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Topic: Exercising after lymph node removal

Forum: Fitness and Getting Back in Shape — Conversations about exercise, diet, and getting back in shape after breast cancer diagnosis and treatment.

Posted on: Mar 6, 2011 03:13PM

herbnstan wrote:

I had my lymph nodes removed on 1 side.  I had the talk with the nurse about avoiding repitition type movements and heavy lifting on that side to avoid the lymphedema.

So I am wondering what type of exercises are ok to do?  For instance I enjoy workout dvds that have a lot of arm movements in.

 And this is a permanent thing right?  The restrictions on arm usage, like not shoveling snow, or raking leaves.   What activities are ok?  Can I mop my floor or stir cookies with that arm?

And if I do develop the lymphedema that can be a permant thing as well?

Emily

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Mar 6, 2011 03:40PM kayb wrote:

Hi Emily. If you haven't seen it yet, there is a thread for lymphedema patients on BCO an d those ladies can help you with this. Because you had many nodes removed on that side, I'd ask your doctor for a referral to a lymphedema specialist ASAP so they can help you rehab that arm without causing lymphedema to start up. It's VERY important that your physical therapist specialize in lymphedema so don't go to anyone who doesn't have that training.

Good luck,
Cindy

DX May/2010, synchronous bilateral cancer, triple positive

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Mar 6, 2011 03:47PM JBinOK wrote:

herbnstan

If you develop lymphedema, yes, it is a life-long condition.  Prevention of lymphedema is the key.  If you did not consult with a lymphedema therapist prior to your surgery for prevention exercises, a sleeve, etc., you must get in touch with one now.

For me, all activities are OK, but if they involve rapid repetitive movements I should wear my  sleeve.  Also flying, I must wear my sleeve.  Road trips to high-elevation areas, I must wear my sleeve.  Also, I do daily slow stretching exercises for approx 20 minutes each day, in a precise order, which focus on the areas of lymph node clusters, to encourage the flow of lymphatic fluid. 

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Mar 6, 2011 03:57PM annamari wrote:

I had lymph node disection about 2 years ago.  that included a mastectomy and followed by 30 rads.  I had and have no lymphodema.  There are exersises you can do to improve range of motion and increase strentgh but what ever you do do not push yourself beyond pain.  I have shoveled my own snow, mowed lawn, dug potatoes cleaned up flower beds etc.  I can even lift 50 lbs,  which I sometimes need to do at work.  Since begining recon I have to take it a bit easier on my arm but not to the point of doing nothing. do some stretchs but only to where you feel it and hold do a few reps and a few times a day.  It is important to keep moving or you will get stiff and useless on the surgical side.  All the best with your treatments.

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Mar 6, 2011 07:42PM Shrek4 wrote:

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?
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Mar 7, 2011 07:52PM JBinOK wrote:

Day,

I had a SNB on the "bad" breast in January when I had my BMX.  As this was the 2nd malignancy in the same breast within a 12 month period, my surgeon wanted to check the node while we had the opportunity in case the final pathology revealed an invasive aspect not seen in the biopsy sample.  

Regarding lymphedema, my breast surgeon is proactive when it comes to prevention, and requires all patients having a SNB, or additional nodes removed, to have a minimum of 1 pre-op and 1 post-op visit with a lymphedema therapist.  

Read my post again.  I said, "...I do daily slow stretching exercises for approx 20 minutes each day, in a precise order, which focus on the areas of lymph node clusters, to encourage the flow of lymphatic fluid."

The purpose of the exercises is prevention, same as with wearing the sleeve when flying or traveling to higher elevations.  The exercises are to be performed every day, and are shown to improve the flow of lymphatic fluid and reduce the risk of developing lymphedema.

So, in answer to your question, I do those things for prevention.  That is the one and only key with lymphedema; once you develop the condition, you will always have it.  So you have to focus on prevention.

