This past Saturday, my friend L. talked me into signing up for a week of yoga classes at Bikram Yoga NYC. Of course, like any reasonable person who knows little to nothing about Yoga, I thought Bikram just happened to be the name of the yoga studio.
Boy, was I wever wrong.
MEET MR. BIKRAM
Bikram Yoga is not just the name of the yoga studio. It is the name for a school of Yoga developed by a guy named Bikram Choudhury. (That’s him up there, showing off. )
Mr. Bikram’s yoga is a copyrighted series of 26 standard asana Yoga poses performed over a 90 minute period, and”designed to scientifically warm and stretch muscles, ligaments and tendons in the order in which they should be stretched.”
Bikram claims to have cured his knee problems as a young man with this Yoga method. He then came to the US at the urging of the likes of Shirley MacLaine and Richard Nixon in the 1970’s, and opened franchises across America to spread his gospel. Truth be told, he is a bit of a controversial figure whose American business ways have led some to nickname him “McYoga“.
The Bikram Yoga Poses (from BikramYoga Madrid website)
THE CLASS
Looks like fun”, I said to L. as we stared at the poster of the 26 poses in the school lobby. “I’m pretty sure I can touch my toes if I bend my knees a little.”
Just before class, the nice guy standing next to the sign-up desk advised that I might want to purchase some vitamin C and minerals to take for my first class. I turned him down, figuring that I’d already sprung for the class, a rented mat and towels, and a big bottle of water.
“This place makes it’s money like the movie theater does on popcorn”, I muttered to L.
Wrong, again.
Because there was one little teensy-weensy detail about Bikram Yoga that I didn’t know at that time. It so happens that Mr. Bikrams’ classes are held in a room that is heated to (are you ready?) 104 degrees Fahrenheit. You read me right – 104 degrees. (For my readers outside of the US, that’s 40.5 degrees Celsius.) According to Bikram, the heat is necessary to keep the muscles warm and prevent injury.
Thanks, L.
As we entered the room, the heaters were blowing despite the 80 plus sunshine outside. Suffice it to say that we were sweating before we even laid our mats down. Good thing I rented those towels…
Our teacher (who, I should mention, was wonderful) took us through Mr. Bikram’s copyrighted series of 26 poses at a pace that I know was relatively easy, demonstrating for us while we rested between moves, urging us not to push ourselves, even giving me her towel to use to extend my stretch when it became evident that I could not reach my heels.
And in terms of the poses, I did much better than I would have expected. As I had discovered in other yoga classes, I found I have lots of flexibility in my lower spine, none in my upper, and that being overweight gets in the way of a good pose. But I held my own, I thought.
Till the class was over.
At that point, standing up after taking a little rest in “corpse pose”, I practically fell flat on my face from dizziness. And, as I went to put on my sandals, which had slipped off so easily when I began class, I found my feet were so swollen that I had to loosen the straps just to get them on.
L. wanted to walk all the way down to the river for a little al fresco lunch.
“Air conditioning”, I simply said, and that was that. We went for a nice healthy lunch, and I spent the rest of the day feeling like a damp dishrag.
THE AFTERMATH
The next day, Sunday, I felt even worse – nausea, headache, feverish and fatigued down to my bones. To compensate, I drank tons of water. Wrong move – my feet swelled even more, a situation aggrevated by sitting at the computer till all hours cleaning up the trojans that had crashed it via my husband’s email inbox. (E-email me if you want advice on this, I am now an expert…) At 1:30 am, I hit the sack feeling like I would never get out of bed again.
And then, the oddest thing happened.
I awoke at 6 am Monday feeling refreshed, alert, headache-free and more relaxed than I have felt in months, maybe years. We’re talking a sense of relaxation and calm that was peppered with energy. Still with swollen ankles, but happy as a clam. I literally floated through the day.
It lasted about 24 hours.
