Post-mastectomy yoga :-)

Hi IndigoMont11,

I finished chemo almost a year ago and active treatment (Herceptin) 6 weeks ago. For the past month or so I have been taking a yoga class regularly, and am now going twice a week. I had a UMX and still have a tissue expander in (will eventually get implant but letting radiated skin heal) and am on tamoxifen. I have felt lots of discomfort around the chest , shoulder, cramps, stiff, poor range of motion. But since I've started doing yoga regularly my arm and chest feel much better and tamox aches are less as well. I've also started taking magnesium which helps with aches as well. Anyway, I find the yoga makes me so happy even though I'm horribly inflexible.  I have trouble with being "even" with my tissue expander and my natural droopy side-- we'll see if the implant is any better; or perhaps I'll  go flat---  (i'm 48 by the way and spend much of my day in front of the computer or driving my kids (12,10) long distances). 

Would love to hear of any favorite yoga poses! And if anyone with  UMX/TE/Implant  has bra suggestion I'd appreciate it!

I've been wearing these for piyo.  Love them!

http://www.target.com/p/beyond-bare-women-s-2-pack...

I have been doing yoga for about 2 1/2 years now and started after all my surgeries.  I LOVE it and it has really been a good thing.  I have NO tightness in my chest at all even with implants. I highly recommend yoga for BC survivors!

Indigo, yeah I know everyone says that but I am 29 years old and I just hate being coddled.  I do so much better if people are like "Cowboy up!" and just make me push through things.  I feel like my physical therapist is more gentle with me than I would like.  Maybe it's the years of Water Polo in high school that make me desire a drill sergeant?  In any case I don't have nearly enough time to do Piyo because I've spent waaaaaayyyyyy toooooo much time on my friends wedding!  

love this

I was doing sun salutations, with plank at 4 weeks post surgery, with no problems. (no recon). I've done some simple home routines since, along with restorative yoga classes. I've cut back some during rads..as my armpit is sore, but I almost done and looking forward to building back my strength. Hot yoga sort of scares me! I'm afraid I'll pass out (I have low BP).

I've been wearing tank tops with built in shelf bras with soft cups and a teeny bit of fluff..makes me look ballerina flat. Or maybe intense yogini flat.

Lojo - that's great - but I do worry a bit as that's a lot of stress on your upper body so soon after surgery.  Everyone, please be careful and be aware of the symptoms of LE.  I thought I was home free because in the months after my surgery, I was working out, lifting weights, doing pushups, downward dog, etc. and was fine.  It wasn't until fifteen months after surgery that I was dx with LE.  Unfortunately after my surgery, my surgeon minimized my concerns about LE, so I took few precautions to reduce my risk during that time.  I realized later that I'd inadvertently engaged in a lot of risky behavior in the months after my surgery.  I don't know whether I could have avoided LE or not had I not engaged in those behaviors, but I wish I'd known what I know now as I would have been a lot more careful.   We all have that "no pain, no gain" feeling about exercise.  And especially after a dx of b/c, it's empowering to take back control and work out hard, pushing through soreness and fatigue.  But unfortunately that's exactly the wrong thing to do if you're at risk for LE. Slow and steady is much safer. 

There was a study that was just published that showed that the incidence of LE after SNB was 7% after 6 months, but rose to 11.9% at 5 years after subjective assessment.  When they measured arm volume, close to 25% of women had increased arm size in the at risk side after 5 years.  And that's just with SNB.  The figures for ALND are even higher.

http://www.firstwordpharma.com/node/1196009#axzz2w...

From the study:

A previous prospective, multicentre study from the American Society
of Surgeons Oncology Group (ACOSOG) demonstrated an incidence of
lymph-oedema of 7% at 6 months after sentinel lymph-node dissection in
women with early-stage breast cancer. The study was undertaken to
evaluate the prognostic significance of micrometastasis. Eligible
patients included women with clinical T1-2 N0 M0 breast cancer.

Following up on the longer-term incidence of lymph-oedema in the same
cohort, researchers compared 5,210 women who underwent sentinel-node
dissection with 885 who had complete axillary lymph-node dissection.

The cumulative incidence of lymph-oedema after sentinel lymph-node
dissection was 3.7% at 1 year, 8.9% at 3 years, and 11.9% at 5 years by
subjective assessment (n = 3,993), stated lead author Mediget Teshome,
MD, University of Texas M.D. Anderson Cancer Center, Houston, Texas,
speaking here on March 14. The incidence by objective arm measurements
(n = 3,918) was 10.5% at 1 year, 17.4% at 3 years, and 24.1% at 5 years.

This is not to say you can never do yoga or other upper body exercise again - in most cases you can.  Just be aware that like it or not, b/c surgery has some impact on us physically, and we need to accept that and modify our exercise progression accordingly.  The good news is that most women will not get LE, but since now there's no way to know who is likely to develop it and who is not, it makes sense to take precautions if you are at risk.  There's no reason you can't achieve the levels of fitness you want, but it may take just a bit longer to get there. 

