, not just while seated in meditation.

The Stimulating Breath (also called the Bellows Breath)

The Stimulating Breath is adapted from yogic breathing techniques. Its aim is to raise vital energy and increase alertness.

• Inhale and exhale rapidly through your nose, keeping your mouth closed but relaxed. Your breaths in and out should be equal in duration, but as short as possible. This is a noisy breathing exercise.
• Try for three in-and-out breath cycles per second. This produces a quick movement of the diaphragm, suggesting a bellows. Breathe normally after each cycle.
• Do not do for more than 15 seconds on your first try. Each time you practice the Stimulating Breath, you can increase your time by five seconds or so, until you reach a full minute.

If done properly, you may feel invigorated, comparable to the heightened awareness you feel after a good workout. You should feel the effort at the back of the neck, the diaphragm, the chest and the abdomen. Try this diaphragmatic breathing exercise the next time you need an energy boost and feel yourself reaching for a cup of coffee.

The 4-7-8 (or Relaxing Breath) Exercise

This breathing exercise is utterly simple, takes almost no time, requires no equipment and can be done anywhere. Although you can do the exercise in any position, sit with your back straight while learning the exercise. Place the tip of your tongue against the ridge of tissue just behind your upper front teeth, and keep it there through the entire exercise. You will be exhaling through your mouth around your tongue; try pursing your lips slightly if this seems awkward.

• Exhale completely through your mouth, making a whoosh sound.
• Close your mouth and inhale quietly through your nose to a mental count of four.
• Hold your breath for a count of seven.
• Exhale completely through your mouth, making a whoosh sound to a count of eight.
• This is one breath. Now inhale again and repeat the cycle three more times for a total of four breaths.

Note that you always inhale quietly through your nose and exhale audibly through your mouth. The tip of your tongue stays in position the whole time. Exhalation takes twice as long as inhalation. The absolute time you spend on each phase is not important; the ratio of 4:7:8 is important. If you have trouble holding your breath, speed the exercise up but keep to the ratio of 4:7:8 for the three phases. With practice you can slow it all down and get used to inhaling and exhaling more and more deeply.
This exercise is a natural tranquilizer for the nervous system. Unlike tranquilizing drugs, which are often effective when you first take them but then lose their power over time, this exercise is subtle when you first try it but gains in power with repetition and practice. Do it at least twice a day. You cannot do it too frequently. Do not do more than four breaths at one time for the first month of practice. Later, if you wish, you can extend it to eight breaths. If you feel a little lightheaded when you first breathe this way, do not be concerned; it will pass.
Once you develop this technique by practicing it every day, it will be a very useful tool that you will always have with you. Use it whenever anything upsetting happens - before you react. Use it whenever you are aware of internal tension. Use it to help you fall asleep. This exercise cannot be recommended too highly. Everyone can benefit from it.

Breath Counting

If you want to get a feel for this challenging work, try your hand at breath counting, a deceptively simple technique much used in Zen practice.
Sit in a comfortable position with the spine straight and head inclined slightly forward. Gently close your eyes and take a few deep breaths. Then let the breath come naturally without trying to influence it. Ideally it will be quiet and slow, but depth and rhythm may vary.

• To begin the exercise, count "one" to yourself as you exhale.
• The next time you exhale, count "two," and so on up to "five."
• Then begin a new cycle, counting "one" on the next exhalation.

Never count higher than "five," and count only when you exhale. You will know your attention has wandered when you find yourself up to "eight," "12," even "19."
Try to do 10 minutes of this form of meditation

What can I do to help maintain my weight and build strength?

Along with taking any medicines your doctor prescribes, there are many things you can do to help your body stay strong. Good, balanced nutrition and proper hydration are very important:

• Eat a balanced diet, and be sure to include protein to protect lean body mass. Beef, pork, poultry, tofu and soy nuts are excellent sources of protein. So are dairy products – try some Greek yogurt, which is higher in protein than regular yogurt.

• Increase the number of calories you eat. Choose nutritious foods that you enjoy. If appetite is a problem, try eating smaller, more frequent meals; make milkshakes, smoothies, and purees, which may be easier to digest; and add milk or protein powder to your foods.

• Drink plenty of liquids throughout the day. Water is best, but you can also get fluids from soups, popsicles, sports drinks, and even Pedialyte.

Physical exercise also plays a key role in building new muscle and decreasing fatigue. It has also been shown to improve mood, outlook, and self-image:

• Start off slowly. If you are very weak or tired, start with 3 or 4 minutes of walking at a time and build up from there. You can also try some upper body exercises while sitting in a chair – moving your arms up and down and front to back can help maintain flexibility. Making a fist and lifting your arms up and down in front of you can increase strength.

• Pay attention to your breathing. Rounded shoulders restrict chest movement, but good posture helps your breathing and reduces fatigue. Focus on maximizing your breath during activities: for example, when climbing stairs, breathe out with each step so you won’t be as tired when you reach the top.

• Keep a diary. Note the type of exercises or other physical activities you do and how they affect your mood and energy level. Seeing the positive benefits may encourage you to keep moving.

Nutritionists and physical or occupational therapists can advise you on other ways to maintain your weight and build strength as you cope with cancer. Ask your oncologist for a referral if these professionals are not already part of your health care team.

How are weight changes and muscle loss treated?

To help manage these symptoms, your oncologist may prescribe medicines such as megestrol acetate (Megace), anti-nausea medications, and steroid medications. These drugs can increase appetite for some people and may help to prevent weight and muscle loss, but they do not build up lost muscle tissue. A lot of research is underway to better help patients with these problems. There are two promising treatments that are currently in clinical trials. One trial involves ghrelin, a hormone that affects appetite and stimulates the release of growth hormone to build strength. Another study involves SARMs (selective androgen receptor modulators), drugs that encourage the body to build new muscle tissue. An example is the drug Enobosarm (GTx-024), which is currently being tested in patients with non-small cell lung cancer. Learn more about these and other related clinical trials at www.clinicaltrials.gov.
Keep in mind that appetite and energy levels may be affected by other treatable conditions, such as pain, anxiety or depression.

Why do weight and muscle loss happen?

One cause is the cancer itself. For example, in an effort to fight the cancer, the body produces substances called cytokines. These substances can lead to weight loss, muscle loss, and a decrease in appetite. Another common cause is the treatments for cancer. Radiation and chemotherapy often cause a decrease in appetite. They can also lead to side effects such as nausea, vomiting, and mouth sores, which can affect your ability to eat normally, further contributing to weight and muscle loss. Fatigue is also a factor, since the decreases in exercise and other physical activities that happen when you’re not feeling well can also contribute to muscle loss.