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Therapy helps breast cancer survivor remain active

Therapy helps breast cancer survivor remain active

When Tamara Thomas-Walker was told she had breast cancer, she wasn't surprised. Her father survived breast cancer twice, three of his five sisters had breast cancer and 10 of her first cousins have had at least one type of cancer, with the majority being breast cancer.

"With my family history, I thought it might happen," she says. "I found out on Jan. 15, 2015, after a mammogram. I had never felt a lump, and neither did my doctor."

Thomas-Walker immediately became a patient of the Cancer Center at Missouri Baptist Medical Center, where her cancer team of oncologist Alan Lyss, MD, breast surgeon G. Paul Yazdi, MD, radiation oncologist Pawel Dyk, MD, and a nurse navigator oversaw her treatment.

Due to her strong family history, Thomas-Walker also underwent genetic testing, like many of her family members. But none has tested positive for a genetic mutation such as BRCA1 or BRCA2.

The 57-year-old mother of two biological children and three foster children is a criminal investigator for the state of Missouri's public defender system. She already had a lot going on in her life, but was ready to take cancer head on.

"I started my cancer journey believing that cancer only wins if it can steal your spirit," she says. "I decided that it couldn't have mine. I had a great support system of family and friends who were very encouraging. I also shared my journey with anyone who would listen, so that alone kept me from being afraid of the cancer or the treatments."

Thomas-Walker had two lumpectomies in her left breast, the first in February and the second in March 2015.

"After two surgeries and radiation, I just knew that I would return to my very active life and that would be that, but that's not what happened," she says. "For me, recovery after radiation was more difficult than having cancer."

Due to the fatigue and muscle restrictions she was experiencing, a social worker at Missouri Baptist recommended that she try occupational therapy (OT) and physical therapy (PT).

"Quite honestly, I didn't think it would help, and I was very skeptical," she recalls. "But my family encouraged me to do whatever was necessary to get healthy, so I scheduled OT and PT. It was the best move that I could have made toward recovery."

Thomas-Walker began her therapy at the Center for Outpatient Therapy and Wellness at Missouri Baptist in July, just months after her surgeries. It was there she worked with physical therapist Ashley Kumar, DPT, and occupational therapist Kara Hoette, MOT. Both are highly experienced and certified in several therapy modalities.

Kumar and Hoette applied many of the principles of the STAR program, a survivorship, training and rehab program for cancer patients offered at MBMC. Through STAR, OTs focus on fatigue management, while PTs work with patients to track and set goals that will return patients to their prior activity levels, whether they be at the gym, work, and/or their daily functional goals, Kumar explains.

After her cancer treatment, Thomas-Walker experienced muscle tightness and neck and knee pain that limited her mobility. Kumar focused on that pain and the resulting tightness that followed her surgeries and her positioning during radiation. "We worked on her neck for more than a month using manual therapy and exercises to get her back to a full range of motion," Kumar says. "She was very compliant with her exercises and very motivated. She also wanted to return to the gym, so we spent time on doing exercises safely so she wouldn't hurt herself.

"She has returned to full function, in part because of her mindset," Kumar says. "People can get down during this time, but Tamara remained positive. She's a good face for all women who are battling cancer and continue to juggle many different responsibilities. Now she's ready for anything."

Like many cancer patients, Thomas-Walker was exhausted following her treatment for cancer. In fact, she admits surprise that the fatigue she experienced became such a challenge to her daily activities. She worked with Hoette on managing her fatigue and understanding what it was doing to her body and mind.

"The most important step we take is to determine a patient's awareness of their fatigue level," Hoette says. "We emphasize taking short rest breaks before you reach a level of exhaustion, and we work on energy conservation techniques, such as preparing a meal while sitting for awhile, rather than standing the entire time."

Hoette, a certified lymphedema therapist, also evaluated Thomas-Walker for lymphedema, a chronic swelling that can occur if there's damage to the lymphatic system. "Anytime someone has a lymph node removed, we address lymphedema with the patient," Hoette says. "Tamara was a stage 0, so we offered her general knowledge and reminded her that although she's low risk, it's always a concern."

In addition to the therapy, Thomas-Walker says she found great value in working with both therapists because of their compassion and willingness to listen and address her specific needs.

"Occupational therapy and physical therapy helped me in more ways than I thought possible. I no longer have fatigue, and through hard work and exercise, I have full range of my muscles. Overall, I feel great," she says. "I may not be the woman I was prior to cancer, but I'm darn close."

The Center for Outpatient Therapy and Wellness at Missouri Baptist offers physical, occupational and speech therapy with a hands-on, patient-centered approach. For more information, call 314-996-3500.

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