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Jay Lake
Date: 2012-10-21 05:56
Subject: [cancer|food] The chemo diet
Security: Public
Tags:cancer, child, food, health, personal, radiantlisa
Ah, food. Having this third week between two chemo sessions is actually further interfering with an already unsteady balance.

First of all, I cannot have calcium within two hours before or after taking my Doxycycline. (I take this to counteract the side effects of the Vectibix, which means that I will be on an antiobiotic for about ten months straight.) Calcium binds with the active ingredient in Doxycycline, thus rendering the dosage less active or even inert.

Note this is not the same thing as lactose intolerance. I can still have butter or heavy cream, both of which present only vanishingly small traces of calcium as the milk solids have been removed from them during processing. On the other hand, most milk substitutes are calcium-fortified, which means that soy milk, almond milk, etc. do not work for me unless I can find an unfortified brand.

Meanwhile, I am lactose intolerant from about day four after chemo to about day seven after chemo. This is a transient effect caused by the overall damage to my stomach lining. Those fast-growing epithelial cells take almost as much a beating from the chemotherapy as does the cancer itself. This is the same timeframe in which I experience shedding, which is, over a dozen heavy bowel movements per day for one to two days as all that stuff just dies and sloughs off. During this period, the lactose intolerance kicks in, manifesting largely as gas and stool odor that would be barred by the Geneva Convention. People leave the house choking and crying if I forget and have some milk products somewhere in there.

Meanwhile, I am also restricted from consuming antioxidants and certain supplements such as ginger in larger quantities, because of unfavorable interactions with the chemo drugs. My food intolerances are already emerging, albeit still fairly low key. Acidic and spicy food makes my lips burn and produces questionable sensations inside my mouth. Bananas are starting to taste weird to me. And so on and so on, scooby dooby doo. Prior experience tells me that eventually I'll be eating nothing but soft white carbs with the occasional bit of lamb or vegetable.

Then comes my metabolism. If I don't eat periodically (right now, about every 2-1/2 hours, in the days immediately after chemo, every hour), I have a hard crash in my gut that leaves me nauseous and woozy. There needs to be something in there nearly all the time that I'm not sleeping. This leads to a tendency to overeat, as I'm still having meals at mealtime with Lisa Costello and [info]the_child and whomever else happens to be kicking around.

Except the nutritional advice from the chemotherapy team is eat everything I can. They're most paranoid about excessive weight loss leading to wasting, due to a combination of lethargy, nausea and loss of appetite.

As for my tastes and cravings, I'm mostly dying for citrus drinks and savory, carb heavy foods with a lot of meat protein. I could live on limeade and meat lover's pizza right now, I swear.

And all that advice about eating carrots or high vitamin C foods or whatever? Yeah, right. Good luck getting any chemo patient to stick to something like that.

So far, I've seen weight swings of around 10 pounds (4% of my body weight) through the chemo cycles. I expect that to continue, with a gradual declining trend in the range band of that weight. ie, a slow net weight loss over time.

Is it any wonder that it's darned difficult to figure out what I can or should be eating at any given moment?

Welcome to jolly happy cancer fun time! Gastronomic edition.

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User: deborahjross
Date: 2012-10-21 16:05 (UTC)
Subject: (no subject)
I took care of my first mother-in-law during her palliative radiation for lung mets (primary site was thyroid). When I arrived on scene, she was extremely thin, lethargic, dehydrated. I called the American Cancer folks and had a long chat about what to feed her. Their advice was very much the same: anything she's willing to eat, and as many calories as you can get into her.

She didn't have the problem with calcium interactions, not being on chemo, so I created milkshakes out of vanilla Ensure, the highest-fat premium ice cream I could find, and fresh fruit (she liked peaches, so I went with them). Super charged comfort food.

So go for it!
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Jay Lake
User: jaylake
Date: 2012-10-21 16:36 (UTC)
Subject: (no subject)
Doing the best I can. Forgot to mention my chemo-induced cold and heat intolerances, though. No milkshakes for me!
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Kate Schaefer: First Icon
User: kate_schaefer
Date: 2012-10-21 17:02 (UTC)
Subject: (no subject)
Keyword:First Icon
Yeah, during chemo my sister lived on really crappy cookies of a brand she despises in normal life. How she even figured out that she craved them given that she doesn't like them, I don't know.
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