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Food for the soul.
October 25, 2015

II started my treatment again last Monday, October 19. My neutrophil count a.k.a white blood cells came back big time.

It is amazing what one more week of being off chemo and proper nutrition can do. During the week loaded up on smoothies, veggies, and salad and it helped. My neutrophil count were three times above normal.

My friend ChrisL think I should write a nutrition book. I would just write: eat fresh fruits and vegetables it is good for you. Eat organics, even better. It works. My mom would be a better candidate for writing a book about nutrition and cancer.

Ever since I got sick she would tell me to drink this native leaves, or put this in your food, or go stand in on one leg (not true). I just spoke to her and this time she says; I read that turmeric is good for cancer, you should drink it. Or she insist: put two tablespoon lemon juice, half teaspoon baking soda in water and drink on empty stomach. Really? That’s my mom. Like a good son I will think about it.

She means well, like all of you, I appreciate it. It helps when I have episodes of weariness and depression. I wish it is just as easy as drinking a get well drink. There is no shortcut to this disease. It takes you slowly.

For this cycle, my doctors have reduced the dosage of my treatment. They feel I am not recovering within the normal cycle of two weeks, so they reduced it. Frankly, I don’t notice a difference. Chemo is still chemo to me: in tablet form or infused. It still makes me sick not matter what. Anyway, I got five more days of treatment, then two weeks off. So close and yet feels like a long way.

Cheers.

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Unchanged but neutrophinic

October 13, 2015

YYesterday, was good news bad news day: my recent CT scan showed my tumors were “unchanged” or stable, and I can continue with my current clinical trial.  Woohoo!  But (there is always a “but” isn’t it?), my blood test showed I am neutrophinic.  It means I have low levels of neutrophils or white blood cells (WBC), essential for fighting infection.

Low neutrophils is common among cancer patients undergoing chemo treatments. The bone marrow, which produces WBC, takes a hit during chemo.  This is not the first time I became neutrophinic with my current trial; no worries, I just sit this one out.  My doctors expect me to bounce back after a week.

What to do?  Eat more green vegetables rich in vitamin B.  As you can see nutrition is really important when in treatment or just being healthy. Every green leafy vegetable counts.  They are critical in providing essential nutrients to the body.  I must admit I had poor eating habits before being diagnosed with cancer.  Then I made the change and transitioned to become vegetarian.  Now, I love fresh fruits and vegetables in all forms and organic: salad, smoothies, juice, raw, etc.  It takes time, like all good things, but it is worth it.

So eat your vegetables.  It is good for you.  Go Cubs!

Cheers.

P.S.  My doctors told me that the clinical trial drug I am currently taking, TAS-102, was recently approved by the FDA.  I am glad because others can benefit from this drug.

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All in
September 20, 2015

Ihave been eating salad, soup, crackers, and hummus for the past few days since I started my third cycle of treatment again. It helps me balance my system to minimize the chemo side-effects of nausea and constipation.

Sometimes I get tired of it especially after coming from our Alaska cruise where the food was non-stop and the service was excellent. I still ate vegetarian meals during the cruise but it is different when it is being prepared in different ways by culinary chefs and served by attentive servers.

I still have the Alaska hangover after two weeks. Alaska as been described as magnificent and majestic, and it is true. The place is like being in the presence of God. Perfect. Peaceful. Blessed. The natural beauty of Alaska makes you pause and appreciate what life has to offer. You see the bounties of life represented by whales, bears, glaciers, eagles, crabs, mountains, etc. You can also see the fragility of life too; that all this beauty could end.

As I continue to masticate the earthy taste of kale salad in my mouth, I keep on thinking back to Alaska and wishing that I was back there or some place else. Any place than being in the chemo hole again. I should be use to this but life is such a tease. It forever torments you of the things you don’t have or could have after making you experience the beauty of life.

Why eat kale or hummus, when there is steak and lobster.

