The master plan

I am the queen of the “stay tuned” post with no follow up. Of course maintaining 2 blogs, 3 Instagram accounts, 2 twitter accounts and Facebook may have something to do with it. I forget where I have made my updates. 

I feel like I have pulled myself together a bit. My consult in San Francisco definitely put my mind at ease to a certain extent. I loved the surgeon and her staff, I got my two pages of questions answered and I got scheduled for surgery. It’s next week. Yikes. 

Fun fact. I have beautiful kidneys. The surgeon pulled up my CT scan and walked us through the slices to show me where the mass was located. It’s on the top front of my right kidney. That’s when she remarked I had beautiful kidneys. It does not appear that the mass has gone into any of the collection systems of the kidney so it looks like it can be removed cleanly without impacting kidney function. Good news. 

They won’t be able to confirm Stage and grade until after surgery. At this point she says it’s a 75% chance it is clear cell renal cell carcinoma. There are a few other type of RCC and a few non-malignant things it could be but she feels pretty sure of what she will find. Hopefully the pathology comes back quickly. 

The plan is that she will do the surgery with the Da Vinci robot which will be minimally invasive and a faster healing time. I should be in the hospital for 2-3 days. However, since I have a history of adhesions from my 2 prior abdominal surgeries, there is a chance it may be an open surgery. I won’t know for sure until I wake up. Yikes. 

Knowing I will be at UCSF is a relief. That place just inspires confidence. And the services they offer are amazing. The consult I had with the oncology nutrition department was really interesting. That’s just a free service they provide that will be available to me now that I am a patient. The good news is I don’t have to change much. I eat really well in general and I have started the shift towards plant based. The dietician basically said she didn’t have a lot of suggestions of things to change and that I would be in great shape for recovery. She did offer a few suggestions. 

  • Go whole food plant based. So not necessarily 100% vegan, but reduce the amount of animal products and focus on non-processed whole food fruits and veggies and grains to the extent I can with the Bariatric diet. ✅
  • Reduce sodium. They recommend this for all their cancer patients but controlling blood pressure is important with compromised kidneys. My hope is I don’t lose any function with a partial nephrectomy, but I do have to take good care of them. I never ever ever want to be on dialysis.  My blood pressure pretty much runs low and with the lack of most processed food in my diet, I should be good. ✅
  • Add pre-biotic food and lots of veggies for probiotics. Gut health is still kind of a mystery to me too. Must do more research. She recommended additional flax seeds to my protein ✅ and adding food with live active cultures like fermented foods and yogurt. So kim chi, sauerkraut, kefir, yogurt, etc. And eat more cruciferous vegetables to the extent I can with my protein first rules and tiny tummy. ✅ She also recommended a probiotic called VSL#3. Need to research. May add that down the line. 
  • Keep the protein supplements going and stay at the high side of the 60-80 gram Bariatric requirement. ✅

It’s comforting to know I don’t have to change much and since it’s anticipated that surgery and removing the mass will be the cure for me with no follow-up treatment, life should continue as normal after I recover. They will follow me for 5 years which is typically the timeframe for recurrence. There’s a 5% recurrence rate based on what the surgeon told me — much better than the 80% I’ve read from the National Kidney Cancer association. Stupid Google. 

So it’s all good. I just want to put this surgery behind me. It’s going to be a long recovery. So I’m putting together my Netflix and Hulu playlists and nesting in the house. The worst of it will be over in a few weeks. 

Thursday we get to go down to SF for all of my pre-surgery tests and meeting with the anesthesia team. Those peeps need to be my friends. So another crack of dawn drive to the beautiful bay is in store in a couple days. Have I mentioned how amazing my husband is?

So there you go. Now I am off to make lists. 

The waiting is the hardest part

Adobe Spark (7)

Tomorrow is my consult with the urologic oncologist at UC San Francisco. I found out on June 6 I have kidney cancer, on June 7 that I was being referred to UCSF, and on June 19 that the appointment would be tomorrow. Waiting almost 3 weeks knowing you have an evil entity inside you is not fun. I’ve spent way too much time being angry about the wait, and even worse, looking up stuff on Google.

The good part of that is there is a lot of information, and much of it comes from authoritative sources. The bad part is I have some unique things in my health history that I have questions about and I’m just not going to find the answers online.

