Fitness

Kathleen,

Congratulations on making the decision not to tackle fitness goals alone. There are a wide variety of fitness tricks and nutritional approaches that might be helpful, however many find that the best approach is often the one that considers (in no particular order):

1) Life/family responsibilities (i.e. your energy demands)
2) How regularly & intensely you trained before chemo
3) Resources ($, access to exercise equipment, facilities, etc)
4) Current energy levels and your energy cycles (i.e. good day vs bad day)

Because those variables can really impact how you approach slimming down, I'll include just a few exercise-based and nutrition-based notes.


Exercise
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* Get a journal and record snapshots of your general activities, nutrition and exercise. Journaling will keep you honest and enable you to, truly listen to your body. Speaking of snapshots, you may also want to take before photos and put them in your journal and wallet. They can be powerful motivators.

* Listen to your body and obey it. This really bears repeating. Pay close attention to not only how your body feels right after a workout but how it feels 1-2 days later as well! The journaling will help a lot, review it weekly.

* In the beginning, start with short, low to moderate intensity workouts, 20-30mins long. Do them only on your higher energy days. Avoid exercising on low energy days at first...consider making gentle stretches the most that you do on low intensity days. Some people find that they can only handle 10-15mins. That's ok. You might even try doing 2 short but vigorous workouts of 10-15mins, gradually increasing the length of workout by a few minutes and decreasing intensity before increasing intensity and length.

* As you progress (after a few weeks or so) you may want to try incorporating 1-2 more intense interval (burst) style workouts per week. They are a great way to help boost the metabolism without introducing some of the inflammatory effects that could potentially accompany lots of long workout sessions.

* If you are more of an enthusiast and are ready for it, very controlled interval training using a modified tabata scheme, could be a useful strategy, minding the caveats above. The Tabata scheme is based on 4 minute exercise cycles composed of 8 continuous, 30-second rounds of exercise, where you work as hard as you can for 20 secs and rest for 10 secs. Initially, 20 secs will probably be way too much. Consider the following scheme for progression:

Initial Stage => Modified Tabatas, w/ 8 rounds of 5-10 secs full-out exercise followed by 20-25secs break.

Progression => Add 2-5 secs of work every 1-2 weeks or as tolerated.

* If you choose to work with a trainer, make sure to find one that's sensitive to not only the inevitable energy swings but also the importance of balancing movement around joints (e.g. pushes and pulls are balanced) as well as moving in all planes.

Nutritionally
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* Especially in the beginning, try to train only when you're both rested and well nourished (eat ideally 1-2hours beforehand). Smoothies/Shakes are great for pre/post workout meals since it can be a bit easier to absorb the nutrients easier.

* Eat every 3.5-4hours (~4-6x per day) and Eat your largest meals earlier in the day and taper your meals as it gets later. Last meal should be the smallest, though still complete.

* Typical meals should include (low GI & fibrous carbs, lean complete proteins, good, higher omega 3 fats). Of course, avoid processed foods in favor of loading up on leafy greens and the like (organic is best)!

* Discuss _any_ supplementation (multivitamin/mineral, probiotics, fish oil, etc) with your doctor first.

* Try to avoid snacking within ~2 hours of bedtime. If you must, try to limit the damage by stocking the fridge and cupboards with fibrous, low GI/GL foods (glycemic index/glycemic load)

I'll close by encouraging you to remember to periodically add to your mental/spiritual toolkit for navigating the almost inevitable bumps along the road to your body transformation, it's often great to add an inspirational quote, story or song to your journal, on your journal review day (for example). Sorry if that was waay more than you were bargaining for, but I hope you'll find the info useful. Enjoy!!!

I was fairly active before my diagnosis -- running, tap dancing, swing dancing, etc -- and found that keeping up with my exercise/activities as much as possible was crucial to both my mental health and my recovery during treatment. I had four chemo infusions of taxotere/cytoxan (one infusion every 3 weeks) and was able to run through two of them (although not during the first week when the bone pain was too intense). After the third infusion, I had to dial it down to walking (I also had to let the dancing go). But once chemo was over and I was able to get rid of the excess water weight from the steroids, I was able to get back to running and even attain my old mileage within a couple of months. I also ran, danced, walked, etc. during 6.5 weeks of radiation which I believe is the number one reason why I didn't have too many issues with fatigue.

As far as motivation goes, running and dancing and doing all the things that made me feel normal and healthy and whole was my way of telling cancer it could suck it. It was also a way to stay in touch with my body and to appreciate what it could do, even under duress, even with a couple of essential parts missing.

The sooner you can resume normal activities the better off you are. I don't mean push it, and I don't mean start doing jumping jacks. Start walking and add distance incrementally. And do this every day. One block, two, three, until you're comfortably walking a mile or so.

Equally important is the rehabilitation of your arm. If you haven't had physical therapy many excellent resources are mentioned above. You can run through arm exercises in fifteen minutes or so. I still do so to this day. After full lymph dissection and radiation the natural tendency of the arm and skin is to retract and tighten.

One of the best things I'e found is yoga. Many cancer treatment centers (in Houston through MD Anderson and Memorial Hermann) now offer yoga for cancer survivors. It's excellent and a gentle way to reduce stress.

There are exercises developed by lymphedema experts specifically to decongest the swollen limb. They tend to combine stretching protocols with decongestion protocols utilizing the "muscle pump", that is, causing the major arm and leg muscles to slowly expand and contract and squeezing the skin against a compression garment or bandaging. There are a number of videos available demonstrating these specialized exercises.

