Friday, August 28, 2009
The most important thing is to begin with light weights. Even if you did weight training before breast cancer, you need to begin with easy weights to see how your body reacts now that your lymph system is compromised. Our bodies can compensate, but they need a chance to adjust to the change without being overloaded.
So begin with light weights. You may want to begin with slow, no-weight exercises. No-weight exercises, using just the weight of your arm, can be effective at building strength if done properly. The key is to do the exercises in a slow, controlled manner. For example, if you're doing a straight arm raise, raise your arm to shoulder height, hold for a couple of seconds, and lower. The raising and lowering should take at least a few seconds. It's especially important to lower your arm slowly, since about 70% of the work our bodies do in an exercise is in the lowering.
As you gain strength, you can increase the number of repetitions or number of sets, or the amount of weight. But don't do both at once. And as you increase the weight, do it gradually. At Life-Cise, I often recommend using water bottles for weights. Depending on the size, they weigh about a pound or two, and you can vary the weight by pouring out (or drinking) some of the water.
It's also a good idea to measure your arm at several places. Keep a record of the measurements and monitor yourself for any swelling. If you do have some swelling, back off the weight a little and talk to your doctor or lymphedema specialist.
And always remember, the risk of lymphedema is ongoing. Just because you haven't had a problem doesn't mean you can't develop one in the future. However, that risk is not a reason to do nothing. It's quite possible to gain the strength to do some pretty high-intensity activities. And, as I noted in my last post, now it seems that lifting weight may be the best thing you can do.
Tuesday, August 25, 2009
When I had my surgery for breast cancer in 2001, the standard recommendations were still to not lift anything heavier than 5 pounds, carry a heavy purse or groceries on the affected side, or do repetitive movements like scrubbing or painting. However, I found that therapists who specialized in lymphedema were cautiously less restrictive. They did warn against overexertion, but advocated a gradual progression of exercise. Based on anecdotal evidence, they said exercise might not hurt, and indeed might help with lymphedema. Often sighted were the dragon boat racers who were strong women doing a very repetitive sport, who seemed to have no higher rate of lymphedema than other breast cancer survivors.
This was good news for me since I had every intention of returning to climbing and windsurfing. And aside from climbing, I couldn’t see how to live a normal life with those precautions. How would I cook, carry groceries, haul my viola around, or play with my nieces and nephew?
Earlier this month, the New England Journal of Medicine published a new study that suggests that much of the advice we’ve been given over the years about lymphedema is too restrictive. Dr. Kathryn Schmitz, of the University of Pennsylvania School of Medicine, and colleagues studied 141 breast cancer patients who had lymphedema. Half followed the standard restrictions, and half took part in a progressive weight lifting program. The weight lifters had significantly fewer flare-ups than the women who restricted their activity.
In an accompanying editorial, the New England Journal suggests that the “policy of avoidance” should be replaced with advice on rehabilitation.
With my clients at Life-Cise, I always advise starting slowly and progressing gradually. It is really no different than rehab after an injury. You begin with very light weights; even just the weight of your arm may be enough to begin. Slowly increase the stress in a progressive manner, and keep monitoring the arm for swelling or pain.
This is great news for everyone at risk of lymphedema from cancer. You don’t have to want to climb or row or hammer. You may just want to be able to hold you child or cook a roast.
Thursday, August 20, 2009
Aside from my article, I hope you'll visit GalTime often; it's well worth reading. And I don't say that just because I've got an article there - they've got a lot of terrific women writing a lot of great articles! Please, take a look.
Saturday, August 8, 2009
When I started climbing I thought a lot about it. Mountaineering distills life to it's most basic elements: food, water, the need for shelter, and elimination. In the mountains, it's important to think about poop and safety: how and where to do it so we don't destroy the environment, compromise the health of ourselves or others, and protect ourselves (as in, how not to fall in a crevasse and die!).
But, except for the occasional bout of irregularity, most healthy people don't think much about it.
For people fighting cancer or many other serious diseases, regularity can be a constant concern. It's a big issue after any surgery; you will never be released from the hospital until you can go to the bathroom. Many chemotherapy and other drugs cause constipation. Depending on the cancer, radiation can disrupt regularity. And if cancer spreads to other organs, elimination can become a constant problem.
Diet is a key factor in regularity. It's important to eat a well-balanced diet with plenty of fiber.
And drink water! Sometimes, the importance of water is missing in discussions of diet and regularity. Your body simply cannot move waste through it's system without adequate water. Drink water!
But exercise is also important in maintaining regularity. That's one of the reasons it's so important to start walking after surgery. For people in various stages of treatment, exercise offers many benefits. It can improve energy level, relieve pain, improve mood, for example. But it's also useful in maintaining regularity. A simple walk can stimulate your body and encourage all your body systems, including digestion, to function smoothly. The American Cancer Society, in CA a Cancer Journal for Clinicians, says exercise can help relieve constipation, even for people living with advanced cancer.
With all of the other side effects of cancer treatment, constipation may seem like something relatively minor. But most people going through treatment find it a pretty important issue. It's just impossible to feel good if you can't go to the bathroom. And it's an ongoing issue throughout cancer treatment.
So, this topic may be TMI (too much information) for a lot of folks, but people in cancer treatment know just how important it is.