To continue with my thoughts from last post, I want to stress again how important it is to begin exercising at an appropriate level. Don't worry, you will get stronger and you will progress, but you have to accept what your current fitness level is and build from there. It can be maddening, especially for those of us who were quite active before, to accept our current limitations. Just remember that this is temporary, it's just a starting point.
If you've had extensive surgery or are extremely deconditioned from treatments, a tough workout for you may seem like nothing to others. The important question is: is this a good workout for you at your current fitness level? Often, with my work at Life-Cise and Stay Fit Stay Strong, I find that people can initially be a little nervous that I'll push them way too hard. I climb mountains, ski, run, windsurf - in fact, I climbed Mt. Rainier just one year after finishing a full year of treatments. Some people are afraid that I'll expect them to do what I do. I always reassure them that I never expect anyone to do what I do, I expect them to do whatever they can do. If someone wants to get back into shape for a big backpacking trip, I'll help them with appropriate exercises. If someone has limited shoulder range of motion, I'll help them increase their range of motion with effective stretches and exercises. If someone wants to be able to play with his grandchildren, but has a hard time getting out of a chair and walking un-aided, I'll work with him to gain the strength he needs to lead a more independent life. Unfortunately, some fitness trainers are not always sensitive enough to the current condition of cancer patients. After an extensive surgery, just doing a straight arm raise with no weight, only using the weight of the arm for resistance, can be enough to begin. What anyone can expect can vary wildly during the course of chemo. or radiation treatments. Trainers need to be sensitive to the changes and work accordingly.
It's a good idea to work with a trainer, but choose wisely. Make sure it's someone who will listen and pay attention to your current limitations, but figure out creative ways to continue to challenge you. If you feel they are not really listening to you about cancer related issues, find another trainer. Just get started! Start now, where you are, and work to progress toward your goals.
Julie
Saturday, May 31, 2008
Saturday, May 24, 2008
The Struggle to Begin
Many people who are struggling with an illness or have simply gotten really out of shape feel like there's a huge barrier to starting an exercise program. They read the recommendations or see people doing complicated or high intensity exercises on tv and know that they aren't up to doing any of those things. Unfortunately, very often they're not presented with any realistic alternatives, and this can seem like a huge hurdle to getting started. It's extremely important to begin at an appropriate level of exertion. Be honest about your current fitness level and build from there.
If you are largely chair-bound, recommendations to walk for 30 minutes 5 days a week may seem totally out of reach and pretty meaningless. Look at where you are right now and exercise accordingly. For you, just standing up can be a real workout. Standing up might be nothing to your son or your neighbor, but that doesn't matter - this is your workout! You could try standing just partway (maybe raising only a couple of inches off the chair, using your arms to help support you), repeat a few times if you are able. Build this into your normal day. Every time you need to get out of the chair, first do a couple of these small raises, and then stand up. You will build up more strength over time and move onto the next appropriate exercises.
Through Life-Cise and Stay Fit Stay Strong, I work with clients to develop exercise programs that are appropriate for their current fitness level, whether it's struggling to get out of a chair or training for the 2-day Avon Walk for Breast Cancer (www.avonfoundation.org). I also try to help them see how to fit exercise into their normal activities. Not everyone has the time or the interest to devote 30-45 minutes at one time to a workout. But I find that as people get used to adding exercise into their day, even in small doses, they grow accustomed to the idea of exercising. Danny Robbins, one of the participants in the Duke lung cancer study I wrote about last week said that being part of this study helped him develop an exercise habit, which he hopes will help him continue to beat lung cancer, as well as combat his high blood pressure and diabetes. "Before I participated in this study, I struggled with walking in the neighborhood with my wife," Robbins said. "Now, I exercise five days a week and it's gotten to the point that I don't feel like I have to do it; rather, I feel like I don't want to miss it."
Be realistic and get started. Get into the habit!
Julie
If you are largely chair-bound, recommendations to walk for 30 minutes 5 days a week may seem totally out of reach and pretty meaningless. Look at where you are right now and exercise accordingly. For you, just standing up can be a real workout. Standing up might be nothing to your son or your neighbor, but that doesn't matter - this is your workout! You could try standing just partway (maybe raising only a couple of inches off the chair, using your arms to help support you), repeat a few times if you are able. Build this into your normal day. Every time you need to get out of the chair, first do a couple of these small raises, and then stand up. You will build up more strength over time and move onto the next appropriate exercises.