Life can be experienced even if you are eating kale or broccoli. Some have found a way to fully embrace what others could not. It is a matter of acceptance and being all in.

Munch…munch…munch.

I have found a way to appreciate life during chemo. It is hard. You just have to have faith you can do it.  Think positive.

Travel Notes:  The majestic and magnificent Alaska

These two words are the most over-used words to describe Alaska. I could not help use it myself in seeing the (magnificent) glaciers and (majestic) mountains.

Wait there’s more: there’s the whales, salmon, crabs, eagles, bears, otter, shrimp, etc. Then there’s the people themselves: the natives, fishermen, loggers, artists, transplants, and Sarah Palin.

I came to Alaska as a tourist with every intention of enjoying the place. Also, it does not hurt that cruising to Alaska is the way to complete the experience. Cruising primes all your senses by getting pampered and fattened on board, and then see Alaska. Boom.

We took the ms Amsterdam by Holland America Lines from Seattle, WA with about 1300 passengers on board. It is a relatively medium-size boat with a crew of about 600. Most of the passenger were retired but active. This boat does not cater too much to kids, which most passengers like since it is quite. I belong to that group. The idea is to relax and see kids running around. If you want fun for kids, go for Disney cruise or Carnival.

The service staff were mostly from Indonesia and the Philippines. I got to meet fellow “kababayans” (countrymen). The trip was smooth except when we hit the open sea going to Sitka, AK. There was strong winds and I vomited in my room. I am use to vomits but there goes my dinner.

Here are some pictures we took.

Cheers.

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Banquet of life: It is free.
August 15, 2015

At mass, the priest told the story of an immigrant family on a ship bound for the US.  The father and his family kept to themselves in their cabin with their food and belongings.  Until the son ventured outside and found himself in a banquet of food, eating to his heart’s content.  The father found the son and was worried how he was suppose to pay for all the food his son ate, and the possibility of jail sentence.  The son saw the worried look of his father, and said:

Father, it is free.  It is part of our passage.

Life has many things to offer and it is free for us to enjoy.  Everyday we wake up is a gift, as many have said.

That gift was recently enhanced by the news that my CT scan last August 7 was good and I can remain in my current clinical trial.  I know I should have written much earlier as some of my friends have already sent messages asking for news.  I am sorry but I was busy in a banquet.

Stable was in the medical impression.  It means my current clinical trial is containing the tumor growths in my lungs and liver.

Unfortunately, my white blood cell (WBC) count took a hit, and I was not allowed to started my third cycle last August 10th, Monday.  A low WBC makes me susceptible to infection and further treatment would make it worse.  My doctors delayed my next cycle for a week to August 17.

So I have been busy eating any thing that will increase my WBC.  I can almost hear my mother prescribing the latest herbal diet she heard of to increase white blood counts.  Stop it, Mom.

There are drugs out there that can boost your WBC, like Neulasta, which is injected under the skin.  It is painful, expensive, but it works.  However, I am in a clinical trial program and cannot take it.  Instead, I am eating my way like a rabbit: kale, spinach, broccoli, hemp., etc.  More kale, spinach, organics, etc.  You know what I mean.  I am also keeping active by walking and yoga.

Living with cancer, and restricted by the clinical trial rules, is not exactly easy but I am not complaining.  Right now, this drug has given reprieved in the growth of my tumors and gave me another week of chemo holiday.  However, I am not naive to say I am cured only that I am still here.  I know how this works.  It is a matter of time that my cancer will adapt and I myself would have to adapt as well.

In the meantime there is the banquet of life to partake of, and it is free.  Come and enjoy it with me…in appreciative moderation.

Cheers.

P.S. My doctors warned me that they might have to reduce the dosage of my treatment to help maintain my WBC.  Huh?  This is like winning fight by a draw resulting from a stable scan but next time they tie one hand to your back because your WBC is low.  WTF.  Later in the week they double-checked the counts and said, there was no need to reduce my dosage.  I was .02 above the limit.  Whew.  I am glad .02 is not the alcohol-limit test otherwise I would have been in jail for drunk driving.

