Friday, November 25, 2022

Breast Cancer Fight: Exercise After Mastectomy and Breast Reconstruction {First 4 Weeks}

Recovery after a surgery does not mean staying in bed all day. Actually, physical activity is just as important as rest to aid in recovery and can ease treatment-related side effects {e.g. fatigue, pain, depression, lymphedema} and reduce the risk of breast cancer recurrence, as well as the risk of developing breast cancer in the first place.

This is supported by my doctors. 

In fact, the day after my mastectomy and breast reconstruction surgeries, they called in the hospital physiotherapist to come teach me some specific exercises to keep the range of motion in my shoulder and arm, relieve stiffness and pain, and reduce swelling.

As someone who is used to exercising almost daily, it is very important to me that I restarted my fitness activities as soon as possible, if not for my health, but for my sanity as well. Even if it was for something as simple as walking, which I started doing 2hrs after my surgeries.

The important thing is to ease back into exercise gradually to avoid overloading the system, and of course follow your doctors' orders. Best if you have a trusted trainer/ exercise specialist to advise and guide you as well. 

Dr Jane's general instructions are that I can do simple upper body exercises and stretches except for anything that stretches the chest, and not lift anything more than 2kg for at least 4 weeks. After 8 weeks when my wounds have completely healed, I can start doing heavier weights. If not, the wounds may open and the implant may shift. 

Below are some of the physical activities I did for the first 4 weeks post-surgery. Mostly, I avoided vigorous exercises and heavy lifting so that my wounds have a chance to heal nicely. 

Also including a bit more background reference about me below to manage expectations if you haven't been following my blog, as what I did may/ will not be the same for anyone else due to different circumstances:

 At the time of my surgery {see part 1 and part 2}, I was 38 years old. I have been active since young and pre-surgery, I used to exercise by weight-lifting, cycling, climbing stairs, hiking or walking about 6x a week. My overall health and fitness levels is pretty ok. 

I also have an experienced personal trainer, Superman, whom I've been training with the past 7-8 years and has helped me through various injuries {mainly bad knees and chronic back pain} and health issues. He understands my limitations and helps guide and monitor my physical activities and diet. 

Week 1
I started with assisted walking 2hrs after my surgery, mainly because I wanted to pee naturally in the toilet instead of using a bed pan.

The day after my surgeries, a physiotherapist came to teach me how to do some simple exercises which can be performed from the first day after surgery. These included neck-stretching, shoulder rolls, shoulder pinch, forward arm wall walk and side arm wall walk. He recommended doing 10 reps, 3-5 sets a day.

I was quite surprised that I was allowed to raise my left arm overhead so early as I had read that I could only raise it to shoulder level for the first few weeks post-surgery. However, the physiotherapist assured me that the doctors allowed it as it was they who asked him to come and I checked with Dr Jane again that day and she said it was ok. 

Other than the really gentle upper body stretches and mobility exercises, I tried to walk around 1-2k steps a day, using my FitBit to monitor.  In the beginning while I was still at the hospital, I'd walk around the ward twice a day after breakfast and dinner. Then when I returned home, I'd walk around the apartment or downstairs at the void deck in the evening when there was less people and the weather was cooler.

Week 2
I continued with my walking into week 2 and slowly increased the steps. I had no issue with slow walks and my first appointment back to the hospital was that week with Dr Jane on Wed 2 Nov anyway. 

No vigourous cardio, even though I felt up for it, because of the suture healing and also because I still had my wound dressings and drainage tube in, so did not want to perspire that much as I couldn't bathe properly yet. 

I started doing simple bodyweight exercises to maintain my muscle mass and strength somewhat and prevent muscle atrophy. Easy bodyweight squats with tempo, bicep curls, lats side raises and shoulder raises for 10 reps, 4-5 sets each.  

Constant easy stretching for the upper body whenever I can to keep my mobility. 

Week 3
I walked more to go for my hospital visits and also did grocery shopping. 

That week, I also went to the club gym {with my drainage tube!} one early morning with no crowd to do my bodyweight knee rehab exercises, weighted leg press {110lb, 12 reps, 5 sets} and seated hamstring curl {50lb, 12 reps, 5 sets} and light upper body exercises {1kg, 5 reps, 12 sets}.

Dr Mikael and Dr Jane said I was fine to cycle if I wanted to, so after my wound dressings and drainage tube were completely removed on Wed 16 Nov, I went for an easy 27km cycle during the weekend. 

For cardio, I also stair-climbed for 20 mins at the end of the week. 

Week 4
I progressed and did a session with Superman at his home gym. No upper body exercises, just a simple lower body program to ease me back into gym workouts and work on my squats, hip thrusts, tibia, hamstrings, and calves. 

As I would be starting on my chemotherapy treatment, we had no idea how my body would react and how the side effects would affect me, so these are the basic lower body exercises that I can easily do to maintain my fitness somewhat for now. Superman would help to plan the programming.  

My aim for the next year is not to get stronger or to lose fat as before. The main focus would be to maintain a base level of fitness and stay healthy enough to undergo the grueling adjuvant chemotherapy and Herceptin jabs treatment, and not start from ground zero from when I do want to restart my strength training again. 


Follow my breast cancer fight on the blog, Facebook or Instagram {#AiFightsCancer}

Before mastectomy and breast reconstruction surgeries

After mastectomy and breast reconstruction surgeries
Surgical Drains Removal After Mastectomy and Breast Reconstruction 

Adjuvant Chemotherapy and Herceptin Injections

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