Through Life-Cise and Stay Fit Stay Strong, I work with clients to develop exercise programs that are appropriate for their current fitness level, whether it's struggling to get out of a chair or training for the 2-day Avon Walk for Breast Cancer (www.avonfoundation.org). I also try to help them see how to fit exercise into their normal activities. Not everyone has the time or the interest to devote 30-45 minutes at one time to a workout. But I find that as people get used to adding exercise into their day, even in small doses, they grow accustomed to the idea of exercising. Danny Robbins, one of the participants in the Duke lung cancer study I wrote about last week said that being part of this study helped him develop an exercise habit, which he hopes will help him continue to beat lung cancer, as well as combat his high blood pressure and diabetes. "Before I participated in this study, I struggled with walking in the neighborhood with my wife," Robbins said. "Now, I exercise five days a week and it's gotten to the point that I don't feel like I have to do it; rather, I feel like I don't want to miss it."
Be realistic and get started. Get into the habit!
Julie
Lung Cancer and Exercise
A new study led by researchers at the Duke Comprehensive Cancer Center has found that patients who have undergone surgical removal of lung cancer can tolerate and benefit from exercise programs started just one month after surgery. The study followed 20 newly diagnosed lung cancer patients with stage 1 to stage 111b cancer. Patients participated in 3 hour-long exercise sessions per week, using stationary bikes.
"Previous studies have demonstrated that exercise can benefit cancer survivors but lung cancer patients have been a particularly challenging group, because surgery on the lung was perceived to have a restrictive effect on the amount of exercise a person can do," said Lee Jones, Ph.D., a researcher at Duke and lead investigator on the study. "Our study showed that this population can not only tolerate exercise but that it can lead to improved tolerance for exercise, and better quality of life."
Patients attending the exercise sessions were less fatigued and gained greater aerobic fitness over the course of the study.
Researchers will present their findings June 1, at this year's American Society of Clinical Oncology meeting in Chicago. The study was funded by the Lance Armstrong Foundation.
"Previous studies have demonstrated that exercise can benefit cancer survivors but lung cancer patients have been a particularly challenging group, because surgery on the lung was perceived to have a restrictive effect on the amount of exercise a person can do," said Lee Jones, Ph.D., a researcher at Duke and lead investigator on the study. "Our study showed that this population can not only tolerate exercise but that it can lead to improved tolerance for exercise, and better quality of life."
Patients attending the exercise sessions were less fatigued and gained greater aerobic fitness over the course of the study.
Researchers will present their findings June 1, at this year's American Society of Clinical Oncology meeting in Chicago. The study was funded by the Lance Armstrong Foundation.
Monday, May 19, 2008
Teen Exercise Fights Breast Cancer
Last week, the Journal of the National Cancer Institute reported that new research shows exercise during the teen years can help protect girls from breast cancer when they're grown. Researchers tracked nearly 65,000 nurses, aged 24 to 42. The participants answered detailed questionnaires about their physical activity from age 12 onwards. The study found that women who were physically active as teens and young adults were 23% less likely to develop premenopausal breast cancer than women who grew up sedentary.
What does this have to do with those of us who have already had breast cancer? We already know that we need to exercise: for our cardiovascular health, maintaining bone health, keeping our weight down to lower our risk of lymphedema, diabetes and recurrence of breast cancer. We know it's important for us, and we can choose to heed or ignore this advice. So what about the news for teens? We all need to do our best to encourage the girls in our lives to get and stay active. Take just a little time with the girls you care about to ask them about what they're doing to exercise. If they play sports, ask how it's going or go to a match. If they don't play sports, ask them to go for a walk or bike ride with you (good for them and for you). At Life-Cise and Stay Fit Stay Strong, we are all making an effort to reach out to the girls we know to encourage them to stay fit. We know it can be difficult with school work, exams, college applications, music lessons, and all the other things that take up their time. But we hope that by encouraging fitness, maybe a few less women will suffer through breast cancer in the coming generations.
Julie
What does this have to do with those of us who have already had breast cancer? We already know that we need to exercise: for our cardiovascular health, maintaining bone health, keeping our weight down to lower our risk of lymphedema, diabetes and recurrence of breast cancer. We know it's important for us, and we can choose to heed or ignore this advice. So what about the news for teens? We all need to do our best to encourage the girls in our lives to get and stay active. Take just a little time with the girls you care about to ask them about what they're doing to exercise. If they play sports, ask how it's going or go to a match. If they don't play sports, ask them to go for a walk or bike ride with you (good for them and for you). At Life-Cise and Stay Fit Stay Strong, we are all making an effort to reach out to the girls we know to encourage them to stay fit. We know it can be difficult with school work, exams, college applications, music lessons, and all the other things that take up their time. But we hope that by encouraging fitness, maybe a few less women will suffer through breast cancer in the coming generations.
