Teri Friedland

October is Breast Cancer Awareness Month, but the women I work with are reminded about their breast cancer every day.

I’m an occupational therapist, breast cancer exercise specialist and exercise instructor. I created Pink Ribbon 360 to help breast cancer survivors recover physically and emotionally through specialized exercise programs.

Every woman with breast cancer has her own journey. Two women may have the same type of breast cancer, the same surgeries, chemotherapies and hormone therapies, but each woman’s journey — how her body responds and the impact it has on her life — can be very different. Let me take you through the journey of one woman, who I will call “Emily,” to make this disease more tangible.

In April 2020, Emily was 41, lived alone, was active in a few community groups and worked in an office. Of late, her job became remote due to the COVID-19 pandemic. She exercised regularly and ate a healthy diet.

When she went for her usual mammogram, it showed a shadow on her breast. She was devastated, though not surprised, when she was diagnosed with stage 1 breast cancer. She had inherited the BRCA1 positive gene mutation, which gave her a higher chance of getting breast cancer and/or ovarian cancer.

People of Ashkenazi Jewish descent have a higher likelihood of having a positive BRCA gene mutation. Minkoff Center for Jewish Genetics is a great resource in Greater Phoenix for genetic screening for women of Ashkenazi descent.

Finding out she had breast cancer and that she needed surgery was traumatic enough, however, finding this out during the pandemic made the process lonelier, scarier and riskier.

In June, Emily went through a double mastectomy. She then began five months of chemotherapy.

Chemotherapy and surgery can cause a lot of side effects. Emily experienced numbness in her fingers and toes which caused her balance to be off and she had difficulty holding onto her hot cups of tea, which she enjoyed regularly.

She had lymph nodes removed to make sure the cancer hadn’t spread, which caused her to have lymphedema, a build-up of fluid in soft body tissue, in one arm. This came with pain, discomfort and tightness. She worked with a lymphedema therapist for 6 weeks to resolve the swelling.

Emily lost her hair and toenails, which was very painful. She couldn’t reach over her head and was extremely tired and fatigued, which prevented her from exercising.

Once she finished chemotherapy, she thought she’d begin to feel better and recover quickly. But this is where depression, anxiety and fear often increase. This surprised her, as it does many people. Emily was busy during her treatments, so it wasn’t until afterward that the feelings of emotional trauma hit her. She also felt guilty because she was depressed while her family and friends were congratulating her on being “done.”

Her body was free of the cancer, but she didn’t feel free. She still had difficulty moving, and experienced pain and weakness throughout her body. She was tired of asking for help. She wanted to be independent. She felt alone and blamed herself for not being better physically and emotionally.

Emily heard of Pink Ribbon 360 through a support group in town called Bosom Buddies. We began to work together virtually in May 2021. Emily’s doctors told her she should exercise while going through chemotherapy and afterward. Studies show exercise can decrease cancer recurrence and mortality by 40%. It also can help with the side effects experienced during treatments.

However, the doctors don’t realize that their patients need support and guidance to exercise safely, even if they exercised before cancer. Emily was extremely tired; she didn’t know safe exercises to do and wasn’t comfortable going to a gym.

We began with gentle stretches and exercises in a chair and progressed to core stability exercises on the floor, full body cardio movements and we are moving towards resistance work. Our sessions are private and focus on her goals and needs. She’s been introduced to meditation, breathing and self-massage techniques.

Talking with a specialist allowed her to feel understood. She accepted that she wasn’t at the physical strength she was prior to her diagnosis, and she began to appreciate the improvements she is making. Some days are better than others. She continues to have fears of the cancer returning. That fear is coupled with the challenge of staying healthy through a pandemic. But the fear doesn’t control her life.

When we first began working together, Emily’s goals were to wash her hair on her own, get up from a chair easily and have more energy throughout her day. Today, Emily can do those things. She’s able to work a full day and is stronger throughout her body.

It’s important to remember that Emily’s story is unique and breast cancer affects people differently. Emily’s journey isn’t over, but she sees how far she’s come and won’t stop until she’s thriving, not just surviving. JN

Teri Friedland, OTR/L, BCES, is the founder of Pink Ribbon 360. For more information, visit pinkribbon360.com.