The week before, radiologist Dr. Don Goodwin had spent an hour on Pain 2 Power talking about breast cancer screening. This week Dave and Mike wanted the other half of the conversation: once you know the risk is real, what can you actually do about it? Dave brought two friends to answer. Elyse Marrone is a registered dietitian who sees patients in Jupiter, and Danielle Armstrong owns Pilates Life on Northlake in Palm Beach Gardens.
Between them they covered food, movement and sleep before, during and after a diagnosis, plus one of the better stories we have heard on the show, about a dancer, a radical mastectomy and Joseph Pilates himself.
By The First Rehabilitation Team · Reviewed by Dr. Dave Kashuba, Ph.D.
Starting from 400,000 diagnoses a year
Dave opened with the number he could not shake from the week before. By his count there are over 400,000 cases of breast cancer diagnosed in women in the United States. Mike called it a horrifying number and admitted it is hard to get your head around.
What bothered Dave more was the word “cure.” As he put it on air, a cure rate often means living about five years, and that, in his view, is not a cure. So he steered the hour toward the things people can influence. There are plenty of factors you can’t control, he said. But eating well, taking care of yourself, not smoking and not drinking too much all count, and he put the share of risk those habits touch at coming up on 40%.
Mike had been reading about the same idea that week. We pick up cancer cells all the time, he said, and the immune system finds and clears them in small doses. Dave ran through the cells he had been reading about, the CD4 positive and CD8 positive T cells and the macrophages he called the pig of the blood, because it eats everything. The point of the whole show followed from there. Give the body the right environment and it does a lot of this work on its own.
Those figures are Dave’s, as he said them on the show. If you want the screening side of the story first, it is the episode just before this one on our Pain 2 Power podcast page.
Elyse Marrone’s triple HD plan and the seven pillars
Elyse introduced herself as a registered dietitian who is functionally and integratively trained. In practice that means she does not stop at matching your plate to the current food pyramid or whatever diet is in fashion. She looks at all seven parts of your lifestyle and asks how to get each one working. Quality of life, she said, should travel with quantity of life.
Then she gave the line that became the episode’s first clip. “So I say I want to be healthy, healthy, healthy, dead.” She doesn’t want the long slide down. She calls it the triple HD plan. Mike’s summary was quick: “We’d rather thrive than just survive.”
The seven pillars are the backbone of every appointment she runs. She does look at labs. Her view is that the labs move with the pillars, and Dave added that they can move quickly, in either direction.
| Pillar | What was said on the show |
|---|---|
| Food first | Dave listed high fiber, omega-3 fatty acids, cruciferous vegetables like broccoli and cauliflower, and less alcohol and processed meat |
| Exercise | Dave: exercise “makes what we eat turn into gold”; Elyse said it can also increase deep sleep |
| Sleep | Deep sleep, wearables like the Oura ring and the Whoop band, and blue light blocker glasses from 8 o’clock in the evening |
| Stress management | Elyse: stress raises cortisol, which can set off a cascade of events |
| Supplementation | Elyse checks vitamin D for the immune system and discussed DIM, an extract of Brussels sprouts |
| Hydration | Named as one of the seven; not discussed in detail on this episode |
| Community | Named as one of the seven; Mike admitted he is good at about two of the pillars |
Why the first look is at the gut
Dave asked what happens when someone newly diagnosed with breast cancer walks into her office. Her first step is what she calls looking at their terrain, and that usually means the gut. “So like you said we all get cancer all the time and our immune system fights it,” she said. “80, 90% of your immune system is in your gut. I’m always looking at the gut.”
From there she works through the rest. What are they eating? Are they sleeping? Are they managing stress? She also makes sure vitamin D levels are where they should be.
DIM, hormones and a Polish plate of Brussels sprouts
Dave had mentioned cruciferous vegetables, and Elyse picked that up with DIM, short for diindolylmethane. She described it as an extract of Brussels sprouts that helps the body process estrogen down to a less toxic form, and she said she has people taking or making estrogen take it daily. That is her clinical approach as a dietitian. Supplements are a conversation for you and your own provider, so please don’t read it as a prescription.
Dave saw his chance. The way a Polish family makes Brussels sprouts, he said, is fried in bacon grease, with bacon. Elyse was gracious about it (that might be the only way some people will eat them) and then made the practical point. “But to get enough DIM you’d have to eat many many pounds of Brussels sprouts.” Nobody is eating pounds of them, bacon or no bacon.
On hormones, she was clear about her lane. She does not prescribe them. She works alongside providers who do, and keeps an eye on markers like sex hormone binding globulin so the hormones a patient is making or taking can do their job. A new breast cancer diagnosis changes that appointment, she said, because most of those patients are off hormones by then.
Danielle Armstrong and the women she trains through treatment
Danielle’s path to the microphone ran through our front door. She was seeing Dr. Paula Newmark, a chiropractor in Jupiter, for a shoulder problem, and Paula sent her to Dave, who got her out of a frozen shoulder. She is a former dancer, which explains a lot about how she moves and teaches.
She described her clients plainly. This is a big retirement area, and people come to Pilates as gentle exercise that helps with ordinary tasks, reaching a shelf, carrying groceries. Then she described this year. “I found this year in particular I’ve had a lot of women, I’d say mid 60s to mid 70s who have been diagnosed with breast cancer,” she said. Her studio’s job has been keeping them active through diagnosis and treatment: “Giving them a positive environment to be able to work in and be able to do movements that are gentle for them. But still keep them strong through their process.”
Balance before the first scare
Mike connected it to the daily things that get harder first. Walking. Taking the garbage out. Getting in and out of the shower or the bathtub. Balance and muscle strength sit under all of them, and so does fall prevention. Danielle’s answer was to start early, before balance becomes a problem, and Dave added a story he has told before: President Bush Senior, he said, named balance as the one thing he wished he had worked on and not let slip away.
