Kirklin Clinic Head & Neck Cancer Support, Birmingham, AL
Distributed by American Cancer Society
Pat Sanders, Editor
Second Quarter, 2008
STRETCH AND STRENGTHEN
By Shari Aizenman
Welcome back! This is the first in a series for and about you. I am Shari Aizenman, a massage therapist in Atlanta, GA and Birmingham, AL. I have been in practice for twenty-two years now and have had the opportunity to work with thousands of people in a variety of situations. I specialize in recovery from injury and illness and incorporate the following exercises into my client's healing programs.
In my previous series, Massage and Stretching, I focused on relaxing and stretching as a part of an overall wellness program that anyone can integrate into their daily routine. In this series, Stretch and Strengthen, I will focus on a little more of an active and energetic role you can have in your wellness program. The first routine is more specific to the upper body. Subsequent routines will address other areas of the body.
Remember that each of us is different in many ways, and each of us can respond in a variety of ways to different stimuli. Let your body be your guide, and if you have any doubts or questions regarding beginning an exercise program of any sort, please consult your physician. These stretches and strengthening moves are designed get your blood moving, your muscles flexible, joints well-oiled, and your mind clear in a relaxing, comforting way that is also energizing.
Many of the stretches in this program can be done while sitting in a chair, while others require you to be standing near a wall or in a doorway. You may need a yardstick as a tool to assist in passive stretches.
Here we go! Begin by sitting in a chair, your feet firmly planted on the ground with your back supported. (Have these instructions nearby.) Gently allow your head to lead your spine into lengthening. You can imagine a string coming from the crown at the top of your head (that's an imaginary place where, if you draw a line from ear to ear across the top of your head, the center would be). Use this visualization of a string to gently lift your head, letting your chin drop and your jaw relax, while your head lifts up and up and each of your vertebrae separate. Get as tall as you can through your spine, your shoulders relaxing, and feel your ribs expand as you inhale. Then, allow your breath to relax and take a rest. Repeat this three times, feeding your body oxygen, preparing it for this routine.
As you sit with your back supported, relax your arms over the sides of the chair. Raise your right arm in front of you, palm up, as high as you can. When you reach your highest point, stretch your fingertips toward the sky, allowing your arm to separate away from your shoulder. Your palm will be pointing backward. From your shoulder, turn your arm in the shoulder socket until your palm is facing forward, and continuing to stretch your fingers out, lower your arm slowly to the side of the chair. Take a breath, and on the next inhale, raise your arm again, reaching and turning when you reach the top, a total of three times. Rest if you need to, and never work to the point of exhaustion. Repeat with your left arm.
Next, as you inhale, raise your arm out to the side, palm up, until your arm is next to your ear. Reach up with your fingers, turn your arm in the shoulder socket, and, palm facing down, slowly lower your arm to the side of the chair. Repeat for a total of three, rest, and repeat of the left side.
Here comes the strength part! Clasp your hands together on your lap. Stretch your arms straight out in front of you and on an inhale lift them together as high as you can. Hold for a count of ten as you relax into your breath and lower your arms slowly. Repeat for a total of five. Rest. if necessary, then place your palms on your knees. On an inhale, stretch your arms straight in front of you, lock your elbows and raise your arms at the same time as high toward the sky as possible. Hold for a count of ten and lower them slowly. Repeat for a total of five.
Last in this group is resting your arms out to the sides of the chair, and on an inhale, raise your arms, palms facing the floor, toward each other until your arms are touching your ears. Reach tall with your fingertips and slowly bring your arms back to your sides. Repeat for a total of three. Rest for a moment, then turn a few circles with your wrists, shake your hands out and shrug your shoulders ten times to let your body know that this portion of the exercise is over.
Time to use your yardstick! Stand with your feet a bit more than hip's width apart. Allow your knees to relax and hold the yardstick in front of you, hands side by side, palms facing down. On an inhale, lift the yardstick out in front of you until it is directly in front of your shoulders. Then gently twist at the waist toward the left, moving your upper body as a unit, as far as is comfortable. Breathe while there, lowering the yardstick and raising it again for the trip back to center. Now bring the yardstick back down, rest and repeat in the other direction. Go to each side a total of three times. Rest the yardstick against a wall and rotate your arms in windmills, making three big circles in one direction and then the reverse.
Pick up the yardstick and this time spread your arms out to the ends. As you inhale, raise the yardstick above your head and twist your body at the waist toward the left as far as is comfortable. With the yardstick still above your head, gently turn toward the right as far as you can. Once there, inhale and come back to center. Lower the yardstick, take a rest and repeat three times. Do a few windmills with your arms, rotating slowly through the shoulders to loosen and oil the joints. Then go in the opposite direction.
