Personal records

This competition year finished with two successes:
At the American Open Series III  I hit a personal record in the snatch and the total. This resulted in a gold medal. I had to be on the platform in the evening past by my usual bedtime, but it was fine.
In a local competition a month later I could repeat the snatch result and set a new personal record in the clean & jerk and the total.

This year I also branched out to help more at competitions as a referee and marshall.  It is very gratifying to help others have a good competition experience.

Meditation and Olympic Weightlifting Competitions

The warm-up during an Olympic weightlifting competition is perhaps the most intense and stressful part of the sport. Months of training but only six lifts count on the day of the competition, three for the snatch and three for the clean & jerk.

How does Meditation help?

I like to close my eyes, shut out the noise and craziness of the warm-up room, and practice a breathing meditation (Joshin Kokyo Ho) between the warm-up attempts.

It calms the mind, aligns the body, and brings energy and focus to the core. The craziness of thoughts subsides. Confidence and trust can surface: confidence in my ability, and trust in the laws of physics that the bar will accelerate and keep on moving upward, even if I don’t pull with the arms. The bar is too heavy for the arms anyway. 

It creates a state of openness that allows me to concentrate on the execution of the lift, no matter what weight is loaded onto the bar. It can bring forth my strong and capable Self on the platform. Having faith that I am better than I thought possible. The openness allows me to let go of whatever happened the weeks before in training, and also let go of the expectation of making the goal weight. The latter is important as it can create tension that is misplaced at the moment of the lift.

Breathing in and feeling energy in every cell of the body is strengthening and helps with recovery. It may also help to visualize a column of white light from the bottom of the feet to the top of the head. The bar will travel along this path (weightlifting is a linear vertical movement with minimal horizontal displacement): lift-off with control and then exploding upwards without fear.  However mental images may change from one day to the next. Enjoy when they come. They may be appropriate at that time, but holding on or mentally constructing such images can be obstructive.

In order for meditation to be helpful, it is important to practice regularly. This enables the mind to access that meditative state quickly and easily in the midst of stressful situations. There are no short-cuts in training for weightlifting, and there are no short-cuts in meditation practice. If everything flows smoothly and flawlessly together, weightlifting is like a miracle and brings great joy – and relaxation!

Bodybuilding benefits

Bodybuilding exercises are a great confidence booster. The Turning Point program is offered by some YMCA branches for breast cancer patients. One of these classes introduced me to bodybuilding. It is lovely to build up muscles in the chest, arms, and back after mastectomy. However, when trying something new, it is important to build up slowly to avoid complications such as lymphedema [see references below].

Weightlifters can use bodybuilding exercises to complement their training. It is not necessary to add more leg work as this is covered in the lifts, pulls, and squats during the regular training. But upper body exercises for  shoulders, chest, back, and arms can be helpful to gain stability or confidence in the overhead position of the Olympic lifts.

About 8-12 repetitions and 3 sets are sufficient. The bodybuilding exercises can be organized such that different muscles are used in any two exercises. In that case very little, if any, rest periods are needed between sets. It is helpful to use concentric and eccentric motions for each muscle group. For example,  push-ups vs rowing for the arms or pulls vs pushes (e.g. squats) for the legs. Using free weights rather than machines train combinations of muscles and activate the core (and won't strain the back through sitting). There are many exercises so that a bodybuilding program can be changed every couple of weeks to add variety. Having someone correct your form is needed to avoid injury and to get the most out of these exercises.
Soon we can start posing in front of a mirror and flex muscles.

