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Stage IV MBC Fitness

zarovka
zarovka Member Posts: 2,959

Hello! Welcome! We are done with Stage IV, moving on and planning to staying healthy for a long time. We're Stage V (Which is not dead. We're doing fine, ready to live with this beast.)

This is the American Cancer Society/NCI consensus on exercise for cancer patients.

  • 150 minutes/week moderate-intense aerobic exercise or 75 minutes/week of vigorous exercise
  • Strength training 2-3 times/week, 8-10 exercises of 10-15 repetitions/set, with at least one set per session
  • Return to normal daily activities as quickly as possible
  • Continue normal daily activities and exercise as much as possible during and after non-surgical treatments
  • Avoid Inactivity!!!

OMG. The PhD's who wrote these guidelines obviously do not have MBC, but we get the point.

I find the advice in the book The First 20 Minutes more relevant and achievable than the ACS guidelines. The point of the book is that 20 minutes of daily, consistent exercise, any kind, has a huge effect on our health. I've seen studies that show that 15 minutes of moderate exercise (a brisk walk, moving yoga) two or three times a day is better for recovery then a single tough workout.

However, the ACS/NCI guidelines can motivate us. They remove any doubts about the benefits of exercise for MBC. This thread is about showing up and doing your best despite the fatigue, pain and dark clouds that plague us all. If your goal is a trip to Walmart or a marathon you will find support here.

The article Lifestyle modifications for patients with breast cancer to improve prognosis and optimize overall health summarizes the data on lifestyle changes on survival outcomes. It is worth reading in its entirety, but here is a summary of key points.

Exercise and maintaining your ideal body weight are the most important lifestyle interventions you can do if you want to decrease your risk of breast cancer recurrence and death. Physical activity (150 minutes per week, moderate intensity) can reduce the chance of death from breast cancer by up to 40%.

Two analyses showed a substantial inverse dose–response effect between hours per week engaged in physical activity and breast cancer mortality.26,27 Similar beneficial metabolic effects have been shown for both aerobic and resistance exercise, but optimal results are achieved with a combination of the two.22

A population-based study in the United States involving 856 women found that only 13% of breast cancer survivors attained the recommended 150 minutes of exercise each week, and with increasing time after diagnosis, only about 10% comply with the recommendation. 28 Patients who have undergone chemotherapy or radiation have significantly greater decreases in physical activity, by 50% and 24% respectively, compared with patients who have not experienced these therapies.22

As noted in the article, a combination of aerobic and resistance training is optimal. Resistance exercise has more durable effects than aerobic exercise and improves your aerobic workout. You don't need weights or a gym membership. Gather a door knob, a cheap Theraband and a little time and commitment and you'll be quite sore. Bodyweight exercises are equally effective and require no toys at all.

You are all welcome to buy a Fitbit, join the Stage V Fitbit Group and challenge us to keep moving through the year. You will need to PM me with a personal email to get an invitation from the Fitbit community that I run. The Fitbit is just a fun side thing to motivate anyone interested. It's not for everyone and it's not the point of this thread.

One theme that keeps coming up in this thread is the challenge of working out in bad weather or if you are tied to oxygen or just unable to get out of the house. We often need a 10-20 minute indoor routine that is a motivating and provides an easy way to get back into working out. Leslie Sansone videos are excellent. I personally like the Fitbit exercise plans that you can get through their app and the Nike+ Fitness programs on my phone or my Xbox/Kinect system. These videos are all great at providing a short, effective medicinal dose of exercise.

Yoga does wonders for joint pain and increases energy. I can run about twice as far when I have a regular yoga practice (4-5 times per week). I can do this yoga sequence recommended by DGHoff in 15 minutes. It is taken from this study which showed the sequence improved bone density if you practice regularly over an extended period. Generally I mix in some ab work between poses and add a couple of resistance exercises for a 30-40 minute routine. Highly recommended as a component of an exercise routine.

I'm a determined person. I've exercised all my life, but I have many days where it is hard to just get out of bed much less make it to the gym. Thank you for your support it's made a huge difference in my treatment and my life.

Let's kill it in 2018.

>Z<

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Comments

  • mdillard04
    mdillard04 Member Posts: 83
    edited January 2017

    Z.

