Exercise/CrossFit and Lymphedema
Hi everyone!
I've had sentinel and axillary nodes removed (18 total) about a month ago and my MO has been stressing that I can't lift anything over 10# EVER AGAIN due to the lymphedema risk. I pretty much had to hold back my laughter as the insane idea. I'm 35 and you don't want me to lift anything over 10# for the rest of my life? That might be more of a death sentence than cancer.
My surgeon as well as radiologist both think that's insane and told me that I NEED to continue to work out and continue doing what I used to do but just to ease back into it. Even when I told them that I CrossFit, they both didn't seem phased in any way. Told them I do olympic lifting and they didn't seem phased again.
Went to a physical therapist last week just to get stretches and massage ideas to try to prevent lympedema I also brought up the CrossFit stuff. She got really quiet and pretty much said that I might have to look into other forms of exercise if I ever start to get swelling...have I ever tried yoga??? *sigh* Next week she's going to measure me for a compression sleeve and I will GLADLY wear that to the gym every day, as long as I can keep on going.
Cancer has already taken so much from my damn life this past year there's no way I'm going to let it take away one of the things that I absolutely love and am passionate about. There are professional CrossFitters with lymphedema due to past surgeries (mostly in their legs from what I've found out) and they know how to control/manage the symptoms without any issue.
I know not to be stupid and jump back into throwing 140# over my head tomorrow. But is there anyone else out there that still does high intensity exercise without any issue? There are women that NEVER get lymphedema so why should I kill another part of my life if there's only a chance I'd get it?
Comments
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Whitney, who is on our March 2015 forum had sentinel nodes removed and she is completely into cross fit, doing dead lifts, and everything. I have never quit carrying around my 35 plus pounds of grandkids, and have done some weightlifting, so far, no issues other than a mild soreness occasionally which my surgeon says is just part of the healing process. I've read many articles saying using the arm is better than not using it, gets things flowing. There really needs to be therapists that help teach us how to live normal life after surgery. But a 10 pound restriction? That will never work in my life. I just try to not over strain my arm, but I keep on doing everything.
I've read there are tests they can do to see if you are at risk. One involves a dye injection into the hand area to see if the dye flows correctly through your arm. The other I saw mentioned is some woman had some kind of electro thing done to test her arm.
Hugs, there are no easy answers. All I know if my grandchildren do not understand a 10 pound restriction, they want grandma to pick them up.
I had only three nodes removed though, so not sure with the number you had taken out
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I had 16 nodes out, and no one gave me any restrictions. They just said work back up very very alowly, do your manual lymph drainage, and wear your sleeve and gauntlet if you need to. I'm no crossfitter, but I do rock climb and lift weights. I haven't had any problems. Just start with light weights and low reps. I'm 35 too. 😊
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Italychick, thank you! Definitely no easy answers but I love hearing stories where women in the same situations aren't letting them hold their lives back. I'm pretty sure I know which Whitney you're talking about, I'll go find her and pick her brain too!
littleblueflowers, rock climbing is insane!
In a great way, ha! I've tried it and it kicks my butt every time. Glad to see no one is freaking out to you, my MO is so overly cautious it's starting to drive me insane.
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StefLove,
All the recent research points to re-engaging in exercise after node removal, but doing it knowledgeably. With 18 nodes out you are definitely at risk for LE, but it just means that you should be strategic in how you return to Cross-Fit and any other physical activity you love to do. Here is an excerpt from stepup-speakout.org, with links to three documents you may find helpful. The second one is just a shorter version of the first one, and helpful if you'd like to send it to your MO for a little umm...re-education.