References

1. Stegink-Jansen et al.  Computer Simulation of Pectoralis Major Muscle Strain to Guide Exercise Protocols for Patients After Breast Cancer Surgery. Journal of Orthopaedic & Sports Physical Therapy 2011: 41(6); 417-426. Link to article.   Findings: Combined stretches, such as extension and external rotation puts most strain on the pec muscle. Early postoperative abduction should be increased gradually. 
2. Schmitz.  Weightlifting and lymphedema: Clearing up misconceptions (about interpretations of the Physical Activity and Lymphedema (PAL) trial with  7 guidelines)

Sample exercises by muscle group:

Legs

• squats
• leg presses

Back

• Lat pull downs
• cable rows

Shoulders

• lateral raises
• DB presses

Chest

• pec flys
• chest presses

Triceps

• tricep extensions
• reverse cable pull down

Biceps

• DB curls
• hammer grip row

Core

• planks and side planks

International Womens Weightlifting Grand Prix

This competition took place in Nagold, Germany, June 8-10. There were around 100 women weightlifters from 16 countries, ages 10 to 58.  There was a DJ playing encouraging music when a lifter walked onto the stage, the audience clapped in rhythm, and, as we stepped up to the bar to get ready to lift - silence. It was fun, and a great opportunity to make new friends.

 Global sisterhood!

Reach to Recovery

I finished volunteer training with the American Cancer Society, Reach to Recovery Program. This is to talk to women going through the breast cancer experience who need a sympathetic listener ,or more information ,or just know that others have gone through similar things and came out OK.

Warm flashes

Hot flashes have arrived! I was hoping to avoid them, since I have had no problem even though the menses have become irregular, and my sister had no problem. It may be possible that Tamoxifen speeds up the natural process of entering menopause.
They started mild, just like blushing, so it took two weeks to recognize for what they are. At first they were few and far in between, e.g once during the day, twice at night, but now they are visiting regularly, at least hourly, and during every kind of situation, including while talking with others. Sigh....    At this point they could be described as warm flashes.
It is said that they stop when hormonal therapy stops. FOUR YEARS of this???
What may help:

• acupuncture (already doing it, it didn't prevent it)
• diet without alcohol or spicy foods (already doing it)
• relaxation (stressful situations/thoughts can bring this on, so be sure to have  regular meditation practice)
• drugs (treat side effects of drugs with more drugs, possibly on the WADA list)

Update from the future: The warm flashes only lasted about 6-7 weeks. 😊

What we say or how we react

"There is no single right approach and no simple answer to dealing with the human side of cancer." 

--JC Holland, The Human Side of Cancer

You will find out that you are not the only woman with breast cancer and that breast cancer patients come from all paths of lifestyles. Beware that incomplete information can result in erroneous ideas, and decisions may be made without backing of scientific evidence.

Upon hearing of a breast cancer diagnosis or treatment, people have to deal with their fears and uncertainties. That includes both sides, women who get the diagnosis, and people who come in contact with these women. We can switch between numerous coping mechanisms during a cancer journey.

Here are some coping mechanisms/attitudes of women with a cancer diagnosis:
Avoider/Procrastinator:  Me? It can't be that bad. I don't need to see a doctor/get treatment/...
Fighters:  I am going to beat this thing. I am going to start exercise/meditation/acupuncture/....  I choose to do the most aggressive treatment, chemo, mastectomy,  even if it is not needed scientifically.
Stoics/Non-fighters: Accept and endure what comes, but I don't go out of my way to seek new treatments.
Paranoid: May choose aggressive treatments so that the cancer won't come back.  I can (will) die from this even though the diagnosis was 15 years ago.

Here are some coping mechanisms by people who hear about your cancer journey:
Cheerleaders: You'll be fine. They caught it early. You don't look like you have cancer.
Therapists: This is because you have too much stress in your life (bad job, difficult relationships, ...). Think positively, so that you can beat the odds.
Fighters:  Who needs boobs, cut them off. Get over it and move on.
Problem Solvers: You can cure your cancer, if you take whatchamacallit, or become a vegan, or ...
Unsure what to say, but want to say something: The relative of a friend has cancer and has such and such an experience.
Clichés: Everything happens for a reason. Think positively.

Bad things happen:
"Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick.[...] Sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place."

