Chronic Backpain
When doctors at the HMO Group Health Cooperative in Seattle pitted 12
weekly sessions of yoga against therapeutic exercises and a handbook on
self-care, they discovered the yoga group not only showed greater
improvement but experienced benefits lasting 14 weeks longer. A note of
caution: "While many poses are helpful, seated postures or extreme
movement in one direction can make back pain worse," says Gary Kraftsow,
author of Yoga for Wellness, who designed the program for the study.
Depression
Low brain levels of the neurotransmitter GABA are often found in people
with depression; SSRIs, electroconvulsive therapy, and now yoga, it
seems, can boost GABA. Preliminary research out of the Boston University
School of Medicine and Harvard's McLean Hospital found that healthy
subjects who practiced yoga for one hour had a 27 percent increase in
levels of GABA compared with a control group that simply sat and read
for an hour. This supports a growing body of research that's proving
yoga can significantly improve mood and reduce the symptoms of
depression and anxiety.
Yoga and Diabetes
Speeds Nerve Impulses
One of the major problems from long term diabetes is nerve damage due
to constant high sugar levels in the body. This nerve damage leads to
the slowing of nerve impulses, decreased sensation, numbness of the
feet, and poor bowel function. Can yoga help? Scientists at Guru Tegh
Bahadur Hospital, in Delhi, India, studied a group of 20 type 2 diabetic
subjects between the ages of 30-60 years. Their aim was to see whether
Yoga asanas had any effect on nerve conduction. TheYoga asanas included
Suryanamskar Tadasan, Konasan, Padmasan Pranayam, Shavasan,
Pavanmukthasan, Sarpasan and Shavasan. The Yoga exercises were performed
for 40 minutes every day for 40 days in the above sequence. The
subjects continued their normally prescribed medicines and diet. Blood
sugar and nerve conduction velocity of the median nerve (in the hand)
were measured and repeated after 40 days of the Yogic regime. Another
group of 20 type 2 diabetes subjects of comparable age and severity,
called the control group, were kept on prescribed medication and light
physical exercises like walking. Their initial & post 40 days
parameters were recorded for comparison.
At the end of the 40 days, those who did the yoga had improved the
nerve impulse in their hands. The hand nerve conduction velocity
increased from 52.8 meters per second to 53.8 m/sec. The control group
nerve function deteriorated over the period of study, indicating that
diabetes is a slowly progressive disease involving the nerves. The
authors conclude that Yoga asanas have a beneficial effect on blood
sugar control and improve nerve function in type 2 diabetics who have
mild nerve damage. Dr. Sahelian says: In addition to Yoga, I recommend
my patients with diabetes take a nutrient called lipoic acid which has
also been found to improve nerve function in diabetics.
Yoga Lowers Blood Sugar in Diabetics
Certain yoga asanas, if practiced regularly, are known to have
beneficial effects on human body. Researchers at the University College
of Medical Sciences, in Shahdara, New Delhi evaluated 24 patients aged
30 to 60 year old who had non-insulin dependent diabetes mellitus, also
called Type II diabetes. Diabetics who require insulin are called Type
I, while Type II diabetics are treated with diet, exercise, and oral
medicines that lower blood sugar. The researchers evaluated the baseline
fasting blood sugar levels of the patients, and they also performed
pulmonary function studies. These pulmonary function studies measure
lung capacity and the amount of air that can be exhaled within the first
second of a rapid exhale.
After performing these basic tests, yoga experts gave these patients
training in yoga asanas. The yoga practice was done 40 minutes a day for
40 days. These asanas consisted of 13 well known and common postures,
done in a sequence. After 40 days of yoga asanas regimen, the testing
was repeated. The results indicate that there was significant decrease
in fasting blood sugar levels from about 190 initially to 140 after the
40 day period of yoga activity. Fasting blood sugar in people without
diabetes is usually below 120. The lung studies showed an average
improvement of about 10 percent in lung capacity. These findings suggest
that better blood sugar control and pulmonary functions can be obtained
in type I diabetics when they stick to a daily schedule of yoga asanas
and pranayama.
The exact mechanism as to how these postures and controlled breathing
interact with physio-neuro-endocrine mechanisms affecting blood sugar
and pulmonary functions remains to be worked out.
