Lessons Learned & Learning 20: 600 Days of Maintenance

Anastrazole vs. E. coli SMACKDOWN Edition!

Prior maintenance updates: 30 days, 60 days, 90 days, 120 days, 150 days, 180 days, 210 days, 240 days, 270 days, 300 days, 330 days, 360 days, 390 days, 420 days, 450 days, 480 days, 510 days, 540 days, 570 days.

The vertical red line on my chart for average weight indicates the day that I had started taking anastrazole, the drug I'm on to try to prevent cancer recurrence. More on anastrazole and its effect on weight is in my 540-day update. Here's how my 20 30-day maintenance periods compare:



My twentieth 30 days looked like this:


Weight:
I had reached my goal weight of 150 lbs. on Dec. 17, 2013. According to MFP, that would place my net calories at 1600 for maintenance.

Between days 571 and 600 inclusive my weight averaged 149.8 and ranged from 147.5 to 152.

But wait! Enter E. coli (most likely) into the mix. The culprit there: one raw carrot.

I write about that episode in detail here, which also explains my low/zero calorie and rest/sick days. A more realistic way to look at my weight is to compare the time period before and after my bout with E. coli during these 30 days:



Before: Days 571-579. Average weight was 151.4, a .4 lb. gain from the previous 30-day period. That continues my upward trend from the time I had started taking anastrazole.

After: Days 583-600. Average weight was 149.2, which is roughly comparable to my average weight three months ago: an earlier data point on my upward-trending curve.

The before/after graph does not include days 580-582. On those days I had no exercise and little to no food, plus most of what little food and liquid I consumed had come back up. Not even anastrazole can pack on the pounds under those conditions. My average weight over those three days came to 148.7.

It remains to be seen whether my previous climb will resume, or if (wishful thinking here) my bout with E. coli has pushed some kind of reset button that will somehow let me offset anastrazole's weight gain side effect. Notably, once I had been able to eat and drink again, my average total and net calorie consumption each fell by 12 percent over what they had been prior to E. coli during this maintenance period. Maybe that degree of calorie reduction has had to become my new normal. Stay tuned!

Exercise Calories Burned:
I took 3 rest/sick days (0 calories burned) during maintenance days 571-600, compared with 0 rest days during maintenance days 541-570, 0 rest days during maintenance days 511-540, 2 rest days during maintenance days 481-510, 1 rest day during maintenance days 451-480, 3 rest days during maintenance days 421-450, during maintenance days 391-420, 1 rest day during maintenance days 361-390, 0 rest days during maintenance days 331-360, 1 rest day during maintenance days 301-330, 1 rest day during maintenance days 271-300, 2 rest days during maintenance days 241-270, 1 rest day during maintenance days 211-240, 2 rest days during maintenance days 181-210, 1 rest day over days 151-180, 3 rest days over days 121-150, 5 rest days over days 91-120, 3 rest days over days 61-90, 4 rest days over days 31-60, and 2 rest days over days 1-30.

My average exercise calories burned for this period (including rest/sick days) equaled 402/day. My highest burn was 633 on July 25, representing stationary cycling and treadmilling. Not counted is the calorie burn from my Better Bones and Balance workouts, because I have no idea what that burn would be. In this 30-day period I have done 12 BBB workouts, one with a 5-lb. weighted vest, the rest with 7.5 lbs. Also added to my regular cycling workout is nine 30-minute sessions on my manual treadmill set at a 10-degree incline, eight with a 7.5-lb. weighted vest and one with 10 lbs. added.

Total and Net Calories Consumed:
Total calories for maintenance days 571-600 averaged 1696/day and ranged from 0 (July 20, when I could keep neither solids nor liquids down; also, most of the 548 calories I had consumed on July 19 had come back up) to 2237 (July 18). Net calories (total calories minus exercise calories burned) averaged 1294/day (81% of maintenance and my lowest average for any maintenance period) and ranged from 0 to 1640 (same dates as for total calories). July 18 also marks the only day during this period in which my net calories exceeded my maintenance goal (by 40 calories).

As shown by the Before and After graph above, maybe I have found a maintenance calorie goal that sufficiently offsets anastrazole's weight gain side effect. Taken by itself, my "after" net calorie average of 1309 is lower than that for any other maintenance period. My main challenge is making sure I eat enough, while doing what I can to keep my weight at a healthy level and to deal with the other side effects of cancer treatment. For analysis on my weight gain despite increased calorie burn and decreased calorie consumption, see the "Analysis" section in my 540-day update.

My main concern during my E. coli episode concerned whether or not I could keep the anastrazole down. I had delayed one dose by a couple of hours until I was sure my stomach had emptied (again), and then took it with just a couple sips of water -- and fought to keep that down. Since I take that med to stave off cancer recurrence, I checked this with my oncologist. He said it's no big deal if I have to skip a day or two. Also, if I can't keep liquid down to the point of dehydration, I can go to the cancer center for a saline drip. No need for the "drama" (his word) of the ER. I was especially happy to hear that, since my cancer center is just a few miles down the road, less than a third the distance from home as the hospital.

I continue to monitor my carpal tunnel flare-ups and am happy to note that their severity has gradually decreased since a three-hour weed-whacking session during my last maintenance period had put them into overdrive. That tells me to be more liberal with anti-inflammatories on those days when I work my hands more than usual. My oncologist clarified that anastrazole doesn't affect my CTS directly but instead affects the muscles and joints around my carpal tunnel. My main concern had been over any potential for permanent damage from the anastrazole, but I seem to be in the clear there.

"Dream" was the prompt for my July "Creativity Heals" meeting:


Full size

This piece is based on an image from a dream I had some weeks ago. For most of the dream I wandered around an unfamiliar house of glass and chrome. Then I stepped outside and was surrounded by ginkgo trees in a very bright, saturated green. After all that glass and chrome, the effect was downright magical. I drew several different ginkgo leaves freehand and duplicated/rotated them throughout the image.

Just before my bout with E. coli, I created this "dream" image using the unbeknownst-to-me malevolent carrot:



I had photographed the bunny in my yard three years ago.

A friend of mine has been enjoying adult coloring books, which inspired me to create this:



The original size can be downloaded and is best when centered on an 8-1/2 x 11-inch paper with half-inch margins (margins will be slightly larger at top and bottom); it can also be brought into digital painting programs and colored there. Here's my coloring job, done with fine-point and extra-fine-point Sharpies:


Large size