    Thanks for starting up this thread!! I need some motivation to exercise consistently!


    Monika

  • zarovka
    zarovka Member Posts: 2,959
    edited January 2017

    Welcome Monika! What kind of activities do you enjoy?

    >Z<

  • MSL
    MSL Member Posts: 46
    edited January 2017

    Yay Z

    This is such a top thread and gives so much motivation

    I've started the new year running five miles per day and aim to keep that up and build on it if I can

    I find exercise helps so much in making sure I get rid of those awful morning blues that hit me with this damn diagnosis

    And I'll take on your suggestions about weight training Z

    Go everyone


  • Apg
    Apg Member Posts: 112
    edited January 2017

    I don't have a Fitbit but I would like to follow this for motivation. I have been doing yoga but I also want to do cardio too. I just had surgery a week ago so I have another week before I can start back to doing anything but I can't wait! I will do anything to make sure I can be here as long as possible. I have done Zumba a lot in the past. Is it safe with bone mets?

  • mara51506
    mara51506 Member Posts: 6,069
    edited January 2017

    Found this thread. Glad it is here.

    No set exercise, lots of walking around while shopping. That counts for me as well. Tomorrow is infusion day so I may or may not get stuff done. If I get too bored waiting for the chemo suite, I may walk around the clinic. The pager has a pretty far reach. Only if I manage a good brunch since it is an early morning appointment. Usually takes a couple of hours to manage to eat until I wake up a bit. We will see.

    Good job everyone. Z, when I am more reliable with exercise I plan to get a fitbit. Not ready to be that accountable yet LOL.

    Monika, I noticed on the old thread you mentioned feeling tired after day of work. Is exercise shortly after you get up for the day possible? I have used that to help me over fatigue humps until it is easier to do.

  • shazzakelly
    shazzakelly Member Posts: 620
    edited January 2017

    A happy progression free 2017 to all. I haven't been posting but have still been exercising. I have just been on a New Year break to Lake Taupo and welcomed in the New Year with a 21k bush walk starting the year the way I mean to carry on, even got some paddle boarding and swimming in. Back to work tomorrow so need to get back into a good everyday routine.

    Thanks Z for getting the New thread started

    Shazza

  • zarovka
    zarovka Member Posts: 2,959
    edited January 2017

    Mara - Exercising when when we are a fraction of ourselves or even getting weaker is extremely hard but everyone here has been there. That's the kind of thing we are here to support you through. Your regular short walks strategy is on the mark. I think you would be surprised how much you are doing. Thinking of you during chemo tomorrow. Walking a bit to get the stuff through ... and out ... of your system could help.

    MSL - A five miles run was my goal before xmas. Working on walking that far at the moment, but I'm right behind you.

    Apg - Zumba is so much fun and so motivating that I would not deprive yourself if that is what you want to do. Mindful motion within your normal range is the key. I am huge yoga fan, but I have a friend who dislocated a disk and put herself in the hospital for a weak pushing herself in a simple twist in a yoga class. You can hurt yourself lifting a load of laundry if you don't pay attention, push yourself beyond your normal range, use the wrong muscle for the job, etc.

    Hi Shazza - 21K!!!!

    I have had extreme calf and foot pain the last two weeks. My legs strength disappeared over a matter of days around Xmas. I have a hard time climbing even the steps in my home. This is a common side effect of A/I's but I have not had it this bad before. On one of our hikes last week, I couldn't finish. My husband had to run back, get the car and pick me up at a side trail. So starting the year two steps back myself at the moment.

    The change corresponds with going off all supplements over xmas for a little supplement vacation. Hoping that adding them back will help. I also got myself a cool infrared heating pad for xmas. At a minimum it provides short term relief while lying around watching football. Rest day today. But skiing tomorrow! Life is good.

    Looking forward to this year.

    >Z<

  • heidihill
    heidihill Member Posts: 1,856
    edited January 2017

    Thanks for the new thread, Z!

    I can't seem to upload a pic from a recent hike. We had no snow, so hiking was the sport of the week.

    Hope re-supplementing will give you your leg strength back. Could it be low blood glucose? low magnesium? low Vitamin B12?

  • mara51506
    mara51506 Member Posts: 6,069
    edited January 2017

    Z, hope you enjoyed skiing today and that the legs were better for you. I hope that when your supplements are back in your systems, your legs will behave as they did before.

