One-Of-A-Kind Aquatic Exercise Program Floats Breast Cancer Survivors on to Improved Lymphedema Treatment

Of the two million breast cancer survivors in the U.S., one out of four will develop lymphedema within 11 years of treatment.

Lymphedema, which often develops in survivors after lymph nodes have been removed in breast surgery, occurs when lymphatic fluid accumulates in the interstitial tissue and causes swelling in the hand, arm and shoulder of the affected side. It is characterized by a painful stiffness in the extremity, a substantial loss of range of motion and limited flexibility.

Since there is no universally-accepted definition or tool for diagnosing lymphedema, it had been problematic for women who develop the condition to access available treatment and prevention resources – that is, until recently.

“Making Waves with Catherine M. Shade,” is a one-of-a-kind aquatic exercise program for breast cancer lymphedema patients in central Ohio. The program was developed by Taylor Station Surgical Center surgical nurse and class instructor, Catherine Shade RN, and Women’s Health Center Breast Health Specialist, Sharon Inzetta RN. The grant funding for the program is supported by the Columbus Affiliate of Susan G. Komen Breast Cancer Foundation, Inc., and the Mount Carmel East Women’s Health Center.

Classes aim to teach beneficial water aerobics exercises and self-massage techniques that survivors who suffer from lymphedema can perform in class and on their own. The grant classes are offered at no charge and are open to breast cancer survivors of all swimming levels who have a physician’s medical clearance to participate.

“We saw the struggles women would encounter in seeking lymphedema treatment, so this program was created to fill a real community need,” Inzetta said.

“We want to empower women by teaching them to be advocates for themselves – to recognize changes in their own bodies and get help.” The aquatic exercise program’s main objectives to improve the quality of life of breast cancer survivors are threefold:

To educate survivors about the prevention of lymphedema occurrence.
To target early intervention on any acute symptoms of lymphedema and subsequently implement treatment strategies to prevent progression to a chronic form of lymphedema.
To serve as a support group for survivors where they can come together in a fun, supportive environment and participate in a healthy dialogue about the issues they face.

“It was important for me to start this program to help women get back into good physical condition after their surgeries,” class instructor Shade said. “Getting them exercising in the pool helps stimulate lymphatic circulation to help manage their lymphedema, in addition to increasing strength, range of motion and flexibility.”

And she should know, because in these waters, everyone’s in the same boat – including Shade. She herself is a breast cancer survivor since 1998 who developed lypmhedema after 32 lymph nodes were taken during a mastectomy. She also underwent a TRAM Flap reconstruction surgery with chemotherapy.

Having swam and worked as a lifeguard when she was younger, Shade naturally returned to the pool after her surgeries to try to get back in shape, and it was there she discovered the healing and therapeutic impact of water. After some research she found that the hydrostatic pressure of water acts as a compression garment on the body and effectively reduces the symptoms of lymphedema.

Shade’s quick recovery is strong evidence that an aquatic exercise routine does help manage lymphedema. Within ten months of her surgery, she competed in her first triathlon, completing the swimming portion. Not long after, Shade got re-certified by the Red Cross as a lifeguard and then went on to gain Red Cross certification as a Water Safety Instructor and additional certification as an Aquatic Exercise Association Fitness Professional. She even traveled to The Academy of Lymphatic Studies in Sebastian, Fl., and received a certificate in manual lymph drainage.

For Shade, the aquatic exercise program has been eight years in the making. “I knew that exercising in the water was working for me to help manage my lymphedema, so I had to assume it could be helping others too. I gained my certifications to be fully qualified as an instructor and then started my search for a pool to hold classes in.” Shade began instructing classes in April 2006. A year later in April 2007, she received funding from the Komen Foundation to offer grant classes to survivors free of charge.

And the rest is history. As of this summer, Shade will have instructed two grant class sessions and is looking forward to completing two more as the program has been very well-received thus far. “On top of all the strides the ladies are making with their physical accomplishments in managing lymphedema, the classes have also really lent themselves to be a great support group where everyone is very accepting and supportive of one another.”

Judy Grover can attest to both the physical and the social payoffs she’s received from the program. Before attending classes, Grover had a limited range of motion in raising her affected arm, but since participating in the aquatic exercise classes, she has seen tremendous improvements. “I regained such flexibility in my arm that I’m now able to swim across the entire length of the pool. Cathi (Shade) is so excited and proud. This program would definitely benefit any survivor, whether they have lymphedema or not.”

As for the support she’s found in her fellow classmates, “It’s wonderful to get together and talk with other women who are going through the same thing. Many of us have become such good friends – I love it. I can’t wait to get back in the pool next session.”