Is it possible to have lymphatic disorders and still live an active and full life? The answer - not surprisingly - is a resounding yes!! With precautions - and the blessing of their doctors - people with all kinds of lymphatic conditions at all ages report participating in exercise and active living activities such as swimming and aquatic exercises, golfing (see article on Casey Martin), skin diving, using a trampoline, bicycling and walking - to name a few. Many people find Tai Chi, yoga and deep breathing also beneficial forms of exercise.
In research on breast-cancer survivors with lymphedema who used slowly progressive weight lifting, there appeared to be no significant effect on limb swelling, reduced symptoms, and increased strength.
Some organizations such as the Lebed Method, have sprung up to facilitate movement and dance for breast cancer survivors, those with lymphedema, chronic illness and seniors. Israel's Dorit Tidhar Aqua Lymhatic Therapy and Water exercises are also popular.
Tell us about your sports, recreation and exercise experiences. Drop us a line at: firstname.lastname@example.org.
The second, below, reprinted with the kind permission of Susan Harris and
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In the fall of 1994, I had surgery and radiation for what I jokingly referred to as a "mild" case of breast cancer - Stage I. As a professor of physical therapy, I was acutely aware of the risk of lymphedema, an irreversible swelling of the surgical-side arm. In fact, my own physical therapist, who specialized in treating women with breast cancer, chastised me for raking leaves one beautiful autumn day. Repetitive upper body activities, she warned, could bring on the dreaded ailment.
I started to read all I could about lymphedema, which can be caused by lymph node removal, radiation and obesity, and realized that in the medical literature there were a number of unverified assertions. Women are warned never to carry a purse on their involved shoulder and to avoid strenuous exercise with the affected arm for the rest of their lives.
For the rest of their lives! As a long-time jogger and recreational soccer player, I was irked by the presumed need to avoid strenuous exercise.
Luckily, one of my colleagues at the University of British Columbia, Don McKenzie, MD, PhD, a professor of sports medicine and exercise physiology, set out to challenge that myth. He organized 24 of us breast cancer survivors into a dragon boat racing team.
Dragon boat racing is a competitive and recreational sport developed centuries ago in China. It involves 18-20 paddlers who propel a 40 to 60 foot wooden boat along a 500 to 650 meter course. It's a strenuous and repetitive upper body sport - just the type of exercise my physical therapist warned me against! (I took a certain mischievous pleasure in disobeying her orders, but you should check with your doctor before undertaking an exercise program).
To prepare for on-water training, Dr. McKenzie and other coaches developed a three-pronged, land-based training program, involving stretching exercises, three 20- to 30-minute aerobic workouts a week, and weightlifting, to strengthen our upper arm and back muscles. I loved the training and the weekly regimen. I also loved my team-mates - breast cancer survivors all. Soon we developed friendships that endured both on and off the water.
Our team, Abreast in a Boat, has competed in dragon boat festivals in Vancouver, Toronto, Seattle, Portland, and Wellington, New Zealand. And it has fostered the formation of 22 other breast cancer teams around the world. Not one of the original members has developed lymphedema, nor did the condition worsen for the two members who had pre-existing swelling. More significant, and quite unexpected, many of the women from the team became important role models for me.
Three months after competing in New Zealand, I was diagnosed with a second primary tumor in the opposite breast. Two of my teammates accompanied me to hear the worrisome initial diagnostic news from my surgeon - Stage IIB. When I was deciding whether to have bilateral mastectomy in June 1998, teammates who have been through the procedure bared their breasts (reconstructed and otherwise) to help me make my decision. During all 12 chemo sessions, at least one team-mate was there with me, as a role model and supporter.
Although I had to sit out my year of treatment and six months afterwards, I'm eager to train and compete again. The women from my team, their partners and kids have become family for me. They have enriched my life in unexpected ways: inviting me to join their families for Christmas when I was too immuno-compromised from chemo to fly home to my own, and serenading 150 guests at my 50th birthday party with songs they wrote about me and dragon boat racing. I am so grateful for their ongoing love and support. After all, as one of my teammates said, "We're all in the same boat!"
Lymphedema Part II
Follow-up letters to the Editor
MAMM, July/August 2000
In MAMM Letters (May 2000), two readers with lymphedema took issue with my article "Abreast in a Dragon Boat" (February 2000), suggesting that I was trivializing the threat and impact of lymphedema. Let me assure both readers that we were all terrified the moment we each lifted our first weights and paddled our first strokes!
Due to limited space for that article (700 words), I was unable to mention that there were several women from our original team who had pre-existing lymphedema. Nonetheless, they were willing to help us "challenge the myth" that strenuous exercise would cause or worsen existing lymphedema. They have both felt so much better since beginning the paddling training four years ago that they have tossed out their compression sleeves and their physical therapists!
A physician colleague, Maria Hugi, MD, (who has arm lymphedema that is 10 cm greater than her unaffected arm) and I have recently written the Canadian Clinical Practice Guidelines for Management of Breast Cancer-Related Lymphedema. (Note to readers: this article can be viewed at: www.cma.ca/cmaj/vol-164/issue-2/0191.htm#app2) We have evaluated all the peer-reviewed literature on lymphedema and its causes. There is absolutely no scientific evidence to support the longstanding medical myths that raking leaves, carrying a heavy purse, shoveling snow, or lifting weights will cause lymphedema in women at risk or worsen the condition for those who already have it. In fact, research by Donald McKenzie, MD, PhD, and me at the University of British Columbia is suggesting just the opposite sport - that exercise is certainly not harmful and is most likely beneficial for women with lymphedema.
The publication of my arm circumference/lymphedema research that was conducted on the original "Abreast in a Boat" team will appear later this year in the Journal of Surgical Oncology. It is only through controlled research that such pervasive myths can finally be laid to rest and women with breast cancer and/or lymphedema can get back to enjoying their lives.
Susan R. Harris, PhD
School of Rehabilitation Science
University of British Columbia
Challenging the Myth of Exercise-Induced Lymphedema Following Breast Cancer: A series of case reports, was published in June 2000 in the Journal of Surgical Oncology.
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