Yoga

Our local rec department offers several yoga classes at very reasonable cost.  I've been taking a Gentle Yoga class which eases into poses, uses aids such as blocks and straps to help you with poses. Most of the people who take the class have either been inactive for a long time and want to ease into activity, are older, have special needs like arthritis or who have other medical issues - like recovering from cancer treatments.   The teacher is very good about reminding us to invite the body to do as much as it can, but not to the point of pain or injury, and if we need to stop or can't do a pose, that's fine.  

I've been taking it since active treatments ended and find that it really helps with the AI aches and pains, and also helps with stress management.   I agree with your recommendation whole-heartedly. 

hi ladies...

i am a survivor and a yoga instructor...any questions you have - i would be happy to help.

after surgery, and especially mastecomy - slow flow and gentle yoga...as well as "restorative" classes are very good.

you will really enjoy the time that you have to yourself and the refocus.....the classes just help you put stuff into perspective...

hugs..kosh

to koshka, i have a question for you.  i am 4 weeks out of a left mastectomy w/ tissue expanders. had only 2 sentinel nodes removed.  i've heard that you should not do downward dog as it is not only very weight bearing but the gravity aspect of it can increase lymphedema risk.  how the heck can you practice without downward dog??  is this true? and if inverted poses help lymph flow, isn't down dog inverted?  thanks!

Hi Ladies,

after an operation of this type, it is imperative to go slowly. Both body and emotions have been through a lot of trauma. I would recommend at least three months of slow, restorative yoga. You can also add a gentle, reclining pranayama (breathing). Breathwork and restorative poses combined are healing and nurturing.

Please make sure your are under guidance of your breast surgeon as well.  Many doctors think yoga is only done very passively and we know that it is not the case.

For at least three months and maybe longer, you should avoid anything strenuous, such as Sun Salutations and arm balances, including Chaturanga Dandasana (Four-Limbed Staff Pose) and Adho Mukha Svanasana (Downward-Facing Dog). You need to avoid all weight-bearing poses in the chest, shoulders, and arms. Gentle, supported inversions and supported backbends are important poses to include in your practice.

After some time-and just how long depends on the individual-you can resume a standing pose practice. At first, try not use your arms, but simply put them on the hips. You could also begin trying some shoulder openers, such as Gomukhasana (Cow Face Pose), reverse Namaste, and Urdhva Hastasana (Upward Hand Pose). You will need to experiment and see what works.

Standing poses that demand that the arms be held out in space like Trikonasana (Triangle Pose) and Virabhadrasana I and II (Warrior I and II ) , make sure the arms are supported with a prop like wall ropes. 

Wait until you heal before doing Down Dog.  Have your instructor place wall ropes around your hip creases and have you hang forward in Adho Mukha Svanasana (Downward-Facing Dog) to reestablish the action of the arms without it being weight bearing.  As you gain strength, and down the road, you can do the Down Dog. 

As for lymphadema. It occurs because the body's normal fluids don't drain as well after a mastectomy and node removal. This can become an issue when you raise the arm or bear weight on it-as in Downward-Facing Dog. If you have it, then D-dog is not recommended.  If you don't have LE I have not heard that it will cause it......I as well have also had node removal and only 1...have not had a problem.

I will look into this further and get back to you all.

Hugs and Namaste

Kosh

As for the node removal...I had 1 removed and have been teaching yoga since then with no problems.  I will look into this further and get back to you and see what answers I can find about lymph removal especially where more are removed. 

Hi Kosha, I have been seeing a physical therapist for breast rehab (I am a physical therapist but my specialty is pediatrics).  The physical therapist that I am seeing is LANA certified, and skilled in breast rehab.  She feels my risk for lymphadema is very low (I had bilateral mast with sentinal node biopsy on the right 8 weeks ago). She has given me the OK to try weight bearing activities. I have gone back to yoga and strength training, and have done downward dog and push-ups.   Although I am weaker, I have not experienced any symptoms.  I was in very good shape prior to surgery and want to continue with my fitness regime.  I am certainly not questioning your expertise.   However, are these recommendations guidelines, or are they based on research?  Again, please don't take any offense, just trying to make the best decisions.    

So nice to meet everyone who has joined this group

I have begun returning to my practice slowly.  I had my sentinel lobe (one each side) with no radiation or chemo. I am now 7 weeks out from my exchange and feeling pretty good (physically). Some modifications I have done is to incorporate a chair to take the weight of my arms while doing down dog, plank or anything that I need to put weight on my arms.  This allows me to feel the lovely stretch without full weight on my arms.  How does this sound?  So far I am comfortable after my practice without feeling any negative symptoms.  I do not have LE and hope to keep it that way

Here's link to a nice video using a chair:  http://www.youtube.com/watch?v=Lasm-FmdQ3c&feature=related 

I look forward to learning from you all and following your experience

Strength and healing,

Laura 

If I understand correctly, you had one sentinel node per side.  My PT lymphedema expert says the risk is approximately 3% per node.  There is very little to back this up, the LE world is only recently getting play.  It's all very complicated.  For instance, my PT told me that ill fitting compression garments can cause lymphedema.  That's why they won't fit for a long flight until 4 weeks before you go.