If you are in that stage right now, our guide to strength training after 60 and fall prevention goes deeper on what a balance program involves, and the wellness program page covers our on-site gym.
From Mönchengladbach to Juno Beach: Danielle’s Pilates lineage
Dave asked how she got into Pilates, and Danielle started with a fact that surprises a lot of people. Joseph Pilates was a real person. He was born in Mönchengladbach, Germany, and was a sickly child with rickets. Mike found that the most mind blowing part, because Pilates grew up to be a boxer and a circus performer.
During the war, Danielle said, he was on the Isle of Man rehabilitating soldiers, and he took springs from the beds to build his own version of what she described as physical therapy. Later he built his own equipment, emigrated to the United States and opened a studio in New York. When he died, his wife Clara, a nurse who also taught, took it over. After Clara, Romana Kryzanowska ran the studio. Romana was a direct disciple of Joe, and she is where Danielle’s original training comes from.
Lolita San Miguel, 92 and still traveling
When Danielle moved to Florida, she met Lolita San Miguel, whom she called the last living elder who trained with Joseph Pilates. Lolita lives in Juno Beach, just up the road from our clinic. Danielle works with her, and at the time of recording Lolita was about to turn 92 on the 9th of October. She still travels. The two of them had just come back from the yearly conference in Mönchengladbach, which Lolita started.
Mike wanted to know whether Lolita’s energy comes down to how she treats her body. Danielle said yes, definitely.
Eve Gentry, a radical mastectomy and the alphabet soup
Then Danielle told the story that ties Pilates to this episode’s subject. Joseph Pilates had a client named Eve Gentry, a dancer, who was diagnosed with breast cancer in the 1950s (Danielle placed it around 1950 to 1955). She had a radical mastectomy and was told she would never dance or do Pilates again.
He worked with her anyway. It took a year for her to get full range of motion back through her pectorals. One of the hospitals in New York suggested his work belonged inside the hospital, so he filmed Eve doing her exercises. Someone took the film to the hospital, and they did not believe it. So it was filmed again, this time topless, so nobody could doubt she had had the mastectomy. The hospital still turned him away. In Danielle’s retelling, they said: “You don’t have the alphabet soup behind your name. So we can’t take you.”
Mike called him way ahead of his time. Dave thought about all the senior homes and nursing homes that work could have reached.
What Dave sees at the clinic after breast surgery
Dave sees many women after a mastectomy. Some deal with scar tissue even after a partial mastectomy or a tumor removal, and the work is getting range of motion and strength back, along with the daily activities that go with them. His caution was about jumping straight into a hard group class. “It’s more important for people to have someone supervised,” he said. He loves yoga and he loves Pilates. He wants the first steps watched.
That supervised start is what therapy after surgery is for. Our post-surgical rehab page explains how it works here, and the shoulder pain page covers stiffness and lost motion in the shoulder. Our hand therapist, Laura Drumm, MS, OTR/L, CHT, CLT, is also a certified lymphedema therapist; if swelling is part of your picture, ask the front desk about it when you call.
Deep sleep, an Oura ring and blue light glasses at 8 o’clock
Mike asked the question that sounds simple: when does cancer occur? Elyse’s answer was the shortest line of the hour. “When the conditions are exactly right.” Then she finished the thought. “So we’re going to make sure that the conditions are never exactly right.”
That brought Dave to his own weak spot, which is sleep. A neurologist friend he plans to bring on the show told him total hours matter less than deep sleep, so Dave got a ring to track it. He reported nights with an hour and 49 minutes of REM against an hour and 30 minutes of deep sleep and wanted to know how that works. Elyse said she wasn’t sure about the REM part. Deep sleep she was sure about: exercise and fasting can increase it, and she called wearables like the Oura ring or the Whoop band a great thing to have.
The ring, the watch and Karen
Dave’s nightly dilemma got a laugh. At 11 o’clock his ring tells him to get ready for bed, and his watch tells him to get up and take a brisk half hour walk. Who does he listen to? Karen, his wife. Mike voted for the walk, with some meditation on the way.
Elyse’s easiest habit of the hour was the blue light blocker glasses. Wear them starting at 8 o’clock, she said, and they help your body start producing melatonin, so you fall asleep faster and deeper. Danielle tied the whole morning together: exercise, stress and late meals all feed into how you sleep. “It all correlates into each other,” she said.
Dave’s version was don’t create the perfect storm. You can’t fix all seven pillars this week. You can pick one.
How to reach Elyse, Danielle and the show
Both guests gave their details on air, and Mike read them back. Elyse sees patients in Jupiter, working alongside Dr. Paula Newmark at Back to Health; her number is 561-252-7857 and her website is thenutritioninstitute.org. Danielle’s studio, Pilates Life, is on Northlake in Palm Beach Gardens, at 561-288-8151 or PilatesLifeFlorida.com. You can read more about each of them on our guest pages for Elyse Marrone and Danielle Armstrong. Dave also offered to put any listener in direct contact with either of them through the clinic.
If you live in Jupiter or Palm Beach Gardens, our clinic is at 733 US Highway 1, Suite 2A, in North Palm Beach. Questions about how the gym fits alongside therapy are answered in the wellness and gym FAQ.
Listen to the whole conversation on the Pain 2 Power podcast page, watch it in our video library, and catch the show live Saturdays at 8:30 AM on 100.3 Legends Radio. If a stiff shoulder after surgery, a balance worry or a plan to get moving again is what brought you here, call us at 561-624-4263 or request an evaluation.
This article is general information, not medical advice. Every situation is different, so please consult a qualified professional about yours.