    Had a good day. Walked around the cancer clinic while waiting my turn to go to the infusion. It is usually at least an hour long wait so was worth it. Walked for an hour off and on. Sat in between after approx 20 mins. Walking is getting easier for me. Stopped a couple of times for water and got a sandwich before my pager went off to send me off to infusion. I spent the couple of hours relaxing, watching a movie while I got my Herceptin/Perjeta. Not a bad day at all. Not sure why I was not tired after the infusion as usual but will take it as a good thing.

    Shazza, I still am amazed by you because I know you have done oral taxol for approx 3 and a half years. Great job on the marathon.

    Hope everyone else is well and moving as they wish.

  • Zillsnot4me
    Zillsnot4me Member Posts: 2,122
    edited January 2017

    I had a virus over Christmas and I have weak legs due to Ibrance. Have been trying to do a mile every day. Did the wii boxing yesterday. Both myself and my son are very sore.

    I don't have a computer to charge my Fitbit but will keep that in mind.

    Would love to hear if supplements got rid of your jelly legs.

  • zarovka
    zarovka Member Posts: 2,959
    edited January 2017

    Thank you Mara. Sounds like a really great day given that you got a chemo infusion. I hear more and more good things about Herceptin/Perjeta. This should go well, particularly since it isn't knocking you out.

    The local ski area behind my house was randomly closed today ?!? but it is only 15 minutes away. We turned around a got a lot of errands done. My legs hurt. They may be getting better but they still hurt. It's mostly the calves but also the thighs. It feels like I ran a marathon yesterday, but I most certainly did not. One knee hurts as well so maybe skiing would not have been a good thing. I managed to get in 10,000+ steps with a 1 mile fast walk on a treadmill, a short hike while my daughter was in her violin lesson, and errands. A little body weight exercise and some stretching and I have called it a day.

    So we adapt and keep going ...

    >Z<


  • mara51506
    mara51506 Member Posts: 6,069
    edited January 2017

    The nice thing with the Herceptin/Perjeta is that they are only targeting the HER+ proteins. This is nice because unlike a standard chemo, they do not attack all cells. There are still some side effects but for me they are mild. Slight diarrhea is about it, sometimes get a runny nose. Beyond that, I don't have any issues. I am hopeful they can keep me met free at least from the neck down. I will get scans in 6 weeks or so to check on progress. The walking pre infusion was good. I would never try it while plugged into my IV pole. I am a terrible driver of those and half the time, forget to unplug them when visiting the restroom LOL.

  • MSL
    MSL Member Posts: 46
    edited January 2017

    great work everyone - it's amazing how you can get to the 10K steps a day if you choose walking etc for errands and shopping and zipping around the clinic!

    Zills hope the virus is gone soon and your that your legs feel better Z - very impressive efforts despite not feeing 100%.


  • Zillsnot4me
    Zillsnot4me Member Posts: 2,122
    edited January 2017

    I didn't walk or exercise today. Took a two hour nap instead.

  • zarovka
    zarovka Member Posts: 2,959
    edited January 2017

    Zills - I think curcumin is what i was missing. My jelly legs slowly disappearing as get back onto 2000mg/day of liposomal curcumin. There are many brands of liposomally encapsulated curcumin, but that is what I take. The other stuff is not absorbed. That said, I take a bunch of stuff and I really can't say what is helping.

    Fitbit only needs a cell phone.

    Fighting a virus, a few good naps is what you need before anything.

    Skied a couple hours. Having vietnamese food at the moment in the big city while my kids play laser tag. Came down to ABQ to get some special blood tests and have fun.

    MSL - Thanks.

    Keep moving ladies!

    >Z<


  • iwrite
    iwrite Member Posts: 745
    edited January 2017

    Z- Glad the legs are getting better. I take curcumin but haven't noticed a difference...bet the kids loved laser tag

    Zills- The nap sounds perfect.

    Today I did one of the "8 minute on demand" tv dance workouts and then an hour long Pilates mat class.

    Yesterday was a total loss after my 9500 step day...so sore!!

    Coming down with a bad cold (first time since dx in 2015). Ugh- may have to miss seeing my granddaughter play hockey at the United Center before the Blackhawks game tomorrow night :-(. I need a photo of her at center ice!!