Menopause
A preliminary study at the University of California, San Francisco,
found that menopausal women who took two months of a weekly restorative
yoga class, which uses props to support the postures, reported a 30
percent decrease in hot flashes. A four-month study at the University of
Illinois found that many women who took a 90-minute Iyengar class twice
a week boosted both their energy and mood; plus they reported less
physical and sexual discomfort, and reduced stress and anxiety.
Stress Management and Relaxation
Using Yoga to Relieve Stress
To combat stress, many people turn to meditation or other mental stress
reduction tools. But stress also creates physical response in the body
and, as such, can be managed with exercise -- in particular, with yoga.
"Stress sends the entire physical system into overdrive," says Garrett
Sarley, president and CEO of the Kripalu Center for Yoga & Health in
Lenox, Mass. "The muscles tense, the heart beats faster, breathing
patterns change, and if the cause of stress isn't discontinued, the body
secretes more hormones that increase blood sugar levels, raising blood
pressure. Yoga is one of the few stress-relief tools that has a positive
effect on all the body systems involved."
Recognizing the detrimental effects of stress, especially in the area
of heart disease, the preventive and rehabilitative cardiac center at
Cedars-Sinai Medical Center in Los Angeles began offering yoga to their
patients more than 10 years ago.
"Over the years, yoga has become one of our primary therapies for
stress management," says C. Noel Bairey Merz, M.D., director of the
preventive and rehabilitative cardiac center at Cedars-Sinai Medical
Center.
Yoga-based guided relaxation reduces sympathetic activity judged from baseline levels.
35 male volunteers whose ages ranged from 20 to 46 years were studied
in two sessions of yoga-based guided relaxation and supine rest.
Assessments of autonomic variables were made for 15 subjects, before,
during, and after the practices, whereas oxygen consumption and breath
volume were recorded for 25 subjects before and after both types of
relaxation. A significant decrease in oxygen consumption and increase in
breath volume were recorded after guided relaxation (paired t test).
There were comparable reductions in heart rate and skin conductance
during both types of relaxation. During guided relaxation the power of
the low frequency component of the heart-rate variability spectrum
reduced, whereas the power of the high frequency component increased,
suggesting reduced sympathetic activity. Also, subjects with a baseline
ratio of LF/HF > 0.5 showed a significant decrease in the ratio after
guided relaxation, while subjects with a ratio < or = 0.5 at
baseline showed no such change. The results suggest that sympathetic
activity decreased after guided relaxation based on yoga, depending on
the baseline levels.
Psychol Rep 2002 Apr;90(2):487-94 Related Articles, Links. Swami
Vivekananda Yoga Research Foundation, Chamarajpet, Bangalore, India.
Asthma and Breathing
Asthma is a lung condition involving chronic inflammation of the
airways (bronchi) which can narrow and go into spasms. During asthma
attacks, the smooth muscle cells in the bronchi constrict, the airways
become inflamed and swollen, and breathing becomes difficult.
Symptomatic control of episodes of wheezing and shortness of breath is generally achieved with fast-acting bronchodilators.
A study of the effect of yoga training on pulmonary functions in patients with bronchial asthma.
Indian J Physiol Pharmacol. 2009 Apr-Jun; Sodhi C, Singh S, Dandona PK.
Department of Physiology, Christian Medical College, Ludhiana - 141
007.
The role of yoga breathing exercises, as an adjunct treatment for
bronchial asthma is well recognized. One hundred twenty patients of
asthma were randomized into two groups i.e Group A (yoga training group)
and Group B (control group). Each group included sixty patients.
Pulmonary function tests were performed on all the patients at baseline,
after 4 weeks and then after 8 weeks. Majority of the subjects in the
two groups had mild disease (34 patients in Group A and 32 in Group B).
Group A subjects showed a statistically significant increasing trend in %
predicted peak expiratory flow rate (PEFR), forced expiratory volume in
the first second (FEV1), forced vital capacity (FVC), forced mid
expiratory flow in 0.25-0.75 seconds (FEF25-75) and FEV1/FVC% ratio at 4
weeks and 8 weeks as compared to Group B. Thus, yoga breathing
exercises used adjunctively with standard pharmacological treatment
significantly improves pulmonary functions in patients with bronchial
asthma.
