Thursday, October 29, 2009
To follow up on something we talked about on the show: How to get started?
We all know we should exercise, right? Whether we've had cancer or not, we should; but a whole lot of us don't.
One of the barriers to getting started is how. If people are out of shape and have not been exercising for whatever reason (cancer, other illness, injury, or just haven't been active), it can be difficult to figure out how to get started. Many of the exercise recommendations or workout shows/DVDs can seem far out of reach.
Recommendations from the American Heart Association, the American College of Sports Medicine, and the US Dept. of Health & Human Services are to get at least 2.5 hours of moderate exercise per week. That breaks down to 30 mins. most days per week. It's important to remember, though, that those 30 minutes do not have to be done all at once. It is still effective to break it up into shorter segments: for instance, three 10 minute segments.
Two things are key: starting at an appropriate level, and doing something you enjoy.
If you are severely weakened, you may not be able to manage 30 minutes. Strive to do as much as you can - a little bit is better than none! This is simply your starting point. You can build up slowly from there. As my friend Mike from Asphalt Green says, if the most you can do is to get out of bed in the morning, fine. Get out of bed, now climb back into bed. Get up again - you've just doubled your exercise for the day!
It's about finding the appropriate level for you, not your neighbor or some fitness model on TV. You should feel like you are working, but not exhausting yourself. You should get your heart rate up some, be breathing a little harder, but not be gasping for air. You should be able to speak in short sentences. If you can recite all the lyrics to your favorite song, you can probably push yourself a little harder. If you can't even utter one word, ease up some.
And do something you enjoy! If you think that exercise means walking on the treadmill at the gym, but you hate walking on the treadmill, you are not very likely to continue with it. Do you like dancing? Gardening? Riding a bike? Walking with your best friend at lunch time & catching up on the latest gossip? Whatever it is, if it gets you moving, do it! You are more likely to continue if you do something that's fun.
So get started. Turn off the computer and go do something active that you enjoy. If you can only do a few minutes, OK. Do what you can. If you can do a lot vigorously, great. Whatever you can manage - do it & have fun!
I'm turning off my computer now and going out for a hike - bye.
Wednesday, October 28, 2009
Saturday, October 17, 2009
I am so going to get in trouble for that title! - this is another post about my mom.
Some of you may remember my mom; I mention her pretty often. She's my star client. I made her do pushups, so I show her off whenever I can.
When I first did her fitness assessment, mom was not able to push herself up off the floor once in the pushup test. Aside from the pushup test, she was in good shape. I asked her what would happen if she fell sometime when dad wasn't around. Sure, she could probably roll to her side and manage to get up, but she understood my point.
She began in earnest to work on her upper body strength, especially pushups. She began doing wall pushups, moving her feet further from the wall as she gained strength. As her strength increased, she did pushups against the kitchen counter, and then moved on to modified pushups on the floor. I thought she would be satisfied with that, but she was on a roll, she was determined. Finally, she started doing full pushups. At first, she could only do 1 or 2. But she kept working on it until she could do 10 full pushups (in great form, I might add).
Now, this didn't happen overnight, or even over a couple of months. This was a slowly progressive exercise plan. It took her about a year and a half to go from just a few wall pushups to 10 full pushups.
Mom's new idea is that she wants to start running, maybe even run a race (I'm thinking the Komen Race for the Cure would be good). We worked out a plan. She's beginning with adding short running segments into her walk, and more strengthening exercises. As she gets comfortable and builds strength, she'll gradually lengthen the running segments.
Mom is 72. She wasn't some super athlete. She's just realized that she feels better when she exercises, and if she slacks off for too many days she feels worse. And, it seems, she like having a goal.
What's key about mom's progress is that she starts at an appropriate level, and makes gradual progress. She knows it's not going to happen quickly, and she is diligent.
So in response to people, decades younger, who ask if they can really expect to make fitness gains at their age, I say "Hey man, check out my mom!"
Wednesday, October 14, 2009
Thanks to dedicated researchers, we know much more about breast cancer than we did even a few years ago, so more women are surviving. Breast cancer is no longer seen as one disease. Each cancer has it’s own genetic makeup, and we’re learning how to target the specifics of each woman’s cancer. Twenty years ago, we basically had one cocktail of drugs. Now we have many more choices.
And more women are living longer in part due to earlier detection. More breast cancers are being found in stage 0 or 1, rather than at a late stage when treatment options are limited.
And how are they being detected earlier? – Mammograms! Ladies, get your mammograms. Here’s a sobering thought: according to a large Massachusetts study, 75% of breast cancer deaths occur in women who don’t get regular mammograms.