    Hoping for a miracle recovery.



  • dghoff
    dghoff Member Posts: 235
    edited January 2017

    Way to keep moving everybody!

    Mara- I get the same side effects from Herceptin and Perjeta, especially the drippy nose that just comes on randomly out of nowhere! I too am not a good drive with the infusion pole. I think those little wheels are sort of like the wheels on a grocery cart and never quite work the way they are supposed to. Not to mention all the cords and tubes that you have to worry about. I wish it were easier to walk around with them as that would be a good way to use the time!

    Z- so sorry that you are having the leg pain, but glad that the supplements are helping again. I take Turmeric and a product called Breast Defend that includes Curcumin among other things. What AI are you on? I take Femara (Letrazole) and haven't experienced any of the joint issues, although I do have some knee pain where I haven't before. Mostly it's mild so I can live with it. Saw you got your Fitbit charged up and are ready to roll! Yay!

    Apg - I think Zumba should be fine. I have bone mets too, but I suppose it depends on your own personal situation and if you can tolerate the bouncing. It's Sooo cold and icy here in Minnesota that I haven't been able to get out for my regular walk/run so I've been doing my own version of dance/zumba/aerobics in my living room. We do what works and whatever keeps us moving, right?

    MSL - Wow! 5 miles is awesome. I have never in my life run that far. I might try to shoot for a 5K but that even seems like a lot to me.

    I have started up again on the weights too and working on my push-ups. I'm trying to get to five in a row without sacrificing my form, but golly those buggers are hard. I'm at four and can't quite get past it. Just have to keep working on it, I guess.

    lwrite and zills - sorry you are dealing with the winter colds and viruses. Hope you feel better soon!

    And last but not least, welcome Monica!

  • zarovka
    zarovka Member Posts: 2,959
    edited January 2017

    I am on letrozol. Periodically the muscle and joint pain is a nightmare. Last August I had a couple of days where the pain in my feet was so bad I could not walk. I tweak my supplements, get some bodywork done, and wave crystals over myself until it gets better. It does get better.

    After some Pho this evening I went back and played a few games of laser tag to have some fun (and get my steps up so you guys wouldn't feel I was slacking). 9600 steps plus skiing today. Legs MUCH better but still challenging. Packing it in for the day. Kids in pool. Fasting blood test tomorrow at 8am. I hope the frozen probiotics, I mean yogurt, I just had is gone by then.

    >Z<


  • MSL
    MSL Member Posts: 46
    edited January 2017

    Push-ups are the hardest things DG and well done you, you've given me motivation to have a crack at them tomorrow.

    Z, no one would ever accuse you of slacking! Terrific effort with sore legs to do so many steps and skiing!

    We live in Australia so it's hot here at this time of year of course. Did a massive walk with my eldest today, which included on the beach and shopping. We both got sunburnt but it was huge fun. The beach is beautiful. For those facing snow, thought I'd send you a shot from January in Oz.

    image

  • Laurie09
    Laurie09 Member Posts: 29
    edited January 2017

    Happy New Year! Thanks for starting this thread. I don't have a fitbit but would like to follow as well.

    Probably one of the best things about being Stage IV for me was that once I started treatment and had improvement in my pain, I could exercise again!! I consider myself one of the lucky ones that I CAN exercise. I've tried to be consistent about it since. I do what I call low impact high intensity workouts with strength training and body weight type exercises. In addition to resistance bands, I have a couple of hand weights at home that I use. I also started taking a class once a week at the rec center where I have learned some of these exercises, then I incorporate them into my own workout at home. Stair climbing can also be very good. I like to bike too in summer months.

  • teacher911
    teacher911 Member Posts: 152
    edited January 2017

    Just starting my second cycle of Ibrance and finding my way so to speak. Some of the more difficult classes I use to take at gym just aren't happening right now. Hoping to find my way back eventually. I go to workout on weight machines twice a week and trying to recommit to yoga and walking. I would love to join fit bit group could someone please tell me again how to connect on that I would appreciate it.

    Bionic Bunny, I was at the race, but it was a last minute decision because I wasn't feeling great. I'm glad I went,most of my family was there

    image

    . I think of you often and wish I could have seen you. Maybe a short road trip in the spring.

