Monday, November 20, 2006

Yoga For Breast Cancer Survivors (again)

I admit I have been kind of remiss lately about getting this class up and running again. But it isn't for lack of good intentions. It's just that because all of my students continue to press on with their careers despite their treatments and surgeries (go girls!), we have to meet at night, and since my own October 11 surgery, I have been exhausted at night. I fall asleep reading or watching television most nights, unable to accept that I simply need to get to bed earlier with all of the recovering my body is doing.

But, I am six weeks post-surgery now, and I feel good. The energy is coming back. And an email I received from a breast cancer survivor in Washington, D.C., which told of a physical therapist's admonishment NOT to practice any sort of yoga that involves bearing weight on the hands lest she develop lymphedema (and this breast cancer survivor happens to be an Ashtangi who truly looked forward to getting back into yoga upon recovery from surgery, which did include the removal of lymph nodes, which is what puts one at risk for lymphedema), jolted me back into the realization that there is an urgent need for a yoga class that supports the physical and spiritual fitness of breast cancer survivors.

In the words of John Locke, the Lost character, not the philospher, "Don't tell me what I cannot do."

Moreover, yoga is probably the PERFECT physical exercise for avoiding lymphedema! It improves circulation, and good circulation is of the utmost importance in avoiding lymphedema (which is a serious, disfiguring and ultimately chronic localized swelling caused by the failure of lymph fluid to circulate properly, due to a lack of lymph nodes in the area). The number one and primary cause of lymphedema has nothing whatsoever to do with bearing weight on the at-risk area. The number one and primary cause of lymphedema in breast cancer survivors is infection in the arm from which lymph nodes were removed. An infection is a battle cry to the immune system, which then calls for action by the lymph nodes. When lymph nodes have been removed, the lymph fluid may not flow properly. Picture a highway filled with cars. Now picture a large, many-laned toll station. Now picture the same toll station with most of the lanes closed. What happens to the traffic? It backs up, swelling the highway with cars and exhaust and no one is happy. This is what happens in lymphedema.

Pop quiz: What is the number one cause of infection in the at-risk arm?

Pop-answer: Manicures. Seriously. I got this info from my breast surgeon and her physician's assistant, who together have, I don't know, like more than 40 years of anectodotal experience with this. Infections from manicures are rampant. So those at risk for lymphedema must avoid, not the yoga, but the manicures. Or if you must get manicures (I prefer simple polish changes now), make sure the manicurist uses your own tools and does not do anything funny to your cuticles.

Thus spaketh Yoga Chickie (via her breast surgeon).

But going back to the traffic analogy, it stands to reason that another major cause of lymphedema is repetitive pressure - such as, and most commonly, in the form of a blood pressure cuff being placed on the at-risk arm and being kept there for several hours during surgery. (Using the traffic analogy, think about what happens when there is construction on a four lane highway, and suddenly four lanes are merged into two...or even one...disastrous!)

This is why whenever I have surgery, I write all over my at-risk arm with a Sharpee Pen: "NO NEEDLES!" "NO CUFFS!" and simply, "NO!!!!!" My most recent anesthesiologist was a bit peeved by this. "I would have read your chart and seen that you can't have needles or blood pressure taken on your right arm," he pouted. "It's not you I'm worried about. It's anyone who hasn't read my chart," I explained, trying to make nice (he was my anesthesiologist, after all, and I didn't want any sort of problem with the man who was in charge of eliminating my pain), "or anyone who gets their right and their left confused."

Anyway, it's my body. I'll Sharpee it if I want to. Na na nana na.

But this actually DOES pertain to yoga, at least in the types of yoga that rely on props (not naming names here, Om cough Yoga cough cough, Iyen cough cough gar cough cough cough...). One who is at risk for lymphedema in her arm must NEVER secure a belt around said arm or the fingers of said arm, particularly in order to pull herself into Gomukhasana.

But bearing weight on the arms? Where is the lymph blockage in that? And this isn't just my sense of logic and reason speaking. I went over this carefully with my breast surgeon and her physician's assistant. While I am not a doctor, and I cannot possibly give out medical advice (you should talk to your doctor for that, mmmmkay?), I am going to take a stand here that there is nothing harmful to those at risk for lymphedema about yoga, so long as it is practiced mindfully and under the tutelage of a trained and experienced teacher.

Hmmmm....but I have digressed into a full-on soap-boxy speech here, when all I really wanted to say was....

I have decided that it is high time to kick Pink Lotus Yoga back into gear. I emailed my students and even put an ad up on Craig's List to see if there's anyone else out there who might be interested (and it turns out, there are). But I figured that perhaps there might be breast cancer survivors who have only recently started reading this blog who don't check on Craig's List and who don't know about Pink Lotus Yoga (since I haven't taught it since September).

Anyone who is interested, please email me. I think my email address is in my profile. If not, try lscnyc425 at the email service that is "hot".


1 comment:

Anonymous said...

Hi there. Just a quick note on your yoga and lymphedema post. You are right in so many ways. I would however stand by the general idea of care in weight bearing and exercise in the at-risk limb. Every individual case of lymphedema is unique. Therefore weight bearing may not trouble one individual and yet can bring onset of lymphedema in another. Given this, my professional recommendation as a Lymphedema Therapist would be to excerise with a compression garment on the at-risk arm. It is the most conservative approach to this concept. All the best, Connie C, PT,CLT

Copyright 2005-2007 Lauren Cahn, all rights reserved. Photos appearing on this blog may be subject to third party copyright ownership. You are free to link to this blog and portions hereof, but the use of any direct content requires the prior written consent of the author.

About Me

My photo
Northern Westchester, New York, United States
I live by a duck pond. I used to live by the East River. I don't work. I used to work a lot. Now, not so much. I used to teach a lot of yoga. Now not so much. I still practice a lot of yoga though. A LOT. I love my kids, being outdoors, taking photos, reading magazines, writing and stirring the pot. Enjoy responsibly.


Ashtanga Blogs

Thanks for reading Yoga Chickie!