In the heavily touristed areas of southern Kerala, the insincere and exaggerated claims put forth by many less scrupulous practitioners can be an exhausting distraction when looking for authentic Ayurvedic care. Everywhere one turns, it seems, there spas and billboards claiming to be able to cure all diseases, extend mortality, and restore youth. As I began again in my search for an authentic practitioner, I was becoming skeptical that I would ever find “real Ayurveda.”
While my sneha paana treatment with Dr. Raj had been authentic in that he didn’t cater to tourists looking for massages rather than medicine, all that time spent suffering the strict diet and ghee drinking failed to pass the simple test of alleviating any of my symptoms. Still, I felt I needed to give a full course of pancha karma a chance before going home, if for no other reason than thoroughness; it was what I set out to do when I started this blog, and I didn’t feel I could make a fair judgment about Ayurveda without the experience.
In my search for a provider, I returned to scour industry-related Facebook groups, AYUSH recognized hospitals, Green Leaf certified clinics, and traveler review websites. I cannot overstate how difficult it is to find a good pancha karma clinic that is both authentic and provides treatments at a reasonable price. Those two criteria immediately eliminated all the fancy spas and resorts from my list, but there were still dozens of choices to sift through. After many emails and phone calls with several top treatment centers, each of which had a price tag averaging in the $100+/day range, I finally found Dr. Bina through her high ratings on a travel website.
While most Ayurvedic centers I corresponded with recommended 21-28 days treatment in order to reach a “cure” (sometimes even before I explained my symptoms), Dr. Bina told me that two and a half weeks should be plenty for my “mild” conditions, and that, while she thought we could see some good effects, she was was not making any false claims she could provide a cure. Her honesty in setting my expectations about results was the main reason I chose her center for treatment, but there was also the price, which was about half of what I was quoted everywhere else: only 70,000 rs ($1087) for the treatments, room, and board for 19 days.
When I arrived at the center around noon on the first day, Dr. Bina was there to greet me and chatted with me as I ate the delicious homemade vegetarian lunch they provided. She then left me to unpack in one of two guestrooms upstairs where there was also a treatment room, cook’s quarters, living room, and dining area. She and her husband, a government Ayurvedic doctor who also consulted on treatments, lived with their young daughter in the lower unit of the spacious residential duplex, so she was never more than an instant message away when I needed anything.
My first treatment, an abhyanga massage, was administered expertly by the only therapist at the center, a woman in her late 50s named Anna. When I remarked later how strong Anna’s hands were, Dr. Bina told me that she had worked hard as a laborer while raising her daughter alone after her husband died tragically during her pregnancy. After years of odd jobs, Anna had come to be a PK therapist after Ayurveda cured her from a serious disease. Dr. Bina spoke of how difficult it was to find a committed therapist who had both “the hands and the heart,” but Anna had both. Unlike many of the massages I had experienced, she seemed completely present and aware during her treatments, and I felt something like love coming from her hands: for me and for the practice.
The chief complaints I presented with were the recurring insomnia, although I’d largely gotten it under control with help from daily meditation; constipation with any change in diet or routine, which was a bothersome issue while traveling; emotional excesses such as anger, impatience, and anxiety; both dryness and inflammation of the skin, which my dermatologists had shrugged off as rosacea; and pain in my fingers and hands, usually after typing, that felt like the beginning of joint issues or maybe carpal tunnel. In short, I was middle aged.
Despite well-groomed case of hypochondria, Dr. Bina told me I was pretty healthy, but that I had some vata (one of the three main doshas, or energies) imbalances that led to the dryness, insomnia, anxiety, and joint pain. She also noted a healthy dose of pitta in my doshic makeup that tended toward its own set of disorders, such as the inflammation of my skin, the pre-hypertension, the anger, and the impatience.
For these imbalances, she suggested the following plan, with modifications to come as we saw how I progressed.
The Treatment Plan
Abhyanga: whole body massage with oil. Six days.
This massage technique consists of long, vigorous strokes up and down the body in an effort to stimulate the internal organs and improve circulation. There are copious amounts of oil used, which softens the skin and is part of the “sneha” (oleation) process preceding PK. Abhyanga is thought to help with sleep and to aid in longevity.
As someone used to having massages in the US, I was surprised and unabashedly delighted to discover that traditional Indian massage includes massaging the breast area, usually with long strokes that include the arms and go down to the belly or ankles. It’s healthy for the breast and surrounding lymphatic tissue to be massaged regularly, and it’s a good addition for women to include in their daily practice of abhyanga self-massage.
Jambeera Pinda Swedam: application of poultice with medicinal powders, lemon—jambeera—and coconut. Three days.
I thought I was going to miss the abhyanga, but the poultice treatment was a lovely substitute. Each morning, Anna cooked up a batch of herbs in oil with lemons and crushed coconut, which she wrapped in a tight muslin poultice. During the treatment, she dipped the poultice in oil before rubbing it over my body with deep strokes that felt like a cross between a massage and an exfoliation treatment. The smell is heavenly, and the slightly coarse texture of the muslin left my skin feeling silky soft.
Patra Potala Swedam: application of poultice with medicinal leaves—patra—lemon, and coconut. Four days.
This treatment is the same as the one above but incorporates the addition of medicinal leaves as the primary ingredient. These “swedam,” or heat treatments, use hot oil to prepare the body for PK. As Dr. Bina explained, the body must be both lubricated (“sneha”), either internally, externally, or both and steamed with warm oil or water (swedam). When it comes time for the actual treatment, the body will be pliable enough to fully receive the medications.
