A diary of my journey managing blood glucose on chemotherapy

Medicines
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Date: 11/10/2023
This is not to focus on the cancer (bladder) that I have, but on how chemotherapy laced with a steroid will affect BG management.

I am type 2 on a Tandem pump, loving C-IQ. My last HbA1c was 5.4% and my time in range has been in the high 90% for the last 3 years. I am very sensitive to stress hormones whether naturally produced or as medication.

Today I had the mediport installed for the chemo. In the past 5 or 6 weeks I have had several procedures to diagnose and inspect in two hospitals. Both allowed my pump and Dexcom G6 in the OR.

Today, because they were fitting me in to a tight schedule I was fasting from 7:30PM Thursday to 4PM Friday. About 30 minutes before surgery my BG had fallen to 74mg/dl. This had been a steady decline over the past couple of hours. I confirmed it with my own finger stick as did the nurse.

I attempted to turn off the pump, didn’t work so I suspended insulin for the max 1 hour.

During surgery my BG rose to 109 and settled down to the 90s.

I have an appointment with my endo on Thursday 11/16 unless someone cancels for me to come in earlier. This is to discuss strategies to keep BG at good levels without overloading sites with insulin. I have an unopened vial and box of Lantus pens. I am thinking that using the Lantus by injection and lowering basal rate.

I don’t want any of my sisters and brothers here to have to undergo chemotherapy, but stuff happens. I want to share my experiences that it might help others.

Responses are welcome if you so chose.

I will do a new post as it becomes relevant. Next will either be after the endo consultation or when I start chemo.

These are the 2 possible drug combos.
Cisplatin and gemcitabine.

Or

methotrexate (Rheumatrex, Trexall), vinblastine (Velban), doxorubicin, and cisplatin.
Both cocktails will be flavored with this steroid, dexamethasone.

Signing off for now.

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I had chemo 10 years ago, and happy to say no re-occurrence. Steroids during chemo was one of the biggest challenges with insulin dosing. Being nauseous after recent bolus can be a problem too.

I found that more frequent small meals worked best, some liquid only breakfast/meal replacement drinks worked well too.

But may be other new options in last 10 years.

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I plan on increasing my consumption of Boost and to see if ginger tea works as well on chemo nausea as on normal nausea.

I’ve been trying to gain some weight as I was slightly underweight so far I’ve gained 8 pounds.

Eating some Junior’s genuine New York cheesecake. Has sugar but no crust.

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@CarlosLuis I appreciate your willingness to share the info and approach you’re taking! Good thoughts headed your way for a good outcome!

I remember watching my wife’s port being installed. She bled quite profusely, actually got me concerned for a minute, but it quit as quickly as it had started. They tried her on Interferon first (standard at the time), but her liver numbers made her a drop out and they didn’t want to even try anything else. They used internal radiation treatment for her uterine cancer, though they thought the tumor was well encapsulated with no spreading. Luckily, she has been clean for 10 years from melanoma and just over 3 years from her hysterectomy.

I hope you have someone to be there with you and any significant other during the treatments. I noted several people that were alone during treatments, probably post as well, and I think it helps to have someone to talk with and discuss something OTHER than the treatment during the sessions.

Best wishes!

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Yeah!!! Cheesecake! My favorite desert…though I used to like it drizzled with some chocolate! Never went in for the jams, jellies, or other flavor toppings! Enjoy a slice for me!

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As much as I like chocolate, I really like the subtle flavors and texture of this particular plain cheesecake from Brooklyn.

You don’t have to tempt me to have an extra piece, I will think about you mmmmmm :yum:

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My secret to gaining needed weight before treatment.

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I cut it into 6 slices I had to do a little math as they give the serving size as 1/5 of the cake. I cannot do that, maybe someone can. Anyway I cut it into 6 pieces which gives:
380 calories
25g carbs
28g fat
6g protein
Per slice

I may add a few blueberries to my next serving.

Oh notice that on the box it says NEW YORK CHEESECAKE and not New York style cheesecake. This is the real deal.

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Yellow cake crust, eh? I’ve always been a graham cracker purist but it looks fantastic. Sorry I didn’t know about this when I was actually in NYC a few weeks ago!

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There is no crust in a true New York Cheesecake. It is firmer than the other cheesecakes that require a crust to give a firm enough foundation so you can lift it to the plate. The yellow you are seeing is from the oven heat discoloring the cake a bit, notice some browning.

And how does this born and bred Texan know about NYC cheesecake, well he married up to a woman from Stanford, CT. I got quite a good education over our 44 years of marriage. She did as well.

Once she was visiting with her best friend, Emma. She thought Emma was making apple turnovers, and was shocked when she dropped they in the deep fryer - fried pies not baked turnovers.

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This is the way my mom made cheesecake. LOL I remember the recipe said to leave the cheesecake to rest in the oven with the door open! I gotta find that cookbook!

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Delicious!! 25g carbs worth it! And definitely add some blueberries!! :blueberries:

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Hard to see the blueberries.

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I remember my introduction to cheesecake being Sara Lee’s store bought with graham cracker crust and thin layer of sour cream (or what passed for it) on top. Since then I’ve tried many varieties and recipes (including the Cheesecake Factory low carb version available almost universally).

You guys have convinced me, I’ll be off to the store to buy ingredients and make one shortly…breakfast first!

All of this said, additional good thoughts @CarlosLuis’s way!!

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Yum, looks delicious esp with the blueberries!!

Yes, sending good thoughts your way, @CarlosLuis :pray:

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@Trying looking at my picture, I don’t think I have a future in food photography for magazines :camera: :crazy_face:

Thanks, I for the good words, everyone.

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I gained weight just by looking at the pictures.

Best to you, @CarlosLuis !
:heart:

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November 16 update
Today I see my Endo to work out strategies on how to manage BG with chemo with steroids. Also the possibility of increasing the Farxiga dose to prevent kidney damage from 2 of the Chemo drugs.

Friday I have an orientation session at the Cancer Center to get me ready for my first DD MVAC chemo treatment on the following Tuesday.

A combination of increased stress, lack of my regular exercise and trying to gain some weight has increased my TDD about 47%, My AGP has increases by .5% and my TIR, especially the high end is worse.

With the break from minor surgeries limiting my exercise regime, hopefully I will feel well enough to get some in. Bicycle riding is great for me in reducing stress, increasing insulin sensitivity and giving a general all round feeling of wellness and joie de vivre.

I am a little down, yesterday was the anniversary of a dear friend who had a cardiac arrest while cycling, in the past 6 months 2 friends have died from cancer and I visited another dear friend who is in hospice. All are younger than me.

Well enough moaning, I need to feed our one dog and one goat. Some routines continue.

Love you all, FUDiabetics Stay strong, we are ONE.

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Oh my, Carlos, one cannot help feel down with what you are going through, and lament the difficulties of your friends, too. I hope you are able to return to your beloved exercise regime and know it will give you back your joie de vivre while it improves your wellness. Caring for your dog and goat is also a de-stressor. My two dogs de-stress me at the very thought of them. One is laying at my feet as I type.

:two_hearts: :pray:

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My boss, Sheelah the Empress Cat, sitting right next to me as I type. She wants to make sure her man is ready to serve. :rofl:

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@CarlosLuis
This sounds tough. How is your appetite? Is it hard to eat?

It is just weight you are worried about, right? Like not necessarily trying to hit a particular percentage of carbs, protein, and fat, but just getting enough calories?