--Susan Sontag, Illness as Metaphor

What can we do?
Cancer patient: Separate fact from fiction and seek medical help, and otherwise stay with the attitude that comes natural.
Supporter of the cancer patient: Listen! Say you are here for them. Give some concrete suggestions how you can help.
P.S. Take this moment to familiarize yourself about choices such as mastectomy or reconstruction and what decisions you might be inclined to make. It might happen to you in the future.

One year follow-up

Exactly 12 months ago was my bilateral mastectomy.

As a celebration I competed in a local weightlifting competition. This event was also my first competition a year ago. Despite the weight loss and although I hand't managed such weights in training I really wanted to repeat the weights lifted for the clean & jerk a year ago, 55kg - 58kg - 61kg.  It went fine until the clean of 61kg, which I caught badly. I was feeling disappointed that I had to drop it. But  then I thought "No way am I going to loose this bar!!!" And with sheer willpower and a little stumbling on the platform  I managed to save it. It is surprising how little time it takes to think all these thoughts and feel all these feelings and still act timely.

On the one hand I am much healthier now than I was then and feel awesome. The one year follow-up tests (blood lab values) were super good and better than before.  And I think about the cancer less and less, although it is a chronic disease.
On the other hand I have to take Tamoxifen for 4 more years. It has side effects. I take only half the dose to the dismay of the oncologist. Clearly tamoxifen has a good track record (it's been around for 30 years) of preventing recurrences. The unanswered question is how to balance the risk of recurrence with the risk of long term side effects increasing comorbidities for somebody with little or no risk factors like myself.

National Masters Weightlifting Championships 2017

• Good preparation with much more shoulder stability than it was a couple of months ago
• Excellent coaching
• Meditation between the warm-up lifts to stay calm
• 3rd place!

Benefits of competitions

It is well known that we benefit from exercise. How about the challenge of competitions?

In the preparation and participation for competitions we can find enjoyment in the physical improvements and testing our limitations, getting positive effects on mood from the training, being motivated to pursue regular, intensive exercise in order to reach the goals for competitions. Meeting other women weightlifters at the competitions and staying in contact via social media enriches life. In interviews at the World Masters Games in Sydney 2009 competitors aged  56-90 identified five themes, namely enjoyment of challenges, satisfaction with what their bodies are capable of, winning, motivation, and companionship ("Older athletes perceived benefits of competitions")

Competitions and training for competitions provide physical and mental challenges.  One has to deal with doubts or unreasonable expectations and finding a balance. There is the risk of injury, typically measured in number of incidences per 1000 hours of activities in the chosen sport. It is relatively low in weightlifting compared to ball or contact sports or running (Pakkari et al. Active living and injury risk.  Int J Sports Med 2004; 25: 209-216).  Injuries or comorbidities (such as cancer) make it necessary to adjust the training and not being able to achieve what one hoped. However at the competitive level athletes make these adjustments and continue to train.  In the documentary Impossible Dreamers (2016)  a 68 year old swimmer talked about how "something inside her kept her going and going" after a surgery so that she was able to break the world record a year later. An 85 year old sprinter said that "we don't let things stop us from max effort." A 94 year old yoga teacher and dancer said that it is the dance of life inside her, and that she tells her students not to give in to anything but to know that they can recycle their own bodies. 

At competitions we learn how to deal with our nervous system so that we can focus and find a still point that allows us to be at our best. It can be helpful to dedicate our efforts at a competition to something. For example, I wanted to succeed (meaning to participate and do well) at the world masters weightlifting championships for my breast cancer sisters in the world, and as an example that breast cancer need not stop us. There are many women with breast cancer diagnosis who participate in competitions at the highest levels: Sisterhood of breast cancer athletes

Cancer Care Bag

A girl scout group is designing a cancer "care" bag for anyone going through cancer treatment.  This is such a delightful idea. Cancer treatments  are at different stages: surgery, chemo, radiation, hormone therapy, side effects of any of these. To keep it generic here are feel-good suggestions:

1. a fun (self made?) tote bag with some of these:
2. peppermint essential oil
3. 4 fl.oz of massage oil, e.g. apricot kernel oil, almond oil, coconut oil 
4. eye pillow with lavender scent 
5. CD with relaxing music
6. a journal and pens/pencils
7. stress toy
8. a fancy scarf
9. IOY for cooked meals, shopping, cleaning, mowing, etc...
10. gift card for Amazon or iTunes  

The Mermaid

A great exercise for shoulder mobility and reducing or preventing swelling is the Pilates exercise "The mermaid".
This is a slow moving exercise without static holds.