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It is official:  I am out.

March 1, 2015

I

I am officially out of my current clinical trial because they have determined I am (again) no longer responding to the treatment.  I have exceeded the growth threshold.

Now, we look for another one that I can enter.  Needless to say this journey is just frustrating.  I have traveled far and long with this cancer.  I have had victories and defeats, lately, it is more of the later.

I will meet with my doctors again this week to discuss my other clinical trial option.  We have stopped my treatments and will not expect to have one in the next four weeks.  This is to wash out the trial drug in my system before entering a new trial.

I should be rejoicing, especially since they are stopping my chemo.  You have heard me say before: I hate chemo.  Now it stopped it feels weird, awkward, like a break-up.  What do you say after?  It is as if somebody took my security blanket.  I am lost.  I am hanging untethered for the next four weeks. Hopefully, I find the answer in Jerusalem and Rome, if not peace.

Cheers.

 

 

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Lenten Season: Journey to Calgary

February 18, 2015

TToday is Ash Wednesday, the officially start of the Lenten season for Catholics.  Yesterday was Fat Tuesday, pig-out day before the fasting starts, and it is Mardi Gras time in New Orleans and Rio de Janeiro.  My office-friend, Mary AnnG, told me she was going to go to her church’s Shrove Tuesday or Pancake Day.  That should be fun.

Looking back to last year’s Lenten season I marked it by attempting to become a vegan.  The experiment for Lent was to give up my favorite Japanese ramen but along the way ended up as a vegetarian.  I already gave up eating beef and pork long time ago, then I took out poultry meat and its associated products, and then the hardest was to give up because it was my favorite: fish and seafood.  As vegetarian I made an exception to cheese because of runner’s power food, pizza. Then of course, it would not hurt to indulgence once in a while on brie, camembert, and blue cheese.  Yum.

The intention then was to prune and grow.  Give up something to make room for new and better things.

Better things: it is relative.  It is anchored on what each of us value most.  My journey  with cancer puts me in a different category that only fellow cancer survivors would understand.  However, I must acknowledge I have bouts of “buyer’s remorse” or episodes of regrets.  I gave up many things, at times reluctantly but mostly willingly, for a long shot, a chance, a moment, to live life without cancer.  Then, when it does not workout as I expect it, I sulk.

Remind me again: Why I did gave up steak or fish or coffee or half a liver for what?”

Looking ahead, I am looking forward to our pilgrimage trip to Jerusalem and Rome.  It is not only for the chance to run a half marathon in Jerusalem, it is more solemn than that.  The trip coincides with my 7th year anniversary of being diagnose with cancer.  Thus, for this Lent I am not going to pledge or give up anything to grow; technically, I have been fasting by not eating meat for a long time now.

“You got to have an intention for your practice”, my yoga teachers would say.

For this Lent, the intention is to accept the cross I am asked to carry.  Do the 14 Station of the Cross or the via Dolorosa in Jerusalem by carrying my cross all the way to Calgary (Golgotha).  I want to experience the struggle of Jesus at the Garden of Gethsemane: Why was Jesus asked to carry the cross to certain death?  Why am I being asked this?  Perhaps after understanding it, I can shed off my agnostic feeling towards religion.  I am not perfect but I am being asked to do something I cannot fully comprehend or accept when others live fully without remorse.  It is not bitterness that I feel, perhaps anger, but in the end it just does not compute.

Cheers.

P.S. Today at the hospital, a chaplain came to my room to give me ashes on my forehead.  An ashen cross marks my forehead to start my Lenten journey.  Good luck! – a common meaningful greeting among cancer patients and survivors.

