Digital Mammograms

Recently, two different women I know had "suspicious" readings on their mammograms. In both cases, it turned out to be fine, but it naturally caused a lot of anxiety. It also prompted a certain amount of anger. I've heard it before; we probably all have: "all this needless anxiety - it makes me not even want to go for the exam." As many radiologists switch over to digital mammograms there may be an increase in suspicious readings. Digital imaging is better at detecting potential problems for younger women with denser breast tissue and detecting calcium deposits, called calcifications, which can be associated with cancer. The problem seems to be the transition from x-ray to digital imaging. It takes many radiologists a little time to adjust to reading the new images. When first using digital, they may call more women back in because they are just seeing more details than they did before. There was an excellent article about this in the New York Times, April 11, 2008 (http://www.nytimes.com/2008/04/10/health/10scan.html?pagewanted=2&_r=1&sq=breast%20cancer&st=nyt&scp=3).

This newer technology is an improvement: it's more accurate and in the long run will save lives. I hope that during this transition period women will not get frustrated enough to put off going for their regular mammograms. It can be quite frightening to be called back in for further images. But no matter how scary it is, it's better than having a cancer and finding it too late. Keep in mind that this is a screening test that saves lives.

Julie

Building Upper-Body Strength

Rock climbing season is approaching. I love climbing, so I get very excited about the start of the season. But since I have an increased risk for lymphedema, I have to prepare. Unfortunately, while I was traveling in India I lost a lot of my muscle tone. Since coming back, I've been doing exactly what I tell my clients at Life-Cise and Stay Fit Stay Strong: start slowly and build. I went back to using much lighter weights and fewer repetitions at first, and kept an eye out for any signs of puffiness. I have been gradually increasing the intensity of my workouts, first by increasing the repetitions and then gradually increasing the weight. I'm still not back up to my pre-trip strength, but I am finally back to doing a few full pushups.

It can be frustrating to back-track. It's so tempting to jump back in where we left off. But whether we've lost muscle tone because of a trip, surgery or treatment, or just laziness, it's important to take it step by step. Accept where you are right now and make a choice to begin to improve. Fitness is a lifestyle. It's not something you do once. It's a choice you make every day. Choose strength.

Julie

Inactivity and Obesity in Cancer Survivors

A new study will be published in the June 1, 2008 issue of CA Cancer, a journal of the American Cancer Society, that shows many cancer survivors are inactive and obese. The Canadian study reveals that a cancer diagnosis does not prompt major changes in behavior. The authors believe that interventions are necessary to increase physical activity and promote maintaining a healthy weight. The study found that less than 22 percent of Canadian cancer survivors were physically active, with the lowest rate among colorectal cancer survivors, female melanoma surviviors, and breast cancer survivors. I have posted the full article from www.medicalnewstoday.com on my Life-Cise website.

This study is extremely important in pointing out just how much work needs to be done in the area of cancer fitness. So many people become inactive during treatment, and it appears that most of them remain inactive after treatment is finished. For everyone, obesity and physical inactivity are detrimental to health, but this is even more true for cancer survivors. Obesity increases your risk of developing lymphedema, diabetes, and heart disease. Most importantly, numerous studies have linked lack of exercise and obesity to disease recurrence.

This is so important! You're surviving this hellish disease; don't lose the health you're fighting to save. You don't need to make a major, sudden lifestyle change. Take small steps everyday. Choose to eat one healthier meal today. Choose to park your car farther from the door and walk. Choose to take the stairs instead of the elevator. Choose to drink water instead of soda. You didn't choose to have cancer, but in this you do have a choice. Choose health!

Julie

You can read the full article from Medical News Today on my news page: http://www.life-cise.com/lifecise/website/newsShow.do

Lymphedema

Yesterday, my mother related a story of a friend of hers to me. Her friend had fairly recently had surgery for breast cancer. She had a lumpectomy and sentinel node procedure, but later had some problem at the site of the nodes - either an infection or hematoma, I'm not sure. Days later, she had a lot of discomfort in her arm: tightness that was affecting her range of motion, feeling like she had a band in her arm. When she went to her doctor, she was simply told that it was lymphedema and she didn't need to worry, it would just go away, no need to do anything.

I have been very lucky. I've had doctors who warned me about the risk of lymphedema from the beginning. They gave me information to read, told me about early signs to watch for, and gave me tips on preventing it. Unfortunately, not everyone is so well informed. Across the country, many patients are never given the information they need about lymphedema. In their defense, I suppose many doctors don't consider it such a serious risk. After all, they are concerned with saving our lives, so a swollen arm may seem like a pretty low priority. However, for us it can be a major quality of life issue.