Obesity
Obesity rates in the United States have reached epidemic proportions:
58 Million Overweight; 40 Million Obese; Eight out of 10 adults over age
25 Overweight; 78% of American's not meeting basic activity level
recommendations; 25% completely Sedentary; 76% increase in Type II
diabetes in adults 30-40 yrs old since 1990; In 2001 25% of all white
children and 33% of African American and Hispanic children were
overweight.
Solution: Vigorous Power, Vinyasa, or Ashtanga yoga classes done for 90
minutes at least 3-5 times a week will produce weight loss. Yoga keeps
people more in tune with their bodies making them aware of aware of bad
habits, such as eating because of stress, boredom or depression. The
first study investigating the effects of yoga on weight was recently
conducted by the Fred Hutchinson Cancer Research Center in Seattle, WA.
General Stats: According to the Centers for Disease Control and
Prevention, 16 percent of children (over 9 million) 6-19 years old are
overweight or obese -- a number that has tripled since 1980. In addition
to the 16 percent of children and teens ages 6 to 19 who were
overweight in 1999-2002, another 15 percent were considered at risk of
becoming overweight. ("Prevalence of Overweight and Obesity Among
Children and Adolescents: United States, 1999-2002"; Oct. 6, 2004)
According to the Centers for Disease Control and Prevention, over the
past three decades the childhood obesity rate has more than doubled for
preschool children aged 2-5 years and adolescents aged 12-19 years, and
it has more than tripled for children aged 6-11 years. ("Prevalence of
Overweight and Obesity Among Children and Adolescents: United States,
1999-2002"; Oct. 6, 2004)
Heart Disease
Lower blood pressure, cholesterol, heart rate and other heart disease symptoms
Several trials have found that yoga can lower blood pressure,
cholesterol, and resting heart rates, and help slow the progression of
atherosclerosis—all risk factors for heart disease, says Erin Olivo,
PhD, director of Columbia University's Integrative Medicine Program.
While almost any exercise is good for the heart, experts speculate
yoga's meditative component may give it an extra boost by helping to
stabilize the endothelium, the lining of the blood vessels that, when
irritated, contributes to cardiovascular disease. Since the lining is
reactive to stress, and meditation can lower stress hormones, yoga may
be causing a cascade of events that could reduce your risk of a heart
attack or stroke.
Retardation of coronary atherosclerosis with yoga lifestyle intervention.
Yoga has potential for benefit for patients with coronary artery
disease though objective, angiographic studies are lacking. We evaluated
possible role of lifestyle modification incorporating yoga, on
retardation of coronary atherosclerotic disease. In this prospective,
randomized, controlled trial, 42 men with angiographically proven
coronary artery disease (CAD) were randomized to control and yoga
intervention group and were followed for one year. The active group was
treated with a user-friendly program consisting of yoga, control of risk
factors, diet control and moderate aerobic exercise. The control group
was managed by conventional methods i.e. risk factor control and
American Heart Association step I diet. At one year, the yoga groups
showed significant reduction in number of anginal episodes per week,
improved exercise capacity and decrease in body weight. Serum total
cholesterol, LDL cholesterol and triglyceride levels also showed greater
reductions as compared with control group. Revascularisation procedures
(coronary angioplasty or bypass surgery) were less frequently required
in the yoga group. Coronary angiography repeated at one year showed that
significantly more lesions regressed (20% versus 2%) and less lesions
progressed (5% versus 37%) in the yoga group. The compliance to the
total program was excellent and no side effects were observed. : Yoga
lifestyle intervention retards progression and increases regression of
coronary atherosclerosis in patients with severe coronary artery
disease. It also improves symptomatic status, functional class and risk
factor profile.
The overall benefits of yoga on risk factors for heart disease were
evaluated by researchers at Bhabha Atomic Research Centre, Medical
Division, in Mumbai, India. (Mumbai is the new name for the city formely
known as Bombay. The name was changed in the mid 1990s. The effect of
yoga on the body, psychological well being, and cardiovascular risk
factors was studied in a group of middle aged patients. Twenty patients
(16 males, 4 females) in the age group of 35 to 55 years with mild to
moderate high blood pressure underwent yogic practices daily for one
hour for three months. High blood pressure is a risk factor for heart
disease, stroke, and kidney damage. Biochemical and psychological
parameters were studied prior and following period of three months of
yoga. These biochemical parameters included blood sugar, lipid profile
including cholesterol, and blood levels of catecholmines (stress
chemicals like epinephrine or adrenaline). The overall results were
quite positive. There was a decrease in blood pressure along with a
decrease in blood sugar, cholesterol and triglycerides. The patients
also reported an improvement in overall well being and quality of life.
