Published on October 30, 2017
The physical, mental, and even emotional benefits from exercise can help patients feel empowered with an improvement of their overall health, but how much is okay to do? What factors contribute to a patient’s exercise routine? Melanie House, a physical therapist from the University of Iowa Hospitals and Clinics, joins us to share how myeloma patients can exercise safely and what amount is acceptable based on individual conditions.
The Living Well With Myeloma series is a Patient Empowerment Network program produced by Patient Power. We thank Celgene, Takeda, Amgen and AbbVie for their support.
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Transcript | How Much Exercise Should Myeloma Patients Do?
Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That's how you’ll get care that's most appropriate for you.
Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.
So you're a doctor of physical therapy. You work with cancer patients, and you and I were chatting before the program, and you—I was talking about we'd mentioned a bunch of medicines that Matt's having, or Jim has had transplant, you know, heavy-duty dosing things, but you believe that exercise gets dosed and can be precise for patients too.
That's right. Yes. What I was taught in our graduate program is that exercise is as powerful. In fact, research studies have shown times sometimes in cases more powerful than drugs that are FDA approved, and Jim and Matt can attest to this.
And so if you're going to use a drug as strong as exercise, it does need to be prescribed in the proper dose, the proper intensity, and so each person really needs an individual prescription, if you will.
Okay. So, you know, so these guys go through treatment. I don't know about how it is during transplant, you can explain that, but certainly with ongoing or maintenance therapy or some cycles of infused therapy is exercise a good thing, or is there some time you should just get in bed?
Well, there are definitely precautions. There are times when exercise really should not be done, and that's when you have extremely low counts. For example, if your platelets are even—we transfuse people when their platelets drop below 10,000 per millimeter cubed.
So, you know, in my mind I don't see that patient until they have their transfusion. It doesn't really make sense for me to work with them knowing that they need that blood product. So I'll wait. They'll get their blood product in the morning, and I can treat them in the afternoon.
Similarly, red blood cells are another key blood count that we watch because your red blood cells are the vehicle that delivers oxygen to your muscles, and since your heart is also a muscle it's very important that it has adequate oxygen supply if it's going to be working. So there again I watch their transfusion triggers, and we transfuse people with red blood cells when they drop below 7,000 per millimeter cubed.
Okay. So—but let's say if somebody is going through a transplant and you have worry about infection and all. Does that mean don't do anything? Not only don't touch anybody, don't be around little kids who are sneezing and coughing, stuff like that, but also don't go out and take a walk?
Well, we actually—we encourage our patients to still be active. We don't require them to stay isolated in their rooms when they're here for transplant just based on their white cell counts, and that's partly because we're controlling—you know, we don't allow small children on the unit. We don't allow fresh flowers on the unit. We have our patients wearing well-fitting masks to help filter the air that they're breathing.
I strongly encourage them to do good hand hygiene, and that means not just using the disinfectant foam and relying on that but excellent hand washing techniques, because there's certain germs that you can pick up. And one of them is called C.diff, and it's a spore, and so the only way to actually get rid of it is to wash your lands and just debride it right down the drain. So I actually spend a lot of time educating my patients on those precautions, because it doesn't matter how good we are with the exercises if they come down with serious infection.