At the OCB Figure Competition

At the OCB Figure Competition
Leslie celebrates completion of her first competition!

Leslie's Story in Brief...

46-year-old breast cancer survivor

diagnosed in March 2009

final surgery on June 4, 2010

Professor of Health and Exercise Science at Rowan University

Pastor's wife (of Stuart Spencer, Thompson Memorial Presbyterian Church in New Hope, PA)

Mother of Sam (age 12) and Miles (age 7)

Trained all through chemotherapy and radiation

Completed her first body building competition EVER on August 28, 2010!!

Monday, May 31, 2010

How I manage to weight train with lymphedema

Through the late 1990s, women who had breast cancer surgery (especially lymph node removal) were told to not lift anything over 15 pounds…. ever. Lymph nodes in the armpit area are removed and tested to see if the cancer has spread beyond the breast. It’s an essential biopsy to have, but one with lifelong implications. Lymph nodes are necessary to keep the body’s lymphatic fluid circulating. When lymph nodes are removed, it can make the circulation of this fluid more difficult. Women can experience lymphedema, which is a swelling of the arm with lymph fluid. Lymphedema is a chronic condition; you may be able to prevent it from getting worse if you are careful, but it is not likely to go away. Several things can trigger lymphedema, including lifting something heavy (without taking precautions ahead of time), excessive heat (from, say, sitting in a hot tub or sauna), and the cabin pressure change in an airplane.


I had approximately 12 lymph nodes removed from both armpit areas, since I had cancer in both breasts. About four months after my surgery, I was doing some moderate resistance training with exercise bands, when my right arm began to swell suddenly. I knew about lymphedema and recognized what was happening to me. Still, I felt slightly panicked and dismayed. I had been gradually building up my level of resistance training and hoped that I was fit enough to avoid this chronic problem. (Being fit is not insurance against lymphedema, though.) I quickly raised my arm in the air and began massaging it, and the swelling started to decrease, although it has never gone away entirely.

I had been receiving physical therapy to increase the range of motion in my right arm and was working with two terrific therapists, Linda and Melissa of Hamilton Physical Therapy Services (HPTS) in Hamilton, NJ. Both are cancer survivors themselves and trained to work with women who have had breast cancer surgery. In addition to the therapy they gave me in their office, they helped me do two very important things.

First, I was fitted for and ordered a pair of lymphedema sleeves. I wear these stretchy lycra-blend sleeves, which cover me from my hands to my shoulders, every single time I exercise. This includes any type of exercise, whether I am “working” my arms or not. I wear the sleeves when I run, use the elliptical trainer, work my core muscles, or even go for a brisk walk. If my heart rate is elevated, the sleeves are on. If I forget to put on the sleeves (which never happens anymore) and I begin to exercise, I will feel my right arm start to swell. My health insurance paid for these $196 sleeves and will cover a new pair every six months, which is the standard replacement time. I also wear the sleeves when I fly in an airplane.

Second, they taught me how to do Manual Lymphatic Drain (MLD) massage on myself. It takes about 2 minutes to go through the whole technique, is relaxing and feels good. I am also convinced that by doing it daily for 5 months, I was able to reduce the swelling in my right arm further. I will confess that I no longer do the complete technique due to the time it takes, but I do a modified version of it throughout the day. I’ll do it in the car (holding the steering wheel with my right hand and gently massaging the arm with my left hand – not dangerous, I promise!) and throughout the day when I have a few moments where I am not active. My colleagues and students have become used to having me do it in meetings. I even do it in my Sunday School class at church when I’m not teaching.

This was an area where, in a healthy way, I felt the challenge to buck tradition and not accept the limitation of never lifting anything heavy again. Having lymphedema is another challenge to overcome, and I feel stronger for being able to weight train and bodybuild despite the condition. I was also very encouraged to come across the work of Dr. Kathryn Schmitz, an epidemiologist and exercise physiologist at the University of Pennsylvania.  Dr. Schmitz has studied the effects of weight training and lymphedema among breast cancer survivors, with some very encouraging results.  Here's a link to a great NYTimes article about her work:

http://www.cceb.upenn.edu/news/swelling.pdf

So, to summarize, I train six days a week and have gradually worked my way up to using a heavy amount of resistance.  That I did it gradually is key; increasing the resistance too quickly would have exacerbated my lymphedema.  I wear my sleeves EVERY time I exercise and I keep them on through the stretch and cool down.  I follow this with MLD massage on my arm.  This system has been working very well for me.

Thursday, May 27, 2010

Why and when did I decide to enter a body building contest?

