Exercising after lymph node removal

JBinOK, I am confused here. You said you had DCIS twice, that first time you chose lumpectomy and radiation, and that the second time you chose mastectomy without reconstruction. By my knowledge, DCIS does not involve removal of lymph nodes - at most the SNB. Why would you do stretching exercises for lymphedema and wear a sleeve?

First of all, do see a PT who specializes in lymphedema.  You'll get lots of information and support and learn how to do things you want to do.  It will put your mind at ease, too, once you have more knowledge and know what to look for and how to deal with anything that does arise.

One thing that's really important is that at the first sign of LE, get to your therapist -- don't wait until your arm gets severely swollen.  Your therapist can give you a number of things to be aware of that are signs of LE and can also give you some exercises and breathing exercises that help keep lymph. fluids moving so they don't build up.  Mine also taught me self-massage for LE.  She gave me a huge amount of information, and all of this really helped me feel better and more in control.

I was terrified of flying but my PT felt a sleeve was unnecessary -- there's no research to support that flying triggers lymphedema, although some women do develop it after flying -- but now they're thinking it's not from the elevation change but from the salty snacks, lack of fluids, and lack of movement, when flying, and she gave me guidelines to follow.  So far I'm good.   But some PT's will want you to have a sleeve so go with what's recommended for you.

I had 17 nodes removed and was told not to lift anything over 30# ever (so far I mostly haven't) and don't do something repetitive all day (or for hours at a time), but otherwise I can do what I like -- with some caveats.  For example, I shoveled snow all winter this year.  Weight lifting can be done but I started out very light and slow (and there is some research that shows that exercise that will help you strengthen that arm is beneficial -- my PT was in great support of my doing this).   I asked about using an elliptical (with repetitive arm movements) and my PT thought that was a terrific idea, just to start out slow and build up. So although doing something repetitive all day day after day may be a danger, that isn't the same as doing something for a relatively short time each day, like with most exercise.  For example, I lift small weights, but I do a variety of exercises with them, and so far 20-25 reps per exercise, so not really the kind of repetition you've been warned against.

If you've had lymph nodes removed, you're always at risk, but they don't know what all the pieces and parts are that make one women develop lymphedema and another, not.  I was told since I didn't have radiation under my arm (only had it on my breast) that my risk was low, even with all the nodes I had removed, but again, no one really knows for sure, and I'm staying aware and careful, but I also live my life.

Again, see a PT and follow what makes sense to you and your PT --  all I can pass on is what I was told but some PT's have a slightly different take on things and yours may tell you something slightly different.  Most of all, try not to let the worry dominate take too much of your energy (seeing a PT will help a lot with that).  Many women never develop lymphedema; we just all need to be aware and vigilant and follow some basic guidelines.  Best of luck to you.

I agree with everything Ruth says. I just started back on my old strength training routine. I was using 10lbs weights prior to my surgery on Aug. 31st. I am now using 3lbs weights. I will slowly build up to the 10lbs. I do have LE in one arm and the other is at risk. I am wearing my sleeve when I work out. If I feel pain or heaviness I stop and rest for a bit.

You should discuss this with your doctor. My onc said that the research that was presented at the last San Antonio conference (she was there) said the strength training is not only a good preventative but also good for LE but you must do it gradually. I would ask your MD where you can get information on how to do this properly.

natureguurl- would love more details on what your person told you about flying...salty snacks? ok. I will avoid hem...dehudration? ok. I will drink water, sit in the aisle and pee a lot...what else??

Regarding exercize- my surgeon gave me the go ahead to return to the gym the day afer I saw her (which was two weeks after surgery). I made sure the weights were balanced and I started off slow....but I do everything from 10lbs to 55 for chest and pecs...this is a good reminder to me not to go higher than that though. I am going to be talking to my radiologist re. a sleeve but so far, I have been told I do not need one to fly . I also shovelled snow this winter and vacuum (as much as I hae vacuuming) regularly...

Hi Emily,

I took the position that I was not going to let breast cancer treatment interfere with my life any more than absolutely necessary.  So my goal was to resume all my pre-diagnosis activities. I made a point of exercising throughout treatment as I thought would make things go a lot easier.

