Post-chemo update

Keto Flu and Fasting

Well, so, I’ve been much more serious about keto-ish-ness since I last saw Dr. West a week ago. And I’ve suffered the keto flu because of it. There are downsides, but the upside is I had basically no appetite, and had zero problem beginning and keeping my fast from about Sunday morning through Tuesday chemo day, and today’s goal is to continue to about 16 hours past the end of chemo yesterday, so I’ll eat a protein and fat only breakfast in about an hour or so and begin to get back into eating. Re-reading parts of Dr. Longo’s book The Longevity Diet was encouraging last night. It really sounds like from his research fasting and chemo is an excellent one-two punch. It should help reduce damage to normal cells and therefore reduce side effects. I’m all for that!

Bladder Infection

Another thing that has made this last week uncomfortable is another bladder infection. I have got to figure this out because these things are super uncomfortable. I eventually called the medical-fellow-on-call at the gyn-onc department on Saturday and told her what the symptoms were, and asked whether it is best to treat it before, during or after chemo and she said before, so she called in a prescription then and there, but also asked me to have a urine culture done to provide information in case the treatment needed to be changed, which I did on Saturday. It did come back positive and apparently the current treatment is appropriate.

I had been a bit reticent about calling because the recurrent low grade discomfort seems to be a “thing” post-menopause: interstitial cystitis. I can flare it by having too much coffee. But this wasn’t unflaring.

So I looked it up and found a site where it talks about a woman, a nurse practitioner, Ruth Kriz, who has made this her life’s work, and has found that in 100% of cases she treats, the interstitial cystitis is actually an infection that urine cultures don’t pick up. The pathogens may have created a biofilm around themselves, entrenched in the walls of the bladder, and the way to detect them is with DNA testing of the urine. And then one way to treat it is by directly putting appropriate anti-biofilm agents and anti-biotics into the bladder. I am investigating this further, because, frankly, having one’s bladder hurt all the time sucks. My PCP is open to the idea of biofilm, but doesn’t have access to DNA testing, so now I’m on a quest. I may contact Ms. Kriz directly.

Chemo Day-of

So… chemo day. What a day!

Per protocol I needed an echocardiogram first to have a baseline of my heart function before Doxil which can harm the heart. (Dr. West is confident we can avoid that. “It’s what I was trained for,” she said.) In any case, protocol demanded. So the only appointment they could get for me was 7:00 a.m., and as you are probably aware by now I live a good 1.5 away. Ugh. Such an early morning. The echo was fine, interesting, came out that my heart is fine.

Then to wait.

I had blood draw for labs at about 10:30, saw the gyn-onc at 11:30, started the infusions at about 12:30.

I took a nap on a small couch out of the way at this gigantic hospital in between the Echo and blood draw.  I was so tired!

Also the dads (mine and Grant’s) came to hang out with me all day, just in case I had a reaction to this first round. They showed up at about 10:00, and we had nice chats in between this and that, here and there. They went to lunch at Etai’s while I saw Dr. G, then they found me again in the infusion center. They had the luxury of sitting out on the lovely patio that I unfortunately cannot go out on while attached to drip lines. But it was a warm day so then they would come back in and sit with me awhile. It seemed to me that they were having a good time chatting!

I dozed on and off between six different drips: three anti-nausea drips and the three chemo agents: Avastin, Doxil (in liposomal form which should greatly reduce heart damage risk) and Carboplatin. All in all it took about four hours. And I’m happy to say I had no major weird reactions to any of them. So I was able to drive myself home, and the dads were able to just go home, too.  Thankful that they were there for back up and company!

Meanwhile back at the ranch

Grant took advantage of not being the on-site point person and patient advocate, by deep cleaning the most relevant parts of the house so my now immune-compromised system will not have to deal with any excess pathogen load. That’s love for ya! ❤️

Today

Today I’m feeling relatively okay. Not much in the way of side effects yet. Hopefully between fasting and Dr. West’s supplementation regimen I won’t have much to deal with.

We do have the video call with Dr. Parmar in Canada this afternoon, so we’ll be interested to hear what he has to say.

Also my AppleWatch recorded pretty low heart rate readings overnight, in the 40s, and even down to 39. I texted my oncological exercise physiologist and she asked whether the rhythm was stable or not, and I said at the time of writing that it was stable. She suggested telling the gyn-onc so I messaged him in the patient portal and his nurse wrote back that they don’t think AppleWatch is all that reliable so just to tell them if I had any symptoms. So we’ll see.

And today, finally, I get to attempt to break my fast, by having a protein/fat breakfast. We’ll see how this settles.  I hope, well.

Thanks for your attention!