Colostomy

[Verdugo]

I have a 44 y/o F novice lifter and mom 137lb 5'6" with colorectal cancer. She is a talented nurse who provides her own IV nutrition infusions, has maintained decent bodyweight, rows her butt off to manage "deep bone level pain" as she describes due to treatments she recieves.

Is there any hard contraindications on lifting with a colostomy?

Programming wise, I'm assuming she should be treated like most any middle aged woman novice lifter except her progression will be slower due to regular cancer treatments? switch to triples early as normal, maybe only 2.5lb jumps early on, and maybe only 2D/week?

Thank you

[Mark Rippetoe]

When was her surgery, and what was its extent?

[Verdugo]

She had her colon surgery and colostomy placed over a year ago.

She can get after it on a rower she’s told me, but isn’t comfortable in deep hip flexion, so I started her squatting to a box and rack pulling.

[Verdugo]

She’s fearful about her abdomen and so I’ve told her to try a wide elastic abdominal binder as a support tool. Helpful in this case?

Thank you

[Mark Rippetoe]

I have no experience with this, so work it out.

[Verdugo]

Thanks Boss

[Maybach]

On SS Radio #271, Rip, you have a guy call in about training his dad and recommend the Nu-Hope ostomy/hernia support belts. These look pretty good, but are not of course full lifting belts. They are probably similar, if not identical to the hernia support belt you have her wearing, Verdugo.

A product called Stealth belt also come highly recommended, and seems a bit sturdier in construction. These come in a vertical and horizontal variation and I would guess that the vertical version would be more prudent so that the bag has a method of releasing excess pressure out from under the belt so it doesn't rupture.

It is apparently a done thing to simply pop a regular leather weightlifting belt on top of these and lift normally. The effects of a weightlifting belt alleviate the introduced weakness in the abdominal wall in much the same way as they do for non-ostomy lifters. Ostomies are indeed at a greater risk for hernia but weightlifting doesn't seem to post any especial risk for these: the ostomy subreddit is full of guys claiming to have reached near the standard 2/3/4/5 benchmark post-ostomy, so it seems there is no especial contraindication, especially if she is already reasonably active. Caution, not fear, as always seems the mood.

The cancer treatments will present a recovery obstacle, which means you might have to introduce intermediate stress management techniques a bit earlier. The small jumps and moves to triples don't necessarily need to happen faster than normal. Two days a week might be a smart move, depending on how she's feeling.

I would be interested in hearing updates if this doesn't unduly burden you, since this is a slightly uncommon case.

[Verdugo]

Appreciated and I’ll continue to recommend the hernia/stealth belt and for anyone in this boat I’ll reiterate the hernia risk is always there and must be monitored. Unfortunately this client’s treatments are apparently kicking her in the teeth right now and she has said she does not want to train now, that’s all I know. I can only assume that she has been injected with even more fear from her “well informed” oncology team. I tried to get out in front of that by briefing her to expect to hear that kind of crap from them and to realize that you can’t function in life and “not lift over 5 pounds”. That’s what they originally told her.

I have a real hard time not coming across as bitter as hell when I discuss why the most common PCP and specialist exercise recommendations are uneducated and sub-optimal. But I know the criticism coming from a strength coach must remain focussed on the mission. Thanks for the help and I’ll update here if I keep this client moving forward.

[Jason Donaldson]

Thanks to Rip, my mind always goes immediately to "What happens if she lifts SIX pounds, doc?"

Thankfully, I haven't experienced such advice directly since learning to train, though I have brought it up in conversation with others who have. They are usually as thoroughly authority-cowed as your client, sadly.