Athlete's Guide to maintaining fitness during chemotherapy

Back in 2011, I wrote this post: Tips for Staying Fit and Healthy While Undergoing Chemothreapy.  I can say with 100% certainty that not only was I able to maintain health and fitness during chemo in 2011, but I was able to build and regain a very high level of fitness post-treatment.  Women often speak of their new "normal" after undergoing breast cancer treatment.  My new "normal" was healthier, fitter, and stronger.

May 2013 (Photo: Anna Pocaro Photography)

That was until my axillary recurrence this May and four more rounds of chemo followed by radiation.  Between chemo, radiation, and surgeries, I have spent 1.5 of the past 3 years undergoing active cancer treatment!  Based on my unwanted, however increased experience with maintaining health and fitness while undergoing chemo, I am expanding my list of tips.

11 Tips to Staying Fit and Healthy During Chemo:

Tip #1:  Move!  While it is easy to justify laying on the couch when you feel crappy, there is a time when you just need to get up and start moving.  Start with a walk and stretching and build from there. I absolutely guarantee it will make you feel better.

Getting out and moving with my pal, Dizzy

Tip #2:  Take your anti-nausea medications.  I'm not a big fan of filling my body with potentially unnecessary medications, however it is hard to stay active if you are hovering over the toilet, and once the nausea sets in, it is difficult to overcome.  Stay ahead of the nausea and take those darn anti-nausea meds....at least for the first few days after treatment.

Tip #3: Nutrition.  Indulging in a sugary treat feels good for about 30 seconds.  Eating a well balanced meal helps you feel good all day.  Cooking healthy can be time consuming, however with experience and planning it becomes quite manageable, and certainly worth the effort.  I plan a dinner menu for a week at a time and build a shopping list.  While creating the weekly menu does take time, I save time at the store being more efficient and don't waste precious time by avoiding last minute trips for missing ingredients.   When planning my menu, I schedule meals that require more prep for less busy evenings and make enough for leftovers to last 2 or 3 more meals.  The rest of the nights of the week, healthy meals are prepared in less than twenty minutes.  

Tip #4: Don't be afraid to exercise routinely.  Research shows that women who exercise during chemotherapy experience less side effects from treatment.  If nothing else, let that be your motivation.  Chemo side effects suck!

Tip #5: Combine cardio, weights, and stretching.  My chemo exercise regimen included cardio at least 5 days/week to increase circulation, flush toxins out of my body, and help maintain my cardiovascular fitness.  According to one of the exercise physiologists at Huntsman, cycling is one of the very best activities for increasing circulation.  Convenient for me!  The duration and intensity of cardio should be dependent on fitness level prior to starting treatment and remember that even when you are moving slowly you are still moving faster than if you were on the couch!

I also included a weight/core workout 2-3 times/week.  This is especially important for women undergoing chemo and even more important for young women.  Chemo causes hormonal changes simulating menopause which puts us at significantly increased risk for osteoporosis and bone fractures.  A solid whole-body weight program can help maintain bone integrity.  Additionally, maintaining muscle mass helps burn fat more efficiently.  No fancy gym membership is needed.  All of my exercises were done with 8 or 10 lb. hand weights, a 10 lb. kettle bell, therapy ball, and a weighted vest.  My favorite exercises were a variety of squats, lunges, jumps, and kettle bell swings-I prefer whole body moves as opposed to focusing on single muscle groups as they are more efficient when time crunched.

Squeezing a weight workout in the comfort and convenience of my home

My core program focused on both abs and back extensors.  Additionally, side planks were done every single session.  Maintaining shoulder stability and mobility is especially important for women who have undergone breast surgery and radiation.

I also incorporated a short stretching session every single day with an emphasis on shoulder mobility and tight cycling muscles.   

Tip #6:  Plan ahead for workouts and keep a training log.  Fitting workouts in may seem overwhelming, however it too is manageable with some planning.  Although I love riding my mountain bike in the mountains, somedays in order to squeeze a ride in, I would resort to riding the foothills near my home.  Additionally, when possible, I would ride my bike to doctor appointments and always to chemo.  Not only was I squeezing a workout it, but I was arriving to the hospital relaxed and with a smile on my face!   Weight workouts and stretching can easily be done at home.  A solid weight workout can be done while dinner is cooking and stretching has become part of my nighttime wind-down routine.

You can see my 2013 chemo exercise log here.

Tip #7:  Make a list to help with time management.  I found that while undergoing chemo I became more easily distracted and if I didn't have a plan in place for the day I could burn hours doing......nothing.  A simple list of daily tasks helped me stay focused, relaxed, and productive.  Ha!  This is even helpful when not undergoing chemo! On my daily list I may write specific workouts to accomplish, errands I need to run, and food I want to prep.  

Tip #8:  Make exercise fun.  Do something you enjoy with people you enjoy.  Many of my rides turned into social events.  Talk about multi-tasking; I was able to socialize with friends while doing something I love AND exercising.

Riding with one of my favorite buddies

Tip #9:  Pay attention to how your body feels, but understand what it is telling you.  For example, while undergoing chemo I learned that even after a restful night my body often felt sluggish in the morning.  If I didn't know better, I would probably think that I needed more rest, but most of the time a morning workout helped improve my energy throughout the day.  Make sure to get plenty of rest, but don't be afraid to push yourself.

Tip #10:  Protect yourself from illness/infections.  Frequent hand washing is imperative to reduce risk of contracting colds and flu.  While It may seem impulsive to wash your hands multiple times daily, I did this and was fortunate to not experience a single cold while undergoing chemo even though I work in public schools and did not get Neulasta to support my immune system.   Additionally, mountain biking is an inherently dirty sport.  While mountain biking, scratches from tree branches, scrub brush, and tall grass are imminent.  To protect my skin and decrease my risk of infection, I wore long socks and arm coolers.   Despite my precautions I still sustained a fair share of small skin abrasions.  I would shower right after my rides, use tea tree oils on cuts, and fortunately I did not experience any infections.

Mountain biking in CEP arm coolers and tall socks to help protect skin from abrasions

Tip #11:  Finally, allow yourself to feel empowered by taking care of your body.  Know that while maintaining fitness and healthy nutrition you are doing your best to protect your body from cancer and help it to tolerate treatment better.  

October 2013

Other tips:

1-Coconut oil:  Chemo makes skin dry, scaly, and delicate.  In my opinion, coconut oil is the best all natural skin moisturizer!  I used it all over my body especially on my hands, feet, and hairless head! 

2- Mouth care: Chemo can cause mouth sores and tooth sensitivity.  A soft toothbrush and sensitive tooth toothpaste made a big difference.  Additionally, brushing my teeth after every single meal helped reduce mouth sores and the metallic taste that chemo causes.

Tom's Sensitive:  My favorite chemo toothpaste

3- Buff head band:  I tried trendy scarfs, but found that my Buff headband looked just as chic, was simpler to put on, and cooler when temperatures were warm.

4-Don't force yourself to eat your favorite foods or foods that are essential to a healthy diet (like kale) on your bad chemo days.  A strong aversion to these foods, referred to as the "scapegoat effect", may develop.  On these bad days, when nothing tastes good, eat foods you are willing to part with.  I was able to break my addiction to cereal by eating it on my bad days!

6-CEP compression:  I remember from 2011 the heavy feeling in my legs every morning.  Athletes call this lactic acid buildup.  Wearing compression sleeves on my legs during the day helps them to feel so much better.  This morning lactic acid buildup lasted a full year after I finished treatment in 2011 and it has returned since finishing my second round of chemo in September.

Radiation update:  Four weeks down, Two to go!!!!!!  Radiation post to come soon!