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training after abdominal surgery

 
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dennibw
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Joined: 31 May 2004
Posts: 69

PostPosted: Wed Jul 28, 2004 2:19 pm GMT +0000    Post subject: training after abdominal surgery Reply with quote

I had an ovary removed 1 1/2 yrs ago (by regular OB) & have been fine since. My ultrasound pics today are very suspicious of it's return on my remaining ovary. If it's like last time, surgical intervention was all that was needed (no chemo or radiation). My oncologist told me when I first started seeing her that if we ever had to go back in, that she would do the long vertical abdominal incission so that I could be staged at the same time. Since I feel fine, I feel that once again there will be no chemo or radiation, but will have a harder recover due to the type of incission. I would like some ideas on training tips so that I can be ready for the spring season. As long as my bloodwork (CA-125) is still low, I'm gonna try to have surgery pushed back until after Thanksgiving. Obviously I'll have to listen to my body & not push too hard, but I've gotten addicted to riding & really enjoyed my first racing season, & don't want to fall back too far. Can I do trainer work? Will road riding be OK? Can I do light weights for my arms that don't involve pulling my abdominals? I guess what I'm trying to ask is what are things I can do to stay somewhat in shape that will cause minimal strain on my abdomen.

Thanks for any input!!

Denise
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The Bike Doc
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Joined: 08 May 2003
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Location: Corpus Christi and Warda, Texas

PostPosted: Thu Jul 29, 2004 7:06 am GMT +0000    Post subject: Reply with quote

Denise:

Talk long and hard with your oncologist before you delay your surgery. There is always next year's season. It would be a tragedy if you delayed the surgery to race the fall season and find out that you should have had the surgery sooner rather than later.

In regards to recovery, as you will require to have a more extensive abdominal surgery for staging, your recovery will take longer. Talk with your surgeon about getting a physical therapy referral to prescribe an exercise and stregth training program to maximise your recovery. Conventional bicycle riding will be out of the picture until you have had adequate healing of your abdominal muscles. However, you may be able to do riding on a recumbent trainer (often available at many good health clubs) as this will not put undue stress on your abdominal muscles. You may be able to get an earlier clearence to start road riding again by going with a recumbent trike; you will be in a neutral relcined position, there is no risk of low speed fall overs or getting a handle bar in your abdomen. With delta trike styles (two wheels in front, one wheel in rear) using leaning with turns you are very unlike to flip the recumbent trike and injure yourself. I had the pleasure of riding a CATRIKE Speed this summer. It was an absolute scream to ride and comfortable beyond measure. You may want to consider the CATRIKE Tour as an option as it not as low to the ground and may be easier for you to get into and out of. Check out www.bentrideronline.com for reviews of recumbents and recumbent trikes with links to the various manufacturers.

I hope for your speedy recovery and complete cure.

Thanks,
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Paul K. Nolan, MD
AKA: The Bike Doc
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dennibw
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Joined: 31 May 2004
Posts: 69

PostPosted: Mon Aug 02, 2004 9:20 pm GMT +0000    Post subject: Reply with quote

Thanks for the advice. I'll know Wednesday how things are gonna go. My hope in being able to delay surgery a bit is because I'm moving in a couple of weeks, but more importantly, I want to get past allergy season. Mine are bad in the spring & fall, & sneezing after surgery was unbelievably painful! That was really the only rough part of recovery before. I ended up with a hematoma because of my sneezing. Don't worry, I won't be foolish. I'll listen to what my Docs say & what my body tells me. I just don't want to have a lot of muscle atrophy to build back up or loose what cardiac output that I've achieved. At 35, things fall apart easier and take longer to fix. Fortunately I'll have access to a recumbant bike in the workout facility at my complex. I'll be sure to check into physical therapy. Would it be better to go thru a sport medicine type practice? I'm just a beginner with only 1 season under my belt. I may not get to race this fall, but I'll be back in the spring. Most likely not in the top half, but I'll finish.
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The Bike Doc
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Joined: 08 May 2003
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Location: Corpus Christi and Warda, Texas

PostPosted: Tue Aug 03, 2004 8:14 am GMT +0000    Post subject: Reply with quote

dennibw:

Definitly talk with your doctor about your rehab. Physical therapy is the number one priority. If you doctor and PT feels a Sports Medicine Physician referral is in order, do pursue it.

Do not let your allergies stand in the way of your needed surgery. You do not have to suffer with such severe nasal allergies. Talk to your doctor about medication options. Topical nasal corticosteroids such as Rhinocort, Nasonex, Flonase or Nasocort all are extremely helpful. Non-sedating anti-histamines such as Allegra, Clarinex, Zyrtec or over the counter Tavist (generic clemastine is available) are excellent options. If you are on these meds and still are having break through allergy symptoms then adding a new medication, Singulair, that blocks a special receptor in the body, the leukotriene receptor, can be quite helpful. If you still have significant symptoms then an evaluation by an allergist/immunollogist for possible allergy desensitization therapy with allergy shots may be in order. My experience has been 99% of my patients I can get under good control with the above medications without having to resort to allergy shots.

Do not worry about the inhaled corticosteroids. They are not systemically active. In otherwords you do not get the systemic side effects that you would with oral corticosteroids such as elevated blood sugars, excess weight gain and poor wound healing. These side effects are specific for oral or injected corticosteroids not for the inhaled steroids. The nasal as well as the inhaled corticosteroids used for asthma (Pulmicort, Azamacort, Flovent, Beclovent, Vanceril, Advair) all are approved by the International Olympic Committee with a physcians order and they are not addicting.

There are some cautions I do give my patients taking inhaled corticosteroids. With the nasal preparations, before using the nasal spray, apply Vaseline with a Q-Tip to the inner nasal passage along the septum (the center division between the nasal passages) just on the inside of the nostrils before applying the nasal spray. Spay the medication towards the eye side of the inside of the nostril. This will prevent nose bleeds and provide maximal efficacy of the medication. With the inhaled corticosteroids they should be taken just before brushing of the teeth; this will prevent thrush from occurring.

One other caution I give for my patients taking inhaled corticosteroids both nasal and lung preparations, is do not use inhaled steroids with certain oral and intravenous anti-fungal medications of the azole class, specifically, itraconazole (Sporonax), ketoconazole (Nizoral), clotrimazole (Lotrimin), voriconizole (VFend) as there is significant adverse drug interactions with these medications that can lead to severe systemic steroid side effects.

Do talk with your doctors about your allergy symptoms. You can get substantial relief and not affect your performance. If anything, because you are breathing better, you will perform better.

Thanks,
_________________
Paul K. Nolan, MD
AKA: The Bike Doc
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