I tolerated my birthday chemotherapy very well, hardly suffering any side effects except some intensely burning poops the following Friday and Saturday as the chemo comes through my system. The steroid dexamethasone I took with the chemo tends to keep me up all night and screw up my blood sugars, but this time I did fall asleep and got about 5 hours of sleep before waking up. And with the low-carb diet my blood sugars are not as much of a problem, though they do peak up to about 123 — nothing like the 300s I was getting on a regular diet. Also the steroid gives me the worst crash about a day after I stop taking it. And because the side effects have been so low-key, I skipped taking Wednesday and Thursday’s dose. It made Wednesday pretty rough… I was so tired on my commute home from work that I had to focus intently or else fall asleep behind the wheel.

I took Friday off work to prepare for our summer vacation trip to Cook Forest PA. This year the entire family was going, which is exceptionally hard to make happen with everyone’s school and job commitments. The plan was to leave as soon as my wife got off work, maybe about 3pm. I puttered around and gathered our stuff together, consulted and revised my previous checklists, and prepared our minivan for the trip with an oil change and all fluids topped up. I found out at the last minute that my middle kid didn’t get off work until 7pm, so our new time of departure was around 8pm. It would be a late night drive to my sister’s house in the DC area. We were able to leave around 8pm and arrive a bit after midnight. Luckily no one else was crazy enough to drive to DC so late, and we didn’t encounter any significant traffic.

We spent the night at my sister’s place, my parents came over, and we all had a leisurely amazing keto breakfast. My sister made a great keto breakfast casserole that didn’t have potatoes in it; I have to make a mental note to get the recipe from her. Around lunchtime we departed for Cook Forest which is five hours by car if you don’t stop. Though we stopped in Altoona PA, about the halfway point, and had lunch at a Chili’s. It had been some time since we’d been to that restaurant chain, and the food was good, the service was incredibly friendly, and everyone left satisfied.

We made it to Cook Forest in time for a great dinner at the cabin Aunt D. rented for the week, where we got to meet dozens of Grandma K’s family members we had not seen in at least a year. The neat thing about Aunt D.’s cabin was that it was the only place in Cook Forest that had a cellular signal. After dinner and fairly late at night, we checked into our hotel, some of us had a shower and got refreshed, and that was our Saturday.

The rest of the week we relaxed at Grandma K and Grandpa J’s cabin. I prepared keto-friendly side dishes that week like a Turkish-inspired salad with cherry tomatoes, feta, kalamata olives, red onions, cucumbers, parsley, balsamic vinegar and high-quality olive oil. I made some goat cheese guacamole a different night, and a sort of cole slaw but the mustard I had on hand was kind of spicy and it made the dish a bit weird.

We had trips down the Clarion river in canoes and kayaks rented from the Pale Whale in Cooksburg, we hiked around the beautiful old-growth forest, and my middle child J. helped me deep-clean grandpa’s grill for the big rib dinner he always puts together one of the nights.

I went along as co-pilot on a trip with Grandpa J. to fetch his 89-year-old sister, Sister J., in Cleveland to bring her back to our vacation. She is a Catholic nun who taught college physics in Cleveland for many years. Throughout the trip, I was exceptionally worried about the state of his right front brakes, which were starting to grind down the rotor and make noise every time he stopped or slowed down, and the Cook Forest roads are hilly and winding, and brakes are a good thing to have in those kind of situations. Plus, the highway department was blocking off lanes and pouring new asphalt, as evidenced by these mysterious signs:

We made it to Cleveland, and Sister J’s friend, Sister P., made us a fantastic cold lunch of salad, cold cuts, cheese and bread. We had a couple hours of good conversation where I learned that Sister J. didn’t have much of a plan for how to get home. She said that Harriet Tubman often left her plans in the hands of God, and somehow she would get home too. It turned out in the end, after a lot of tricky back-and-forth phone messages from a region with virtually no cellphone coverage, that a friend came, picked her up in Clarion PA and brought her back to Cleveland on Sunday.

