Today was my third chemo session of the second round. It was and still is surrounded by my fifth fasting period. Almost everything went as before. I continue to experience no side effects. The nurses give me three pills to swallow at the beginning of the therapy and then an injection before they give me irinotecan. It would be interesting to see how things go without those pills and the injection, but as they go well with them, I see no point in challenging the regime. Fasting is said to help mitigate the side effects, but I don’t want to explore if it’s enough to replace the pills and the injection.
Fasting is easy. It’s like not fasting, except you don’t eat. Fasting is entirely passive. There’s nothing to do. I just don’t eat and wait for the period to end. It also gets easier with time. This time around I don’t have burning cravings for food. I’m exhausted and feeble, but I don’t suffer. When I first tried fasting, the second day was a mighty struggle. It was tempting to quit. Now I’m almost cruising through, though it is certainly not pleasant.
I am looking forward to breaking the fast each time. Fasting and the desire to break it have a curious upshot. The chemotherapy sessions have become something to look forward to. Chemo allows me to lie on a bed for five hours with absolutely nothing to do. It’s relaxing. I tend to sleep. There’s nothing negative to it. Even the atropine injection doesn’t scare me. And the end of the therapy at the hospital, when I go home with the bottle of fluorouracil, marks the beginning of the last 24 hours of fasting. This fills me with joy. As strange as it sounds, chemotherapy has become the highlight of my week.
I like to eat, but eating has become difficult for me. I’m trying to square several conflicting objectives. I need to regain the weight I lost during fasting. I need to eat healthily, though maybe that’s the least of my worries at the moment. Heart disease and diabetes wouldn’t be high up on my list of worries if I kept one. And I need to starve the tumor of energy it can use and of growth factors. How to get the balance right?
The solution I’ve come up with is threefold.
- I consume lots of fat. It took me a while to dial this in, but I think I’m getting there now. There’s good fat and bad fat. Bad fat, essentially trans fatty acids, should be avoided. They are in fries and industrially-produced baked goods. I don’t eat much of either. Good fat comes from vegetable oils. Drenching your food in oil is a good idea if you want to gain weight. Olive oil is great, but adds a strong flavor that doesn’t always work. I’ve come to like rape seed oil for its milder taste, and I appreciate that it’s probably healthier than butter. Strange that I would suddenly construct my diet based on what’s healthy instead of what tastes good, but these are the days.
- Protein is good. When I come back from a bicycle ride, especially one that involved climbs, I consume a big protein shake. Out of my enthusiasm for fat described above, I mixed the shake with heavy cream instead of milk the other day. Not a good idea. The mix quickly became sort of solid in the blender. I could spoon it out, but it wasn’t what I had expected. Meat also gives lots of protein, and it tastes good. I have already substantially increased my meat consumption. It’s now a race between me and the world. Who’s going to die first?
- Carbohydrates are ambiguous. They are necessary for brain function and generally the primary source of energy. In an effort to starve the cancer even in the inter-fasting periods, I tried limiting my carbohydrate as much as possible after the previous chemo/fasting session. This wasn’t too hard, but the effect was. I didn’t feel good. I didn’t feel myself. I need carbohydrates. But I will avoid simple sugar, which lead to an immediate and strong spike in the levels of insulin and insulin-like growth factors. Is there a way to blunt this spike? With family birthday season – all within a month and a half – in full swing, this is a difficult thing to do.
Fat and protein are easy. There are clear advantages and few drawbacks if you do it right. I don’t have to change my eating habits much to do things right. Carbohydrates are difficult. I’m still very confused about their effects. Not being a nutritionist doesn’t help. Unfortunately, my hospital doesn’t have any nutritionists that specialize on the importance of diet for cancer. This is almost criminal, but nothing I can change. The only thing I can change is my understanding. I need to read more.
Gaining weight is very difficult. From looking at the world and the women’s magazines near the checkout at the grocery store, this can’t be true, but for me it is. I still haven’t stabilized my weight between chemo sessions, which means I’m not regaining all I’ve lost during the three-plus days of fasting. I’m still above my weight back in Utah, but not my much, and it’s worrying me. I don’t want to have to stop fasting. I’m convinced that fasting is good for me. But how do I gain enough weight to stay stable over time?
What do people do to gain weight? There are no magazine covers that address this question. Eating crap and not moving much probably has a lot do with it. I’m not much into either. What do I do? A bit of crap probably doesn’t hurt, and maybe I can move a little less. It was probably not a good idea to go on a 20 km bike ride on Monday in search of gloves lost the previous day on a family outing by the river – not just on an empty stomach, but on a stomach that had been empty for 24 hours already. Maybe I should take the bus to work or the hospital from time to time. Maybe I should think less. This uses a lot of energy.
I am trying to find a balance more than I ever have in my life. To some extent, my life hangs in this balance. There is obviously no guarantee that anything I do will make the slightest difference in the end, but the possibility is there, and I would be foolish not to try my hardest. Brace yourselves. There will be more posts on nutrition in the future.
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