There was also a decrease in the levels of catecholamines, suggesting a
decrease in sympathetic activity. A decrease in sympathetic activity
indicates that the patients were calmer and experienced less tension and
stress, and that their blood pressure would be lower. The authors of
the study conclude that yoga can play an important role in decreasing
the risk factors for cardiovascular disease in those with mild to
moderate hypertension.
Heart rate variability, a sign of a healthy heart, has been shown to be
higher in yoga practitioners than in non-practitioners, according to
research in the International Journal of Medical Engineering and
Informatics. The autonomic nervous system regulates the heart rate
through two routes — the sympathetic and parasympathetic nervous
systems. The former causes the heart rate to rise, while, the
parasympathetic slows it. When working well together, the two ensure
that the heart rate is steady but ready to respond to changes caused by
eating, the fight or flight response, or arousal.
J Assoc Physicians India 2000 Jul; Manchanda SC, Narang R, Reddy
KS, Sachdeva U, Prabhakaran D, Dharmanand S, Rajani M, Bijlani R. All
India Institute of Medical Sciences, New Delhi, India.
Cancer
Yoga Benefits for Cancer Patients Yoga's gentle exercises have numerous
well-known health benefits. Practicing yoga can lower blood pressure,
improve coordination and reduce stress. For those coping with a chronic
illness such as mesothelioma or other types of cancers, a yoga routine
can be added to a treatment regimen, whether it is holistic or
traditional treatment. Like any treatment, yoga should be individualized
to meet specific needs. Unsurprisingly, cancer patients often do not
have enough energy and do not feel well enough for much physical
activity.
Especially during treatments such as chemotherapy, even simple tasks
like making dinner can become daunting chores. Cancer patients often
suffer from fatigue and muscle soreness, as well as various other
ailments like shortness of breath caused by mesothelioma of the lung.
These problems often can be relieved by implementing a gentle yoga
routine. For patients who may have trouble integrating physical activity
into their lives during treatment, yoga stretches and poses provide a
low-impact, low-stress technique for rejuvenating and reenergizing the
body.
A patient should incorporate yoga in whatever way works best for his or
her schedule and body. Some cancer patients find that a weekly 30- to
60-minute yoga session is enough to improve physical wellbeing and
reduce stress. Others benefit from a daily or twice-daily practice. A
short 10-minute session in the morning and another before bed can have
significant physical results without imposing on a busy schedule. As
with any such lifestyle change, a new yoga practice should be approved
by cancer patients' doctors.
Doctors can advise their patients with regards to each specific
diagnosis and condition and may even be able to recommend a therapeutic
yoga instructor. In addition to communicating with their doctors,
patients should tell their yoga instructors of the special circumstances
and any other relevant physical problems.
Courtesy of www.pleuralmesothelioma.com
Fatigue in Cancer Survivors
Yoga improves fatigue in cancer survivors
Cancer can be a devastating disease that saps energy often due to
radiation and chemotherapy. Researchers at the University of Rochester
Medical Center in New York assigned more than 400 cancer survivors to
one of two groups.
Most had been treated with chemotherapy for breast cancer. The first
group did gentle Hatha yoga and restorative yoga twice a week for a
month. The other group did not engage in such activity. The individuals
who did yoga were able to cut back on sleeping pills and slept better.
Yoga also increased their energy levels and improved their quality of
life.