The Cliff's Notes on the LE worry is that when you push your arm/trunk in ways that it is unaccustomed, the body interprets the effort as stress and sends lymph to the rescue. So the advice to re-enter gradually is meant to add resistance/repetition in doses that stay just under the 'stress' signal. You were accustomed to physical activity at a level that's well beyond many of us, and I'm pretty sure that you'll find you can progress rapidly through the slow/small increment advice you'll see in these documents. What's most important is that you learn the subtle signs of early LE, so you'll know when to back off and seek help from a qualified LE therapist. Even if you do get LE, you'll be able to do what you love, with some adjustments perhaps. I love to kayak, and I measured with a fitbit on my paddle that I do 19,000 strokes in a day on the water, often five or six days in a row. All that resistance and repetition should have sent my mild LE into watermelon-sized arm swelling, but it doesn't, I believe because I'm lifting weights in the gym regularly, so I got my arm and trunk to a point where my lymphatic system no longer feels compelled to save me from myself.
Also, there's a wild card about LE risk--some of us seem to be born with robust lymphatic systems, others less so. You have no way of knowing which version you got. My mother had dozens of axillary nodes removed and had much more extensive radiation therapy than would ever be given today, so she had an armpit full of nodal dead-ends and scar tissue. She never got LE in her remaining 47 years on earth. I had just five axillary and one breast node removed, and I got it. All of which means that we cannot generalize our experiences, and knowing that some women don't get LE despite losing 20 nodes and doing world-class athletic competition does not mean another woman is any less likely to get it. But still--live your life!
For inspiration, take a look here:
http://games.crossfit.com/article/persistent-deborah-cordner-carson
Seriously, so many women with and at risk of LE are sure lifting many more pounds than your MO thinks is our limit! Do read the following articles and just be as smart about managing your LE risk as you are when you're figuring out every teeny competitive edge when you're strategizing for cross fit meets.
From stepup-speakout.org:
See and download our Essential Knowledge for fitness trainers, Yoga teachers, and Pilates teachers regarding breast cancer related lymphedema
See and download our Handout What-you-should-know-about-lymphedema-and-exercise as a breast cancer survivor
Visit our page on Weightlifting and Lymphedema, Comments on Study published in New England Journal of Medicine and Questions and Answer with Dr. Kathryn Schmitz, Lead Author of study. -
I went back to my old evil habits. Cycling events, skiing, 10 lb weights, crunches. I am just fine. The big thing is keeping moving and keeping that lymphatic fluid flowing. I thought I would be just fine, and I was. As a bit of other info, I learned (without being too graphic about things) that even cycling and walking produce significant fluid.
My take is that if I need help, it is there. Six years later, I am just fine. Cycled 50 miles today in the cold, if that gives you any idea. I was much more worried about black ice, than lymphedema.
Much more important to keep moving. Good luck. - Claire
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@Claire, I just got back from Seattle and BRRRR it is cold there now! Hats off to you.
I definitely have lymphedema, and I doubt it was from over exertion of my arm. I do not think anyone really has the answer as to what causes or worsens it in some people versus others, but I really don't think it's lifting weights. I suspect in me that it's a proclivity toward fluid retention and an all-over slow lymph system.
Hope you get back to your Crossfit. -
My LE lady said "NO heavy lifting". I had to press her pretty hard to get a definition of "heavy". She finally admitted that it doesn't mean a specific weight since everyone is different, it means "something that you have to strain to lift", in other words, more than what you are accustomed to. So I was comfortable going back to doing the things I had been doing before, which might seem "heavy" to some, but not if you have been doing it every day all your life. I was told to wear the sleeve if I'm going to be doing anything more strenuous than normal everyday activities, or going on an airplane. I have worn it all of once. Honestly it's so uncomfortable I feel like it might do more harm than good. I have not gotten up the nerve to fly anywhere yet. That's more scary to me than any kind of physical exertion.
Edited to add...... There are some things I no longer do. Like pushups (something I was able to do before, but due to losing a pec muscle on one side, can't really do anymore) or weightlifting with arms. I do exercise videos but concentrate mainly on the ones that work the legs and core.
