The Huntsville Times
By Mary Ann Swanstrom
If you've got back pain, broken a leg or had a stroke, physical therapy is going to be big part of getting both your mobility back and your life in order. But breast cancer patients benefit from PT, too, said Michelle Nesin, a physical therapist with Nesin Therapy Services.
Nesin has been treating breast cancer survivors for almost 20 years and has long advocated for early PT intervention following mastectomy, reconstruction or other surgical intervention, radiation and chemotherapy.
"My clinical experience has demonstrated that early physical therapy promotes scar tissue healing, posture training and increased cardiovascular endurance," she said.
The therapy sessions also provide an opportunity to educate the patient on safe lifting, carrying, pushing and pulling, all of particular importance to patients whose careers depend on being able to perform physically, say, a young mother or physical therapist.
Nesin's co-worker, Bridget Dietz, was diagnosed with breast cancer two years ago. She underwent a double mastectomy and eight rounds of chemotherapy. Over the next two months, Nesin observed that Dietz's posture began to alter because of the scar tissue development following surgery for breast cancer. Her shoulders crept forward and her frame slumped.
"Bridget treated patients directly across the hall from me, so I saw her on a frequent basis during her recovery," Nesin said. "What I watched was someone in pain but staying strong for her patients, family and co-workers."
Dietz's posture was a symptom of the greater problems compounding inside. Her scarred tissues hurt when stretched in her line of work. She had a rotated rib that caused her a great deal of pain when she tried to straighten up. And, because she had lost breast tissue, she exhibited a subconscious protection of the anterior chest, Nesin said.
Nesin offered many times to treat her friend but was refused.
"I was overwhelmed with the whole experience," Dietz, 41, said. "I was getting a lot of new information in a short period of time not only from my medical team, but from friends and family. In addition, I got on the Internet in those wee morning hours when I was worried. I was on information overload.
"Plus, I didn't want one more person telling me that something else was wrong with me."
Dietz finally relented, and treatment improved her posture, her ability to use her arms and her ability to breathe properly.
Nesin said that breast cancer survivors will wait to come to her a year or more after surgery when they begin to develop back pain or experience loss of arm function. They also lose sight of how inactive they become because everyone around them is taking care of all the lifting and carrying."At the time, the discussions they are having with their doctors are about treatments to save their lives, and unfortunately, these things can seem trivial until later," she said.
Dietz agreed: "As a breast cancer patient, you have to make so many concessions to the disease and the treatment you lose your ability to know what is truly a limitation. You lose your control, your hair, and your nails turn black; I was just so sick of medical appointments and being messed with."
Even so, it's never too late for breast cancer patients to seek help with healing through physical therapy.
"Physical therapy interventions are effective at any time that a patient realizes they have some functional limitations," Nesin said. "Even if it has been years, we can still help."
Michelle Nesin, PT, OCS, FCFMT contributed to this story.
