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[cancer] Field notes from cancerland, further observations - Lakeshore
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Jay Lake
Date: 2013-01-04 05:54
Subject: [cancer] Field notes from cancerland, further observations
Security: Public
Tags:cancer, family, friends, health, healthcare, personal
Note the first.

A number of people in my immediate circle of family and friends have commented on how lousy my day was yesterday. (See the post immediately previously to this.) I have to say that minor procedural errors in the medical process don't even rise to the level of annoying any more. Bad days are the GI problems I was recently having, which have finally settled. Bad days are any day on the chemo pump. Bad days are the cognitive and emotional meltdowns brought on by a combination of chemobrain, stress, fear and guilt. Misplaced paperwork and dry hole pokes in the chest? That's just the cost of doing business.

Note the second.

Stories like this are all over the news cycle right now: Being Overweight Is Linked to Lower Risk of Mortality.

Speaking as a fat guy, I say 'hmmm'. I've weighed almost 300 pounds at one time in my life. My 'lazy' maintenance weight these days is 240, my 'work hard at it' maintenance weight is 225. Except for chemo, I don't seem to be able to get below 220 without radical diet and more exercise than I have time for — which in good health is up to an hour a day, with longer bursts of activity on the weekends.

At my current height (2" less than when I graduated high school), my ideal weight is 149 - 183 pounds, according to the charts. With my build, at 183 pounds I'd look like a skull on a stick, with surely a slight pot belly even then.

Yet my weight has allowed me to sustain drops of 20 pounds and more on chemo without seeing new medical problems from the weight loss. If I did weigh 183 pounds, the chemo weight loss, either in absolute or proportional terms, would be a serious health risk. I was slightly under 240 pounds when this series started, now I'm hovering just over 210 pounds. (Which, incidentally, is what I weighed when I graduated high school.) My lowest weight since childhood was 205 pounds around the end of chemo series two in December of 2011.

So fat? Yes. Not so socially acceptable, though so much more so for men than for women. (Don't even get me started on the genderism of weight.) Healthy in a large scale sense? No. Not unless I like the idea of eventually adding diabetes and hypertension to my list of medical hobbies. Keeping me alive and relatively healthy through the extreme weight loss of chemo? Hell yes.

Fat for the win?

Note the third.

I have been preoccupied with a combination of physical, emotional and mental stress since mid-December, thanks to chemo infusion number six, the Late Unplesantness, and the New Unpleasantness all happening back to back over a period of about 20 days. That has been a profoundly distracting series of events. This has led to a significant fall off in my blogging on topics other than my personal hell. At this point, assuming no new crisis emerges over the weekend, I expect to get back to blogging about publishing, politics and culture by the beginning of next week. Among other things, I have a quite a bit to say about guns that I need all my faculties in order to express with the appropriate combination of nuance and outrage. I am certain we are all relieved.

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mevennen
User: mevennen
Date: 2013-01-04 13:58 (UTC)
Subject: (no subject)
>Keeping me alive and relatively healthy through the extreme weight loss of chemo?

Yes. Trevor lost about 6 or 7 stone, but he's a big guy and he had it to lose. The sister of a friend, who also had throat cancer, dropped half her body weight, going down to 7 st. That drastic weight loss makes people who are slight to start with very ill, but you can't get enough calories into a pump.
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Angie: New Me
User: aiela
Date: 2013-01-04 14:03 (UTC)
Subject: (no subject)
Keyword:New Me
The biggest worry for my sister during chemo was her weight, since at her heaviest, even in her 40's after having had two children, she weighed 110 lbs. She got down to about 85 or 90, and it was damn scary. At that point they were telling her if she was the slightest big hungry, she should eat whatever the hell she wanted - if she wanted a Big Mac every day, go for it. If she wanted three Big Macs a day, go for it. Just get calories in, and they'd worry about nutrition.

They offered her medical marijuana to try to keep her appetite up, but she didn't want it. She's actually heavier now than she was before she got sick, but she hasn't been on the crazy strong chemo in a while, just on every three weeks maintenance.
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Jay Lake
User: jaylake
Date: 2013-01-04 14:04 (UTC)
Subject: (no subject)
Even at my weight, they give the same advice about calories. Since I have trouble hitting 1,000 calories a day on my chemo weeks, this makes sense.

Good luck and good health to your sister.
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Jay Lake
User: jaylake
Date: 2013-01-04 15:12 (UTC)
Subject: (no subject)
FWIW, I am in fact at genetic risk for both hypertension and diabetes, from both sides of my family. Both my parents are diabetic, as were some of my grandparents. Likewise heart issues, which are also present on both sides. Which is where I was coming from in that remark.
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Jay Lake
User: jaylake
Date: 2013-01-04 15:14 (UTC)
Subject: (no subject)
PS, oddly I am at no identifiable genetic risk for cancer. The only cancer among my first or second degree genetic relatives is one person with occasional relatively benign skin issues directly linked to years of unmoderated sun exposure. Even decades of smoking on the part of several relatives (all now quit) doesn't seem to have affected them. And I don't carry any of the known genetic markers for predisposition to my type of cancer.

So of course I got dealt the cancer card.
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Dave O'Neill
User: daveon
Date: 2013-01-04 17:37 (UTC)
Subject: (no subject)
I was at a medical conference in December and chatting to two doctors specializing in weight loss services who were a little shocked when I mentioned that I used to be 310lbs and congratulated me on losing so much weight... Apparently they thought I was about 240. I'm actually 280.

I would like to be 220 (100kg).

The last time I weighed what the guides say you should, which was about 180/190, people actually though I was dying of something.

About 12 years ago I changed Doctor and had the usual assessment at the new doctor. At the time I was exercising a lot and weighed about 110kg. The screen on her computer flashed up 'Obese' when she put in my height and weight. I wasn't skinny, but was far far from being over weight.

That said, I do have hypertension, and I do have borderline Fasting Blood Glucose, so I am working on pulling the weight down, purely because heart problems and diabetes do run in the genetics.
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fledgist
User: fledgist
Date: 2013-01-04 23:57 (UTC)
Subject: (no subject)
Weight is one of the truly complex issues. I've gone from being fat man to being almost thin man (mid-170s). I've also gone from hypertensive to low-end-of-normal blood pressure (I have a family history of low blood pressure on my mother's side).
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sillylilly_bird
User: sillylilly_bird
Date: 2013-01-08 00:00 (UTC)
Subject: extra weight helps
My mother was lucky to have that extra 50ish pounds to lose during her initial chemo run up to her autologous stem cell transplant [multiple myeloma]. When I was at the Hope Lodge that week, I was thrilled when she was able to keep a couple spoonsful of broth down. That was summer of 2009 and at her last check up, she was declared officially in remission [after a long series of Revlimid]. I am hoping for the best possible outcomes for you. Fuck cancer.
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Jay Lake
User: jaylake
Date: 2013-01-08 00:02 (UTC)
Subject: Re: extra weight helps
Good for your mother! I hope she continues in health.
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sillylilly_bird
User: sillylilly_bird
Date: 2013-01-15 17:39 (UTC)
Subject: Re: extra weight helps
Thank you! The thing that really sucks about the MM is that they think it was caused by the radiation treatment for her breast cancer back in 1997. And they found the elevated protein levels at her 10 year check up. Fuck Cancer!
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