Introduction to How a Diabetic Survived Chemotherapy
When I found a lump in my breast in October 2017 I tried not to panic. I did a poor job because, as I was locking up my house to go to the local GP, I had a bit of a melt down. Sweaty palms, breathing fast and trying to keep it altogether. I drew on the strength and determination inherited from a very strong Mother to calm down and drive to the surgery to learn my fate.
Within 3 weeks I was lying on the pre-surgery trolley waiting for what I hoped would be a life-saving operation. I didn’t know then that the odds would be stacking up against me. 7 days later my fate presented itself on a platter of issues:
- 2 Different types of cancer in the same tumour — 1 common, 1 not so common and more likely to return within 12 months.
- A Grade 3 tumour because of its size
- A very large goiter on my thyroid that couldn’t ruled out as cancerous
- A suspect bone scan.
As an insulin dependent, over 60 who had been diabetic for over 10 years, it wasn’t looking good.
Taking Responsibility for my Health
Apart from wondering how I had actually gotten to this stage, I started to realize that it was time to take responsibility for the things that I could positively change if I was going to survive these challenges. After all googling diabetes and cancer made me hyperventilate as I read about the possible difficulties and side effects having these 2 chronic illnesses together meant.
The most obvious result was that there were no studies or instances where the oncologists, radiologists and diabetic specialists worked together to present a management plan. Clearly cancer took precedence and it looked like the diabetes side was mainly ignored or overlooked until after treatment. This made me realise that I, at least , could make a managed attempt to reverse my diabetes as I had no control whatsoever regarding the cancer treatment.
The Life-Changing Decision
Making the decision to try and reverse my diabetes while undergoing chemotherapy resulted in more positives for me and I want to share my story so that others who might be starting on this journey can gain some insight into what is possible.
This is my story on how I survived chemotherapy and at the same time reversed my diabetes which resulted, for me, in less side effects from the chemo and a more positive mental approach to the whole shebang.
My Initial Research
Before I get started on explaining what research I did, I just want to make it clear what being diagnosed as a type 2 diabetic means (for those who have never experienced it).
First of all, you are told that it can’t be cured and it will get progressively worse. Then you are told that it will take 10 years off your life expectancy.
You are put on medication right away and as the disease progresses you take more and more medication until you go on insulin. Eventually facing either kidney failure, amputation, blindness or cancer.
In my case the GP was right. I ended up on
- 2 x 1000 Janumet which is a combination of Diabex and Januvia
- Coversyl (for high blood pressure)
- Lipitor (for high cholesterol)
- Injecting 2 x 10 units of Insulin (Lantus)
and I got breast cancer.
The out look didn’t seem bright at this stage.
Starting The Research
Of course I went to Google. Every site said to loose weight. However, every type 2 diabetic knows just how impossible that is. Insulin is not conducive to helping you lose weight. In fact, quite the opposite – it packs on the lbs or kgs more specifically.
I came across an article in the UK where they had treated newly diagnosed type 2 diabetics with diet. They were feeding them soups and shakes. I was more interested in the results as they were getting really good blood glucose readings. It meant that your diabetes could be controlled through diet alone.
I then found a Ted Talk by Dr. Sarah Halberg in the USA. The title of her presentation was “To Reverse Diabetes You Have to Ignore the Guidelines”. I liked that language as I hadn’t heard of any health practitioners talking about reversing diabetes (just controlling it or managing it). It gave me hope.
This YouTube Video Changed My Life
If you listened to the video you know that what Sarah Halberg was saying that by cutting out grains, potatoes and sugar you can start to reverse diabetes completely.
To put this into perspective as a diabetic, the dietitian told me to eat 45 grams carbs at each meal. This equates to 135 grams each day. I had followed this for years. Sarah was making a lot of sense to me. If you are insulin resistant (which type 2 diabetics are), eating this many carbs each day would not help me in the slightest. I had to look at the dietary advice that I had been given and make some significant changes.
Now you may find this incredible, but I have kept all my blood reports and any written advice I had been given over 10 years and was able to go back to my original dietary advice and check the information. It was definitely 45 grams of carbs at each meal and this was the wrong advice. I had to cut carbs and in fact cut grains, potatoes and sugar from my diet completely. How would I be able to do this? I was definitely addicted to carbs and I have since learnt that this addiction ccan be more difficult to break than a drug addicition. Ah well, I had given up cigerette smoking 35 years previously, surely I could break this carb addiction!
Thank you Dr. Sarah Halberg, you gave me hope in a really hopeless situation. If you are looking for ideas and recipes that will change your eating habits, this one from Amazon is pretty good.
Where there is hope…
After watching Sarah’s presentation, I was really excited. There is a real possibility of reversing my type 2 diabetes, yay.
So back I went to the GP and asked about reversing my type 2 diabetes and mentioned Sarah Halsberg, low carb eating and no grains, potatoes and sugar. I came out completely deflated My GP basically said to disregard the diabetes to just get over the cancer treatment and then worry about my diabetes later. Well, that wasn’t what I wanted to hear. Every time I raised it, I was shut down. Her advice was to eat healthily which to her was 135grams of carbs, dairy, protein, good oils, vegetables each day.
