Building Strength and Resilience after Breast Cancer, Cindy’s Story
To say Cindy Olive is one of the strongest and kindest women I know would be an understatement. This 60-year-old oncology nurse, who has also fought and won her own battle against breast cancer, is a model of humility as well as fierce determination. I had the pleasure to work with Cindy in the Regions Hospital Cancer Center up until I left to start my private practice in September of 2021. I have personally seen the compassion and empathy she shows patients who are walking down the path of cancer diagnosis and treatment. She was kind enough to be one of my first personal training and nutrition clients.
Over the past 6 months, as we have watched her progress by leaps and bounds, we knew we needed to tell her story. She has been kind enough to allow me to share her personal story in the case it can help others.
First, a little History….
Cindy has struggled with back issues for a “long time”. In the mid-1990’s, she initially injured her back while attempting to keep a patient from falling during a routine bed transfer. She was off work for 6 weeks at that time. Since then, she has had chronic, recurring lower back and hip pain. Physical therapy has been very helpful, but she admits, she doesn’t keep up with the prescribed exercises.
Being active is very important to Cindy so throughout the years, she has enjoyed attending group fitness classes at various gyms. In 2016, while working out, she reinjured her back causing her to lose feeling in her left leg as well as have a “drop foot”. Drop foot or foot drop is when you have difficulty lifting the front part of your foot sometimes causing you to drag your foot when you walk. Cindy saw a neurosurgeon who gave her a nerve root injection and recommended physical therapy to treat this problem. She says it took 6 months of PT before the issue resolved.
In July of 2018, Cindy was hit another blow when she was diagnosed with ER+, PR+, invasive lobular carcinoma of the breast. She chose to have a partial mastectomy followed by 4 weeks of 5 days per week radiation therapy. Soon after completing radiation therapy, she began taking a daily medication called Arimidex which she will take for a total of 5 years every day. Arimidex is a medication which blocks estrogen and can decrease the risk of future recurrence of breast cancer and other cancers in post-menopausal women with estrogen receptor positive breast cancers. Unfortunately, this medication can cause side effects including:
Joint pain Hot flashes
·
Osteoporosis
· Back pain
· Insomnia
· Weakness
· Depression
· Arthritis
· Swelling of the hands and feet
Cindy reports suffering from most of these symptoms as well as weight gain. She says it was difficult to tell if her aches and pains came from her back or from the Arimidex. Over the past 1 ½ years, she has woken up every night between 2-4 am with severe pain in her hips, especially in her left hip, and couldn’t go back to sleep without taking pain relievers, muscle relaxants and/or sleep aides.
In 2019, she joined another gym and started group fitness classes only to reinjure her back and once again struggle from drop foot. She went back to the neurologist who completed another MRI in December of 2020. It showed Cindy had multi-level degenerative changes in her lumbar (lower) spine as well as L5-S1 (L=lumbar and S=sacral) disc protrusion producing a moderate to severe left side stenosis with possible nerve impingement of her left S1 nerve root. Now, that’s a mouthful.
During this same period, the world was in the thick of the rollercoaster called Covid. In Cindy’s words, “when Covid hit, I became a ‘lazy bones’. I gained weight and became depressed.”
Fast Forward to January 17, 2022: Initial Assessment
Prior to her physical assessment, we discussed Cindy’s medical history, medications, supplements, sleep, stress, current exercise regimen and history, weight history, diet/intake, and her overall lifestyle goals. See chart below:
Physical Assessment:
The first workout was used to watch how Cindy went through various exercises to determine her range of motion as well as potential overactive and underactive muscles. This first assessment is important for developing her future exercise program with the goal to correct these deficiencies. The exercises Cindy completed at this first assessment included:
1. Overhead Squat
2. Quadruped Hold with Opposite Reach
3. Seated row
4. Wall pushups
5. Shoulder press
6. Side Steps
7. Glute Bridge
8. Step Ups
Some of the things I noticed as she went through these exercises were:
1. Cindy’s knees would fall inward, project over her toes and her heels would rise during her squat.
2. Cindy’s left side was significantly weaker than the right side, so she tended to compensate for this by allowing the right leg to do more of the work.
3. While performing exercises over her head, her arms fell forward, neck would lean forward and her shoulders would rise.
Without diving too deep into anatomy and simplifying some muscle names, Cindy’s assessment told me:
A. She is likely weak in the following areas:
a. Gluteus maximus and medius
b. Hamstrings
c. Core
d. Lower and middle trapezius
B. She is likely overactive in the following muscles:
a. Calves
b. Quadriceps
c. Tensor Fasciae Latae
d. Adductors
e. Pectorals
f. Shoulders
g. Neck Muscles
For more information on Corrective Exercise, check out Rachels recent blog here.
The Program
Exercise
Cindy admitted she was unlikely to do the workouts on her own and felt she needed to physically meet in person to complete them. She committed to training 3 days per week. Considering her assessment as well as her history, our main goal was increasing her balance and stability without causing any further injury. Our workouts always include a warmup, foam rolling of overactive muscles, activation exercises, full body strength training and stretching. Here is a sample of one of our first workouts:
Nutrition
Since Cindy is taking Metformin for blood sugar control and considering her strong family history of Type 2 Diabetes, her nutrition goals are focused on eating for optimal blood sugar regulation.
They include:
1. Consuming high protein foods with each meal and snack
2. Limiting portion sizes of high carbohydrate foods
3. Limiting intake of sugar and ultra-processed carbohydrates
4. Incorporating vegetables and other high fiber foods into most, if not all, meals, and snacks.
5. Using mindful eating techniques to avoid emotional and stress eating.
Results
Cindy has lost 26 pounds in total, gained muscle and lost body fat. She has increased her basal metabolic rate meaning she burns more calories at rest because she has more lean tissue. She has lost inches around her waist and chest.
These results are amazing but lets talk about the more important ones…
Cindy has:
increased energy and stamina
increased strength in her back, legs, and arms
“a healthy outlook on life”
restful sleep all night without medications
no longer has ANY PAIN!
decreased her blood pressure medications
and lastly, prior to starting training….(see below)
“I was unable to climb stairs without holding onto the railing and taking one stair at a time on my strong leg, now I ‘fly’.”
Cindy likes to joke that “I am stuck with her”. She understands that this is a process, and it can take time. Just a couple days ago, we completed another set of measurements with the understanding that this is not our focus. We focus on how this is helping her quality of life. Cindy was very happy with her progress and said, “I’m so excited to see where I will be in another 2 months”. I love this woman and feel very lucky to have been chosen to be her coach.
If you enjoyed reading about Cindy’s story, please leave your comments below. We would love to hear more about what you are interested in hearing more about.