Last Thursday I completed the final session in my twelve-week “Livestrong” program at my local YMCA. This was a program that had come highly recommended to me from other members of my cancer support group, many of whom have continued with the alumni program which is offered under slightly different terms after the initial twelve-week session.
After completion of the program, I heartily agree with the endorsement of my sisters in the support group. I thoroughly enjoyed the sessions, so much so that I rarely missed one—which is a pretty good testimonial right there. I would say they even exceeded my expectations, because they not only helped me make another advance in my post-treatment recovery, they helped me reconnect with my old athletic and slightly competitive self.
I think it’s been fairly frequently acknowledged around here that once we have cancer, we have to deal in one way or another with a sense that our body has betrayed us. Never mind that (in my case, anyway) the betrayal was if anything the other way around—I had once been fit and active, but those days were long ago and far away. More recently I was surviving on 20 oz. bottles of Coke and small bags of potato chips while driving from work to home, with very limited opportunity for any physical exercise beyond walking. Something was bound to give, though I didn’t expect it to be cancer or to come so soon. Someone else with cancer who had always been extremely fit would have to comment about that circumstance, since that wasn’t my personal experience—but I expect in that case a diagnosis of cancer would really seem to be a bolt from the blue.
For me, all the slow and careful steps I have made in the past two years toward reclaiming my health, in whatever condition it will be, have indeed included a process of forgiving myself for the lack of care I have afforded myself, and the adoption of new habits that I hope will serve me better. And that, of course, is where the Livestrong program came in.
I hasten to add that I had not been entirely sedentary since my diagnosis, because (apart from my neuropathy, which fortunately for me subsided after some solid weeks of acupuncture treatments) I have had no cause to limit my physical activity. In fact, I started regular restorative yoga classes at around the same time I started my chemo treatments, and I think the former helped me get through the latter with as little harm as I did. Shortly after ending chemo, I started studying qi gong, which added another beneficial routine to my physical recovery. But of course neither one of these disciplines incorporated much aerobic activity for the sake of promoting cardio fitness.
Our Livestrong program at my local YMCA included both a cardio component and a strength-building component. During our first session, the personal trainers who were our professional guides for the twelve weeks had us complete a series of assessments that provided benchmarks for our cardiac capacity, our overall strength, and our flexibility and balance. Over the next twelve weeks, we learned how to set up the strength machines and to track our progress on them. (Here is where my long-dormant competitive drive manifests itself: I really feel motivated to keep increasing weights and reps. Funny how such a simple thing can keep me going.) During the 75 minutes of each session, I typically did 17 minutes on an elliptical machine, then all but the last 15 minutes on the strength-training equipment. The last 15 minutes were devoted to group time, so that the trainers could introduce other kinds of equipment (free weights, balance aids) and take us through a cool-down stretch.
During our sessions we really didn’t have the time—at least, I didn’t—to talk a lot with each other about what kind of cancer we had or what we had gone through by way of treatments. One of the breast cancer survivors has serious lymphadema, so she has to wear a compression sleeve and glove, but she was the only one who had any obvious markers of cancer—apart from those of us whose hair was still very, very short. For the most part, that made sense to me. How we got there was not nearly as important as what we were going to do now that we were here.
I will admit that sometimes I just didn’t feel terribly motivated to go. Perhaps I had something I wanted to do at home, or another activity that had to be rescheduled for the sake of attending the workout. But I will also attest that I always, always felt better (at least in terms of my mood) after I did go. Hooray for endorphins! Now, some days I would also come home very weary, so much so that I’d need a nap. That did make me wonder about the overall net good it does me—though not for very long. It was clear over time that having the regular workouts has improved my energy on the short term and my stamina over the long term.
I have one very homely anecdote to demonstrate that efficacy. A week or so ago, I took a carful of dirty linens (bedding and towels, mostly) to the laundromat. Our machines at home are just not big or sturdy enough to handle the oversize items even in good conditions, and lately they’ve been suboptimal. (We need to get our landlord to clear a plumbing block. Long story.) I was actually apprehensive about taking all that laundry over there because it’s a big job to get it all pushed through, dried, and folded. As it turned out, I had three extra-large (4x) loads, two large (3x) loads and two regular loads, so that was a lot of stuff. It took me about four hours of steady work, during which time I was almost always on my feet, to get it all done. But I did it. I wouldn’t have thought twice about it in the old days, but at this juncture it feels like a big accomplishment. I’m glad for that kind of validation of my efforts these past few months.
For the most part, our trainers (all women) were old hands with the whole process. Only one of them was new to Livestrong, and at least one of them has been with the program for the entire six years of its existence at this particular YMCA. (Ours had one of the first in the country, and at this point they’ve had 25 groups complete the intro session.) Interestingly enough, all but one of the participants in our initial group of twelve was female, and the only man wound up dropping out only a couple of weeks along. Apparently the predominance of women in the group was not at all unusual. On occasion, when we were stretching at the close of a workout session it made a difference in terms of the tenor of our conversation, but otherwise I don’t think I noticed much. I will say, however, that I did enjoy working with the female trainers. They are all clearly fit, including the woman who is a grandmother in her 70s, but not exaggeratedly so; their level of comfort in their bodies gave me some reassurance that I can regain the fitness and comfort that I once enjoyed (or a reasonable facsimile thereof).