Are you sweating yet? Remember that you can design this program to fit your own needs. If a specific move causes discomfort, modify it or omit it. Are you resistant to trying something? My thought is this: What you resist persists! Let go of whatever is keeping you from at least trying and go for it! Also, it may help to make sure you do gently rotation movements through the shoulders after doing exercises where the arms are above your head. This keeps the joint well-oiled.
Rest for a moment. Walk around and give your legs a little exercise. Keeping the blood flowing throughout the entire organism (your body) is the best way to retain optimal health! Clap your hands together and then rub them together and then the backs of them to allow friction to get blood flowing down into your fingers.
For this next set of movements, you will need to stand next to the smallest doorway you can find. If you can reach the top of the door, hook the fingertips of your right hand over the end of the door. Then gently bend your knees to stretch the arm forward. Then lean forward to flatten your armpit against the edge of the door. Do not lean backward. Hold this stretch to the count of ten. Gently lower your arm, shake it out and repeat for a total of three stretches. Change arms and repeat on the other side.
Now stand in your doorway with one foot six inches ahead of the other. Bend your elbows 90 degrees and put your palms, forearms and elbows against the outer doorjamb. Gently lean onto your forward foot, allowing a little of your body weight to stretch your chest muscles outward, as you move forward. Remember to move from your center, belly button going straight forward and no arch in your back. Once you get to a comfortable stretch, hold to a count of ten and come back to the beginning point. Repeat the stretch for a total of three with your first foot forward, shake your arms out and repeat with the other foot forward.
Last in this series is to give yourself a variety of modified hugs. Reach your right arm across your chest toward your left elbow. Grasp your left elbow and pull it across your chest with your right hand, stretching out the upper shoulder. Assist the stretch by reaching around your waist with your left hand. Hold this to a count of ten and repeat five times, alternating sides with each stretch. Then reach across your chest as far as possible with your right hand toward the back of your neck, then grasp your right elbow with your left hand and hug your elbow further across the body and flat against your chest. If you want, you can give your left shoulder a squeeze with your right hand. Repeat this stretch a total of five times on each side, alternating sides with each stretch. Complete the stretch with a few windmills.
Finally, rub your hands, arms and shoulders briskly and give yourself a hand! Good job! If you have any questions about the stretches or strengthening moves in this series, please feel free to email me at: email@example.com.
When watching "Auntie Mame" as a child, I fell in love with this marvelous, crazy, nutty, eccentric who could make things happen. My major goal in life ever since has been to become an eccentric. I have found that should be as much a financial goal as a mental one. It is the financial part that has avoided me. I am not there, yet. Oh, I have reached the crazy part; some might say I have occasionally reached lunatic status. Of course, those are personal opinions and we all know what they are good for.
I was going to write this really nice, heartfelt, article about my new medical protocol and the wonders of medical science. It was to be a ten day ordeal; I can do that, I thought. Then reality set in. Ten days of absolutely no change, in short, house arrest. No change in diet, exercise, temp, or behavior. My doctor must have been out of his mind. First off I live with really crazy people. I love my mom dearly but she is a nut; this apple did not fall far from that tree! My sister is my caregiver and I have driven her crazy for 47 years (she is younger than I am) and she has a 15 year old. That is self-explanatory and also makes me a real Auntie Debi. We also live with 3 cats, 3 lizards, a hamster and a fish.
Along with a suitcase full of drugs, patches, food, and 3 volumes of instructions, there is a little note included that says if any one of these 63 changes occur, pack everything up and go to the emergency room. Now, I have a great sense of humor - warped, but great. I can joke with EMTs while light blue with 104 degree temp but walking into an ER with a suitcase full of instructions for a strange doctor is stretching even my sense of humor. However, doesn't it figure, 3 days into the 10, my trach dried up, my breathing was shallow, and I was vomiting (this protocol was for stomach infections), had elevated temp and basic distress. So, away I go to the ER, after a shower and putting on clean undies (my grandmother's training).
A few months back Pat wrote about some pages that show our reconstruction, before and after surgery. They are awesome. I printed all my medical stuff on the back and thought, I have one major explanation down. Wrong. I went to the ER in the hospital that did my laryngectomy 15 years ago. They should know me after all this time. Wrong again. I get a very nice young man that fought with me about where my oxygen should go. I showed him the reconstruction page to clarify what we were doing. He looked it over and said, "That is just not possible." I also heard, "That can't be true, she can talk," and another really frightening one, "We need to close off the trach." My sister called the surgeon in a panic afraid I would kill this nice young man, since my sense of humor is good but limited. My surgeon is wonderful. He talked to him, told him to listen, that I knew what I was talking about.
We need a PBS special on types of speech in this country! And did I mention I had to clear myself with a security guard to get into the ER? Like he was qualified to diagnose a hangnail, let alone anything else. He didn't ask if I was armed and I was not smacked with enough stupidity to be dangerous. But, given a few more minutes and I might have made it.
