Ask the Exercise Physiologist: Amanda Putnam

In a previous  Survivor Newsletter* we offered survivors the opportunity to ask questions regarding exercise during and post treatment and surgery. We’re fortunate to have Amanda Putnam from Mount Carmel Cardiac Rehabilitation answer some of the questions submitted.

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Q1: Where should I focus my time, cardio or weight lifting?

A1: It is important to do a good balance.  A cancer diagnosis can mean many things: a change in the center of gravity with surgery; weakness due to surgery, treatment side effects or a more sedentary lifestyle during recovery; and many side effects that may involve bone loss, lymphedema and possibly many other things.   It is suggested that we all get 150 min/week of moderate aerobic exercise, less if exercise if more strenuous.  It is important to take into account where you are starting and ease into the exercise as you try to reach this goal.  This does a lot to keep the cardiovascular system healthy, decreases cholesterol and blood pressure, among many other benefits.  It is also very important to maintain muscular strength and endurance, bone mass and balance, all of which can be prompted wth resistance training.  If lymphedema is not an issue, finding a weight that is moderately difficult to lift 10-15x is key.  Do a balance of muscle groups to prevent injury and try to do them three days per week, trying not to work the same groups two days in a row.  If time constraints are an issue, combining many muscle groups in one exercise and doing some intervals of aerobic and weights can be helpful.

Q2: How can I cope with post-chemo muscle fatigue?

A2: Keeping up with everyday activities is important, but adding stretches, light weight workouts and even gentle exercise like Tai Chi or some yoga can keep muscles strong and limber.  Rest and listening to your body is also key, but too much rest can lead to  muscle loss and weakness.  Sacr tissue  from surgery or treatment can also form, so keeping up with range of motion exercise can help to avoid that issue.  Be sure to stay hydrated since dehydration can make muscles feel more fatigued and even cramp.  Proper nutrition with a balance of vitamins and minerals can also affect how the muscles feel.

Q3: Can exercise cause lymphedema?

A3: A short answer: yes, it can.  But, the good news if that we are in the times of continuing advancement in surgery and treatment that is allowing less and less removal or scarring of multiple lymph nodes.  Given that, if you are at risk, it is important to first go to a class that will teach you of the symptoms and prevention of lymphedema and to see if you need a compression garment.  Wearing these during exercise gives the muscle extra pressure to contract against and helps to recirculate some of the fluid that may tend to pool.   Start slow with exercise and go lightly on weights AND low on the repetitions.  It may seem tedious, but advancing repetitions and then weights gradually will allow you to keep track of symptoms and to know at what level they may have occurred.  Avoiding these huge changes all at once also keeps you form getting sore, which can lead to the body sending extra fluid to the muscles (a normal response.)  Pool exercises are ideal since the water elicits a nice even pressure against the body, like a compression garment might.  There are many many women who safely exercise with risk of lymphedema or with developed lymphedema that does stay in control.  Asking a professional who is has knowledge on this topic is also helpful.