Day 127 - a quiet pre-chemo day

Not much to report on for today: weaving, napping, 1.5 mile walk, dinner at Tommie's, another try at eating ice cream. I was hoping to get the weaving all set up so that when I came home from chemojail all I would have to do was sit down and start, but not quite there. I was successful at my nap. Terry and I went for a nice little walk which is always a highlight of the day. We wanted to have Green Bean for dinner, but figured out at 3:59 that they closed at 4:00 so not to be. We had Penang and Tokyo instead. They have this very plain chicken noodle soup (nabe yaki udon) which is one of my favorite things to eat in the world. It would be great comfort food during chemo, but I doubt it could be made neutropenic friendly due to all the vegetables so I had it today and I'll just have to remember it when I am having a bad day and wish I could eat it. We went to Stillwell's ice cream store which is my default ice cream store and I ordered my favorite, chocolate with peanut butter. It tasted almost normal which is the effect of five weeks off chemo and Dr. Hill will fix that tomorrow. but in December I will get six weeks and then seven weeks off chemo and I bet my taste buds will come back to normal just in time for Christmas cookies.

There have been a couple of good journals recently; let me point them out to you. The Oct 17 JAMA has a great article on smoking cessation which is a very important topic and I thought the article put it all together very nicely. There were also two interesting research articles. The first was examining trends in lipids in US adults over the years 1988 to 2010. The average cholesterol and all of the subfractions (LDL, non-HDL, HDL and triglycerides) have all improved for men, women, Mexican American, Non-Hispanic White and Non-Hispanic Black. The most telling table I think is the last one which charts LDL of people not on cholesterol lowering meds from 1988 to 2005 in each of the demographic slices I mentioned above. The biggest decline is in non-Hispanic white men from 132 to 119. The smallest is in Mexican American men from 127 to 123. When I started reading the article I thought about all the emphasis on lower fat higher carbohydrate diets that has happened since 1988 and expected that people's LDLs would be lower, but thought there would be an increase in triglycerides that more or less cancelled out the LDL lowering, but triglycerides seem to be lower too (I couldn't find a table that didn't include people on cholesterol lowering meds which has also gone up a lot since 1988). Really interesting stuff. Those kinds of differences, lowering a single persons' risk by 0.1% or whatever the improvement is, when applied to the millions and millions of Americans there are can make a big difference. Very cool. I have actually noticed an increase this year in how many people are riding their bikes and walking in downtown Exeter. I don't know if it's just a local phenomenon or if it's a trend, but I'm hopeful. The next step would be that they would put a bike lane in the road that goes to the middle school in town, but that might be too hopeful.

The second article that I thought was really interesting, not because I will do anything with the info, but just because wow! is a trial of chloride rich versus chloride poor IV solutions for volume resuscitation in the ICU in a single hospital in Australia. They found that chloride rich solutions lead to more kidney failure and dialysis. It may not have been the best done trial in the world as the average person only got 5 liters of fluid which doesn't seem that fluid down to me and there was no real mortality difference which you would sort of expect if you were going to have a big difference in the amount of dialysis you were doing. I have always wondered about how internists give normal saline (chloride rich) and surgeons give lactated ringer's (chloride poor) and how each specialty clings to their fluid as best. I have wondered if there really was a difference and now I have been informed--maybe.

This will be my last dispatch from home for a while. I'm off to Lebanon in the morning for more taste bud distorting, leukemia killing HIDAC. My hope for myself for tomorrow is that the HIDAC is highly effective. For you, I hope whatever enterprises you start tomorrow are highly effective, too.