  • dlb823
    dlb823 Member Posts: 2,701
    edited January 2017

    Happy to see this thread, Z -- love the Stage V thought -- and hoping it will help me get re-motivated. I got a requested FitBit Activa for Christmas, and what an eye opener! I have gone from walking 5 and 6 miles a day + gym time prior to re-dx to near couch (or computer) potato status. No wonder I'm slowly putting on weight in spite of a mostly vegetarian diet.

    Back in the 2009-10 timeframe, some of us here had a "Motivation" thread with a 10 minute rule -- which is, no matter how sluggish or uninspired you feel, you make yourself get out there for 10 minutes, which, of course, almost always turns into a much longer exercise session. But for some reason, I'm having trouble even doing that these days. I really need a serious kick in the butt and I'm hoping this thread will help. My goal is to get back to walking 5 miles most days.

  • Sherriw
    Sherriw Member Posts: 23
    edited January 2017
    Happy New Year! I took a BCO break over the holidays, it was great to come here this morning and catch up with you all. Good job everyone!


    My sister has lost some fitness over the last year also, so we've challenged each other to get back to at least a 3 mile run when I visit her in February. Actually more like a three mile race because we are competitive that way 😀 We'd planned on signing up for a 5k but I seemed to have missed it by a week when planning the trip and booking flights. Oh well.

    She's never beat me in a race. She's always close but I'm always a little bit faster. I don't think I'm always fitter, more like Ive had an edge by mental toughness/ pain endurance. I swear all the poking and prodding have worn away my pain tolerance so running now is so much harder. but I am competitive so maybe this will help with the will power part.

    (And don't worry, we are competitive in everything so she gets her payback)
  • dghoff
    dghoff Member Posts: 235
    edited January 2017

    Still bitterly cold here in Minnesota so it's all indoor stuff for me this week! I teach a yoga class on Thursdays and it so cold that nobody showed up for class tonight. But instead of just heading home, you would all be proud of me as I used my time to run on the treadmill at the gym, a few weight machines, and a little yoga of my own to finish up. I have not done a yoga headstand since well before my diagnosis last year, but I was feeling strong enough to try. I was able to do it, but I totally regretted it afterward as my spine and shoulders are NOT used to that kind of behavior. I think I need to be a little stronger yet before I try that again.

    Sherri - That's great you have a friendly competition with your sister. Motivation comes in many forms!

    MSL - I am jealous of your photo! Looks nice and warm!

    dbl - I like the 10 minute motivation rule. Seems very doable, even for those days when you just don't feel like doing anything. I usually find that once I start moving, I crave more movement, so it's just a matter of making myself get off the darned chair.


  • mara51506
    mara51506 Member Posts: 6,069
    edited January 2017

    I use the 10-minute rule all the time I find that it really helps me feel better when I get moving and 310 minute sessions are just as beneficial as one 30-minute session. I even like 5 minutes sessions.



  • zarovka
    zarovka Member Posts: 2,959
    edited January 2017

    Didn't make my step goal, but I did spend an hour in a trampoline park with my kids. Lots of fun.

    MSL - Thank you for your support. Muscle pain receding a bit each day. I don't wince at the mere sight of stairs anymore, so that's improvement. Also generally feel more alert, motivated and focused now that I am back on supplements. Somewhat satisfying to know there is a reason to take these things. Also just glad to be improving. So many ups and downs. The downs, even though I know to expect them and I know they pass, are demoralizing.

    Deanna - good to see you over here. I expect your 5 mile walking routine will be back in no time.

    There are so many things that set back an exercise routine with this disease. We are constantly starting over. The 10 minute rule is an essential tool for fitness with MBC. It's the place to start.

    Sherri - welcome. I am glad you and your sister are close and have this healthy positive little challenge going on. I put fitbits on my 10 and 13 year old daughters and it's working like a charm in that regard.

    Teacher - PM me your personal email and I will add you forthwith. I could use your energy and I look forward to having you join us.

    Kathryn - those 8 minute high intensity workouts are handy and effective, way to go.

    All - The Fitbit thing is a gimick to motivate me, and any one else who choses, through the winter . It can be hard for me to move in the winter with the darkness (seasonal affective disorder, check) and the cold and the Fitbit has given me a little boost when I need it most. In the past I have tired of it after a few months. But I get back to it after some time once it feels new again. Haven't done it for a while. Seemed like a good time to deploy the fitbit.

