Expanding the diet

My cousin Kelly will be starting chemo soon, and we’re meeting up this evening so I can bestow upon her the icing kit that I used with many of my own chemo infusions, last year. We discussed meeting up for dinner, and I realized I had a conundrum: is there a local restaurant I can actually eat at, given my current restrictive diet? My go-to is always Asian food (Thai, Japanese), but I can’t eat vegetables, or peanuts, or virtually anything else that is healthy …

After puzzling over this quite a bit, exploring (and then striking out) many options, I sent a message to my care team at Fred Hutch, asking if they had any advice on this. I was happy to hear that they are ok with me beginning to expand my diet, at this point. They explained:


First, you can now advance your diet to include more fiber slowly as tolerated over the course of a couple weeks. The goal here is to introduce fiber one food at a time, chewing well.

Second, you can think about the shape/size of the food to assess the blockage risk. If it is a large chunk, it should be well cooked and/or well chewed.

Third, focusing on soluble fiber first is best as soluble fiber dissolves in water and doesn’t cause bulk, but you can start introducing all kinds of fiber one at a time.

Cool! I am happy about this. Still, however, I wasn’t sure about a restaurant. I was considering Indian food, maybe somewhere where I can get dal or something like that, but it seems like my initial experiment with new dietary options should be at home. Kelly and I have solved this issue by settling on meeting up a dessert place. That’s easier for me — it’s strange but true: less healthy, more processed foods = easier to do with an ileostomy.

But hey, I am very, very ready to move back towards a healthy diet. I mean look what I was doing, back on the morning of my first chemo infusion last summer — an insanely healthy smoothie with chard, kale, various berries .. gotta get back on that train, as this is a key part of the lifestyle to keep my cancer-free, moving forward. So my first venture into healthier eating involves a lentil soup, that I made last night. It includes:

Important to note, after cooking up this soup, I thoroughly pureed it in the blender, to reduce risk of any issues from the lentils. Had this for lunch today (combined with some white rice), and it’s tasty!

I’m realizing a blender is like your best friend, if you’re looking to eat healthy with an ileostomy. Next, I’m planning on starting to incorporate some greens (baby kale) into my smoothies and see how that goes.

Today’s smoothie

I am still at Fred Hutch, although due to the late time, I have been transferred to another building, where I’m now doing the irinotecan infusion. This part is 90 minutes and this started at 6pm. With some stuff to happen after this. Long day.

No big side effects currently, another than ongoing jitteriness apparently caused by my pre-chemo cocktail. And, fatigue and brain fog to the max, but … now sing it with me … “That’s what chemo’s all about!” (Sung to the tune of Hokey Pokey!).

So, let me leverage my current delirious chemo-addled condition to describe for you: this morning’s smoothie. I know people are curious. At least you, Tad! :). So here we go – try and guess what’s in there. All the ingredients revealed below!!!

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Calm before the chemo

We are on vacation this week in Westport, WA: a family tradition. Perfect timing, as my radiation side effects subsided about a week ago.

On this vacation, I’ve been focused on a healthy diet, exercise, and minimizing stress. I think I am mostly succeeding 🙂 although I did get pretty angry the other day, when I was trying to get a clear answer about billing for upcoming chemo (I think I have this question mostly answered now).

To answer Kurt’s question from my last post, I have indeed been making smoothies, every day! I’ve been tinkering with the ingredients. This one had spinach, almond butter, avocado, frozen banana, strawberries, blueberries, protein powder, and oat milk.

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A good problem to have

Since I lost so much weight earlier this year, I’m in a position currently where I actually need to gain weight, if at all possible, as I prepare to start chemo a week and a half from now.

Nuts of all kinds are a great way to get protein, and some studies indicate certain nuts may be particularly effective at suppressing growth of cancer cells. But, nuts can be difficult for rectal cancer patients like myself; everything we eat comes with an “exit cost” — especially as I just finished up radiation treatment, everything is very inflamed and sensitive around the location of my tumor.

So I have been opting for nut butters. I have been putting nut butter in oatmeal and smoothies. I actually tried making nut butter in a blender. I used a “paleo mix” (walnuts, macadamia, cashews), some more cashews, and even threw in some roasted lentils.

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Chemo port implantation complete

The IV port was successfully embedded in my chest yesterday. I am now a cyborg! The craziest part was when they shaved my chest ..

Fortunately, my chest-shaving experience was painless, nothing like a certain classic scene. Just like everyone else at Fred Hutch, the nurse who did this demonstrated masterful skills of distraction-through-conversation. He has many food-based tattoos, and that gave us plenty to talk about. The PA (who performed the implant operation) came in afterwards and introduced herself — I noticed she had tattoos on her arm as well.

The overall procedure was quick and painless. I was technically awake and aware of what was happening, but I was heavily sedated and happily daydreaming throughout the process. After the pain meds wore off yesterday, I was aware of the port inside my chest — it’s definitely an odd feeling. There isn’t really pain, per se, but I can see why they restrict you from any strenuous activity for 3 days after the procedure. My job now is to watch the area and make sure it doesn’t get infected. There is a visible bump where the port now lives.

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