Stretch toward Recovery Program helps cancer survivors
After having a mastectomy due to breast cancer in 2000, Cheryl Schaefer of Center Township was anxious to return home.
Having anticipated some weakness and limitations in the use of her arm, she prepared several meals ahead of time.
Still, there were tasks she hadn't considered.
"Ihad an awful time lifting things. I couldn't lift the coffee pot to pour myself a cup of coffee," said Schaefer.
To accommodate her limitations, Schaefer's family moved items from high shelves down to countertops, downsized from their normal gallon milk jugs and purchased lightweight Corelle dishes.
With a pamphlet of exercises and some instruction from her doctor, Schaefer worked day by day to regain full use of her arm.
"In the back of your head, you keep thinking, 'I wonder if I'm gonna rip these stitches out,'" she said.
When pilates instructor Lisa Snyder met Schaefer in October at the Hot Pink art show at The Art Center, she was unable to share in Schaeffer's experience with breast cancer, but she offered some insight about recovery.
Snyder is certified in the Pink Ribbon Program, Post-Operative Workout Enhancing Recovery, a series of pilates-related exercises aimed at helping those who have had breast cancer surgery.
Many of the exercises target areas affected by mastectomies, lumpectomies and lymph node removal.
To become certified, Snyder also learned about the anatomy of the breast and side effects of surgery including lymphedema, a condition in which swelling occurs due to a buildup of protein fluid.
Dr. Victor Vogel, a surgical oncologist with Magee-Womens Hospital, said many patients like Schaefer are hesitant to use their arms and shoulders after surgery. Still he said, the sooner a patient begins to use his or her arm, the faster and easier it is to recover.
Snyder said the gentle, stretching motions of pilates exercises are well suited to physical therapy needs.
"It is geared toward really lengthening a muscle, and it strengthens it at the same time," she said.
Originally called contrology, the method of exercise named for creator Joseph Pilates was developed as a way to rehabilitate patients in an internment camp in England during World War II.
When the trainer later came to New York City, his methods for stretching and strengthening muscles became popular with dancers in a nearby studio.
For clients in the Pink Ribbon Program, exercises begin small, done on a mat, with no equipment and using a small range of motion.
Exercises detailed in the program manual include walking the wall, in which a client "walks" his or her fingers up a wall to improve an arm's reach, and shoulder slides, in which arms are outstretched and the shoulder blades are drawn together and then stretched apart as the arms reach forward.While the majority of the methods focus on the arm and shoulder, others concentrate on the back and abdomen muscles, which Snyder said is an essential part of a well-rounded workout.As students progress, Snyder said they may choose to begin more advanced pilates exercises using resistance equipment.After trying several of the exercises instructed by Snyder, breast cancer survivor Mary Lou Kephart was reminded of the need to exercise daily to maintain her range of motion.Kephart had mastectomy and lymph node removal surgeries in 2002 and a breast reconstruction surgery, known as TRAM Flap in 2004.Though doctors informed her of some exercises to help her recover just after her first surgeries, Kephart said much of the advice was lost when she returned home."By that time, you don't even remember what they told you to do,"she said.In addition to reduced strength and range of motion in her arm, Kephart's need for rehabilitation was exacerbated by the TRAM Flap procedure, in which a section of abdominal muscle, known as the transverse rectus abdominis muscle, is cut and pulled up through the body to form a breast.Though her plastic surgeon prescribed physical therapy to aid in recovery, Kephart said she felt that consistent exercise was not stressed enough."I actually talked to my plastic surgeon and said they as physicians need to follow up," she saidAfter Schaefer's surgery, however, her doctor asked her to demonstrate the exercises provided to determine her progress.Eight years after her surgery, she now uses the exercises from time to time when she senses a change in her arm."Periodically, I notice the numbness and tingling more than I was having," said Schaefer, who also suffers from lymphedema.While Vogel feels that many of the exercises needed to regain and retain full use of the arm and shoulder can be done at home, he advises patients looking for advanced strengthening workouts to seek the assistance of an instructor or personal trainer to avoid the harm caused by misuse of gym equipment.In her studio, Snyder works with one or two clients at a time, providing encouragement, monitoring progress and ensuring proper form."What is good about a studio is it's not a gym, it's very private," she said.Schaefer pointed out that meeting regularly with someone can also be comforting after treatment."When you finish treatment, a lot of the time you're very lost, because you were used to going in to see those nurses and techs," she said. "You really miss them."Schaefer, Kephart and other members of the Butler Breast Cancer Support Group will learn more about the Pink Ribbon Program in April, when a visit is planned to Snyder's studio. For information about the program, contact Snyder at 724-431-0292 or visit www.pinkribbonprogram.com.The Butler Breast Cancer Support Group meets from 7 to 9 p.m. the first Tuesday of each month on the fourth floor of the Morgan II Center, at the intersection of Routes 38 and 68 in Butler Township.