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The uncertain future.
January 25, 2014

Tomorrow is certainly going to come but sometimes I am not certain I will be there.  The promise of tomorrow is always just hours away and there is certainty in its arrival. With such certainty and hope I find myself lost at times.

 My tumor is active again, specifically the right one in my lung: a stubborn one.  For now, it is not enough for me to get bumped off my current clinical trial its growth is still within the 20% limit.  Besides the other nodule, the one on the left, exhibited minimal decrease in size, so for now I am considered “stable.”  Whew.

Stable is a temporary state.  It is not permanent.  It is more like a goal (like finding stability) that is very hard to achieve.  When threatened, there is uncertainty and anxiety: not fun.

My state of stability was recently shaken when my clinical trial doctors broached the subject of other clinical trials that is open for me, and those that are coming down the pipeline.  I can tell right away the muted concern they have no matter how delicately things are explained to me.  I know.  So the net is, it is a matter of “when” I will move not “if” I will move.

Hope is a very precious commodity when stability is challenge.  I have been in this situation before.  The easy part is the move, it is what changes or what you give up as part of the change that is harder to accept.

When to move?  Hey, I am a gerbil spinning on a wheel stuck.  Where do you think I am going?  I am stuck and unbalanced.

Cheers.

P.S.  Wednesday, January 28, is next treatment.

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2015: Resolutions and absolutions.
January 16, 2015
So far 2015 is starting out good.  There is always great expectations for new beginnings.  It normally begins with resolutions and absolutions for me.

For starters, I absolve or renounce the habit of counting how chemo treatments I have received (one to start 2015 last January 7th…sorry!)  I think this is a force of habit from my work.  I deal with data (lots of data), risks, likelihood, and impact.  That decisions should be based on data to minimize bias.  But sometimes you just have to throw away these things because it restricts your ability to…live.

I just had my CT scan today.  I normally get anxious for the results of my scan: good or bad.  There was a time I would hold my breathe when I see the caller id is from the office of my oncologist or radiologist.  Now, I get it by email that reads:
     “Scan looks stable.  One nodule increased and one decreased.  Dr. S said he would keep you on.”
That summarizes my world.  I am like a gerbil running on a wheel going nowhere.  I just keep on running until I am told to get off and move to another wheel (trial).  So why bother counting how many treatments I have received: it does not matter.  What matter is you are running on the wheel.  In fact, I would continue on any wheel they give me: big or small.

My wife notices my frustration of being stuck.
“Your nodules are stable and you are here with us.”  she admonishes.
Yes.  I am surrounded by people who love me.  There should not be any “if’s” and “but’s” about this.  That is why I am running on a wheel-to-nowhere.  Is there anything beyond love?  Thus, for 2015 I resolve to live beyond the numbers that define my cancer.  I resolve to fully embrace my new normal lifestyle and fully enjoy the experience of running round-and-round “the wheel.”I would still continue to keep fit, practice mindfulness, pray, help others, set goals, run, and have fun.  Does it matter how many chemo treatments I have?  Does it matter how many miles I have run?  There will be more treatments as much there are paths to run.  Just go and enjoy.

Cheers.

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Round 12: Surprises and blessings