I had a lumpectomy and was sent home with a sheet of arm exercises and told to do them the very next day.  (Cancer centers have different views on this one.)  So I did.  I never lost any range of motion.  I resumed cycling the 10 days later, after my surgeon gave me the OK.  I was walking in the mean time.

When the drain came out about three weeks later, I resumed my weights and crunches, first with 5 lb weights, then my 10 lb ones.  My abs were having a field day, and I had to show them who's boss.  Also, I did not like the way my upper body was looking.  I cycled throughout chemo.

I finished radiation in June, and did about 8 cycling events last year.  Even more group rides.  Then, in December I went back to x-country skiing.  When I do this, it is usually back-to-back treks of 12 miles each, and at about 3500'.  I live at sea level.

It is really odd this weekend not to be doing anything strenuous, but I am down for the count with the creeping crud.  Expect to be skiing again next weekend.

If and when I do show signs of lymphedema, I will go get help.  I do watch things, and take the BP, blood draw precautions.  My oncology team just shakes their head.  Good luck. - Claire

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More info on flying and sleeves:
http://www.lymphnet.org/pdfDocs/nlnairtravel.pdf

I was initially told it there was some disagreement on whether to wear a sleeve during flying as a preventative but my BS gave me a script anyway. I have LE on the left so I will be wearing on both now.

Exercise after surgery. I would check with your BS/PS regarding which exercises you should do. Some of these are too advanced for right away and yet others not advanced enough. Here are some links to exercises:

 http://www.cancer.org/Cancer/BreastCancer/MoreInformation/exercises-after-breast-surgery
http://www.cancer.sutterhealth.org/information/bc_notebook/postoperative_care.html  

Claire in Seattle, you are an inspiration!  

Good for you Angie. You have the right attitude and that is half the battle right there.

i go for monthly lymph drainage massages...I figure i am well worth it...i also paddle in a dragon boat three time a week and there is not any difference yet. plan on continueing to do what i do to ensure it. it helps

I also found that as long as I keep it moving and go to massage regularly, it helps. The radiation softened my ribs so when I paddle, I often end up putting one or two ribs out of place...and then my side where the bra sits, hurts or aches....but it gets better. I was just thinking this morning, as I lugged back a one-shouldered backpack full of water and mild and veggies, how much things have changed for me in the past could of years....especially the past year since going fo massage etc....my mobility is back and I am so delighted.....so don't lose hope..it gets BETTER...pu the wire bras in the back of the drawer and forget about them for 6-10 months...find something soft to wear (I fould some great full body tanks for $14.00 at Walmart) and get erercizing:)

Iwent to African dance and llifted weights 2 weeks after surgery...i think it really helped me to feel strong and when the bouncing hurt my breast ofr the weight leaned against it and I felt sore...I reminded myself that I would be sore anyhow so I may as well get stronger while I am healing...and I massaged the scar tissue a lot..that helped

Check out the new thread - Guidelines on Exercise For Those With/At Risk for Lymphedema.  It contains links to detailed, medically vetted info about how to safely start or resume an exercise program after node removal.

Stepup-Speakout.org, an amazing website about all things lymphedema has added two new exciting exercise resources.  Here are the links.

stepup-speakout.org/Handout%20...

stepup-speakout.org/Trainer%20...

These links take you to downloadable, printable PDF documents.

The first link is for anyone with or at risk of LE who needs some quick guidelines on safe exercise. Even if you only had a single node removed, you are at an increased risk for LE, so a lot of us need to know this information.  If you want to start or resume your exercise program, this documents can give you some helpful ideas about exercising safely.  Also, we hope that fitness professionals might find this document useful to give to clients who are b/c survivors. 

The second document is designed for exercise professionals like personal trainers, yoga instructors, fitness class teachers, Pilates instructors, etc.  It explains Breast Cancer Related Lymphedema, and is designed to help all of them understand LE and what they need to know to provide safe exercise instruction and coaching for those of us with, and at risk for, LE.  The idea is that when we start a new fitness class or start working with a personal trainer, we can print out this document and share it with them.  That way they'll be aware of our concerns and the extra care we need to take.  They'll be better understand why we may avoid certain exercise moves and can give us alternate moves, or why we need to go especially slowly with upper body weight training exercises.  It will help them help us.