Back to the general ER circus. After an hour, I got a real doctor. Cautiously, he asked about my trach and my speech. (I don't know how to explain esophageal speech. Elizabeth Finchem should be ashamed of me about this. But, frankly, I was a wonderful student for her. She said, "Trust me and do what I say." I did, it worked, and since I seem to mystify the powers that be, apparently she is a wonderful teacher.)
I was sent upstairs for a week of rest and medical care. I woke up in the morning to a room full of people. That is always fun in the hospital, given the wonderful coverage of gowns and interpretation of privacy. They had never seen anyone with a trach sleep on their stomach so they called all their friends to see, too. I have had Superbowl parties, Christmas parties, and a birthday party in a hospital but never a pajama party at 5:00AM and I was less than my usual gracious self.
Now the medical day begins. Someone comes in to teach me how to swallow. Why? Because I have a trach. First off, I am a very large woman, I don't look like I have ever had a swallowing problem nor have I ever had a complaint about this. And I have had this stoma for 15 years, now would seem a bit late to teach me to deal with it. You think?
Then I get the "no sodium, no fat, no sugar, no taste" diet. Am I smaller yet? But I am a vegetarian, so how bad can they mess up vegetables. Oh, they do have a long list of ways! Unidentifiable gray matter is not limited to meat. Then the dietitian comes in to argue with me about eating meat. As politely as I can possibly be, I explain to her that I do not move or exercise enough to properly digest meat and it is not a matter for debate. She thinks we are going to argue more. I was not the little ray of sunshine in her morning.
Next I get the pharmacist. Bless him. No one can take this many drugs. Why not, I have all these problems? It is not normal. Define normal to someone that has been rebuilt; on bad days, I am battery operated! Three calls to my doctor and my meds arrive with instructions and another pharmacist. Maybe, to watch me swallow?
Next my room is changed. Why? Because I have to be in front of the nurse's station. Why? Because I have a trach and they have to watch me. Watch me do what? Breathe? Dealing with them should be performance enough you would think. This is in case I go into distress. The reason I am in here in the first place is distress!
Next I get a social worker. Why? In case I need someone to speak for me. They just don't make drugs good enough to deal with this. Let me see: there is no way I can live through reconstruction, you want to close my trach and stick oxygen up my nose, you want to take my meds from me, force me to eat what you eat and now you want to speak for me? Hmmmmmm...
You just couldn't make this stuff up if you tried. On day three, I get a nurse that knows me and my situation. The "keep out" sign goes on the door and I start getting better. Ringling Brothers has nothing on this hospital and it is one of the better ones. And they wonder why I have such a warped sense of humor. It is called survival.
Due to changes in Medicare and other insurance carriers, communication is frequently nonexistent in the medical industry. Doctors have to jump through hoops to do their jobs and nurses and other medics have to worry more about legal bull than professional knowledge. It is a wonder we have "health care" in this state at all; I live in California.
Always keep your medical info on you! Never let them guess how to take care of you. Never assume because they are medical professionals they know about you. Good professionals are worth their weight in gold and then some, but from time to time we also have paper weights. Thank goodness, not often.
And I ask myself, "What would Auntie Mame do?"
Written by Debi Austin (out of the hospital and still alive)
I had heard about the following product and asked Dorothy Lennox of Luminaud to send information so I could share it with you just in case you have a need for it.. It provides a lightweight portable method of talking on the telephone for those of you with soft voices or those who need amplification on the telephone.
VOICE MAGNIFIER, Model VM
sent by Dorothy Lennox
The Voice Magnifier is a new device to amplify outgoing voice when talking on the telephone. It should be helpful to almost anyone who can speak but has difficulty producing voicing that is loud enough to be heard easily by the person on the other end of the line.
Laryngectomees will find improvement if their esophageal, TEP or even artificial larynx speech is not as loud as they would like for phone use. It is also useful for those who have Parkinson's, MS, ALS, or any other medical condition that limits voice volume due to vocal cord problems, limited lung capacity, physical impairment of speech or who find producing sufficient voice volume for telephone use to be unduly difficult or tiring.
A big plus is that the Voice Magnifier is compatible with most multi-line business phone systems, an area which has been a major problem in the past for people needing phone amplification in a work setting.
The VM should be usable with almost any current telephone that has a modular (plug-in) connector or connectors on the cord between the handset and phone base - and it is easily portable. It's quick to attach to a phone and simple to detach, weighs 8 oz. with a 9 V. alkaline battery inserted. One battery will provide about 20 hours of actual use depending on the chosen volume setting.