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Mar 12, 2011 08:35AM Heidihill wrote:

It's possible to get truncal or chest lymphedema with a mastectomy. And I agree prevention is key. There are studies that show different protocols for exercise for this purpose. A Spansh study included manual lymph drainage massage and scar massage as well as arm exercises in the first year. I did something similar and progressed to using weight machines in the gym 18 months after surgery. I have exercised my arm every day for 3 years now.

Dx 8/2007, IDC, 2cm, Stage IV, 2/19 nodes, mets, ER+/PR+, HER2-
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Mar 12, 2011 09:07AM NatureGrrl wrote:

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.

Carol, living out loud! http://fire-of-our-hope.blogspot.com/

Dx 4/2009, IDC, Stage IIa, Grade 3, 0/17 nodes, ER+/PR-, HER2+
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Mar 12, 2011 10:27AM ruthbru wrote:

I will chime in and agree with the others who say that you just need to be cautious. Most people do NOT develop LE and I think many who do are predisposed to do so. That being said, there are things you can do to minimize the chance it will happen to you. No needles or blood pressure taken on that side (I have a great website for beautiful medical ID bracelets, if you want it). Build up slowly when you exercise; but exercise is good for you. Carry a heavy purse on the other side, if you are hauling groceries into the house, put the heavier bag on the other side. Yes, you can shovel snow, vacuum, whatever (darn), just don't do it for hours at a time without a break. Wear sunscreen so as to not sunburn that arm, wear gloves when you are gardening or doing yard work, if you get a cut make sure you wash it with soap and slap a bandage on it right away. I don't wear a sleeve to fly (I did when I first started but it was really a pain in the butt and there is no proof that it prevent LE; if down wrong, it could actually bring it on, I believe. Of course if you already have it, that is a different story), but I stay really hydrated and make sure I move my arm around alot, make a fist etc. All these a little things that eventually become second nature and not in the front of your mind like when this first all happens. Best of Luck! Ruth

"Invisible threads are the strongest ties." Friedrich Nietzsche

Dx 2/2007, Stage IIa, Grade 3, 0/11 nodes, ER+/PR-, HER2-
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Mar 12, 2011 11:13AM lago wrote:

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.

DONE!! alturl.com/3o9ni • Tattoos 2.7.2012 • Nipples 10.6.2011 • Exchange 6.24.2011 • Chemo 1.18. 2011 • BMX 8.31.2010

Dx 7/13/2010, IDC, 5cm, Stage IIb, Grade 3, 0/14 nodes, ER+/PR+, HER2+
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Mar 12, 2011 01:44PM ruthbru wrote:

Emily, I do a wide variety of different workout DVDs, almost every day. When did you have surgery?  Arm movements are fine just about right away (and will actually help you get your range of motion back) and about weights, do as Lago says; start with no weights, go to light and procede slowly up from there.

"Invisible threads are the strongest ties." Friedrich Nietzsche

Dx 2/2007, Stage IIa, Grade 3, 0/11 nodes, ER+/PR-, HER2-
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Mar 12, 2011 09:59PM Sandeeonherown wrote:

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...

Sandee...two years four months cancer free! February 2013

Dx 6/16/2010, IDC, <1cm, Stage I, Grade 2, 0/8 nodes, ER+/PR+, HER2-
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Mar 12, 2011 10:09PM Sandeeonherown wrote:

Ruth- wha is the name of he websit eyou got your bracelet from? Time for me to get one ...might as well add the info just in case!

Sandee...two years four months cancer free! February 2013

Dx 6/16/2010, IDC, <1cm, Stage I, Grade 2, 0/8 nodes, ER+/PR+, HER2-
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Mar 12, 2011 10:49PM Claire_in_Seattle wrote:

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

Completed all active treatment (AC +T, lumpectomy, and radiation). Now on to the rest of my life. So much to celebrate.

