Kirklin Clinic Head & Neck Cancer Support Group,  Birmingham, AL

distributed by American Cancer Society

Pat Sanders, Editor

August 2003 

Session One

Hi again.  I am Shari Aizenman, a massage therapist in Atlanta and Birmingham.  I have been doing massage professionally for seventeen years.  In addition to self-massage, which I encourage all of my clients to practice, I also teach stretching as part of a regular self-care routine.  I am designing this series especially for laryngectomees, although these stretches can be utilized by anyone desiring the benefits offered as part of a regular stretching routine.

First things first.  What, who, why, where and how? 

Stretching is defined as the sustained lengthening of a muscle beyond its normal limit.   Muscles only have two capabilities:  contraction and relaxation.  Therefore, stretching is a passive exercise on the muscles and tendons to lengthen previously shortened fibers.  The different types of stretching are:  1.active, where the person does their own stretches from a set point, lengthening the muscle;  2. passive, where an assistant stretches the muscle for you;  active assisted, where you and an assistant work together to stretch; resistive, where an assistant resists your stretch, and then as you release, stretches the muscle for you.  In this series, we will be focusing on active stretching, although we will do a little self-assisted resistive stretching.  I will also include a couple of yoga postures, called asanas, in this program.


Everyone can benefit from stretches.  As a certified infant massage instructor, I teach caregivers of newborns how to gently stretch their babies in an ancient Indian method of massage.  We all know that athletes use stretching as an integral part of their routine to prevent and recover from injuries.  As we age, keeping our bodies flexible allows us more freedom of movement and faster recovery from injuries. 


The benefits of stretching are many.  Most importantly, the muscles and tendons being stretched are kept elastic and the joints, over which the tendons are attached, are kept oiled and mobile.  Stretching assists in cleansing toxins from the soft tissues of the body.   It also increases blood flow to the area being stretched. 


Stretching can be done anywhere, in almost any position.  We will be working on the floor or bed, in a chair, and standing.  Allow ten to fifteen uninterrupted minutes for each of the stretching sessions.  We will work one section of the body at a time, and at the end, will have an all-over, everyday stretching routine.


When stretching, remember these simple rules: 

1.      A slow sustained stretch gives the best results.  No bouncing!

2.      Go to the limit of your range of motion and hold the stretch ten to twenty seconds and release.

3.      After a stretch, gently return the body part being stretched to its original set position.

4.      If you feel pain- BACK OFF!

5.      Do each stretch two or three times.

6.      Inhale before a stretch, and slowly exhale as you stretch.  Breathe at least one full breath while in the stretch and release on another inhalation.

7.      Relax, relax, relax, into the stretch and watch that other body parts are not tensing as you stretch.


So, let’s get started!  You will need a couple of tools for this series of stretches.  Have a tennis ball, a cane or yardstick, and a hand towel available.


Our first session will focus on the head, neck, shoulders and upper back.  You can sit in a chair that has a back for the first part of the session.  Always take a moment before stretching to prepare your body, tools, and working space, and to get rid of any distractions.  Sit in a chair with your feet flat on the floor and breathe deeply three times.  Breathe in through your nose, and out of your mouth (I just put that in for non-larys because, for them, it makes a difference) 


Begin your routine by rotating the joints at the ends of your fingers.  Use your left hand to move the joints of your right hand, working from your fingertips to your hands, then rotate both wrists in either direction, bend your elbows to their full range, open and close at the elbow.  Then rotate your left arm at the shoulder, making small circles to large in one direction, then the other.  Repeat with your right arm.   Then take a moment to focus on your head and neck.  First, imagine that there is a pencil coming out of the top of your head.  Slowly draw small circles on the ceiling with the pencil in a clockwise direction.  As you complete one circle, begin the next, larger circle, continuing until the circles can get no larger.  Take time and be aware of any sore or tight areas while making your circles.  Repeat the circle drawing in the other direction.