Sitting on the floor with feet tucked by your side, hold onto your ankle and arch over to that side. Then place the other hand on the floor or on a foam roller to arch over to the other side. Next "thread the needle" with the arm reaching underneath the arm that is anchored to the floor and look through. With a foam roller you can the place both hands on the roll and use core strength to roll out and in keeping the neck in alignment with the spine.

An easier alternative: sit cross legged.

1. arch over the foot

2. arch over the roll

3. thread the needle

4. roll out and in

Shoulder strengthening with resistance band

Shoulder stability is especially important in weightlifting. Here are a few exercises with a resistance band that help after a mastectomy to strengthen the muscles on the side of the ribs and in the back around the shoulder blades:

Exercise 1: Anchor the resistance band to one side of the hip and externally rotate the other shoulder. Particularly important is the holding and making sure the back muscles are activated. Repeat on both sides.

Exercise 2: Stand on the resistance band, bend forward and row. Again once pulled up, hold, and stabilize the shoulder blades.

 Exercise 3: Tie the resistance band overhead and pull down.

Benefits of Bilateral Mastectomy

1. no more bras (especially during the summer!)
2. no more mammograms
3. closer hugs ❤️
4. chest massage
5. Fashion:
• wearing fancy shirts backwards
• smaller clothing size
• wearing men's shirts  
• tank tops don't show bra straps
6. Sports:
• push-ups are easier
• streamlined for olympic weightlifting and other sports 🏊
• jumping on a trampoline
7. better posture 💃

Tamoxifen Blues

Tamoxifen is prescribed for premenopausal women, when the breast cancer is determined to be estrogen receptor positive. It is to be taken for 5 long years (or longer, if newer studies are to be believed).

Every morning I look at the little white pill and have to remind myself of the abundant scientific evidence from the last 30 years to prevent recurrence, so that I work up the will to take it. But I resent the side effects that accompanies this medication. Five years of diminished quality of life.
There is a whole host of side effects: https://www.drugs.com/sfx/tamoxifen-side-effects.html Side effects that I experience are

• brain fog/memory lapses. Reduction in cognitive function is very disturbing! Sometimes this may lead to forgetting to take the little white pill.
• red face. I mean really red. Chin and up red, throat and down white. Heat, cold, stress, thinking thoughts that make me tense, and more, can bring it on. This is really weird at the work place.
• depression
• dry skin and dry, itchy eyes (terrible in my job having to work on a computer a lot)

I must admit that in the beginning I skipped some doses, and then for a while I took only half the dose (10mg). It is a long acting drug, and will stay in the body for months after stopping, so it is not terrible to skip a day. 

What may help to prevent such side effects:

• relaxation (to remove stress)
• plenty of water (2.5 liters a day, red face points to inflammation processes)
• lots and lots of exercise (it is always better afterwards even if only for a little while)
• some women swear by supplements: vitamin D3, vitamin B12, magnesium (I don't know, but I take it anyway)

For somebody who has never used supplements or avoided putting foreign substances such as medications in my body, this is a downer. The alternative is to take more drugs to combat the side effects.  Another drug is Aromatose inhibitors (AIs) prescribed for postmenopausal women but comes with its own side effects. Common is the drastic reduction in bone mineral density. I am weightlifter! This activity might make fractures more likely when taking AIs. And switching medication will require another application to the US Anti Doping Agency and a lengthy process to get a Therapeutic Use Exemption. These drugs do nothing for performance enhancements, but are on the forbidden list because they mask side effects of steroid use in men.

The side effects are supposed to get better the longer one takes the drug. Let's hope!