I had been doing this for 10 years and my type 2 diabetes was progressing. I had breast cancer for goodness sake. I felt alone and at a loss.
The Research on Reversing Diabetes
I did some online research about studies that were being done in the UK. They had some success with shakes and soups and had reversed some peoples diabetes quite successfully. They were new studies and they only worked with people who had type 2 diabetes for less than 5 years. I decided that this was enough evidence that something could be done.
I then spoke to my sister-in-law who had been making green smoothies in the UK for some time and had good results as far as general health and weight control were concerned. I wanted a few recipes for green smoothies so that I wouldn’t get bored. She gave me Jason Vales name and I downloaded his app. It was a 28 day program with enough different smoothies to choose from that I felt it was something I could do for some time. (see info here)
Visit to the Dietitian
Rather than go back to the GP and try and convince her that this was the way to go. I went to my dietitian and diabetes educator that I had been seeing for sometime. Sarah was very helpful. She helped me modify the smoothies to slow down absorption (add protein) and add those healthy oils like flaxseed, avocado, walnuts. We also talked about possible side effects and what I could add to my smoothies to help with this. (mostly bowel issues)
Visit to the Surgeon
The day my husband, Ed and I travelled into the PA to meet with my surgeon was nerve wracking. I had made a playlist to play in the car to try take some of the stress out of the situation. Amazing Dragons song Not Today reminds us both of that day and as we look back realise how prophetic it actually was. Click on the link to find it.
The Amazing Health Team
Heidi Peverell was a God send. She settled us both down, made the surgery seem routine and gave us some really good advice. I thank her from the bottom of my heart for this. Ed and I both left feeling that we had a good person in our corner and that maybe it wouldn’t be all that bad. We needed it at the time. Heidi did such a good job of my surgery that when I went to radiation they had difficulty finding my scar! (but I jumped ahead a bit).
My surgery was completed within 2 weeks. I was in overnight and home the next morning. Now this piece of advice is very important – take a small pillow in the car with you for after surgery as you feel every bump. Ed had to drive really slowly.
They wait for 3 weeks until you start chemo as the pathology has to come back and you have to recover from your surgery. There is quite a bit of bruising but it heals fairly quickly.
The Results That Determines Treatment
My pathology came back and it revealed that I had 2 different types of cancer in the one tumour. Because of its size they staged it at 2A (treatable). I had triple negative cancer and Her2 cancers which meant I had to have the works. Chemo (AC) and Herceptin for 12 months as well as radiation. A total of 15 months. I was hoping for a lot less. I had to take it on the chin and because I had no control over the cancer – I focussed more on eating well to control my diabetes. I still wasn’t sure if I could reverse it but I was hoping for something positive out of this whole terrible experience.
So I have had the surgery and the terrible news about the cancer. If you google triple negative breast cancer you will see that the news isn’t good. It means that this cancer does not have any of the three receptors commonly found on breast cancer cells – the oestrogen, progesterone and HER2 receptors. But not to be left out, I also had HER2 positive cancer in the same tumour. When I found this out I really thought that it couldn’t get much worse. Googling breast cancer and diabetes didn’t give me much and googling diabetes with the types of cancers didn’t give me anything at all. It seemed that I was on my own on this journey.
At this stage, I didn’t factor in the power of family. I should have and so should you. They are the motivation and support that you need. It really didn’t matter what type I had or what treatment I needed, but I didn’t see this at the time.
The Shopping Trip To Top All Shopping Trips
My Daughter had spoken to her friends whose Mothers had a similar story. Googled the hell out of cancer treatment and came up with a 5 page list of things I would need. I will never, ever, forget that shopping trip. We ended up with 2 trolleys full of stuff “just in case”. It was mind boggling. But then the list of possible side effects of the treatment was mind boggling and numbing because you just can’t imagine that the cure is worse than the disease. You have to take into account that I hadn’t actually had any pain at all. It was a lump. Here I was looking down a list of side affects that could last a short time or a lifetime. You just have to question it. There must be a better option surely.
I had no choice, I had promised my kids that I would do everything possible to fight this and live. I had to put my faith in the experts and trust that what they said would be the best pathway to take. I couldn’t risk taking a path with no efficacy.
The positive from this shopping trip was that I felt ready for anything and it reinforced to me the awesomeness of my daughter and her generosity of spirit.
It’s The Simple Things that Make a Huge Difference
Of all the things that we bought that day, the most useful was a very lovely journal from Typo. Storm wanted to buy it so that I could write down thoughts and motivations. Now, I have never been a very touchy, feely person. I am more an organiser and action type person. It is one of the reasons that I felt really lost on this journey. There wasn’t much I could actually do about it.
But look, I did try………here is the first page I wrote in my journal.
Liz’s first journal entry in her first journal:
This could be the happiest road I have to the end of my life. I have to treat it that way and understand how precious that is.
“This is the life I made and I can’t be afraid of the hands I played”
Triple whammy but all manageable separately. My body needs to hold up that’s all.