There are so many things we can do to prevent and manage it; we just need the information. To begin with, try to elevate the affected limb as much as possible. Sleep with your arm or leg up on a pillow. Take deep breaths, it helps to pump lymph through your system. There are some easy exercises that can be done several time a day.
For upper-body: start with shoulder rolls; clasp your hands together and stretch your arms, palms out to the front, repeat overhead (or just at a higher angle if your range of motion is limited); with your arms out to the side, palms up, move your arms in little circles to the back; with your elbows bent and at your side, pull your elbows back and in, squeezing your shoulder blades together.
For lower-body: lie on your back with your legs up in the air, point and flex your feet; make circles with your feet, going in both directions; make small circles with your whole leg.
For either legs or arms: frequently elevate the limb to let gravity help you; jiggle the limb, easy jiggling helps to stimulate the lymph system; keep your trunk clear - do curl-ups or other core exercises; and most importantly, keep breathing deeply.

Many of these exercises are covered on the Lymphedema page (http://www.life-cise.com/lifecise/website/generalInfoLymphedema.do) on my website, Life-Cise.com. A great resource for more information is the National Lymphedema Network, www.lymphnet.org. Also, the Circle of Hope Lymphedema Foundation, www.lymphedemacircleofhope.org, offers information and the opportunity to pose questions to a lymphedema therapist through the website. Other resources are The American Cancer Society, www.cancer.org, and the National Cancer Institute, part of the National Institutes of Health, www.cancer.gov. There is also an excellent book published by the American Cancer Society: "Lymphedema, Understanding and Managing Lymphedema After Cancer Treatment"

There is much we can do to prevent and manage lymphedema. We simply must be given the information. Ask your doctor about it; insist on information. We need to demand that doctors take this risk seriously.

And educate yourself.

Julie

Julie on Youtube

Many of you know that during February and March I was in India working on a very interesting music/dance project which was performed for the 40th anniversary of the founding of Auroville. For those of you who are new to Life-Cise or Stay Fit Stay Strong, you can read about my trip in the archived posts from those months. There is a video on youtube.com about the making of the piece. It's shot at Darpana during the early stages of rehearsal. I feel so privileged to have been a part of "Savitri...", and to have worked with Mallika Sarabhai and the musicians and dancers of Darpana. I am very happy to be able to share a little of this project with you. You can see the video at http://youtube.com/watch?v=0mO2rP_JhkM.

Enjoy.

Julie

Strong Women are Sexy

I am a strong woman. I like being a strong woman. Strong women are beautiful. Strong women are sexy. At Life-Cise and Stay Fit Stay Strong, strength training is an important focus of our training.

I can't tell you how many times I've heard women say they don't want to do much upper-body work because they don't want to "bulk up" and look like weight lifter. "It just looks gross!" (There is an exercise video on the internet in which the trainer actually says she doesn't want big-looking muscles because they're not very sexy.) First of all, it is just not that easy to "bulk up". Because of our hormonal makeup and the percentage of muscle in our bodies, it is much harder for us to get those big, bulging muscles than it is for men. I am strong, but any of you who have seen me know that I don't look particularly muscular. I wish I did have more definition in my arms, but for all of my work, my muscles don't look bulky.

And, aside from not being particularly easy, what's wrong with looking muscular? If you don't have strong, functional muscles, you just have lifeless fat hanging, jiggling, dangling from your skeleton. Is that really so much sexier than toned muscle? Muscles allow you to be independent, to take care of yourself. Muscles allow you to feed yourself. Muscles allow you to get out of a chair, to bathe and dress yourself. If you don't use them, they shrivel and recede. You are left, breathless, unable to do the tasks that get you through your day. This may be the extreme result, but it's where you are headed if you don't work to prevent it.

I am a strong woman. I like being able to carry my groceries. I am happy that I can carry heavy objects if no one is around to help me. And I am happy to know that, if something bad does happen, I have a pretty good chance of protecting myself. When I was in treatment, in spite of my continued exercise, I did get weaker. I lost muscle; I lost cardio-vascular strength. I had a harder time carrying heavy loads; I ran out of breath. Being weaker only made me feel vulnerable - and vulnerable is not beautiful; it is not sexy! So I worked to minimize my loss of muscle, and worked hard to build my strength back when I finished treatment. I am a strong woman. And I think that is infinitely sexier than the alternative.