Nasyam: instilling liquid medication through nostrils. Six days.
Anna gave me this treatment in the morning a couple of hours before the abhyanga. After she massaged my face, chest, and back with a mentholated substance, I would deeply inhale from a steamer to open up the sinuses and bronchial areas. Then she would tilt back my head back to drop up to six drops of medicated ghee into my nose, which she would have me sniff deeply to draw in but not swallow, which was a difficult reflex to suppress. Instead I had to spit it out into a container until my saliva no longer tasted of ghee, which usually lasted only a few minutes.
Sirodhara: pouring warm oil on the forehead continuously for 45 mins. Seven days.
The poster child of Ayurvedic massages for good reason. This technique involves a stream of warmed oil pouring over the forehead for 45 minutes, which is exactly as hypnotic as it sounds. I was not supposed to go to sleep during the session, but a few times I couldn’t help dozing off as my body and mind reached total relaxation.
Vasthi: a combination of five oil enemas and three decoction enemas where a special medicated liquid will be inserted through the anus. Four days.
This treatment and the virechana (below) are the main PK treatments which all others have been leading up to and will begin shortly after this blog post goes live.
Virechana: purgation therapy aimed at eliminating excess pitta dosha from the small intestine, liver, and gall bladder. One day.
Not originally part of the treatment regimen, she added a mild virechana PK treatment after I arrived as I had more pitta imbalance than she originally thought.
The Medications
I started on all three medications immediately, and all were provided free of charge. In addition to the diet and massage, these were used to prepare the body for the PK (Vasthi).
- Gandharvahastadi Kashayam: used to treat digestive issues and bring vata dosha under control. After 5 days, we switched to Guloochiaddi Kashayam, which is indicated to clear liver heat in case of high pitta dosha.
- Ashwagandharishtam: used to soothe neurological disorders (anxiety).
- Gandharvahasta Tailam: a castor-oil based liquid used to treat vata digestive and neurological disorders.
- Medicated ghee starting on the 4th day with 20 ml, increasing to 50 ml by day 10, which was the day before virechana. Post virechana treatment, we returned to 20 ml.
The Diet
I knew the diet was going to be vegetarian as non-veg foods are too heavy for any PK diet, and I also expected it to be a little bland and pretty restricted. I could not have been more wrong. Each meal was a south Indian specialty, and the subtle flavors and complex but mild spices did not leave me missing the spicy, salty, and oily diet I had become accustomed to while eating in restaurants since my last treatment. Dr. Bina even let me have raw fruit, although raw vegetables were not part of the plan. South Indians just don’t do salads, she told me, and besides raw vegetables were hard to digest, which was not allowed during treatment.
She also dealt me the blow of no more coffee—not ever—due to its heating and drying properties and how much it increased stress and blood pressure, which were two things of the issues I was battling. I think she noticed how saddened I was by this news because she relented to giving me a nice thermos of chai early each morning to ease my SBS (shy bowel syndrome). When she first started the clinic, she had her patients follow a stricter diet, but then noticed they were becoming even more stressed out by the deprivation. She now allows for some small joys, such as oil, some spice, some fruit, and a little caffeine as long as the patient’s condition is not too severe.
Typical meals were as follows:
Breakfast: a south Indian specialty like rice noodles (Iddyapam) with coconut milk, puttu (steamed rice and coconut rolls) with curry, or rice pancake rolls stuffed with shredded coconut. Rice and coconut are common and beloved staples in this part of India, and they provide sweetness in a diet that does not include refined sugar. If these dishes sound bland or boring, I can assure you they are not, despite their simplicity.
Lunch: the largest meal of the day, as the digestive strength (or agni, fire) is considered highest at this time in Ayurveda. At first they were serving me white rice until I requested brown, which puzzled them as brown rice is considered inferior and is often fed to animals, and they proudly had been serving me the best white rice available. I explained that I wanted the extra nutrients and fiber with brown rice, so they accommodated my eccentricity with good humor. In addition to the rice, they usually served a soupy coconut-based curry along with a couple of vegetable masalas, and fresh fruit for dessert.
Dinner: whole wheat chapatis with a simple vegetable curry. Whole fruit dessert along with fruit juice, although I cancelled the juice later because I wanted to reduce my calorie intake.
The Results
Each day I have kept a journal, and, looking back, it was on day five that I started to feel really relaxed and at peace. My skin, oiled each day during treatment, has taken on a lustrous quality, and my hands looked younger. It will doubtless return to a drier state once I stop the daily oleation treatments, but for now I’m enjoying it. The inflammation has lessened but still remains.
My sleep, pretty good before I arrived, has deepened to a level I haven’t felt since I was in my 20s. It’s so good, I don’t even want to tell my other friends in their 40s who almost all complain of having lost the ability to sleep through the night.
Of course, my main issue is stress, and there is none of that here. The house sits back from the main road over a quarter mile and backs up to wetlands framed by palm trees in the far distance, so there is no noise other than bird song, the bleating of goats as a herd wanders by, and children playing in the adjacent field. All my meals are prepared, my room cleaned daily, my clothing washed, and my body manipulated into relaxation every day by someone else’s hands, so I have nothing to do aside from read, write, do yoga, and take gentle walks. The test will come when I return to the real world, and Dr. Bina has warned me that conditions that got better often worsen again after her patients go back to their old environments and perhaps old habits, so it will take discipline to maintain a lifestyle that will allow me maximum benefits from the treatment.