The switch can be instantly flicked to on when voice amplification is wanted, then to "off" when the conversation is over. With the switch "off", people who do not need voice amplification can use the phone. Another switch allows the user to adjust the Voice Magnifier for good sound.
The Voice Magnifier does not work with cordless or cell phones and it will not work for someone who doesn't have any real voicing. It will not improve pronunciation or voice character - it will just make the user's own speech louder.
The Voice Magnifier is made by HearSay Corporation in Arizona and is sold by Luminaud, Inc. For further information, contact Luminaud. Phone: 800-255-3408, Fax: 440-255-2250, e-mail: firstname.lastname@example.org, web site: www.luminaud.com.
Letter from: Max Hoyt
I am sitting here this morning about to shut down for the year and get ready for our trek to Florida again. What I wanted to share with you goes back several years. You have often, in the past, shared your experience with exercise in your quest for an active, fulfilling life as a Lary. For a long time I agreed with you and went about my usual way of doing things, myself, my way. I was riding a bike several miles a day, either on the street or a stationary bike in the gym and lifting a few weights. Following my open heart surgery, I continued that schedule until recently, when I started to ask myself if there wasn't a better way.
I observed several older people in the Pilates program at the gym where I work out and they all seemed to be doing really well and moving with agility that I wished I had. I finally got to the point where I spoke to one of the trainers in the Pilates Program about what they could do for me. The first thing she told me was that I needed to improve my breathing technique. She felt that my breathing was much too shallow and would eventually turn on me. Secondly, she wanted to do a simple test to determine my strengths and weaknesses, after which we could discuss specifics.
I learned more about myself in one-half hour than I knew existed. Weakness was the report that came out, loud and clear. Since I was leaving for the winter in four weeks, she set me up with 10 1-2 hour sessions with the purpose of showing me what I could do on my own, without all of the equipment they have.
I started 3 weeks ago and found muscles/tissue that was connected to things that hurt almost as bad as my chest did after surgery. In three weeks time, I have progressed unbelievably to the point where I can stand for 30 minutes without back pain. I can run, touch the floor to pick up a piece of paper and best, but not least, walk up several flights of stairs without being out of breath. I truly feel at least 10 years younger than I felt a month ago.
We haven't corresponded much of recent but I wanted to let you know that your advice didn't fall on deaf ears. Keep passing out your beliefs and eventually, we will come around.
Congratulations on the outcome of the elections. With your leadership and foresight, the WW will surely have another great year.
Read more about getting started, equipment, instructions and classes:
While reading the last issue about dreaming, I realized that, when I dream, I'm always in it twice. Once, playing whatever part I'm playing in that dream, and once again, I am observing myself. It is in vivid color like it's real life. In the dream, I am without a stoma, always talking and I hear myself.
This dream always wakes me up and I try to figure out why being a laryngectomee doesn't follow me, into the dream. I feel like this dream is an escape, or refuge, where I can get away from this awful thing that happened to me.
The message I had put on my cell phone voice mail three years ago, is still there. I can call from my home phone, to my cell phone, and hear my original voice saying, "This is Steve, sorry I missed your call. I'll call you back as soon as I can." It's not a lot really, but it always makes me cry. I just can't bring myself to delete it and when I wake up from a dream, no matter what time it is, I call my cell phone so I can hear the person I used to be.
All's well that ends well.
Kirklin Clinic Head & Neck Support Group
No meetings until further notice
In the interim, we suggest that you join WebWhispers if you have an email address.
We are also invited to attend an All Cancers group with a luncheon every third Tuesday. Call or email Pat Sanders if interested. (See below)
B’ham: Pat Sanders, 205-980-8416; email@example.com
Kirklin Clinic Otolaryngology : 205-801-8456 FAX
Glenn E. Peters, M.D. Glenn.Peters@ccc.uab.edu
William Carroll, M.D. firstname.lastname@example.org
Nancy Lewis McColloch, Speech Pathologist ; 205-801-8460; email@example.com
WEBWHISPERS - INTERNET SUPPORT GROUP FOR LARYNGECTOMEES
http://webwhispers.org is a site with helpful information on what to do before and after a laryngectomy. It includes educational sections on larynx cancer as well as a complete Library of Information, lists of Suppliers, the monthly newsletter, Whispers on the Web, and HeadLines This is the largest internet support group for laryngectomees and is a member club of the IAL
The Official site of the International Association of Laryngectomees
http://www.larynxlink.com Information is available for the IAL Annual Meeting &Voice Institute held annually in various locations. Educational and Fun.
A Laryngectomee site from the United Kingdom
http://www.laryngectomees.inuk.com presents information from all over the world and HeadLines newsletter is carried on their site under Letters from America.
For cancer information call 800.ACS.2345 or visit our Web site at www.cancer.org
American Cancer Society in Birmingham: firstname.lastname@example.org