So, ladies, I repeat: get your mammograms!
Occasionally, a friend or colleague will complain to me about getting her mammo. It’s uncomfortable, stressful, there’s no time to schedule it, if they find something it just means more tests & it’s probably nothing anyway…. blah, blah, blah. I am always aghast at these comments. Do these women really think they’ll get a sympathetic ear from me?
I am alive because of a mammogram. And because I had a doctor who insisted, even though I was just in my 30s with no family history or risk factors, that I go. My cancer was very aggressive and had already spread to most of my lymph nodes. If I had waited a year, or even six months, I would be dead now.
Mammograms are important!
Sure, it’s sometimes hard to schedule them into our busy lives. Doll, we’re all busy – get over it. True, they are not the most comfortable procedure ever invented. And yes, they can be stressful. But I assure you, a mammogram is much less uncomfortable than a mastectomy or chemo. And while it can be stressful, I guarantee you it is not nearly as stressful as finding out you have a cancer that has already spread!
I repeat: mammograms are important; they save lives! No, mammograms do not prevent cancer; they only detect it. But if it’s detected early, it is much more treatable.
Sorry if I sound a bit testy about this, but it matters. I get crazy at the idea of just one woman dying because she discovered her cancer too late for effective treatment, simply because she couldn't be bothered to get her mammo.
So quit your whining and go!
Monday, October 5, 2009
I, however, plan to spend a lot of time during Breast Cancer Awareness Month at the gym, or running, or hiking. Why? Because, when it comes to breast cancer, exercise matters.
For women who have not had breast cancer, solid scientific evidence shows that exercising is associated with a reduced risk of developing breast cancer. Over many years, numerous studies have shown a strong reduction in breast cancer risk in women who exercise regularly; some studies have shown as much as a 30-40% reduction in risk. In one such study, Dr. Friendenreich and colleagues, of the Alberta Health Servies-Alberta Cancer Board in Calgary, Canada, followed 1,231 women for 8.3 years. The women who exercised at least 4 hours per week had a 44% lower risk of breast cancer death.
Of course, we all know exceptions to any statistics; I’m a perfect example. I was young, very healthy, ate well, exercised, with no history of cancer in my family. And I got breast cancer in my 30s. Yes, there are exceptions, but the fact remains that exercise is one thing you can do to reduce your risk of breast cancer.
But what about women (and men - breast cancer is largely a woman's disease, but about 2% of cases are men) who have already had breast cancer? For those currently in treatment, exercise can be a powerful tool in managing the side effects of treatment. There is also evidence that exercise can reduce the risk of recurrence. Studies have shown that moderate exercise can reduce the risk of breast cancer recurrence by as much as 50%.
Fifty percent! That is a huge number. I happen to enjoy exercise. But even if I hated it, with numbers like that, you can bet I’d be lacing up my gym shoes!
And there’s more good news about exercise for breast cancer survivors. A recent study shows significant benefits from weight lifting for breast cancer survivors with lymphedema. Lymphedema is a swelling of the arm and hand that can result from removal or damage of the lymph nodes during surgery and treatment for breast cancer. It can be a debilitating condition, and precautions should be taken to minimize the risk of developing it.
In 2001, when I was diagnosed, the standard recommendations were 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. I couldn't figure out how, if I followed all those recommendations, I could actually live my life. So I set out to prove them wrong - just like a lot of women over the years, who have shown that with the right preparation, we can do most anything.
In August, the New England Journal of Medicine published a new study from researchers at the University of Pennsylvania School of Medicine. This study found that, counter to the common advice, a gradually progressive weight training program may be the best thing women can do for lymphedema. Those in the weight training program had fewer arm and hand problems, and fewer lymphedema flare-ups.
This is great news for everyone at risk of lymhedema from cancer – for those of us who enjoy some high-intensity activities like rock climbing, windsurfing, or tennis; as well as those who just want to be strong enough to hold their child or cook a roast.
So this year for Breast Cancer Awareness Month, after you’ve washed your hair with your pink ribbon shampoo, eaten your pink ribbon yogurt, placed the pink ribbon book mark in your book, do something else. If you have not had breast cancer, congratulations! Try to keep it that way - go to the gym. If you’ve been diagnosed with breast cancer, go for a walk (or swim, or dance, or whatever you enjoy). And if you have someone you care about who’s being treated for breast cancer, do something that will help both of you. Call her up and take her out for a walk.
(read more about exercise & the reduction of risk of recurrence in my June post; and the lymphedema study in my August posts.)