Julie
Tuesday, May 13, 2008
Muscles
In today's New York Times special Wellguide section, http://www.nytimes.com/interactive/2008/05/13/health/20080513_WELLGUIDE.html, Gina Kolata writes about muscle health in "More than an Exercise in Vanity". Researchers say that for muscles, size doesn't matter for health. Muscle bulk depends on factors we don't control, like our sex and genetics. But for health, what matters is using them. Healthy muscles must have enough strength to get us through life. They need to be worked and stressed.
The two aspects of healthy muscles are endurance and strength, which comes from lifting weights. "I still lift, because it makes doing other stuff - yardwork, carrying groceries, carrying gandkids - easier," says Dr. Paul D. Thompson, a 60-year-old marathon runner and chief of cardiology at Hartford Hospital who has been lifting weights since he was 12 years old. "I think some folks outlive their muscles, meaning that they are fine mentally and cardiacwise but have so little muscle strength that they can't catch themselves with their other leg when they start to fall. And if they fall they cannot get up."
Many people find lifting weights intimidating and use weights that are too light to stimulate their muscles. According to William J. Kraemer, professor of kinesiology at the University of Connecticut, this is especially true of women, who often say they are afraid of bulking up. An effective method of training the muscles is known as progressive resistance. One day per week, lift weights that are so heavy that you can only do 3-5 repetitions. Other days alternate with moderate resistance - weight you can lift 8-10 times, and light resistance - weights you can lift 12-15 times before your muscles tire.
Check out the article - and lift weights!
Julie
The two aspects of healthy muscles are endurance and strength, which comes from lifting weights. "I still lift, because it makes doing other stuff - yardwork, carrying groceries, carrying gandkids - easier," says Dr. Paul D. Thompson, a 60-year-old marathon runner and chief of cardiology at Hartford Hospital who has been lifting weights since he was 12 years old. "I think some folks outlive their muscles, meaning that they are fine mentally and cardiacwise but have so little muscle strength that they can't catch themselves with their other leg when they start to fall. And if they fall they cannot get up."
Many people find lifting weights intimidating and use weights that are too light to stimulate their muscles. According to William J. Kraemer, professor of kinesiology at the University of Connecticut, this is especially true of women, who often say they are afraid of bulking up. An effective method of training the muscles is known as progressive resistance. One day per week, lift weights that are so heavy that you can only do 3-5 repetitions. Other days alternate with moderate resistance - weight you can lift 8-10 times, and light resistance - weights you can lift 12-15 times before your muscles tire.
Check out the article - and lift weights!
Julie
Friday, May 9, 2008
Push-ups for My Mother
Back to push-ups.... my mother called me yesterday - she can now do 2 full push-ups! When I first evaluated her last August, she could not push herself up once from a prone position. She had an exercise routine, mostly cardio work, but she was neglecting her upper body. I started her on a program that included weight training for her upper body, using light weights (like water bottles) at first. Over the last 9 months she has been gradually increasing the weight and repetitions. I also had her doing wall pushups, moving her feet further from the wall as her strength increased. A few days ago, she was thinking that the wall push-ups were seeming awfully easy, so she tried a full push-up - full, on her toes, not modified. She did 2. To go from not being able to push herself up off the floor to 2 full push-ups is serious progress.
I am terribly proud of my mother, and hope she doesn't mind my using her as an example. She is someone who was in pretty good shape, but like many women, was lacking in upper body strength. We talked about the importance of upper body strength, not only for bone health, but for independence and personal safety. She took this very seriously and has worked hard to improve. She had a clear plan, building up her strength in a slow, steady manner. It didn't happen overnight, and she has a clear plan for continuing her progress.
My mother is the perfect example of what we talk about at Life-Cise.com and Stay Fit Stay Strong. She understood the problem, had a plan, and has made steady progress. Good work, mom. And Happy Mother's Day.
Julie
I am terribly proud of my mother, and hope she doesn't mind my using her as an example. She is someone who was in pretty good shape, but like many women, was lacking in upper body strength. We talked about the importance of upper body strength, not only for bone health, but for independence and personal safety. She took this very seriously and has worked hard to improve. She had a clear plan, building up her strength in a slow, steady manner. It didn't happen overnight, and she has a clear plan for continuing her progress.
My mother is the perfect example of what we talk about at Life-Cise.com and Stay Fit Stay Strong. She understood the problem, had a plan, and has made steady progress. Good work, mom. And Happy Mother's Day.