Dx 8/2009, IDC, 2cm, Stage IIb, Grade 3, 1/21 nodes, ER+/PR-, HER2-
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Mar 12, 2011 11:11PM ruthbru wrote:

www.creativemedicalid.com they are really, really nice (and recommended to me by another lady on one of the threads).

if you just had surgery, the American Cancer Society had a good booklet of exercises for the first week or two after surgery; it's online and I can post that link too if it would be helpful.

"Invisible threads are the strongest ties." Friedrich Nietzsche

Dx 2/2007, Stage IIa, Grade 3, 0/11 nodes, ER+/PR-, HER2-
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Mar 13, 2011 10:27AM lago wrote:

Sandeeonherown Here are some places I had researched for nice bracelets:

http://www.creativemedicalid.com/womens_medical_bracelets?b=1
http://www.hahoriginals.com/
www.laurenshope.com/

If you would like to make your own or just want to attach to a bracelet you already own check out these places for purchasing the pendant or charm:
http://www.laurenshope.com/products/236/medical-id-tags/all
http://www.hahoriginals.com/catalog/default.php/cPath/66_69
http://www.creativemedicalid.com/medical_id_charms?b=1
http://www.tlcdirect.org/products/sku-7997__dept-86.html
http://www.idservicesinc.com/ID_bracelets_necklaces.php

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  

DONE!! alturl.com/3o9ni • Tattoos 2.7.2012 • Nipples 10.6.2011 • Exchange 6.24.2011 • Chemo 1.18. 2011 • BMX 8.31.2010

Dx 7/13/2010, IDC, 5cm, Stage IIb, Grade 3, 0/14 nodes, ER+/PR+, HER2+
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Mar 13, 2011 10:34AM Sandeeonherown wrote:

Thanks Ruth, Lago...I have looked at a couple of sites...am going to find a measuring tape tonight and then order one tomorrow....have needed on for years but hated them so have a card in my wallet but much better if it is visible.

Will check in with breast cancer team on the 21st about a cuff (good thing I checked the calendar...it is one day earlier than I had written down!That would not have been a good thing)

Off to a 'tea party' and out to enjoy the brilliant sunshine.

Sandee...two years four months cancer free! February 2013

Dx 6/16/2010, IDC, <1cm, Stage I, Grade 2, 0/8 nodes, ER+/PR+, HER2-
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Mar 14, 2011 01:06PM Sherbear wrote:

Claire in Seattle, you are an inspiration!  :)

5/2010 IDC Stage 2 grade 2a, Oncotype 17, 3.3cm inside noncancerous 6cm mucinous tumour, ER+ 90%, PR+ 40%, Her2 neg, mastectomy followed by 4 rounds TC, and 30 rads.

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Mar 26, 2011 04:23PM agnieszka wrote:

Claire_in_Seattle,

You are great! Your attitude sounds so much like mine and to be honest that is hard to find. I was diagnosed only about 3 weeks ago, already had my BMX March 21 and progressing well. This is exactly how I intend to approach this "monster". I was always very active and healthy but not obsessive. I am sure all that helps recovery. But your attitude is just what I was looking for in all the blogs! Seriously, and with no offence to anyone else. It seams like a lot of us forget that we have a life to live no matter what. All the surgeries, drugs and therapies will not help if we don't help ourselves. I believe we need to try as hard as we can to keep doing what we were doing before the diagnosis to keep sane. Thank you Claire.

Dx 2/25/2011, ILC, <1cm, Stage I, Grade 2, 0/12 nodes, ER+/PR+, HER2-
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Mar 26, 2011 11:00PM ruthbru wrote:

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

"Invisible threads are the strongest ties." Friedrich Nietzsche

Dx 2/2007, Stage IIa, Grade 3, 0/11 nodes, ER+/PR-, HER2-
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Mar 27, 2011 09:50AM vmarie wrote:

I am kind of along the same lines as Claire-I used exercise for my mental health and I worked out daily thoughout my chemo. 

