Cancer survivors, it’s time to move it

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Everywhere you turn is new information on the importance of rehabilitation in the cancer experience. In the feature I did for our summer issue on the importance of rehabilitation for all cancer types, I tried to stay away from breast cancer since that's the association we have already, and my point was to show that rehabilitation is critical for everyone and every cancer. Then the journal Cancer came out with a supplement devoted to refocusing on the importance of rehabilitation for women with breast cancer – even expanding it and adding exercise – and we are again seeing that rehabilitation is important for all of us to keep our muscle tone and strength, and regain and, in some instances, begin using and getting our bodies in shape. (You can read the supplement online for free at http://onlinelibrary.wiley.com/doi/10.1002/cncr.v118.8s/issuetoc .)Arm exercises weren't even something my medical team mentioned when I had a mastectomy 25 years ago. The Reach to Recovery volunteer told me how important it was to do the "walk up the wall" exercise in the shower to stretch out my arm to keep scar tissue from forming, but I have to admit that I was only thinking about picking up my 1-year-old just as soon as possible. Some women have told me that their surgeons told them not to lift anything over five pounds, but mine didn't. I don't think she agreed with that five-pound limit even 25 years ago. So, as soon as I could, I had my baby in my arms and my butt in a swim suit. I was a committed swimmer when I was diagnosed. As many days a week as I could, I hit the YMCA pool and did laps in the moderately slow lane. I found I could meditate and empty my mind when swimming and one of my biggest fears was that breast cancer would end that. When the drains came out I asked my surgeon how soon I could swim again. I didn't have to worry about messing up reconstruction because I hadn't had any. They said they wanted me to wait a while because I was going through chemo (I always felt like they wanted to see if I would live so I wouldn't waste anyone's time or money). She said I could swim in a week after the drains came out and then as often as I felt like it since I would be starting chemotherapy. So I got a few good swims in before I started chemo, and then maybe one or two on the week when I didn't feel like I was starring in one of those zombie movies. Finally, when I was feeling well again, I was hitting the pool regularly. I took the little fiber-filled thingy that Reach to Recovery gave me and sewed it in my swim suit where my right breast used to be. The only problem was that it got saturated with water and continued to drip when nothing else did, so I got in the habit of just reaching over and wringing it out when I got out of the pool. Well, that got a few looks, I'll tell you. It got harder and harder to swim regularly over the years, but I have always had full range of motion and never lost any of my upper body strength. My surgeon and I have talked since then about swimming and how, even after I got lymphedema from a hang nail (yep, a hangnail), when I swim regularly I can keep it from swelling and get it almost to the same size as the other arm. And it sure feels better. The message here is that if you feel you can't move like you should, get a referral from your oncologist or your primary care physician for some rehabilitation and let them help you get moving. Check with your local Y to see if they have the LiveSTRONG at the YMCA program where you get 12 weeks of classes designed just for cancer survivors. Dr. Julie Silver, a breast cancer survivor and physiatrist (rehabilitation doctor) at Harvard Medical School says it's time we stop coming out of treatment and saying that we accept a new normal of a less physical life until we have given rehabilitation a chance to get us as close to the old normal as we can get. And let's face it. Some of us need to toss the old normal for a new one that includes exercise and setting a good example for the next generation.

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