For example, the post-nephrectomy diet seems to be in direct conflict with the post-gastric bypass diet.  I have a consult with the UCSF nutritionist on 7/7, so I am sure I will get my questions answered, but am hoping I don’t have to do a lot to reconcile the differences with the nutritionist in my surgeon’s office. Some of the recommendations I have seen are really similar to the renal diet my dad was on with his dialysis. The irony of it all! It leaves me wondering what I can eat if I can’t have most of the things that are currently staples in my diet. Again…I just have to wait.

In the meantime, I have been making a move towards a more plant-based diet. I’d say 85% plant based.  Most nutrition recommendations I have seen lean towards an inflammatory diet, which is probably what all of us should be eating anyways. I’m sticking with my bariatric protein and following my doctor’s nutrition program.

My appetite has pretty much sucked but I have been eating enough to maintain at the low end of my goal range.  I lost 4 pounds that first week I found out, but that seems to have leveled off.

I worked from home all of last week, mostly due to the heat, and partially due to pain in my side which is either completely psychosomatic, a muscle strain, or stress.  I don’t know if my tumor is big enough to cause pain, but I guess I will find out that too.  I think the heat may have had something to do with it too.  I also took the week off of Kaia, as it just hurt too much.  My body was telling me to rest (which I did with plenty of naps!).

My plan is to get the whole story tomorrow, and then go from there.  My guess is it will take me some time to get scheduled for surgery, so I plan to go back to work to try to be a productive member of society and save my leave time.

I feel like today will be a long day but I am filling it with lovely things like laundry, journaling, meditation and some movement. And gratitude. I am so grateful to my friends and family who have been checking in and offering prayers and help.

Updates to follow…

How do you feel now?

I am loving how the IIN Integrative Nutrition Health Coach program aligns perfectly with my own personal journey. I would imagine that’s the case for a lot of people. So many of the exercises and assignments are introspective and focused around personal goals and intentions, as you’ve heard. 

This week, there was a section called Simple Ways to Optimize Your Life. So many of them have become ingrained in my life already since I started making changes around this time last year in anticipation of my gastric bypass surgery. My gratitude practice is likely the one that has made the most impact. For this program, I have increased my daily gratitude acknowledgments from 3 to 5. And I’ve begun to articulate them to others, as well as in my journal. I have been particularly grateful to the coaches at Kaia Fit for helping me stay active and making modifications to workouts for my current knee situation. Just spent 20 minutes in a magnetic tube today and hope to have some answers soon about next steps for my knee. I am so fortunate to have people who look out for me. 

Another part of this section has to do with being in tune to how your body feels after eating a certain way or specific foods. This is something that came up in our weight loss surgery support group a few months back, aiming to help people connect with their emotional attachments to food. 

I feel like I have worked through my emotional eating issues since my primary cause of emotional eating was triggered by my dad. I have come to terms with so much of that since he passed, coming up on 2 years as of June 9. Heavy sigh. The fact that my appetite and cravings have been well controlled with gastric bypass is a big part of having this urge under control. But I have also practiced mindfulness in this area too. I took to heart the instructions about focusing on the taste and texture of food and listening to fullness signals after my surgery. I really do try to focus when I am eating. I enjoy my food and don’t pick anything that is just okay since I get so little of it. 

This week I have two things going on. One, I am experimenting with going more plant based in my diet. I have met some very passionate vegans who have been very helpful in identifying plant based sources of protein. I need to find a way to ensure I am absorbing sufficient nutrients because of my altered digestive system. I even asked my surgeon about it. I’m curious in general because there’s very little literature about vegan RNY patients and if I plan to be a health coach for WLS patients, I feel like I need more data. My surgeon said there is a medical grade plant based protein made by Unjury, but since the vegan diet is missing several essential amino acids, supplementation is also required in addition. 

I have been doing research about the inflammation caused by dairy and animal products and am seriously thinking I need to make some changes to see if they help with my arthritis and digestion in general.

So I signed up for Peel’d this week at Kaia, and will get soups, salads, juices, smoothies and quinoa bowls for next week. I will need to add whey protein shakes on top of that to get my recommended supplementation in, but otherwise will be trying to stick to plant based all week. I’ll be journaling throughout the process to document how I am feeling, whether inflammation and bloat are decreased, and my overall energy levels. It’s a great experiment and it ties in with my school assignments. I’ll be adding tempeh, fruits and veggies if I get too hungry. 

I am really starting to believe in the body’s capacity to heal itself if given the chance and using food as medicine. What better way to learn than through your own experience. 

So stay tuned for my food and mood report.