I am a yoga enthusiast, but have backed off, as the poses like downward dog are held for long periods and just logically, would encourage "pooling" more than other exercises.  My PT said weight training--go for it.  Light weights, high rep.  Work out, get a little sore, don't overdo it.  Swimming she said was absolutely the best.

I have mild, controlled LE.  I understand that downward facing dog is not recommended if you have le; however,  I have been able to do that posture without any problems.  I think the key is that I went slowly and paid attention to how it felt.  

 The postures I find difficult after my mastectomy are chest opening postures.  They are painful and stir up powerful emotions.    Also it is harder for me to do postures with uplifted arms, even at this point - about two years post surgery - as my arms tire more rapidly than they did pre surgery.  I can't figure this out as I am able to climb (rocks) and lift weights at the same level as I did pre surgery.   I think it may be due to scar tissue.

Thanks, sometimes I get a little crazy (since this diagnosis), people are always warning me not to over do it, but I'm not much of a sitter.  I guess part of it, is just knowing your body, (or getting to know your "new" body for that matter).  I appreciate your clarification, and knowledge, and I'm glad you are doing so well with your recovery!!

Have been doing a light practice about every other day for the last week...so far so good....but frustrating.  I had a DMX and one "breast" is tighter than the other (not because of radiation it just is) ...I can feel that the one side is much harder to open......I know to go slowly but I miss my old body and how easy it was to open my chest......  This will be a very big lesson in patience.  

Hope this finds all doing well and slowly and happily moving forward....

Laura 

joycek - I would be interested to know how your yoga class went. It sounds similar to the one I am looking into.

I've been taking gentle yoga classes off and on since I finished chemo 2 years ago and they're perfect for me. I'm very active aerobically, but still have stiffness and joint pain from femara, so I'm not as supple as I used to be, and the straps and blocks are a real plus for me.  Also, I have LE, and the gentle yoga tends to avoid poses like downward dog that really stress the arms and shoulders.  Like Joyce's instructor, this instructor is very good about reinforcing that we invite the body to do these poses, but if the body cannot do it without pain, then don't force it.  It is definitely not too "soft" for me - I tend to do concentrate too much on aerobic exercise, so this is an excellent class that forces me at least once a week to do slow down and a different workout. I had an injury that forced me to miss class this session, and I really miss it. 

One weird thing I've had ever since chemo is that I cannot sustain positions like forward fold for very long without having a muscle on left side of my ab cramp painfully, to the point where I have to pull out of the pose and arch my back for several seconds to stretch out the muscle for the cramp to subside.  I'd blame it on my DIEP surgery, but I had a delayed DIEP that wasn't done till months after I'd finished chemo, and this started in the first yoga class I took 2 weeks after I finished chemo.  I keep meaning to ask my surgeon about it during one of my followups, but keep forgetting.  I do get the occasional odd leg or foot cramp during yoga, but I blame femara for that, so maybe this big cramp is part of that as well.

Joyce - sending out good thoughts that the biopsy shows all is well - please keep us posted.  

Hi ladies...

If you don't have a cancer center near by that offers yoga classes for cancer patients....check out "Restorative Yoga" classes at some of your nearby recreation centers and studios.

Restorative Yoga is done with pillows, blankets, blocks and all of the props.  It is very slow paced and you will enjoy it.

Also, tell the instructor prior that you are a Survivor.  We need to know this of our patients if it is not a participant specific class.

Hugs and Namaste

I have found a gentle yoga class near me.  They have bc people in the class  I hope to start soon.  Meanwhile I'm continuing with my own gentle practice at home.....

I hit a large bump in the road this week...my heart freaked out and I ended up in the hospital diagnosed a weakened heart muscle  Long story, too shell shocked to give all the details.  I am not on exercise restriction...and with beta blockers and ace inhibitors my cardiologist says I can most likely rebuild the strength of the heart muscle....I'm holding onto that for now. 

NatsFan, for a yoga program at home there is "Yoga for the Rest of Us" by Peggy Cappy....she does a chair yoga tape that is nice....also I posted a You Tube link that has a nice routine for free  http://www.youtube.com/watch?v=Lasm-FmdQ3c&feature=related   

So yoga is still part of my recovery from bc and now heart cardomyopathy =(

Strength and healing,

Laura