You have a new client which you will be training two times a week for 30 minutes a session. Review the client health status of Mary Julia and answer the questions below

Client Health Status

Mary Julia 49 yo female 4 weeks post radiation for Breast Cancer, 10 weeks post chemo

Medical History

Diagnosed with Invasive breast carcinoma IBC, completed a unilateral mastectomy right side to remove cancer. Completed chemo and radiation without event, other than tiredness and feels some depression and anxiety over the whole cancer experience and losing a breast. Her doctor has prescribed Diazepam prn, but Mary Julia doesn’t like to take it because of the side effects. Her hormonal treatment is tamoxifen.

Right arm shows some lymphedema and she has been advised to use a sleeve while doing repetitive movements with her arms. Her range of motion is almost back to normal in her right arm.

She also has exercise induced asthma for which she uses an inhaler – Fluticasone Mary’s asthma bothers her more with outside exercise.

Mary Julia also has borderline hypertension

Her weight is up about 10 pounds and she wants to lose that.

Blood Pressure – 140/90 Resting Heart Rate – 72 Height 5’4” 140lbs

Her exercise test show some right side strength deficits. Her overall level of conditioning is average after her treatments, but before cancer she was very active. She wants to get back to regular exercise, but her anxiety over cancer and worry about it coming back gets her off track.

• Discuss with Mary Julia how exercise can help her current condition as well as her risk of recurrence.
• Explain lymphedema and how it could affect her activity and any precautions she should take.
• Discuss asthma and precautions needed when exercise and how to be ready if she does have an attack.
• Discuss strategies to help Mary Julia with her depression and anxiety and the effects of exercise on depression and anxiety.
• Discuss all medications and precautions for exercise.
• Come up with a complete program that includes a warm up and strengthening exercises for her 30 minute sessions on TTH
• Advise her on a gradual walking program that you want her to complete on MWF
• Are there any other medical professionals that you would suggest she see to assist her with any of the issues that concern her?
• Finally what strategies will you use to keep up Mary Julia’s motivation to complete activity and get back to her former fitness level?