Julie
Wednesday, May 7, 2008
Fitness is a Process
Continuing with the issues brought up by the Well column of Tara Parker-Pope (www.nytimes.com/well) from the New York Times, I'm a little taken aback by how many people seem to think of fitness as an either/or issue, as though we're either fit and healthy or a fat slug. Like most things, fitness is not so black and white. It's a process. It's daily choices, large and small. It starts with accepting where you are right now. What you did before surgery or chemo or radiation or hormones is not what matters now. Reality is that your body has changed and it's in whatever condition it is, right now. But you can choose to change it. Will you magically feel like you did before treatment? No, but you can make changes to feel a little better. It might be a small change, but it's in your control. At Life-Cise.com and Stay Fit Stay Strong, we recommend that adults get 30 minutes of exercise most days of the week. But if exercising for 30 minutes is beyond what you can do, break it up into more, shorter segments - exercise for 10 minutes, 3 times during the day, for instance. If that is too much, start with whatever you can manage and slowly build. Add little exercises into your daily life: lift the milk carton over your head 5 times before you put it away, walk a block before getting in a cab, take the stairs once during the day instead of the escalator. It's amazing how much these little choices can add up to begin improving your fitness level. As these little tasks get easier, do more: walk further, lift more, just keep the process going. You might not be climbing any mountains or cycling across the state of Iowa, but with small steps you might be able to live a more independent life or have a little less pain. And if cycling across the state of Iowa with Ragbrai (www.ragbrai.org)is what you want to do, just continue the process of fitness and you will get there.
Julie
Julie
Friday, May 2, 2008
Fitness and Cancer
Recently I wrote about a new Canadian study that found cancer survivors were more likely to be obese and not exercise as others (http://news.yahoo.com/s/nm/20080421/hl_nm/cancer_obesity_dc). This creates special problems and risks for survivors, including increased risk of cancer recurrence. Tara Parker-Pope, of the New York Times, has been writing about this on her blog, as well. (http://well.blogs.nytimes.com/2008/04/21/surviving-cancer-doesnt-lead-to-healthier-lifestyle/?scp=2-b&sq=cancer%2C+exercise&st=nyt) She has gotten a lot of mail about this study, much of which views this as "blaming the victim". I find this terribly unfortunate.
At Life-Cise.com and Stay Fit Stay Strong, we like to think of fitness as a chance for empowerment. Of course, people who are sick are entitled to just feel crappy sometimes, and we're all entitled to have our moments of wanting to stay in bed all day. We don't expect you'll never feel that way, and we don't expect you to go out and run a marathon tomorrow, but you can do something that can help you to feel better.
I always like to stress that fitness is a daily choice. It doesn't have to be a huge change or a big step for you. Fitness is about a hundred small choices. When you're unpacking the groceries, take 10 seconds and lift and lower the bag of rice before putting it away. Walk up a flight of stairs instead of taking the escalator. Choose one meal today to eat a salad. Start with small steps, get used to them, and then bigger steps will become easier and seem perfectly natural. And allow yourself the time, sometimes, to just sit on the couch - just don't make it every day. It can be tremendously empowering to make those positive choices, no matter how small. You will feel stronger, more in control. Of course, you can choose not to take positive steps in your life - it is your choice. But there are consequences to all our choices. I don't believe this is blaming the victim. These are our bodies and we are responsible for them, and we (not our doctors, or researchers, or our families) face the consequences.
Be strong,
Julie
At Life-Cise.com and Stay Fit Stay Strong, we like to think of fitness as a chance for empowerment. Of course, people who are sick are entitled to just feel crappy sometimes, and we're all entitled to have our moments of wanting to stay in bed all day. We don't expect you'll never feel that way, and we don't expect you to go out and run a marathon tomorrow, but you can do something that can help you to feel better.
I always like to stress that fitness is a daily choice. It doesn't have to be a huge change or a big step for you. Fitness is about a hundred small choices. When you're unpacking the groceries, take 10 seconds and lift and lower the bag of rice before putting it away. Walk up a flight of stairs instead of taking the escalator. Choose one meal today to eat a salad. Start with small steps, get used to them, and then bigger steps will become easier and seem perfectly natural. And allow yourself the time, sometimes, to just sit on the couch - just don't make it every day. It can be tremendously empowering to make those positive choices, no matter how small. You will feel stronger, more in control. Of course, you can choose not to take positive steps in your life - it is your choice. But there are consequences to all our choices. I don't believe this is blaming the victim. These are our bodies and we are responsible for them, and we (not our doctors, or researchers, or our families) face the consequences.
Be strong,
Julie
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