Breast Cancer: A Trainer’s Story

Staying fit and motivated during treatment

Karolina Stepek, 36, says she was “born” into fitness. Growing up in a small coastal village in Poland, Karolina was always active, doing martial arts and even competing in judo on the local, regional and national level.

Karolina moved to the US in March of 2000 and has been teaching group fitness classes since 2007. But things changed when Karolina, who has no family history of breast cancer, was diagnosed with triple-negative breast cancer earlier this year. Below, Karolina tells her story in her own words, sharing how she altered her fitness routine after her diagnosis, her mindset for getting through the tough days, finding motivation, and more.

Breast Cancer: A Trainer’s Story - Staying fit and motivated during treatment

My Breast Cancer Story

In April 2013, as I was taking a shower after my morning workout, I felt a small bump in my right breast. It was roundish and hard, and it didn’t hurt. About a week later I was at the hospital, getting a biopsy.

I was at work when I received the phone call the following Monday. My gynecologist called and shared the news with me. “You’ve got cancer,” she said. “Triple-negative, most invasive of all breast cancers.” The moment she said the words I went into my typical survival mode. What do I do next? were the only thoughts I had. Not, Why me? or What did I do to deserve it? I did leave work early that day. It was Monday, May 13.

For the first time I had to face real decisions; I suddenly learned what it meant to be an adult. I don’t have any family here, and my mom couldn’t get to the States right away; she needed to apply for a visa and wait for the Consul’s decisions whether she would be awarded one.

In the meantime, I was learning more and more about the type of cancer I had. Triple-negative meant that the only options as far as treatment were surgery, chemo and radiation. No pharmacological approach. Also, the triple-negative has a longer period of possible recurrence: five years. But once the five-year mark is met, the possibility drops almost to zero. Still, it’s five years.

Breast Cancer: A Trainer’s Story - Staying fit and motivated during treatment

Getting Through Surgery

I had the surgery on June 5. I opted for the mastectomy of my right breast, even though at the beginning I didn’t even want to hear about it. I thought losing a breast was like losing a part of being a woman; I didn’t even have children yet— something I’ve been wanting for so long. And suddenly I found myself divorced, childless, single, and with cancer. Not the best scenario, even for a natural optimist, like myself.

However, after speaking to my surgeon— a wonderful, amazing woman— I decided to take her advice and have the mastectomy. Thankfully, the BRCA test came out negative, and I could make a choice to have only one breast removed. Had it been positive, I would have no choice, but to have a bilateral mastectomy. During the surgery they also removed several of my lymph nodes. They turned out to be clear, which meant that I caught the tumor right on time; the cancer didn’t spread. I couldn’t be happier hearing the news.

I was let out of the hospital the following day. I was in pain; I had drains coming out of my breast that pulled on fresh wounds, making it hurt terribly. I stayed in bed for the first day. Thankfully, I have wonderful friends who stayed with me, and took care of me.

On the second day after the surgery I couldn’t stay in bed any longer. I got out, got dressed, and a friend picked me up for lunch. Sure, I walked like a crippled old lady, but I was out of the house! Nothing made me feel better than a breath of fresh air. From that day on, I refused to stay in bed. Every morning I’d get up, get dressed (showering was a different story, I needed assistance), and just try to do things. Of course, I cursed like a sailor when the drains pulled on my wounds or I made a move that wasn’t careful enough.

>Breast Cancer: A Trainer’s Story - Staying fit and motivated during treatment

Treatment, and Getting Back to the Gym

Once the drain had been removed, I decided that it was a good time to get back to the gym and see how much I could do. I shared my plan with my doctors and they all advised I “better think twice” and “walk on the treadmill.” I wasn’t thrilled with the recommendations and decided to listen to my body. Over the years, I’ve learned that my own body would always tell me best what it needed.

Since I could barely lift my arms, I decided to do legs. Since I already lifted heavy before the surgery, I didn’t fear working more on the harder side. Little did I know that I’d be walking like a flamingo for another four days! Mastectomy? Phew! Big deal. Sitting on the toilet— now that was a real pain!

The truth is, I COULD work out. My doctors still cringed when I talked about it, especially after I had the tube and the port to deliver chemo inserted. I was told not to lift anything because I could tear the tube, and I’d need a surgery to fish the pieces out. I respected what I was told and was very careful with any upper body movement. Plus, I didn’t want to rip fresh wounds. Slowly, but surely, I could do more.

Then the day of my first chemo came. After speaking to my oncologist, I decided on the most aggressive approach: eight weeks of AC followed by 12 weeks of Taxol. I already had my eggs harvested (something insurance doesn’t cover, but since I didn’t want to give up on having children I wanted to make sure I still have an option), and was also prescribed Lupron Depot shots to put me in induced menopause to shot my ovaries. After the chemo, the ovaries are supposed to jumpstart, but in case they fail, I’ll have my frozen eggs to have IVF. I hope, though, I’ll still be able to conceive naturally. Fingers crossed.

The first chemo wasn’t bad. I mean, I could taste the chemicals being pumped into my body, and it was gross. But I didn’t really feel any side effects. As a matter of fact, I wanted to see what I could do, and on Friday (which is the second day after the chemo; the day when you supposed to feel pretty sick) I went to do legs. Sure, I got a little head spin after Smith machine squats, but I waited it out, and it was all good.

I don’t want to sound cocky here. With each week of chemo, I felt it more. Not even close to how other patients feel, but I did. The difference between me and other patients (besides the age) is the fact that I’ve been training my body for years, and quite frankly, many times I couldn’t tell the difference between chemo-related pains, and after-workouts pains! My body is just used to all kinds of pains. Besides, being conditioned boosts the immune system.