By Tuesday, I was back to my usual stressed-out, neck tightened, migraine-any-minute-now state. And my legs? +2 pitting edema up to mid-shin. I hadn’t seen ankles like those since my 39th week of pregnancy. They stayed that way till today (Thursday).
THE ANALYSIS
So, what happened to me?
According to the National Weather Service, Mr Bikram’s room had a heat index of 119 – in the “danger” range where “sunstroke, heat cramps or heat exhaustion are likely and heatstoke is possible with prolonged exposure and/or physical activity.” (Hmm…like 26 poses?)
So I’m sure that on Saturday and Sunday, my symptoms were the result of a mild case of heat exhaustion. Given that I tried to drink plenty of water during and after class, I expect that I inadvertently became both sodium depleted and over-hydrated (hypervolemic hyonatremia in med-speak). Which made me feel worse. And, in this particular situation, the osmotic forces generated by the imbalance between the hypo-osmolic serum and the relatively hyper-osmolic tissues leads to edema (swelling).
As this recent article in the NY times tells us, I did exactly what they are now advising marathon runners not to do. Because hyponatremia, at its extremes, can cause cerebral edema and even death. Experts now advise drinking limited amounts of electrolyte-laden fluids instead of tons of water.
THE UNEXPLAINED
Okay, so I’ve explained why I felt so bad Saturday and Sunday. What I cannot explain is why I felt so good on Monday. I’ve gone through everything I did, ate or drank for the prior 72 hours and the only thing different for me was that darned yoga class.
Now, the Bikram-Yoga folks believe that all that sweating releases toxins from the body. YEah, right. I never bought that sort of talk. Whenever anyone starts to talk about “toxic cleansing” I give them a lecture on the glories of the liver, colon and kidney, the mop-up crew of the human body.
But then again, I’ve lost track of the number of times my basketball and tennis-playing husband has commented on “how good it feels to sweat” whenever I complain about his damp gym shorts and sopping t shirts hanging on the shower rod. This guy lives on sweating, I swear.
Come to think of it, Mr TBTAM is probably the most relaxed, calm and happy person I know (except when he gets to thinking about the current state of American government…) It’s one of the reasons I married him.
Could it be that sweating really is the secret to happiness? Or was I just feeling so good in comparison to how bad I had felt in the acute throws of hyponatremic heat exhaustion?
I’ll never know. Because, although I have 2 more days left in my one week Bikram Yoga trial, I have too much to do in those 2 days to risk feeling that bad again.
But maybe some day soon, when I have the time to spare, I’ll try again. But next time, I’m bringing my own mat and towel, and drinking Gatorade instead of water. _______________________________________________________________
– See a 60 Minutes interview with Bikram Chadbury here.
– Read a New England Journal article about marathon-induced hyponatemia.
– For patients: Heat Exhaustion and Heatstroke: What You Should Know
– For Physicians: Heat Related Illnesses
Caegory: Second Opinions, Considerations.
Wow, the what happened section is just fascinating!
Thanks!
ps. So would you have felt a lot less bad if the room temp had been warm but not hot, say 80F?
Bardiac:
I’m sure I would have been fine in th 80’s. I hike and bike in that kind of heat, and never have a problem.
I just found your blog (hi!)- I love this post…especially the “artist rendered” sodium diagram.
Nice post. But, yeah, drink gatoraid, or a mild saline solution after that type of workout. Now you know 🙂
Certainly hyponatremia could have resulted from your yoga session which could have explained your initial symptoms.
However, the pedal edema should have resolved fairly quickly if your renal function were normal.
I realize that the following day, you continued to take in a lot of water but what about the next few days?
Most normal patients can clear huge amounts of free water with ease. If your edema persisted for several days beyond the time that you cut back on your fluid intake, then I’d consider checking my BUN, Cr and urine for protein (as well as LFT’s if necessary).
In short, I’d be looking for other things preventing you from excreting your free water load and resolving your edema.