Oh, absolutely moderate exercise in the affected arm is beneficial - if I didn't believe that I wouldn't do yoga, pilates, weight training, running, hiking, and other exercise.  If the impression I gave was that one should not exercise the at-risk arm, that's not the impression I meant to give at all!  Thanks for clarifying that point.  Fear of LE should never keep anyone from starting or continuing an exercise program. 

You'll see in the articles that I linked to, exercise is encouraged, but there are simple precautions one can take as we ramp up our activities.  Fear doesn't need to decrease our activities - I agree 100% about the mental and physical benefits to exercise and wouldn't give it up for the world.  But a healthy awareness of LE is good to have.  As an example, I may never be in a car accident, but I know that car accidents do occur, so buckling my seatbelt is a simple enough precaution to take when I drive.  The awareness that car accidents occur doesn't keep me from driving, but it does get me to take some simple precautions.  LE is like that - most b/c survivors will never get LE, but the latest research is that 12-25% of those who had SNB will get LE.  

I encourage everyone to exercise - studies show over and over again that maintaining a good exercise program can help reduce the risk of b/c recurrence.  I was just encouraging others not to make the same mistake I made in ramping up weight bearing exercises (like push ups, planks, and downward dog) too rapidly, especially since taking the slow but sure approach can get you to the same level of fitness eventually.  I wish in those first heady days after treatment, when I was feeling soooo good getting back into exercise, that someone had given me info about LE risk reduction measures.  If I'd known enough to take things more slowly, I might not have arm and truncal LE today. 

Mom - as for my arm LE, I presented with cording immediately after surgery, which was minimized by my surgical team.  I realized I might have it when several months after surgery and after several months of working out doing weights and yoga while taking no precautions, I noticed that my shirt sleeves seems tight on the ALND side.  I also had a heavy feeling in the arm after exercise, and finally I noticed I had a definite swollen area by my elbow, under the armpit, and in the upper arm.  I finally wangled an appointment out of my surgical team and was evaluated by a LE therapist.  She found that the affected side was 10% larger in volume than  the non-affected side, plus (not related to LE but related to surgery) I had a shoulder impingement.  She did Complete Decongestive Therapy with me (sessions 5x a week for the first week, then 3x a week for the next 4 weeks, then weekly for a few weeks after that), showed my how to wrap, got me fitted for a compression sleeve and gauntlet, and started teaching me LE self-management. She also started me on a gentle exercise program that gradually increased my strength, and also worked on the shoulder impingement.

Indigo - LOL on the dogs and yoga.  When I do a yoga session at home, the min pin thinks shavasana is snuggle time just for him. 

Momwriter:

I've tried a few yoga classes and there's a wide range in how much exercise you get vs. how much yoga philosophy. I tried a "gentle yoga" class for cancer patients that was gentle to the point of putting me to sleep, and others that had me sweating, even though I modify the downward dogs and planks. I found a general definition of "moderate exercise" in terms of heart rate that might be useful if you have a way of measuring your pulse. I have a watch that does the job, but there are a fair number of gadgets that will measure heart rate. 

http://www.cdc.gov/physicalactivity/everyone/measu...

For moderate-intensity physical activity, a person's target heart rate should be 50 to 70% of his or her maximum heart rate. This maximum rate is based on the person's age. An estimate of a person's maximum age-related heart rate can be obtained by subtracting the person's age from 220. For example, for a 50-year-old person, the estimated maximum age-related heart rate would be calculated as 220 - 50 years = 170 beats per minute (bpm). The 50% and 70% levels would be:

• 50% level: 170 x 0.50 = 85 bpm, and
• 70% level: 170 x 0.70 = 119 bpm

New to posting on this board...

I do count yoga as exercise as the classes I take leave me hot and sweaty and it isn't hot yoga but a studio that has a yoga/pilates perspective...so lots of transitions from down dog to plank and back.

I will have my exchange in 2.5 weeks and was wondering from the yoga group...how long were you on yoga restriction after your exchange...a month? two? longer?

Thanks, TT

I joined this studio 6 months after the MX, needed to try something different than my old gym that would provide "exercise", but also centering, core, etc. This has been my first yoga experience, but I have been able to lose 30 lbs since Jan 1st and really like the comaraderie of the diverse folks who practice...college students to me at 56 to seniors in their 80's! I realize I would need to cut back to nothing for a month, then maybe the gentle classes and hopefully at 3 months a full vinyasa class...really hope that is possible. I will up my walking in the weeks/months I can't go to the gym, don't want to gain weight in the "off season."

Hello fellow yogis, I'm almost 8 weeks post mastectomy (right side, no reconstruction). I took one restorative yoga class last week and one this morning. Wonderful to be back!

My question is how will I know when I'm ready to do a plank again? I'm also doing PT massage and the recommended range of motion exercises. I had a sentinel node biopsy with 3 nodes removed.

Thanks and best wishes to all