Cancer Patients and Survivors
Yoga Helps Cancer Patients
A gentle form of yoga helps those with lymphoma sleep better. Lymphoma
is a cancer that arises in the cells of the immune system. The
investigators found that among 39 patients being treated for lymphoma,
those who participated in only seven weekly sessions of yoga said they
got to sleep sooner, slept for longer, and needed fewer drugs to fall
asleep. Study author Dr. Lorenzo Cohen, of the M. D. Anderson Cancer
Center in Houston, Texas, explained that living with cancer can be a
very stressful experience, as patients cope with a diagnosis of a
life-threatening illness and the side effects of treatment. As is well
known, stress can often interfere with patients' sleep habits. Over the
years, studies have linked yoga to a number of health benefits,
including lowering blood pressure, beating fatigue and easing chronic
pain. In the current report, Cohen and his team asked half of the
patients to participate in seven weekly sessions of yoga and the results
were compared to other patients with lymphoma who did not participate
in the yoga program. Some studies have suggested that up to three
quarters of cancer patients struggle with sleep. This may have important
health consequences since sleep disturbances have been linked with
problems with the immune system, and an increased risk of illness or
death. Individuals with cancer should be cautioned that while undergoing
or recovering from treatment one should adopt a gentle routine, and
avoid excessively strenuous routines. This is particularly true for
cancer patients who have metastases to the bones which would make the
skeletal system more prone to fractures. There is good reason to expect
that a gentle form of yoga would be beneficial to not only patients with
lymphoma, but those suffering from other types of cancer.
Yoga has been practiced for thousands of years to improve physical and
emotional well-being. Several recent studies have been conducted with
cancer patients and survivors. Nine studies conducted with cancer
patients and survivors yielded modest improvements in sleep quality,
mood, stress, cancer-related distress, cancer-related symptoms, and
overall quality of life. Studies conducted in other patient populations
and healthy individuals have shown beneficial effects on psychological
symptoms, as well as other aspects of physical function. Results from
the emerging literature on yoga and cancer provide preliminary support
for yoga interventions for cancer patients, although controlled trials
are lacking.
Dr. Ray Sahelian comments: I started yoga 20 years ago and I love it.
It makes me feel so relaxed, revitalized, and supple. I heard someone
once say, "You're as young as your spine is flexible." Although not
completely true, part of staying younger is to have flexibility of
tendons and ligaments. No amount of a healthy diet and supplement intake
is going to replace the benefits of yoga or other forms of stretching
practices. Although I realize how important yoga is, sometimes I don't
have the patience to attend a one and half hour class, so I do it at
home at 20 minute intervals a few times a week. There are several yoga
programs on TV, particularly the public funded channels, and you can
tape some and do the yoga postures at your leisure. Or, you can attend a
local yoga class.
Yoga for cancer patients and survivors
Yoga has been practiced for thousands of years to improve physical and
emotional well-being. Empirical research on yoga has been ongoing for
several decades, including several recent studies conducted with cancer
patients and survivors. METHODS: This review provides a general
introduction to yoga and a detailed review of yoga research in cancer.
RESULTS: Nine studies conducted with cancer patients and survivors
yielded modest improvements in sleep quality, mood, stress,
cancer-related distress, cancer-related symptoms, and overall quality of
life. Studies conducted in other patient populations and healthy
individuals have shown beneficial effects on psychological and somatic
symptoms, as well as other aspects of physical function. CONCLUSIONS:
Results from the emerging literature on yoga and cancer provide
preliminary support for the feasibility and efficacy of yoga
interventions for cancer patients, although controlled trials are
lacking. Further research is required to determine the reliability of
these effects and to identify their underlying mechanisms.
Cancer Control. 2005 Jul;12(3):165-71. Bower JE, Woolery A, Sternlieb B, Garet D.
University of California, Los Angeles Cousins Center for Psychoneuroimmunology, Los Angeles
Breast Cancer
Research is becoming clear on this: Women who do yoga during and after
treatment experience less physical discomfort and stress. Earlier this
year Duke University scientists reported results of a pilot study in
which women with metastatic breast cancer attended eight weekly yoga
sessions. The doctors found that the women had much less pain and felt
more energetic and relaxed.
Yoga and Breast Cancer
Women who took yoga classes during breast cancer treatment reported
they could function better physically and felt better about their
health. Sixty-two women who were undergoing radiation treatment for
breast cancer were randomly assigned to attend yoga classes twice a week
or be put on a waiting list to start yoga after their treatment. The
women who practiced yoga reported better physical functioning, such as
the ability to walk a mile, climb stairs and lift groceries, said
Lorenzo Cohen, director of integrative medicine at the University of
Texas M.D. Anderson Cancer Center. They also felt better about their
overall health and reported less fatigue and problems sleeping. No
difference was seen, however, in rates of depression and anxiety in the
two groups. In the study, instructors emphasized breathing and
relaxation and excluded positions that would be difficult for patients
with weakened range of motion. The average patient in the study was 52
years old.