John
Medicine Man: Your concern is well-approciated, but I acually had those tests done fairly recently, and all were fine. So was a thallium stress test I had during my treatment for Hepatitis C (when my severe anemia led to SOB).
I blame the edema on the fact that I continued to drink a lot of water, but also took in a fair amount of salt, and on the fact that those few days were ones of relative inactivity on my part – too much computer time and not enough exercize to move that fluid up off my legs. Once I got moving again, it was off rather quickly.
Thanks for visiting..
Dear Tbtam,
Glad to hear it!
John
This was a great post. I’m sitting here all ready to get a great medical lecture via video and instead get Baroque (I think) music and a huge third rectangle! LOLOL!
I was laughing so hard, I nearly choked on MY water – you should teach…that got the point across faster and more effectively than any textbook! : )
My daughter doesn’t run marathons, but she does run Cross-Country. Gatorade is her drink of choice…
Kim:
You daughter is clearly a few steps ahead of me on the exercise physiology scene…
By the way, the music I used was indeed Baroque, more specifically, Handel’s Water Music 🙂
I am also a student of Bikram Yoga although I slacked off during the holidays and then injured my back, my sciatica to be exact. Oh off on a tangent again sorry back to business. I would suggest that you NOT dring gatorade since it is loaded with stuff your body does not need, instead I would suggest that you dring SMART WATER that contains electrolytes-the stuff that’s better for your body anyway. Yes i do agree that the first Bikram class does do that to a persons body because I too experienced some of what you did only my foot swelling was due to high blood pressure. I enjoyed your recap of your Bikram experience.
Nature does it best… “coconut water”.
Direct from the source in au-natural seed form.
Caution… it does get addicting, kinda like the Bikram asanas! 🙂
db
Way after the fact, but just to add my two cents… I do Bikram as well, and I find that I can feel really bad if I haven’t hydrated properly BEFORE the class. Drinking water during and after can help, but being improperly hydrated beforehand might have helped bring on whatever it was that was wrong with you
Hi TBTAM, I am a 17 yr. old dancer and was thinking about taking Bikram yoga because i tend to stop breathing while I’m dancing and by the time I’m done, I am completely out of breath and sometimes have to completely stop. With saying that, I wanted to take yoga to maybe help with that. I also have a HUGE problem with heat. If I get too hot I suffer hugely. After reading your experience, I’m starting to second guess myself about going.. should I try anyway?
I don’t want to have that bad of an experience.. -Thanks Jessica
Hi TBTAM, I am a 17 yr. old dancer and was thinking about taking Bikram yoga because i tend to stop breathing while I’m dancing and by the time I’m done, I am completely out of breath and sometimes have to completely stop. With saying that, I wanted to take yoga to maybe help with that. I also have a HUGE problem with heat. If I get too hot I suffer hugely. After reading your experience, I’m starting to second guess myself about going.. should I try anyway?
I don’t want to have that bad of an experience.. -Thanks Jessica
So that’s it. I thought this was a whole blog on yoga. I like your writing – you should’ve stuck with the yoga!
John B.
http://www.theashramyoga.com
please don’t drink gatorade, it’s laden with sugar, try coconut water, i bet the studio has it, or EmergenC packets, powder you add to water.
Bikram Yoga is Advanced Medicine for the human body. The heat is required to get into the poses. It’s intense and it requires that you find a good teacher. You are your best teacher. The teachers go through a 9 week course. You cannot master something in 9 weeks. If your in seattle here is a good school: http://www.theashramyoga.com. Stu R.