After I completed radiation, we did have a lymphedema scare.  I was carrying my 2 yo old while he was have a bit of a tantrum.  The next day, my arm got a bit swollen.  I went to my lymph specialist, whom I had seen just after surgery to get a baseline and a sleeve to have me checked out.  She wasn't sure if it was lymphedema or not, but to be on the safe side, we treated as if it were.  I was doing daily massages and wearing my sleeve.  After a month, my arm went back to normal. 

I gradually added my workouts back.  Very slowly and I always wore my sleeve.  I still wear my sleeve when I am lifting a lot of weight.   I then joined a cross fit gym and slowly, I started to really work out like I like.  I don't know if you are familiar with cross fit, but it is a really challenging workout.  

Listening and watching your body is key.  I also measure my arm a few times a week to make sure everything is okay.  I feel so fortunate that I am able to do my workouts, because this is one of my favorite things to do.

V

Dx 1/7/2010, IDC, 3cm, Stage IIb, Grade 2, 1/13 nodes, ER+/PR+, HER2+
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Jul 26, 2012 10:43PM Sandeeonherown wrote:

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

Sandee...two years four months cancer free! February 2013

Dx 6/16/2010, IDC, <1cm, Stage I, Grade 2, 0/8 nodes, ER+/PR+, HER2-
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Jul 26, 2012 11:16PM lago wrote:

BTW I've been using my 10lbs again. I will admit my LE (left) side is still not as strong as the other side. Granted I am a righty.

DONE!! alturl.com/3o9ni • Tattoos 2.7.2012 • Nipples 10.6.2011 • Exchange 6.24.2011 • Chemo 1.18. 2011 • BMX 8.31.2010

Dx 7/13/2010, IDC, 5cm, Stage IIb, Grade 3, 0/14 nodes, ER+/PR+, HER2+
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Sep 7, 2012 04:52AM Sandeeonherown wrote:

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:)

Sandee...two years four months cancer free! February 2013

Dx 6/16/2010, IDC, <1cm, Stage I, Grade 2, 0/8 nodes, ER+/PR+, HER2-
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Sep 7, 2012 10:28AM, edited Feb 15, 2013 07:56PM by Cottontail

This Post was deleted by Cottontail.

oh these little earthquakes doesn’t take much to rip us into pieces

Dx 3/27/2012, IDC, <1cm, Stage Ia, Grade 2, 0/9 nodes, ER+/PR+, HER2-Chemotherapy 04/26/2012 Adriamycin, Cytoxan, TaxotereSurgery 08/30/2012 Lumpectomy (Left); Lymph Node Removal: Axillary Lymph Node Dissection (Left)Radiation Therapy 10/02/2012 ExternalHormonal Therapy 11/26/2012 Tamoxifen
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Feb 8, 2013 05:06PM Sandeeonherown wrote:

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

Sandee...two years four months cancer free! February 2013

Dx 6/16/2010, IDC, <1cm, Stage I, Grade 2, 0/8 nodes, ER+/PR+, HER2-
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Feb 27, 2013 07:22AM Nikstar wrote:

OMG! I love you! I feel the same about my workout and dance activity.  It's bad enough cancer is robbing time from your life, I'm not letting it take my fitness too.

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Mar 6, 2013 03:44PM NatsFan wrote:

Check out the new thread - Guidelines on Exercise For Those With/At Risk for LymphedemaIt 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.

Mary

Dx 12/31/2007, IDC, 2cm, Stage IIb, Grade 3, 1/15 nodes, ER+/PR+, HER2-Surgery 01/30/2008 Mastectomy (Both); Lymph Node Removal: Axillary Lymph Node Dissection (Right); Reconstruction: Tissue expander placement (Both)Chemotherapy 03/04/2008 Adriamycin, Cytoxan, TaxotereHormonal Therapy 07/01/2008 FemaraSurgery 10/09/2008 Reconstruction: DIEP flap (Both)