Our favorite is the Video "Remedial Exercises For the Upper Extremities" by Klose Norton Training & Consulting is available for $34.95 + $5.00 s&h for NLN members, $39.95 + $5.00 s&h for non-members from:
National Lymphedema Network
1611 Telegraph Avenue, Suite 1111
Oakland, CA 94612-2138

Edema Exercises for Patients with Arm (Leg) Lymphedema by Dr. Vodder School in Austria

Focus on Healing through Movement & Dance by Sherry Lebed Davis which you can order thru the NLN 1-800-541-3259 $28.00 + 5.50 s/h for members, 32.95 + 5.50 s/h for non-members. Or you can order it from the producer, Enhancement Inc.1-800-366-6038 for 29.75 + 3.00 s/h.

Arm Exercises Video by Dr. Vodder School - North America, 2000.

Dr. Judith Casley-Smith, 94 Cambridge Terrace, Malvern SA 5061, Australia, E-mail: casley@enternet.com.au, includes swimming exercises for lymphedema in her book, "Exercises for Patients with Lymphedema of the Arm and a Guide to Self-Massage and Hydrotherapy". She also has one for the legs. You receive it when you order her "Exercise Video" for both arms and legs. Price for overseas including postage & insurance is Economy $60, Air $65. She asks that payment be in a personal check in your own currency on you own band, but please add $15 for conversion.

There are exercise routines described in some of the lymphedema books, but I favor the videos since the demonstrations are more understandable than the dry words and static sketches or photos.

Joe Zuther had an excellent article in his January 6, 2011 blog called "Decongestive and Breathing Exercises for Lymphedema."

Thank you for this great question. Pardon me while I get on my soap box. :)

When we are diagnosed with breast cancer everything changes. Emotionally, we are faced with our own mortality, physically, we are faced with many treatment decisions that will forever effect the way our bodies look and feel. Then the treatment starts and we start experiencing all sorts of strange and uncomfortable things going on.

I know when I went through treatment for breast cancer, I felt like I lost control over my body. Exercise helped me get control back. I found that through exercise, I was able to increase my energy levels, lessen my anxiety and stress, relieve my aches and pains and in general start to feel like a whole person again.

I didn't start with a strenuous, weight lifting program. I started on the floor, trying to raise my arms over my head, just to see how far I could get them. When I finally raised my arms over my head and touched the floor behind me, I was so happy and proud of my self. I haven't stopped moving since. Of course, I went a little overboard and started a rehabilitative exercise program called MovingOn. But that's just me.

I encourage all cancer survivors to start moving. Whether you are in-treatment or out of treatment, get your doctor's approval and get moving. Some like yoga, some like running or Zumba, whatever you like, start moving. You will be surprised at the benefits of exercise, even if you start for just a few minutes a day.

I challenge the TalkAboutHealth community to get out there and get moving!! Drop me a note on facebook at http://www.facebook.com/LockeysMovingOn and tell me what you are doing to get moving!!

For more information about exercise, go to http://www.movingonfromcancer.com

One of the best ways to fight fatigue, nausea and the body aches that come with chemotherapy is exercise. Emotionally, exercise can lift your spirits, help regain self-esteem and, my personal favorite, help regain control over your own body!

A couple of precautions:
1. Get doctor approval before starting any exercise program.
2. If you are vomiting or have diarrhea, no exercise for 24 hours, you may be dehydrated.
3. Start slow. Incorporate low reps, light weight and lots of flexibility exercises in your program.

A good place to start would be with a few stretches to open your chest area and your hips, then move to body weight exercises like squats and wall pushups, then if you feel really good that day, add some resistance band exercises, like bicep curls and tricep presses.

I hope this has been helpful. For more information on exercise go to http://www.movingonfromcancer.com

First and most importantly, check with your doctor, get his/her permission to begin an exercise program.

This is a great question because fatigue is such a big part of cancer treatment. Everyone is different, I know I really struggled with fatigue issues when I went through chemotherapy. My best advice is to learn your energy cycles. Typically when a patient is going through chemo or radiation, there are days following treatment that you are more tired and have less energy. If you have chemo every 3 weeks, you might be the most tired the first week. During that week, concentrate on gentle stretches. Week two might bring a bit more energy, do a little more, add a walk and some body weight exercises (squats and wall push ups). Week three you will have more energy, keep walking and stretching, then add some exercises that include resistance bands.

If you are getting radiation treatments, you may feel fatigue towards the end of the week, use the same formula as above, just be careful using resistance bands. Again, check with your doctor before beginning an exercise program.

The bottom line is just try to move a little bit everyday and be kind to yourself!

For more information about exercise and MovingOn programs go to http://www.movingonfromcancer.com

I waitedd the recommended 4 to 6 weeks post-surgery, but I never stopped even during chemo and radioation. I slowed down or cut down on time when I felt at my lowest energy point, but overall, I forced myself to do it everyday. Post surgery, I waited for my surgeon thumbs up an I was back on the bycicle, running and walking, whiever felt best at the time.

I also took the time to see a physiotherapist specialising in pre-ops and post-ops assessment to provide me with different exercise to gain my strength back with the most efficiency. Also, strangely, what helped me most was an osteopath after my mastectomy that lossened my pectoral muscles that were really thight following reconstruction and radiotherapy. In a few treatment, he took care of a lot of pain I have in my arms and shoulders.

Yoga has been one of the primary, and most important, aspects of my transition from patient to survivor. Yoga is a breathing practice, and as such, heals the mind, body, and spirit. It has made me stronger and more flexible physically, but it has also deepened my spiritual and emotional connection to my healing. I am not just healing from my breast cancer, but also from the lifelong experiences and issues that helped to create an environment in my body that was a host to the cancer. Yoga helps to cleanse the body of these emotional toxins held by the body and create a new environment unwelcoming to the cancer and its recurrence. I recommend it to all patients and survivors. And the great thing is that it is a practice that accommodates all body types, all levels, and everyone who can breathe!