Breast Oncology Rehabilitation

Susannah Haarmann

In 2013, H&W debuted a brand new course on Rehabiltation for the Breast Oncology Patient. This coming year, we are thrilled to be offering this course on the West Coast, in San Diego in April. Pelvic Rehab Report talked to course author and instructor Susannah Haarmann, PT, CLT, WCS about what she learned from teaching this course for the first time and what she looks forward to sharing with participants this year.

PRR: You developed and started teaching this course for the first time in 2013. What did you learn from your first time teaching this course?

SH: I learned that the breadth of topics that ought to be covered in order to present a holistic approach to rehabilitation and breast oncology is gigantic! I was inspired to teach this course because, from my perspective, in most clinics and hospitals, the vast concerns of breast survivors regarding physical well-being and quality of life are not being addressed. I turned to mentors for guidance, but their knowledge had holes. I probed the research, but the information pertaining to rehabilitation seemed disjointed. I sought out continuing education, however, the topics covered were not as complete and detailed as I would have preferred.

In summary, I learned teaching in 2013 that I bit off a lot to chew! Feedback from the course was largely optimistic, however, I have made huge modifications. The course material has been reorganized from a 3-day to 2-day course. Although the course is still steeped in research, the content has been stream-lined. I have also included more labs with pertinent case scenarios for didactic learning and skills development.

Were there any surprises? How did feedback from participants inform the evolution of this course as you prepare to teach in 2014?

I was surprised by the variability in course participants! There were physical therapists and occupational therapists, women’s health practitioners, travelling physical therapists and certified lymphedema therapists, outpatient practitioners and acute care therapists…the perspectives that we had during the debut course was incredible! I treat breast cancer survivors on an outpatient basis, but feedback from the acute care therapists helped me address post-surgical and inpatient issues. Furthermore, I am a certified lymphedema therapist (CLT) trained by the Norton School of Lymphedema, however, there were also Leduc trained CLTs present as well. Interacting with these practitioners broadened my awareness of lymphedema treatment approaches.

Finally, the labs included in this course are broad in scope; they require us to pull from our basic knowledge of cardiopulmonary, integumentary and neuromuscular systems knowledge. Many participants were glad to sharpen their skills in orthopedic testing of the shoulder or vitals assessment and interpretation. In order to be experts, sometimes we have to perfect the basics- Be prepared to call on your generalist wisdom!

What were the most common questions asked by participants during the course? How does the course address frequent questions/misconceptions therapists might have about this topic?

I would say that many of the therapists were inspired by the idea of a health care team that became familiar with the client from the time of diagnosis through the ‘re-entry’ phase into long-term survivorship. Participants wanted to know how to facilitate the practice of the prospective surveillance model in their communities and develop relationships with physicians.

I think that a frequent misconception about breast oncology rehabilitation is that it just addresses lymphedema. In most cases, all bodily systems are affected by treatments related to breast cancer; some rear their heads during the acute phase, whereas other side effects become noticeable with the aging process. We as rehabilitation professionals are able to work with various body systems across the continuum of care. If you take this course be prepared to learn about treating post-surgical side effects such as lymphatic cording, muscle imbalances and post-mastectomy pain syndrome. Get ready to dig into treating side effects of chemotherapy such as peripheral neuropathy, fatigue, osteoporosis and dyspareunia. Learn about rehabilitation considerations pertaining to radiation such as integumentary and potential cardiopulmonary changes. But, we won’t stop there! Behind every ‘body’ is a person; you will also be exposed to what the research says about how medical interventions can affect the psyche and how methods such as mindfulness based stress reduction can not only improve personal well-being, but also affect cancer outcomes.

Want to learn more from Susannah? Check her out in San Diego, April 12-13!

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