I have been seeing people with lymphedema off and on since I started practice; it can crop up from nowhere for no apparent reason, or develop from cancer surgeries that remove lymph nodes. It is no joke; arms or legs swell up and have to be bandaged or otherwise drained, owing to the loss of fluid return pathways.
I’ve always felt as if something was just wrong about the typical prohibition on exercise that most patients get. If you work an extremity you lay down new drainage channels. “Don’t pick up anything heavier than 15 pounds,” the standard protocol, sounds like a life sentence of dispiriting uselessness and deflating fitness. Some of my cancer survivors agreed, wrapping their arms in Ace bandages before jumping on the elliptical trainer or picking up hiking poles, and doing damn well on it, I may say.
Now along comes the New England Journal of Medicine to say my gut is right and so was theirs. Here’s the NY Times breakdown, which also links to strength training programs and DVDs for cancer survivors with lymphedema:
Last week, The New England Journal of Medicine reported on a study of 141 breast cancer patients who had lymphedema. Half adhered to the traditional restrictions, while the other half embarked on a slow, progressive program of weight lifting. To the researchers’ surprise, the weight lifters actually had significantly fewer flare-ups than the women who restricted their activity.
One of the study participants quoted in that article is seventy-five and now a regular at her condo weight room. You rock, lady.
I don’t even like Bob Dylan (I think I’d rather listen to an aviary full of parrots than his voice) but he got that one line right: “He [who is] not busy being born is busy dying.” I wish it didn’t take doctors, who seem to think all problems are solved when they impose restrictions, so long to figure that out.