Be strong.

Julie

Push-Ups

Since returning from India, I've been catching up on some of the news that I missed while away. I just came across an article in the Science Times section of The New York Times (www.nytimes.com). From March 11, 2008, there is an article by Tara Parker-Pope, entitled "An Enduring Measure of Fitness: The Simple Push-Up." Ms. Parker-Pope starts off her column by saying, "As a symbol of health and wellness, nothing surpasses the simple push-up." She goes on to write, "The push-up is the ultimate barometer of fitness. It tests the whole body, engaging muscle groups in the arms, chest, abdoment, hips and legs. It requires the body to be taut like a plank with toes and palms on the floor. The act of lifting and lowering one's entire weight is taxing even for the very fit." She also writes about the importance of push-ups for older people. The strength and muscle memory needed for a push-up are essentially the same as what's necessary to catch oneself in a fall. James Ashton-Miller, director of the biomechanics research laboratory at the University of Michigan is quoted, "What so many people really need to do is develop enough strength so they can break a fall safely without hitting their head on the ground. If you can't do a single push-up, it's going to be difficult to resist that kind of loading on your wrists in a fall." And once someone does fall, they need enough upper-body strength to help themselves back up.

I was very happy to see this attention given to one of my favorite exercises. It is not my favorite because it's easy for me, but rather because it's so useful. It does work the chest and shoulders, but also works the back, abdominals and legs. At Life-Cise.com and Stay Fit Stay Strong we stress the importance of strength-training, with a real focus on functional exercises. Strength is most important because it helps us do normal activities more easily. As people age, they do lose some of their strength, up to 30% by age 70. This decline can be slowed and reversed through regular exercise, however. As Ms. Parker-Pope points out, adequate strength is necessary for basic health and safety in older adults. This is also true for people of any age weakened by disease, surgery, and taxing medical treatments. The ability to prevent falls and protect yourself if you do fall is basic to your safety.

But many people don't have the strength to do one push-up. It is especially difficult for many breast cancer survivors because the muscles of the chest are often damaged by surgery and radiation. Over the years I have worked hard at strengthening my upper-body. Although I had a very extensive surgery and radiation, I am proud to be able to do push-ups. But I didn't get there quickly, and it still isn't easy.Because it's a pretty intense exercise, a lot of people (especially women) just don't try. The key is to do it as a progression. Don't start with a full push-up. A good way to start, whether you're rebuilding strength after breast surgery or just deconditioned from age or lack of exercise, is to do wall push-ups. Stand facing a wall with your feet slightly apart. Place your hands on the wall at shoulder height. Bend your elbows and slowly lower your chest toward the wall. Keep your elbows close to your ribcage and your shoulders back with your shoulder blades flat. Slowly push yourself back to the starting position. When you first start this exercise, stand only a short distance from the wall, maybe six inches. As you gain strength, you can begin moving your feet further from the wall. The next step would be to do the push-up against a counter at a 45-degree angle. As this becomes easier for you, move to the floor. Start with your knees on the floor. Be sure to keep your shoulders back and shoulder blades flat.

So, no excuses, get busy. It's a process. But in time, you too can impress your friends with your upper-body strength - just like Jack Palance during his Oscar acceptance speech.

Be strong - do push-ups.

Julie

Himalayan Inspiration

While I was traveling in Indian, I came across an article in the newspaper about a 75 year old man and his upcoming attempt to climb Everest, again. Japanese skier, Yuichiro Miura, 75, plans to become the oldest person to climb Mount Everest despite having had two heart surgeries in recent years. His team, which includes his son, Yuta, will approach the mountain from the Tibetan side. They hope to reach the summit on May 16.

In 1970, Miura won international fame when he became the first person to ski down the South Col of Everest. He summited the mountain more recently in 2003. Since then he has had two heart surgeries. He was quoted as saying, "The hurdle is high.... Aging is inevitable for humans. But if you have goals in life, you should go through the physical and mental training, forget about age and embark on the challenges."

I think this spirit is exactly what we're trying to promote here at Life-Cise.com. It is pretty much a given that people undergoing cancer treatment will suffer some side effects. But through determination and strong will, you can still attain your goals - whatever they are. I skied during treatment, and then climbed Mt. Rainier one year after finishing treatment. Lance Armstrong rode his bike - really fast! And hundreds of others reach their goals, big and small, in spite of cancer!

We wish Yuichiro Miura luck and good weather!

Julie