    The Fitbit and the Fitbit Stage V community are not the central purpose of the thread, just an option for anyone interested. The point of this thread is to get support to stay moving through the unique challenges of this disease and the associated treatments. If tracking your activity helps motivate you there are a number of tracking devices that are fun. If you want to be inspired by the very active Shazza and DGHoff get a Fitbit and PM your personal email address to me. I have to invite you from a separate fitbit.com community that lets us all see our daily steps.

    Might ski tomorrow depending on how the promised blizzard shapes up.

    Keep moving ladies.

    >Z<

  • JFL
    JFL Member Posts: 1,373
    edited January 2017

    I just saw this thread and read the ACS exercise guidelines in the first post. Wow.

    I would like to do that much a week but it is difficult to squeeze in exercise on weekdays because I work full time and have a 2-year old to take care of before work/when I get home. Getting up early is a good idea in theory but doesn't work in practice, as I am not a morning person and struggle to get up any earlier than necessary for work. I am so tired from doing everything I have to do when I come home from work, don't sleep enough as it is and am woken up to tend to a crying baby at least a few times a week in middle of the night.

    I need to figure something out! Any suggestions are welcome. When I had a nanny (for first year of baby's life), it was easy to get in 3 runs a week. Now, getting in 1 - 2 runs (on weekends) is about all I can do. (I was on vacation for 9 days around the holidays with lots of family members to help out with baby and worked out 3 - 4 times/week for two weeks. It was so great. However, now it is back to the grind.)



  • zarovka
    zarovka Member Posts: 2,959
    edited January 2017

    JFL - With all that on your plate, you may not get runs in during the week. Sleep is the #1 priority. I would first figure out what you can work into your workday. A 15 minute walk during a lunch or (legally required) work break is a huge difference relative to nothing. Throw in 100 jumping jacks and a 1 minute plank and you're getting a workout.

    I had a lot of fun for a while with the Nike+ Kinect Fitness program on xbox. It was amazing how it could motivate me when I was tired. The programs are 30 minutes long. They get the job done. There are similar things on video or online. But I would not short myself on sleep in order to workout.

    I would keep any weekday workout short (20-30 minutes). Short workouts have a huge bang for the buck, which is what you need.

    Consider body weight routines that can be done at home without equipment. Super efficient and effective. My favorite is 100 jumping jacks, some kind of ab thing until it hurts, 10 burpees, some kind of squat thing till it hurts, plank for 1+ minute. And over again. Do it 2-3 times and you have a very efficient workout at home with no toys to take out or put away.

    That first few years with kids are hard. We get through it as best we can. Eventually they sleep through the night and start helping with dishes and make their own PBJ and we contemplate self care again. Frankly you are doing better than I did, without cancer. I am kinda stunned at how well you are doing. Running on weekends? Amazing.

    The place to start is to applaud yourself for holding it together with everything you are dealing with ... Great Job.

    >Z<

  • zarovka
    zarovka Member Posts: 2,959
    edited January 2017

    Here is an interesting High Intensity Interval Training Calculator. HIIT is recommended to reduce fatigue, improve outcomes, etc. but I had a hard time finding an actual definition of what that meant. Now we have a definition somewhat calibrated to age and fitness.

    For those of us with Fitbits, some have heart rate monitors which will help if you are going for this HIIT plan.

    I like Dr. Truitt generally when I am looking for a forward thinking medical perspective; however, he doesn't specialize in cancer.

    >Z<

  • shazzakelly
    shazzakelly Member Posts: 620
    edited January 2017

    We are really busy at work at the moment and short staffed so I'm having to work a few extra hours. Today I started work at 7:30am and finished at 7pm I'm on my feet the whole time but I still managed a 45 min walk on my lunch break.

    I wondered if anyone has set fitness goals for this year. I'm still working on what I want to achieve but I know I would like to incorporate yoga into my daily routine rather than just a class a week. I'm also hoping to get more paddle boarding in and hope to join a paddlefit class in Feb. I have one more goal I'm afraid to say out loud at the moment.

    I'm going to hunt out my Fitbit so I can join the Fitbit group