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I think your MO's advice is outdated. They used to tell women to avoid exercising, lifting anything heavy, etc. after having lymph nodes removed, but that seems to be in the past with most of us being told it is safe to exercise and resume our regular activities-whatever they may be. It might not be a great time to take up heavy lifting if you've never done it before, but if your body is used to it, I think you should be fine (no guarantees of course). Once I was healed from surgery, I went back to hauling around 50 lb bags of dogfood regularly (we have Wolfhounds) with the blessings of the lymphedema prevention people. They said if I was doing it before, I should be able to do it now. So far, so good.
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I have mild lymphedema. I've raced bikes for 20 years and train on the road 400-600 miles a month. It's not the same as cross fit because there's not a lot of lifting, of course. But you have to keep doing what makes you happy and sane. I'm intermittant at the gym (I know, not good) but when I go, it never seems to make my lymphedema worse, and I lift a lot more than the 10 lb limit they try to scare you with.
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thank you all! I didn't get a chance to come over here and reply to everyone in awhile.
I've been going to the gym pretty religiously again and I"m waiting for the compression sleeve to come in the mail and I'll be wearing that as soon as it arrives, just in case.
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Hi! I have been active in CrossFit for 5+ years. I am a CF instructor and was diagnosed with Breast Cancer in Oct 2015. I only had 3 sentinel nodes removed but was one of the lucky 6% to develop lymphedema which was pretty quick after surgery. My surgeon has encouraged me to get back to doing what I did before BC with caution. My first lift was my 20Ib grandson and all went well! Still undergoing radiation which can increase the lymphedema which I have managed to keep it under control. I started back on a underwater treadmill and doing pool exercises trying to strengthen my arm. I have just in the past 3 weeks started back to CrossFit (Surgery was end of Nov) which I believe exercise is the best thing we can do! I am taking it slow which after gaining 40Ibs due to hormone suppressant and lack of being able to kill it in the box and at 55 years old my metabolism has slowed immensely. I am seeing a surgeon in Pittsburgh, Pa to get a consult for a surgical procedure for lymphedema patients who have a score of 0-1 which is me! So I am hoping that I am a candidate to remap the lymph flow! I refuse to let BC/lymphedema to define me. I will be doing the Open in 2017! Prayers to all my CF community who is struggling with any type of cancer!
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Ilovecrossfit-
Thank you so much for sharing your story! We love what you said about refusing to let cancer define you, such a powerful message. Good luck at your consult, we hope you're a candidate!
The Mods
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I had a straight to implant BMX 9/30 and an ALND 10/27. I had little guidance about what to do/not do. My surgeon was more concerned about frozen shoulder than lymphadema, so he had me in PT within 2 months of surgeon. This was aggressive shoulder PT, as I had my rotator cuff replaced in 2014 and the PT started treating for that.
The PT became very painful after 8 visits and my PS said to stop. So I've been using water exercise. The scapula is all swelling
I'm worried now. Does anyone else have the same issue?
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I also was one of the unlucky minority who got LE after having only 4 nodes removed, but I am predisposed to water retention and mildly obese--both risk factors. But I was told that the initial weight lifting limit was mainly to protect my incisions and promote healing. Part of my therapy now is resistance exercise--which includes gently progressive weight lifting. But because any exercise, even aerobic, increases lymphatic load possibly beyond lymphatic capacity (and thus can tip the scales into LE), I was also told to wear compression. (I do even for guitar playing). Of course, you can lift your child using mostly your non-surgical arm, right? I routinely carry 10 lbs or more of groceries and guitar cases with my other arm, without donning compression. As a Cross-Fit devotee, you probably have an optimal BMI and aerobic capacity--both of these lower your risk. But start slowly again and work up
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Leslie13: That is called pitting and I also have it but more around my wrists. I wear compression sleeve...apparently that works all by itself as long as you don't baby that arm.
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ilovecrossfit, I have been told not to do exercises like planks and push ups to prevent lymphedema. I have also been told not to do repetitive weight lifting that will tire the arm. Did you do these kind of exercises after your surgery before getting lymphedema. I do pilates and had my surgery 3 weeks ago. Wondering if I should just exercise one arm or just do the exercises anyway. I am seeing a PT for the second time tomorrow and will ask her some more questions about it.
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