What an interesting blog! I’ve been a Certified Bikram Yoga Teacher for 9 years. When I went to my first class it killed me. I think I left my soul somewhere in the pool of sweat on the carpet in my home studio. Seriously. I didn’t go back for 6 months for my second class. I wasn’t ready to deal with my unhealthy body yet. Bikram Yoga is challenging but not only because of the heat. Think of all of the damage we do to our bodies in our daily lives… sitting on chairs, leaning forward typing on computers, wear and tear on joints as we age, food additives/toxins we ingest, etc. The 26 postures and two breathing exercises work every system in your body in 90 minutes. There is so much going on internally while you are experiencing a Bikram Yoga class. That’s why you feel dizzy and sick to your stomach! After a few classes this subsides and then as a practitioner you have your good days and bad days just like you were practicing any other form of yoga.
There are thousands if not millions of people all over the world who practice Bikram Yoga in 105 degree heat and never have hyponatremia. I only know of one case in Bikram Yoga history that occured due to the student trying to do a fast during teacher training. If you fast and do two 90 minute classes a day – there is a chance you could get hyponatremia. And it is scary. But, there is no reason to be frightened of Bikram Yoga and the heat. Just take care of yourself and you will be fine. Teachers are taught to advise students about how to take care of your body as a Bikram Yogi. One class is not enough to fully understand what Bikram Yoga has to offer. It changed my life. Maybe you, like I was when I took my first class, are just not ready for the challenge of Bikram Yoga. Please try it again. Give it a chance. Get out of your medical mind for 90 minutes and trust an ancient, 1000 year old remedy for stress, health and total body well being.
I too love your web site and Bikram Yoga. However I just heard that he is pulling out of 4 year contract in Palm Springs. This is resulting in people losing their jobs and is a big financial strain on the city and hotel. Then to find out that he is moving the event to Las Vegas. Could their be a more negative space to hold training? I like the yoga but the Man seems to be not a good person.
What a shame that 'business' can have such an impact on a practice meant for healing.
-Rochelle
I felt the exact same way today (minus the edema). I chalked it up to increased excitatory neurotrasmitter release after an increase in physical activity.
Thanks for this great post, I felt many of the same things after my first couple of Bikram yoga classes.
When it comes to Bikram, I'm definitely a kool-aid drinker. Trying it for one day seems like all of the pain and not that much of the benefit. Try it for 60 days and it will change your life… it did mine.
@K: It's easy to judge when not familiar with the details. I don't know the specifics of Palm Springs but L.A. was the original Bikram headquarters and he's been struggling with finding a better place for, what we're talking about, teacher training. Each place has either not been adequate or in many cases, not wanted him there after they realized what it actually meant.
It's popular to criticize Bikram, even sometimes amongst his own teachers. I've met the man a few times and I hope to meet him many more because he's one of the kindest souls I've met in my life (though probably not the gentlest).
Hi there…
I just found your site… Well, not that I was looking for sites like this before but more on because I felt really bad after my yoga experience just this Sunday.
Oh well, I tried to do Bikram twice already a month ago and did it again last Sunday.
In my case, the situation is like this… I didn't have enough sleep the day before (slept 4 am and woke up 7 am, then cannot sleep anymore), had mcdonalds 1 hour before (i didnt know that I shouldnt eat before that, well, I was not eating before and it just so happen that I was so hungry before I did the yoga), and then attended the class.
The policy here (Im not sure if its the same with everyone) is that you cannot go out of the class once you entered the room. If you feel dizzy, you should just stay in your normal position and try to relax yourself)… Anyways, I did attend the yoga and after like the 5th pose, I totally started to feel dizzy. I cannot even do the bending positions which crunches the stomach and so had started to have stomach cramps… During the 90-minute exercise, my whole body was so heaty as if its burning… I felt so exhausted and felt so bad… Until today, my body feels so exhausted and weak. Now, I'm taking my vitamins and is sleeping early to gain energy.
Oh well, I guess its totally my fault. I should have not overstressed my self… Correct me if Im wrong but I think that our body needs total preparation before we can actually do yoga for if we wont be able to relax properly beforehand, then we will just suffer…
But dont get me wrong, I truly believe that yoga is good. But doing it unprepared and improperly, it will be bad to yourself like any other thing.