I have recently started with a new client that has Leukemia. She has undergone Chemotherapy some many months ago and wants to get back into training at the gym. What would the exercise prescription or precautions look for such a client and even more importantly what nutritional/dietary intake would be recommended? Are there any major deficiencies that need to be addressed?

ANSWER:

Let me first begin by stating this:

When it comes to being a trainer or any higher level practitioner, the best process in order to help someone to heal is to develop a multidisciplinary team. This allows all aspects to the healing puzzle to be put together in such a fashion that they fit the person’s needs. With our society today, people are becoming less and less vital. You no longer have people just coming in to loose weight. The come in with injuries, chronic pain, autoimmune disorders and so forth. My best recommendation is to be the team leader in this situation by assessing and recommending her keep her MD in the loop, see a massage therapist, TCM and so forth. Whichever ones you see fit towards her healing.

Here is a quick definition and symptoms from www.wikipedia.org:

Damage to the bone marrow, by way of displacing the normal bone marrow cells with higher numbers of immature white blood cells, results in a lack of blood platelets, which are important in the blood clotting process. This means people with leukemia may become bruised, bleed excessively, or develop pinprick bleeds (petechiae).
White blood cells, which are involved in fighting pathogens, may be suppressed or dysfunctional. This could cause the patient's immune system (white blood cells etc.) to start attacking other body cells.
Finally, the red blood cell deficiency leads to anemia, which may cause dyspnea. All symptoms can be attributed to other diseases; for diagnosis, blood tests and a bone marrow examination are required.

Some other related symptoms
• Fever, chills, night sweats and other flu-like symptoms
• Weakness and fatigue
• Loss of appetite and/or weight
• Swollen or bleeding gums
• Excess bleeding (from a minor cut)
• Neurological symptoms (headache)
• Enlarged liver and spleen
• Easy bruising
• Frequent infection
• Bone pain
• Joint pains
• Swollen tonsils

Here is what I would do with a client such as this:
1. I would refer to some type of Holistic Nutrition and Lifestyle Coach. There are a lot of foundational principles that she can do to strengthen her immune system and reduce the overall sympathetic state that she is in. I find that through dead conventional foods, toxic home/office cleaning and hygiene products, plastics, etc, that these are a large contributing factor to their disease.

2. I would recommend regular Traditional Chinese Medicine treatments (whether it be herbs, acupuncture, qi gong, etc) in order to balance the 5 Elements (wood-LV/GB, fire-HT/SI, earth-SP/ST, metal-LU/LI and water-KD/UB) of the body. The symptoms listed above are common in TCM and correlate to qi deficiencies of certain organs, interior heat in certain meridians and lack of wei qi (the immune system).

3. As for exercise, your best bet is to assess her, design a program that fits her needs, but also on reducing her sympathetic overload. I would start small and work up from there each time you see her. You might have to get creative and play with the exercises, exercise type and variables, depending on how she feels each session. With clients such as this, I focus more on the nutrition and lifestyle first, and then add in qi gong movements for a month or so. This allows the body to adapt to the stressors at hand, and then when she is more able to handle more, you can create a low intensity “functional” exercise program. Exercise is a key to healing, but it might not be first on her healing totem pole!

Good luck!
Joshua Rubin