November 26, 2014
Manila, PH
 This week is Thanksgiving week in the US.  It is one tradition that my adopted country has taught me to appreciate; that and Black Friday shopping (joke).  But seriously, Thanksgiving is one day that is specially dedicated for giving thanks and being surrounded by family.  Christmas evoke the same feeling in me, especially if celebrated in the Philippines.  
This Thanksgiving I am blessed to celebrate it here in the Philippines, where I am on business.  Although I will be celebrating it away from my wife, kids, and Ethan (my grandson), I could not pass up the opportunity to see my mom, brothers, and their families here.  It is my time to say thanks to them for their prayers and support.  It is about being with them sharing stories rather than a formal sit-down-turkey-eating-football-watching day.  Also, I wanted to see the look in my mom’s face when I surprise her by being here.
She did not disappoint me.  Picture this: Sunday, Nov. 23, I arrive early morning.  My youngest brother, Raul, picked her up and along my other brother, Rene, who suddenly arrived from southern Philippines a day earlier.  Rene gave the lame excuse he had to take care of some banking matters in Manila.  (My mom was already wondering why go to Manila when there are major banks also where he lives…hmmm).  Mom was unware of my arrival, so all three went to my hotel Sunday morning on some flimsy excuse.  Mom stayed in the car with Rene, while Raul got me.  My mom always has this infectious habit of praying the rosary to while passing time and she was deep in prayers as I saw her walking up to the car.  I walked to her side and knocked on the door and opened it saying.
Merry Christmas!
Light.  Camera.  Action.  To say that she was crying, shouting, flailing, in total disbelief, shocked, crying again and shouting (you get the picture) is an understatement.  It was a if I appeared in god-like manner as she was praying.  When she finally settled down and managed to speak she just hugged me, and I lost it.  I felt her warm love wash away the pain of cancer.  It was like being born again as a baby.  A mother’s embrace is so nuturing and enduring that it can give you back your life and fill up any emptiness.
My mom has already given me so much that I wanted to give back too by being here with her.  In that moment, my Thanksgiving was complete and was thankful.  Fate has somehow conspired and aligned everything just for me to be here with her: the unexpected business trip to Manila, the timeliness of being off chemo treatment during the week, the clearance from my doctors to travel, the stable scan results, the circuitous route I took due to flight delays and miss connections (Chicago/Tokyo/Guam/Manila), and the support of my family back in the US.  For all that and more I am very  thankful.
Unfortunately, there is no video of the Thanksgiving surprise to share, but you get the picture.  The moment is etched in my memory along the strong feelings that goes with Thanksgiving 2014.  It will become part of my cancer journey of Thanksgiving.  I read back on what I wrote last year and the message was still the same for me; be thankful for all all your blessings.  Happy Thanksgiving to you and your family.
Rene, Raul, me, and mom at Marriott Hotel lobby

Rene, Raul, me, and mom at Marriott Hotel lobby

With mom in car after she recovered from shock.

With mom in car after she recovered from shock.

Cheers.

 

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Round 11: Weekly routine.
November 16, 2014

AAt the hospital: Wednesday, November 12.

Hmmm….  Not very many people today.  The waiting room is not full and it is already the middle of the morning.  I checked in and sat to wait for my name to be called.  The normal routine is to get my vital signs, like weight, blood pressure, temp, pulse, and oxygen saturation.  Then they take several vials of blood for the study and lastly, they access my port.

This is my weekly routine unless I have a chemo break.  I practically have memorized my vital sign stats and at times I would play a game with the nurse tech to guess exactly my weight, BP, pulse, temp.  With the weekly blood test, I know the results my kidney function, blood work, platelet count, and other details enough to understand them.  Then I have monthly CT or PET scans to monitor my tumors.  I know every change in my body and the impact of my exercise and vegetarian diet as a result of these weekly tests.

These weekly routines give me a sense of stability or normalcy, and I am thankful.  Also, I have mentioned it before, it helps me be grounded with my priorities.  Outside the hospital, there is the hustle and bustle of life: the text messages, the email, conference calls, bills, etc., but these are temporary and insignificant when measured against health and family.  My routines at the hospital allows me to see things differently.  I am glad I am given that opportunity and share this with you.

Thanksgiving is coming up in a couple of weeks.  I am looking forward to it because I will celebrate it differently this year.  If all goes well, it will be a special Thanksgiving.  One more round of chemo on November 19, which is also the birthday of my daughter Abby, then Thanksgiving week.  I will definitely write about it.

Cheers.
P.S.  I am still wearing a boot to help heal the fracture in my right foot.  Hopefully, the doctor tells me I can remove this thing.  Then it is rehab time.

 

 

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