1. Welsh Public Health Conference 2013 October 2013 Gwynedd Exercise Referral Scheme Cancer Rehabilitation – Case Study

2. Cancer History The Client - Michelle 46years, GP Surgery Receptionist and Phlebotomist Diagnosed with Grade 3 Stage 1 Triple Negative Breast Cancer in November 2011 Treatment received – Lumpectomy, Chemotherapy and Radiotherapy Side effects- hair loss, fatigue, severe nausea, mouth ulcers, tingling and weakness in left arm and weight gain

3. Start of NERS- Goals Short, Medium & Long Term Goals Short Term - 6 weeks -To Increase physical activity- attend gym 2 a week -To reduce BMI- loose 2.2kg Medium Term – 16 weeks - To Reduce BMI – total wt loss 6.3kg - To Reduce waist circumference – total 8cm Long Term - To maintain weight & BMI to healthiest level - To maintain cross training 5 -7 days per week

4. Wk 1& 16 Measurements Physical Measurements:- Wk1 Wk16 Weight85kg76.8kg Waist Circ91cm81cm BMI28.423.75 Blood Pressure121/81115/75 Resting Heart Rate78bpm65bpm

5. In Michelle’s Words ‘I wanted to get fitter and healthier after the cancer treatment. I had researched that having the lowest BMI within a healthy range was one of the best things that I could do to help prevent recurrence of the cancer. I was determined to make eating healthily and being more physically active a priority in my life- EXERCISE IN LIFE….FOR LIFE so to speak. I was encouraged to exercise gently to begin with under the supervision and encouragement of the instructor, I did circuit and interval training and strengthening and mobility exercises for my shoulder. I also started swimming and Pilates classes. Over the weeks I was able to push myself a bit harder and began feeling fitter and stronger which was an amazing feeling after the way I’d been feeling previously. Having completed the scheme I am still an avid exerciser 9 months later, going to the gym, walking, swimming and still doing Pilates. I have also gone back to work 2 days a week. I am certainly walking taller and feel better prepared to cope with anything life throws at me.’ Michelle January 2013

6. Before & After

7. Thank you / Diolch Emma Quaeck-Gwynedd Exercise Referral Coordinator E: emmaquaeck@gwynedd.gov.ukemmaquaeck@gwynedd.gov.uk T: 01766 512711 M: 07768 988095 Jeannie Wyatt-Williams National Exercise Referral Coordinator for Wales E: jeannie.wyatt-williams@wlga.gov.ukjeannie.wyatt-williams@wlga.gov.uk T: 029 2046 8516 M: 07500 556045