Now that you have warmed the area to be stretched, take a couple of relaxing breaths.  Now it is time to stretch.  Take a breath in and, as you exhale, allow your left ear to drop toward your left shoulder, taking care not to turn your chin downward.  This stretch will imitate the sun, rising and falling over your shoulders.  As you breathe out, reach your left arm over your head, placing the fingers of your left hand just above your right ear.  On the next exhale, gently pull your left ear more toward your shoulder and feel the stretch on the right side of your neck.  Hold this stretch for ten seconds or so and repeat on the right side.  Repeat left and right.


Next, turn your head toward the left, imagining that it is like a pig on a spit, not bending the chin up or down, keeping your nose in a straight line.  When you reach your limit, breathe into the stretch, reach up with your left hand, taking your chin gently and on the next exhale, pull your head a little more to the left.  Repeat on the right side.  Repeat left and right.


Imagine that there is a string running through the top of your head, right on the space where a line running from the top of each ear would land.   Pull this imaginary string straight up, allowing your chin to gently drop and your spine to elongate.  When it is as long as possible, gently roll forward, taking your chin toward your chest, one vertebra at a time, feeling a good stretch through the upper part of your back.  If you would like, you can assist this stretch by placing either hand on the back of your neck and pull gently forward.  When you are ready to release this stretch, do so by coming up in the reverse order, bottom to top.  Then, gently stretch your neck backward, lifting your chin and taking care not to compress the back of your neck.  See the difference in sensation stretching with your mouth open and closed.  If you want to increase this stretch, jut your jaw out.  Check in:  are you breathing through these stretch?


Next, stretch your left arm across your chest, placing your left hand on your right shoulder.  With your right hand cradling your left elbow, on an exhale gently pull your left elbow across your chest and feel the stretch in your left shoulder and upper arm.  Hold this stretch for ten seconds.  Drop your left arm and repeat on the same side.  Then do the same with your right arm, assisting with your left.


If your range of motion allows, place your bent left arm behind your head, elbow in the air.  Reach over the top of your head with your right hand and pull your left elbow behind your head, stretching the area around your left armpit.  Repeat on the right side. 


Now, imagine a ladder going upward from your shoulders.  On an exhale, reach for the first rung of the ladder with your left arm, stretching up through your entire torso, then allowing your left arm to drop, reaching your right arm up to grab the next rung.  See how many rungs you can climb up comfortably, maybe four or five. 


Now it is time to stand up.  Take a moment to breathe as we bring this session to completion with a few relaxing stretches.  Plant your feet firmly on the floor, feet wider apart than your hips. 


Expanding on the ladder theme, gently reach overhead with your left arm, grabbing the first rung of the ladder again.  This time press your left foot into the floor firmly, reaching up with the entire arm, fingertips, hand, forearm, elbow, upper arm, shoulder, allowing your ribs to release, taking in a deep breath and lengthening through your left side.  Allow your head to bend over toward the right.  Release on an exhale.  Take a breath and repeat on the right side.  Open up your body and relax.  Repeat on each side. 


Bringing this session to a close, place the palms of your hands together and bring them up into prayer position.  Keeping the palms pressed together and elbows out to the sides, raise your fingertips up toward the sky, breathing and relaxing.  Raise your hands as far as is comfortable for you and give thanks for the day. 


See you next session.

Shari  <wrldlygrl@juno.com>


TIP OF THE MONTH – Smoke Alarms


I know the primary focus of this newsletter is for laryngectomee rehabilitation, but laryngectomees have non-laryngectomee loved ones and this is a message that needs to get across to all.  EVERYONE should have smoke detectors and be sure that their loved ones have them, too.  They make great wedding or birthday presents, Christmas gifts or door prizes. Everyone needs them because many "face breathers" as our friend Tina Long calls them, don't have a great sense of smell either - and because a fire can get going pretty well in another part of the house or garage before you smell it depending on how the drafts are heading in your home - and because fires often get perking in the middle of the night and even people with a good sense of smell may not wake up very soon - or may actually be unconscious from smoke inhalation without having a chance to wake up.  Smoke detectors are a MUST for everybody, regardless of the bodily location of their air intake!