We had a nice trip back from Cleveland with the brakes squealing on turns now, very concerning. But it was wonderful to chat with Sister J., and listen to her and her brother Grandpa J. reminisce and tell stories. We got back to Cook Forest in time to have a wonderful salmon dinner at Aunt G.’s cabin, and we brought along enough supplies for the kids to make smores around the campfire. I learned that the whole annual Cook Forest vacation and celebration is due to Sister J.’s suggestion, decades ago, that people meet there as a middle ground. It is handy that relatives and friends from New York City, New Jersey, Virginia, North Carolina, California, and Maryland (to name a few), can converge there and spend time together every year.

The next day was preparation day for the Big Rib Dinner. It took all day to prepare, peel membrane off the ribs, marinate them, par-boil them, and I cut tons of garlic, ginger, and did anything else that was handed to me to do. Grandpa J. was under a lot of stress and worry, and prepared more ribs than ever before, so even with the support he was in a frenzy to get it all done. Then we heard there would be some very bad weather around dinnertime, so we went to the picnic shelter at Cook Forest Fun Park for dinner and pretty much the moment we stopped eating, a huge storm blew in with powerful winds and blew much of our stuff away, then deluged us with heavy, heavy rain. We had to abandon ship and leave a lot of stuff in the shelter and retrieve it early the next morning.

After all the chaos, Grandpa J. announced this was the last year he was doing the rib dinner. I hope he changes his mind and just makes a smaller batch; we had leftover ribs for days (which is not a terrible fate).

Somehow on the way home, the bare-metal whining brake pad on Grandpa J.’s car got so thin it slipped out of the caliper and vanished into the night, making braking very difficult and treacherous. We had to find a local garage that was available to do the job. We went to Aunt D.’s cabin to use the internet and found a shop in Sigel PA that ordered the parts from my description of the problem and model of the car, and was able to quickly install new pads and a new rotor and get the car back on the road before the trip home. Thank goodness that worked out!

I have to make a side paragraph about this, but the people in Clarion, Cook Forest, and vicinity are incredibly nice and welcoming. Time and time again I was blown away by their friendliness and helpfulness, just a bunch of outstanding people.

So we drove back to DC on Saturday and stopped again in Altoona, this time at a famous spot called Al’s Tavern, which is well-known for its chicken wings.

We stayed the night again at my sister’s house and got to visit her and my parents a bit more than on the trip north. We had a fantastic huge spread of taco dinner with zero-net-carb La Banderita Street Taco tortillas, and my blood sugar didn’t spike at all. My sister takes such good care of me and everyone she loves, and I am eternally grateful.

The Chemo That Wasn’t

We got home in time for me to get my port accessed for lab tests and chemotherapy. My CEA was up a tiny bit, 7%, to 5.9. It’s not as bad as a year ago, when it was doubling every couple of weeks, and we just had a good 33% drop in CEA, so I was only a bit concerned about the increase.

My HgbA1c was 5.7. My cholesterol was 152: LDL 41, HDL 34 and Triglycerides 465. I’m still losing weight and my fat cells are releasing tryglycerides into my bloodstream, so that explains the high value there. My white blood cell count was very low at 2.0×10^9/L (normal low is 3.0), my platelets were 57×10^9/L (normal low is 150). My neutrophil count was 1.0×10^9/L (normal low is 2.0). As such, my oncologist determined we should skip chemo this time and give my body a chance to rebuild its defenses. We also discussed whether we should go to 3 week cycles, as I have read on the internet that a lot of people doing low carb diet plus chemotherapy, are able to tolerate chemo better and live much longer on a 3-week cycle. We will move to that soon after the next CT scan results, if things look favorable for that.

I can’t complain at all about not having chemo, I was a little worried that my CEA was going to increase a lot without it. As much as you hate chemotherapy and its side effects, it is a warm comfortable blanket where at least you’re doing something to hold down the cancer, and being without it is stressful.

So from July 25 until August 8, I am free as a bird to enjoy life, get more exercise steps in, and build myself back up for the next round!