My hair fell out exactly two weeks after the first session, and it was the most traumatic experience for me. This was the first visible sign that I had cancer. But when it did start to fall out, I couldn’t take it, and I just shaved it off. To make the experience less painful, I had a photo shoot (I have a friend who’s a great photographer) during which I was just playing and having fun: I cut the hair with a knife, scissors, we shaved half of my head, did a mohawk, then shaved it all completely. In all this misery I had a really good time that night.

Each day I would learn new things about myself, what my body could handle, and I would just go with it. The only one thing I knew by then was that I couldn’t stop.

Breast Cancer: A Trainer’s Story - Staying fit and motivated during treatment

Learning to Adjust

In the beginning like I mentioned before, I had to be very careful lifting because of the new scars and stitches. I had to lift lighter, although with legs I quickly went back to heavier weights. I had to stop teaching classes because I would get winded easier and I knew I wouldn’t be able to keep up with talking while teaching. Also, I experienced much longer recovery time, literally by hours. There were also few days when I just knew I had to take a break, and those were usually Fridays (second days after chemo; the “bad days”). It was hard to tell myself I had to go easy on myself. I am just not used to going easy. On the other hand, this was an excellent opportunity to learn how to.

I knew that chemo would cause me to lose my appetite. I knew I might possibly throw up (never happened). I knew that I didn’t want to lose weight; I didn’t want to lose muscle. Well, I had to feed the muscle somehow. But since my body went berserk on me and refused to want to eat anything besides watermelon and ice cream (!!!), I had to come up with a solution. Well, muscle stimulation causes the muscle to grow. In order to grow, the muscle needs protein. In order to get the protein, a signal needs to be sent to the brain to demand food… this was how I would make myself want to eat. I lifted heavy because I knew that two to three hours from that moment I would suddenly become very hungry, and I just used that window to pack as much protein as I could— usually small portions size-wise, but calorie and nutrient dense. Bananas with almond butter, egg whites, protein powders, Greek yogurt, Cliff protein bars… I couldn’t taste any of it, but I knew it was good for me, and if I didn’t want to fall sick and weak, I needed to eat.

I believe that keeping the body fed was (still is; I’m still not finished with chemo) one of the key ways of me remaining in good condition for most of my treatment. Again, I really want to stress, I am not some hero woman. I had my bad days. But because of the positive mindset I maintained (and still am), and training, I could fight a lot of the side effects.

I understand that everyone is different, and goes through chemotherapy differently, but to me training is a distraction; I don’t think how poor I am that I have to deal with cancer. I just think OK, this is where I am now, and this is what I need to do. Let’s kick cancer’s ass. I make sure I start my day with training and then keep my days busy: seeing friends, running errands… I was lucky to be off of work for eight weeks, and I was able to focus on myself. Some people need to work during treatment, and that’s great. Some take daily walks. Everyone should seek what helps them cope. It’s crucial.

Breast Cancer: A Trainer’s Story - Staying fit and motivated during treatment

My Fitness Routine

When I started chemo, I had 20 weeks of treatments ahead of me. But instead of thinking how far I had to go, I thought only of how far I already went. One week down, two weeks down, etc. And now I have only five weeks left! Well, then another surgery and six weeks of radiation. But I’ll worry about that when the time comes.

As far as working out with the treatments, I space them. For example, I get chemo on Wednesdays. Wednesdays are my long days because after chemo I go straight to work from 3 pm to 11 pm. So I don’t work out on Wednesdays. I train on Thursday mornings— but because it’s after chemo, I go easier and only do chest and triceps, and cardio.

Breast Cancer: A Trainer’s Story - Staying fit and motivated during treatment

On Fridays I normally do legs, even though it’s the second, “bad” day. But I learned that it doesn’t really hit me until around lunch time, so if I get my workout done in the morning, I’m able to perform as I normally do. Saturdays differ, but I usually force myself to go because once I’m at the gym all pains seem to disappear (I think this is very psychological). Sundays are off. On Monday and Tuesday I feel back to normal and those are days when I teach. On Monday I teach weights (interval), and on Tuesdays I teach spin. Then go straight to work on both days.

The newest clinical studies show that resistance training is very beneficial for breast cancer patients. I know that from experience. The more I move, the more energy I have, even though, as I mentioned before, my recovery time extended greatly. The days when I felt worst were the days when I had to stay in bed. I was stiff; I didn’t feel like doing anything. When I move, even when I have to force myself, the energy just comes back. I know everyone is at different level, but even little things help. A walk outside, maybe lunch out, maybe swim… whatever it is, it is better to do something, than nothing at all. Another aspect— keeping busy keeps the mind away from the cancer. Less time for thinking! It’s bad enough it showed up, it doesn’t really need additional attention!

Breast Cancer: A Trainer’s Story - Staying fit and motivated during treatment

Looking Forward

There is so much love surrounding us that we just don’t see because we are so busy rushing somewhere, thinking of bills, work, all sorts of things. The amount of love I received is unbelievable and overwhelming. At the gym men and women come to me and tell me how much I inspire and motivate them to work, that they no longer have an excuse because they see me work my butt off. I feel so humbled; never in my life had I thought I’d be someone’s inspiration. But it makes me happy, and I want to continue motivating people because I know how important it is to stay healthy.

Once I let myself cry [on the difficult days], I take a deep breath and say: “Pull yourself together!” and then I try to meditate or just quiet down. If I feel lightheaded and dizzy, I lie down and rest. I try to sleep then. Nothing restores body better than sleep (and proper nutrition). But most of the times I just think of how my body has been serving me, keeping me strong through chemotherapy, and how it was only possible because I never gave up before. This is what really helps get me going.

This information is for general purposes only. Always consult your doctor before beginning any training or diet/supplement program.

Photos by Sebastian Kowalski