The trainers also clearly enjoyed working with us. One of them did acknowledge that it has its tough moments, working with cancer survivors, mostly because they have had some participants die (after their session, that is, which is painful enough). Awareness of the reality of our vulnerability, despite our eagerness to get stronger, must be present somewhere for the trainers, too. And so I am even more appreciative of the enthusiasm and commitment they were all able to demonstrate toward us, no matter where we started or how far we advanced.
Here’s a photo of some of us, with most of our trainers, on the last day of our session. The regulars comprised about 6 or 7 of the original 12, and a couple of them were absent the last day; we had “only” three of the four trainers then, too. Quite a ratio, roughly 3:1 most days; I can’t remember the last time I had personal attention to this extent. (The trainers are the two women in front on the exercise balls and the woman in the middle in the back row.)
Before I close out this section of the discussion, let me mention one other very important aspect of the twelve-week program: IT WAS FREE. Not only was the program free, but parking was also covered. And not only that, but I had free access to the rest of the Y as a full member for the duration of the program. And not only that, but my family also had membership privileges, for free, for that time period. Unfortunately we didn’t use those bennies much, but they are a great idea. I don’t know whether all these would be true for programs run out of other Ys, but it’s worth checking.
The only requirements for joining, as I recall, were that I had to be out of active treatment—that is, out of chemo and radiation, since I am taking hormones—and that my doctor had to sign off on my participation.
Please join me over the squiggle for a brief exposition of the big picture of “bodies in motion.”
Monday Night Cancer Club is a Daily Kos group focused on dealing with cancer, primarily for cancer survivors and caregivers, though clinicians, researchers, and others with a special interest are also welcome. Volunteer diarists post Monday evenings between 7-8 PM ET on topics related to living with cancer, which is very broadly defined to include physical, spiritual, emotional and cognitive aspects. Mindful of the controversies endemic to cancer prevention and treatment, we ask that both diarists and commenters keep an open mind regarding strategies for surviving cancer, whether based in traditional, Eastern, Western, allopathic or other medical practices. This is a club no one wants to join, in truth, and compassion will help us make it through the challenge together.
I love moments of serendipity, like the one last week that prompted me to look at the latest issue of Cure magazine on the table at my local Cancer Support Community. It wasn’t a cover story even, but there was an informative article about the benefits of exercise in that issue (Fall, 2012, to be exact).
Somehow I had missed this finding, but apparently earlier that year the results of a major study on the effects of diet and exercise were published, the gist of them being that exercise does appear to have a positive correlation with longer-term survival and longer progression-free status, as well as improved “quality of life.” If you’re interested, the whole study is available to read online here. It’s a surprisingly informative as well as readable report, and it does supply specific information related to a few of the more common cancers (including mine, which always makes me happy, oddly enough.)
This is one important segment (footnotes and sources available in original):
Exercise has been shown to improve cardiovascular fitness, muscle strength, body composition, fatigue, anxiety, depression, self-esteem, happiness, and several components of quality of life (physical, functional, and emotional) in cancer survivors. In addition, exercise studies have targeted certain symptoms particular to specific cancers and the adverse effects of specific therapies (eg, lymphedema in survivors of breast cancer) and shown beneficial effects that are more cancer-specific. At least 20 prospective observational studies have shown that physically active cancer survivors have a lower risk of cancer recurrences and improved survival compared with those who are inactive, although studies remain limited to breast, colorectal, prostate, and ovarian cancer, and randomized clinical trials are still needed to better define the impact of exercise on such outcomes.And this is another:
For aerobic physical activity, the ACSM [American College of Sports Medicine] panel recommended that survivors follow the US Department of Health and Human Services 2008 Physical Activity Guidelines for Americans. According to those guidelines, adults aged 18 to 64 years should engage in at least 150 minutes per week of moderate intensity or 75 minutes per week of vigorous intensity aerobic physical activity, or an equivalent combination of moderate and vigorous intensity aerobic physical activity.... Some activity is better than none and exceeding the guidelines is likely to provide additional health benefits. Activity should be done in episodes of at least 10 minutes per session and preferably spread throughout the week. Furthermore, adults should do muscle-strengthening activities involving all major muscle groups at least 2 days per week. Adults aged older than 65 years should also follow these recommendations if possible, but if chronic conditions limit activity, older adults should be as physically active as their abilities allow and avoid long periods of physical inactivity.As with many other studies, there is an element of “well, of course” associated with this one, I think—but perhaps I shouldn’t be so cynical about research or so confident about the obvious benefits of exercise. We have had several MNCCers write about how important exercise was to their recovery already, both for their morale as well as for their physical strength. [Alas—I am having trouble finding ANY of them, so I do hope that the original writers, or those who remember the discussions, can help us all out. My apologies.] This seems particularly true for people who were really invested in being fit beforehand. But I think those of us who are coming to it late or after some time away can also be readily persuaded of its beneficial aspects.
It will take me a while, probably into the summer, to gradually increase my aerobic times to meet the goals prescribed above, but I am already there with the muscle-strengthening activities. Beyond that, I hope to be more active than usual this summer--getting out on the river to kayak, and doing some hiking above and beyond the city and park walks that I already do. We'll see.
So now the time has come for you-all to fess up about your own regimes and why you like them (or not). I’m including a poll to get things started. (It’ll be interesting to see how closely we match the results published in the Cure article. No peeking!) If you’re not exercising regularly, what are the barriers that keep you from doing so? What do you think you would need to get you moving?