My blessings. Music, gardening, nature, painting but most of all my precious family and darling grandchildren.
Laugh every day – find a joke, watch a comedy, take the mickey out of Ed. Sing and dance. Paint and organise
I know, its a bit disjointed and pathetic now but I got it down and then thought, now what?
I wrote a list of why I should be thankful that I was getting Chemo:
My First Treatment 7th November 2017
Armed with the results of my blood test and a back pack (bought on the shopping trip of course) packed with goodies I might need as well as a daughter who had her own plan and determination. My first chemo treatment loomed.
In I walked to the oncologist who I now like to think of as my guardian angel. Katherine Middleton. Not a princess but something much more valuable and rare. The person who would instill in me a sense of survival. A thankfulness for the good in this world and the person who would be in my corner and get me the best treatment and situation to fight this cancer. A genuine carer who put the patient first. I didn’t realise how lucky I was during that first appointment but I would by the time the second treatment cycle started.
She approved my chemo – AC – the red one that really packs a punch. I would lose my hair before the end of the treatment cycle. Something most women would find challenging. Bad hair days for some time ahead. I decided to ‘head this off at the pass’ and take the initiative. I went to the hairdresser and told her to do a No.2 all over.
This photo is taken after my first treatment with my daughter Storm with flowers sent from my sister May. The flowers arrived on the day of my first treatment and were beautiful. Over the course of this journey I received so many flowers that I can actually pinpoint my journey by them. Thank you everyone, they all made a huge difference.
The First Chemo Infusion
The first infusion had to be done by cannula (into the back of my hand) because I hadn’t yet been fitted with a port a cath. It hurt a bit because they had difficulty finding the vein. I would get the port a cath fitted the next week which was a blessing.
You are here for hours because they don’t like to set the IV too fast. You are in a room with plenty of others and no-one wants to be there. My daughter had planned this visit with precision. So well in fact that she had me sitting laughing so hard that tears of laughter were rolling down my cheeks. She had saved her stories for this very minute. Thinking back now, I realise how much this cost her and how valuable it was to me. When I think back to that first treatment, I remember the laughter before everything else and I just have to smile. Thank you my very precious darling.
TREATMENT DAY 1 IN MY JOURNAL
Steroids infused. Home at 5pm. Feeling tired. Bed at 7:30 pm. 2 toilet breaks overnight and up at 5.30 am.
- Day 2 after Chemo – BGL on wakening 6.2. Steroid Tablets Insulin 10
- Exhausted with nausea. Ginger shot and smoothie for breakfast + 2 hours BGL 6.2
- 11:00 Morning tea – yoghurt
- BGL before lunch 9.7 (reaction to steroid and expected)
- 13:00 lunch – Avocado, Tuna, Salad, Low Carb Bread
- Before Dinner BGL 11.9 (increase insulin to 12 before bed)
- Dinner – 1 slice of chicken (hard to eat), Smoothie instead with protein powder.
- 4x 600 ml Water for the day and 15 mins walk around the garden.
- BGL 12.2 + 2 hours and before bed increased to 13.0 Woke at 1 am, BGL down to 9.7 and by morning down to 6.9.
Note– I took my blood glucose readings so often to help me understand how my body was handling the steroids. I had been warned that it would knock my BGL around and to increase insulin to compensate. I didn’t want to increase the insulin too much and for too long. I stuck to 12 units of insulin up to Day 8 after the chemo and was able to reduce it to 10 again. On reflection, I was eating too much. As per the guidelines for diabetics I was eating 5 times per day. I now know that this was too often, I should have had longer periods between meals without food – more about this later.
Low White Blood Cells
I had been warned that my white blood cells would be lowest by day 8 and that I had to take my temperature every morning and night. Anything over 38 and I had about 20 minutes to get to emergency as my immune system would not be able to handle any infection.
My side effects after this first treatment:
- Day 2 to Day 12 Dry mouth and burning tongue. Used dry mouth gel “Oral Balance” to help ease it. (thanks to my sister, Eleanor, for giving me this prior to treatment as well as some lip balm).
- Day 6 to Day 10 – Aching legs (similar to having flu). Walking helps
- Bowels shut down Day 2 and 3 – took prunelax and fixed issue next day. Decided to add Psyllium Husk to smoothies.
- By Day 10, I was feeling blessed as everything was fine. Still had the dry mouth but the gel was helping this. Was able to garden, walk and cook dinner.
- Started using a nail hardener as advised by my oncologist and cut my nails short.
Decided to have no carbs at all on days that I had to take steroids. (mainly low carb bread, sweet potato and yoghurt and fruit). To address the aches in muscles I would add more protein and more good oils to the smoothies (avocado, walnuts and flaxseed).
Welcome to my world of taking one day at a time and trying to learn from each infusion on how to manage these side effects going forward. I had 15 months of treatment to face.
As Ed says, confidence is the feeling you get just before you understand the real problem. (or fall flat on your face).
In my next article I will talk about Neulasta Injections and how I managed these side effects.