When you get a couple for yourself, think about getting a couple more for family members in other dwellings just to show you care. 

Dorothy Lennox


Cancer & Diet – Eat your Salads and Veggies


Cancer is a vicious disease.  It hides in corners and peeks out later.  I cannot tell you the number of people who think they "got it all" or have NED "no evidence of disease" and yet...it was still there in some hidden cells.  Remember that when we get cancer in an area, even getting rid of that cancer doesn't mean another won't show up later in the cells next door.  After all they are the same kind of cells, subjected to the same living experiences.


We cancer survivors should be alert for signs and symptoms.  It doesn't mean we live under a shadow, anymore than we live under the shadow of being hit by a car while crossing a street where   we do the best we can and look both ways before crossing. We live good lives, often better than the ones we had before cancer, since we learned to appreciate what was almost taken away and to enjoy the moment.  Often we live longer than we would have if we had not had cancer because we did change our lifestyles, get our regular checkups and are more aware.  Our diets may be of help.


The following was in Doctor’s Guide from the University of California, San Francisco, reporting on 35 different studies examining “the association between vegetables, fruits, carotene, vitamin A, vitamin C, and vitamin E and oral, pharyngeal, and esophageal cancers and looking for a protective role of these dietary components against development of oral, pharyngeal, and esophageal cancers. There is enough evidence to point to a PREVENTIVE ROLE of vegetable intake, including green vegetables, cruciferous vegetables, yellow vegetables, total fruit intake, and citrus fruit intake. Yellow fruits are likely to be protective. Carotene, vitamin C, and vitamin E are protective, most likely in combination with each other and other micronutrients. The role of vitamin A is not clear because of conflicting findings in the studies reviewed.”  So eat the fruits and vegetables that offer some protection against cancer.  No guarantees, but it’s like looking both ways before you cross the street.

IAL and Support Groups


The IAL Annual Meeting and Voice Institute held in Atlanta last month was smaller than usual in attendance but was great fun and, on an inspiring note, the VI part was very well attended.


I participated in a panel where each speaker tried to bring forth ideas for running a dynamic and successful support group. The theme running through the talks was the importance of communication with members and prospects.  I think every one of us recommended a newsletter and meeting notices. Getting meeting attendance up could be helped by a telephone committee and members of the group being in touch with new larys and caregivers.  Work with your local doctors to ask that their office contact you or ask that they hand out a flyer about your group.

Due to my association with WebWhispers, I am very familiar with the power of being on the web and I suggested that clubs and support groups set up a web page with basic contact information, when and where they meet,  and include a welcome message. Jack Henslee, Executive Director of the IAL, said that IAL-affiliated clubs may sign up for a web address on the IAL site for $20 a year. You don't even have to know how to set up a web page.  Get the information to the IAL Webmaster, Dutch Helms, E-mail: ialwebmaster@larynxlink.com and he will set it up for you. You can make the payment arrangements with him, too  That page will have an individual web address so you can put it in your newsletter or on the flyer you are asking the doctor or SLP to hand out.

The official IAL home page is http://larynxlink.com/ . Click on IAL Clubs (at the top of that page) for information about all IAL Clubs.


 “LarynxLink currently provides, at no charge, a complete listing of all IAL Clubs whose dues are current, as published by the IAL. This information includes the club name, city, contact person, a phone number, and a "link" to the club's own website, if known. For many clubs this information is sufficient, however, other clubs like to expand on their Internet presence.

The annual cost of a normal, stand-alone website generally runs around $240.00.  However, for an annual cost of only $20.00, LarynxLink will create and host unique individual pages (up to 2) for your club that provide additional information such as a mission function statement, where and when you meet, a list of your officers, information about your loan closet, if you have one, annual events for your club, or any other information that you would like to make available. This cost includes the design, maintenance and required disk space.”

After the web site has been up for a while, it will be included in the well known search engines, so be sure you use the words you think someone might be looking for, such as laryngectomy, laryngectomee, and support group, and give an email address as well as telephone number. 



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