Breast cancer patients benefit from a yoga program
Researchers in Ankara, Turkey evaluated twenty patients between the
ages of 30 and 50 years who were under routine medical treatment for
breast cancer. Eight sessions of a yoga program were included in the
program such as warming and breathing exercises, asanas, relaxation in
supine position, and meditation. After completion of the study, testing
showed that patients' quality of life scores were better than scores
obtained before the program. After the yoga sessions, there was a
significant decrease in anxiety. It can be concluded that yoga is
helpful to achieve relaxation and reduction of stress, helps cancer
patients perform daily and routine activities in an easier manner, and
increases the quality of life in cancer patients. In addition to yoga,
there are foods and supplements that can be of benefit in reducing the
risk or improving survival outcomes.
Yoga side effect and danger of Yoga
Even though in most cases yoga is safe, there are times that certain
positions could lead to low back pain, neck pain, shoulder pain, hip or
knee problems. For instance, should stands could aggravate neck
problems. Back bends could aggravate back problems. If you have a
musculoskeletal injury, take it slow and don't try to do every position
the yoga instructor recommends to the class.
Yoga and Heart Failure
A regimen of yoga is safe for patients with chronic heart failure and
helps reduce signs of inflammation often linked with death. More than 5
million Americans have chronic heart failure, a long-term condition in
which the heart no longer pumps blood efficiently to the body's other
organs.
Researchers at Emory University School of Medicine in Atlanta who
measured the effects of an eight-week yoga regimen on heart failure
patients found the yoga routine improved exercise tolerance and quality
of life.
Yoga and Weight Loss
Yoga practice is associated with attenuated weight gain in healthy, middle-aged men and women.
Yoga is promoted or weight maintenance, but there is little evidence of
its efficacy. OBJECTIVE: To examine whether yoga practice is associated
with lower mean 10-year weight gain after age 45. Participants included
15,550 adults, aged 53 to 57 years, recruited to the Vitamin and
Lifestyle (VITAL) cohort study between 2000 and 2002. Conclusions:
Regular yoga practice was associated with attenuated weight gain, most
strongly among individuals who were overweight. Although causal
inference from this observational study is not possible, results are
consistent with the hypothesis that regular yoga practice can benefit
individuals who wish to maintain or lose weight.
Altern Ther Health Med. 2005 Jul-Aug;11(4):28-33. Kristal AR,
Littman AJ, Benitez D, White E. Division of Public Health Sciences, Fred
Hutchinson Cancer Research Center, Seattle, Wash, USA.
Yoga, Weight Loss, and Teenagers
Teens bent on losing weight may want to bend into the downward dog pose
-- or any other yoga position. Researchers at Hampton University in
Virginia report that a program combining yoga and breathing exercises
helped teens shed unwanted pounds. The study included 60 overweight high
school girls and boys who were divided into two groups. One group
received 40 minutes of yoga and pranayama (quiet, deep and forced
breathing) four times a week for 12 weeks, while those in the control
group did their normal activities. After 12 weeks, the average body mass
index (BMI) in the yoga / pranayama group went from 22.8 to 21.5 (a 5.7
percent decrease), while the average BMI in the control group increased
from 22.3 to 22.4. The decrease in the pranayama group could be
attributed to two factors: the pranayama and yoga exercises themselves,
and a possible decrease in daily caloric intake by the participants in
the pranayama group because of decreased stomach size.
Yoga, Meditation and Consciousness
Increased dopamine tone during meditation-induced change of consciousness.
This is the first in vivo demonstration of an association between
endogenous neurotransmitter release and conscious experience. Using
11C-raclopride PET we demonstrated increased endogenous dopamine release
in the ventral striatum during Yoga Nidra meditation. Yoga Nidra is
characterized by a depressed level of desire for action, associated with
decreased blood flow in prefrontal, cerebellar and subcortical regions,
structures thought to be organized in open loops subserving executive
control. In the striatum, dopamine modulates excitatory glutamatergic
synapses of the projections from the frontal cortex to striatal neurons,
which in turn project back to the frontal cortex via the pallidum and
ventral thalamus. The present study was designed to investigate whether
endogenous dopamine release increases during loss of executive control
in meditation. Participants underwent two 11C-raclopride PET scans: one
while attending to speech with eyes closed, and one during active
meditation.
1) Run a few inches of cool or slightly warm water into a bathtub an
