Illness and Diagnosis of Gastric Cancer

For a few years, I had been experiencing symptoms of illness in my stomach, and unable to tell what was happening. Living a typical lifestyle, no problems in general, and then once every few months, I’d wake up in extreme gastric distress.

The feeling was like food poisoning. I’d go to urgent care, they would take the usual samples and tests, not find anything, and send me on my way, with instructions like eating oatmeal and toast and other simple foods that supposedly made me feel better.

After several of these episodes, I made an appointment with a GI specialist. That also went nowhere. They tested me for celiac (negative), and then proceeded to write me a prescription for an antidepressant. The reason being that I checked a box stating that I am dealing with stress.

Everyone is dealing with stress. Why is my system screwed up? Anyways I took the next few years into my own hands and proceeded to find ways that didn’t require going on antidepressants. I started elimination diets like Whole30. They were effective in helping my symptoms. I didn’t feel any issues for about another 6 months.

It was my birthday, and my wife took me out to a wonderful French restaurant. The food was top quality, with Elk steaks and several courses. I decided to sway off my diet, assuming this is quality food. That night, I got sicker than I had ever yet. My wife was fine, so it wasn’t the food. She felt terrible for me, and I constantly said it was the best dinner ever and meant it, despite my illness, which I knew was something more complicated.

So I kept eliminating. I went Whole30 & Paleo to Ketogenic, and then to Carnivore. Each elimination happened after an episode of illness. I landed on the Carnivore diet for close to a year. I actually felt great. Better than I ever had, in my life. I was lean and energetic. But a year into it, and I started feeling less hungry.

For a few more months, my appetite reduced further and further. I didn’t feel ill, just had no appetite. Then I had a dark stool and a bad, persistent heartburn. Not good. It took a few days to process this as a new stage that’s probably not good and is out of my control, but I didn’t assume cancer. I assumed and ulcer, GERD, IBS, maybe it really was “stress”.

I talked to my new primary doctor whom I trust, and he immediately referred me to a different GI. This doctor got me on the table pretty quickly for an endoscopy. He thought it was probably an ulcer. After waking up, he told me he found an “abnormality”.

Then I had that feeling of no gravity, everything slowed down, tunnel vision, the whole package. We’ve read it all before… “It can’t be happening to me. I just had a child. I recently managed to pull myself together. Why, when everything just got GOOD.”

So I returned for a more comprehensive Endoscopy with ultrasound, with a different doctor on the same team. I had that spark of hope, just hoping that it was something weird but benign, anything but cancer, please. I woke up after this procedure with this doctor telling me he found “a huge abnormality”. He then started rattling possible diseases. I was still in an anesthetized state and heard some diseases that made me think it’s all over. That was a terrible bedside manner. Enough that I spent the next week assuming that I was going to die.

After about a week, when the biopsy confirmed the actual disease, I received a phone call from my GI team, who immediately referred me to Stanford Hospital for treatment. It was gastric cancer, invasive, well-differentiated. It was also believed to be at stage 1.

After some panic emails to the Oncology team at Stanford, I received a couple replies, expecting to be chewed out for disturbing the doctors. However I got replies encouraging me to stay strong, to keep up hope, to have faith, and a belief that they will beat the cancer. That was the first time, probably in a few months, that I managed to relax a little bit. Very cool of them.

Our friend Harry Who insisted we got family portraits taken, just in case, and he did a wonderful job. I am forever grateful for his suggestion.

Treatment started very quickly. While caught at stage 1, it was about to blow down the walls. I was symptomatic of an advanced cancer: bleeding, lots of fluid build-up, a dead stomach. So I immediately had a small procedure to install a Mediport, which is a port that they can inject the chemotherapy fluids. Since it’s an hours-long procedure, its hard IV’ing an arm and staying still that long, so they place a port on the chest that feeds right to the main artery.

The following day, still swollen and loopy from the port installation, I began chemotherapy. My chemotherapy was done at a Stanford Cancer Center facility about 10 minutes from my home, which was very convenient. I met the nurses, learned the facility, ate some food, and napped a lot. They give you a strong anti-nausea, and all strong anti-nauseas knock you out. Some at an institutional scale.

A couple days into it, I started getting “the sickness” and on top of that, my digestive system slowed to a halt for several days. I really don’t want to publicly get into what meant with that, but I’ll just say that I went through the worst 24-hour period of my life. So much pain, that I ended up at Emergency by order of a nurse at the chemo center. Luckily at the hospital, they accepted visitors, so my family and a dear friend came to visit. Just talking about books and goings-on with the families helped ease my mind.

This was all happening during the peak of the early deadly wave of Covid, so much of this was done over video. Visits to the clinic for scans required my wife and daughter to wait outside. This environment made it very frightening to deal with a deadly disease. I was very fortunate to have a good group of friends that rallied the best they could. A fundraiser was set up do deal with the costs that insurance doesn’t cover. People did what they could and cooked my family dinners and snacks.

After 8 weeks of chemotherapy and 2 visits to the Emergency Department for bad side-effects, it was time to take a small break before my Total Gastrectomy & D2 Lymphadenectomy. The Total Gastrectomy (TG) is complete removal of the stomach. The Lymphadenectomy is removal of l lymph nodes, which are then biopsied to see if cancer has spread. So yeah, I could use a small break after being dead-sick for 2 months.

One nice break I got was that my stomach started working again because of the chemotherapy. I was highly-sensitive to the chemotherapy, known as FLOT.  F – fluorouracil. L – leucovorin, also known as folinic acid, or calcium folinate. O – oxaliplatin. T – docetaxel. Being that sensitive meant I responded very well to treatment. Unfortunately, it also meant that I was very sensitive to side-effects, and I got a lot. As a matter of fact, I’m now officially permanently handicapped because of it. I’ll get to that later.

I was told my stomach might come back online, and took total advantage of it. During my “Stomach Holiday”, I ate like a pig, but stayed ketogenic. I drank buckets of Alfredo Sauce, I ate keto Ice Cream a quart at a time, I made fat bombs, I ate lots of lasagna and cheese and pork and chicken and enchiladas, it was awesome. I gained 30 pounds. I wasn’t really trying to be “keto”, I just wanted to keep the sugar a little low. My last meal before surgery was Braised Lamb Shanks.

Next post, I’ll get more into the surgery.

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