Prior to my cancer diagnosis, I had been feeling the some of the burden of middle age.  It felt like my life was built on all of my RESPONSIBILITIES.  I was a wife, mother, home-maker, professional, and the spouse of a pastor. These are all wonderful things, but they all involve commitment and effort.  They also felt pretty predictable.  I was ready to have a new challenge; something personal, youthful and that would take people by surprise a bit. While I was very fit and healthy, most people would not have expected me to pose on stage in a glitter bikini and four-inch heels. It felt fun to take a risk and do something unpredictable.

At the start, I was pretty sure that I had the build and self-discipline to train for a body building competition.  Working out with Domenick and John every Monday and Wednesday was also very motivating.  I mentioned the idea to them one day and they were both immediate and sincere in telling me that they thought I had the potential to do it if I wanted to.

In early March (just before my cancer diagnosis), I was still debating whether or not to set this goal for myself.  After receiving my diagnosis, something changed for me and I knew I wanted to train and compete as a body builder.  Why?

First, it was something positive to look forward to and work toward during my cancer treatment.  Over 13 months, I had 4 surgeries (the last one will happen next week, June 4, 2010), 18 weeks of chemotherapy and 6 weeks of radiation.  It is a test of endurance, like running a marathon.  Often when I was feeling tired and sick, I would read about body building and imagine how great it would feel to walk across a stage in a beautiful, healthy, fit body.  My good friend and former student, Jason Kilderry, is a triathlete with an amazing story of his own.  After losing both kidneys and receiving a kidney transplant, Jason is preparing to hike the Appalachian Trail.  He was an inspiration to me as I faced my trial.  He says that thinking about and planning for his Trail hike kept him going through his low points during dialysis and surgery.  I understand that exactly, now.

Second, it is a symbol of my victory over cancer.  I've noticed that cancer has a way of aging people, both mentally and physically.  They can become less active, enjoy fewer things in life and seem to age more quickly.  A year of cancer treatment can appear to make a person seem five years older, from what I have observed.  I took it on as a personal challenge to not let this happen to me.  I was determined to remain active, to workout on a daily basis, eat very healthful foods,  take care of myself and enjoy my life through cancer treatment and beyond.  The idea of emerging from over a year of cancer treatment and entering a body building competition   was the perfect challenge for me.

What was it like to find out I had breast cancer?

In January 2009, I had my yearly mammogram as usual.  I had never had any problems before or needed a repeat mammogram.  Wait... when I was 28 years old, I felt a small lump in my left breast and had it removed.  It was benign.  Otherwise, there had been no problems with my breasts.

About 3 weeks after my mammogram, I was called in to have additional mammography done on my left breast due to some tiny calcifications that showed up on the first films.  I wasn't worried.  This happens to a lot of women.

But after the second set of films were taken, I got a phone call from my gynecologist that caught more of my attention.  He did not sound worried, but he was emphatic that I needed to have a biopsy in my left breast AS SOON AS POSSIBLE.  Wow.  Still, there was no history of breast cancer in my family and I was (and still am, in my opinion) a very healthy person.

The biopsy of my left breast was an odd experience.  I've had biopsies and minor surgeries before, where I was given a sedative, made numb in the area, and had the necessary tissue removed.  This was different.  I had to lay face down on a table that had a hole in it for my left breast to hang through.  (I wasn't that big, so it didn't hang down very far!)  My breast was then squeezed between two mammography plates and x-rayed so the surgeon could identify the spots where tissue needed to be removed.  He was under the table and inserted a device into my numb breast to extract the tissue sample.  I remember that it made a loud popping noise (like an air gun) when he inserted it into my breast.  It was quick and relatively pain-free, but unnerving.

I remember the moment I found out I had cancer.  I was sitting in my office (at Rowan University in NJ).  It was 4:50 and I was just about to walk down the hall to the fitness lab in my department, where I would meet with two students who were training me as part of their Practicum project.  Domenick Salvatore and John Stevenson were great students and trainers, and we were having a lot of fun every Monday and Wednesday at 5pm, despite the fact that I was working out really hard!  I noticed the message light on my phone; my surgeon had called, requesting that I call him back.  I reached his assistant, who told me that he had gone for the day and would be unavailable the following day.  I was going to have to wait until Friday to find out the results.  She thought for a moment and said "You seem like the kind of person who would want to know right away, so I'll tell you.  You have breast cancer."  Well, she was right.  I am the kind of person who wanted to know right away and I thanked her for telling me.  The conversation was over in 10 minutes.

It was 5pm; time for my workout.  For about 30 seconds, I wondered what I should do.  Should I call my husband?:  My mother?  I decided that what I really needed to do was to work out hard, and that I would rather tell my husband in person and let my mother get a good night's sleep before I told her the news that was sure to cause her a lot of pain.  So I went to my workout with Domenick and John.  Although I was distracted mentally, I just wanted to tune out and push my body as hard as I could, which is what I did.