29 Weeks Pregnant – A well overdue update

Hey Friends!

This stomachless pregnancy update is well overdue. I made the mistake of watching “Tidying up with Marie Kondo” followed by listening to her entire audio book and have been de cluttering like mad the past few weeks. I wondered when the nesting would begin but Marie has kicked it into full gear. But today I take a tidying break to give you all a much needed pregnancy update.

Since my last update, I have seen my Ob-gyn twice. Once just after Christmas where I was referred for a blood work up for my iron levels as well as to measure my blood sugar levels, and more recently Jan 24th where I completed my 28 week ultrasound as well as got updates on my previous blood work .

Normally women who are pregnant complete a glucose test around 24 to 28 weeks to test monitor for gestational diabetes. From what I understand, this involves drinking a large quantity of a sugar beverage followed by a blood work one hour later. Due to the no-stomach-thing, I did not have to do this test. Thank goodness because I think it may have killed me. Or just given me violent diarrhea and full scale dumping. Instead, I completed some blood work.

Throughout the month of January, I continued to work my regular hours and regular duties. I continued to attend the gym 1-2x a week for Zumba and home yoga daily for about half an hour. My fatigue level started to increase near the last couple weeks of January and I started to look green and pale at the end of the day. I was falling asleep on the couch around 8:30pm every night but figured it was just regular pregnancy fatigue. I also started to have minor dizzy spells and felt slightly faint during the last couple of tracks of my Zumba class. You probably know where this is going.

On my Jan 24th follow up, I was notified that my iron level was low and I needed to double up on my iron supplements. I have been taking Ferramax 150mg since my surgery as stomachless folk often have iron absorption issues post total gastrectomy (TG). This made all too much sense after hearing my results and started doubling up immediately. Within a week my energy levels improved as well as my colour. I will likely have this level rechecked in the future to ensure I am not anemic and if it remains low – I will be referred for an iron IV infusion. This is also common post TG and in pregnancy (especially during the late 2nd trimester into the 3rd).

In terms of my blood glucose levels, I did not have gestational diabetes so this was a bonus. Continue eating ice cream, baked goods, and chocolate for me! I am convinced this baby will be 1/4 chocolate.

On this visit I also had a 28 week ultrasound. At this point in time, I had gained about 10lbs above my pre-preggo weight. The issue the Ob-gyn is concerned about with people who have TG’s is the baby not gaining enough weight. Much to my surprise, I was notified that the baby is currently in the 73rd percentile. Which means that he is bigger than average! I heard these scans are not the most accurate for actual birth weight but I’ll take it. I am hoping to have a 6-7 pound baby but if this scan is accurate, I may have an 8 pounder. Yikes! Maybe I better slow down on the sugar….

In terms of physical mobility, my right hip and pelvis continues to be an ongoing issue and although I am doing as much as I can for it (Yoga, stretching, Physio, and massage therapy) it is getting worse as the baby grows. I’ll spare everyone all the details as I do not like to complain but I am confident that it will all go away once the baby is born. I am determined to keep up with my physical activity though throughout all of this pregnancy.

In terms of eating, my appetite is the best in the morning to mid day. Although, I have been eating a lot, my weight gain has been minimal. This morning I was at an 11 pound gain. As he continues to grow, the baby is taking all the good nutrients he needs and my body composition has been changing. Less muscle mass…larger belly. I think I am all baby.  The evening is a different story. Often it is hard eat the same portions I was able to eat a month ago and I have issues with food getting stuck. Dinner time is the most difficult. I find standing and eating the easiest. Sometimes, I try to shift the baby position around as I suspect my intestines and pseudo stomach are getting all bunched up and the pipework is getting kinked. If I’m successful, I usually feel a good gurgle and the stuck food sensation goes away. I also try not to eat too late into the evening to avoid bile reflux in the middle of the night.

Believe it or not, my surgical scar looks better than it ever has and I think all this belly stretching is stimulating more cell repair. I also think this baby is breaking a lot of old adhesions from surgery. You go baby!

Anyhow, my next follow up is next week. I am down to the every two week appointments now. I am now 11 weeks off of my estimated due date. Homeee Stttreeettccchh!!

Me at 27 weeks pregnant

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Pregnancy post total gastrectomy

I have been a little MIA from the blogging world over the past few months. Not because I didn’t have any ideas but I was saving up for some big news!

After last years adventures with IVF + PGD +PGS followed by a natural pregnancy and a miscarriage, we are happy to announce that we are expecting. I write this with both excitement and hesitation. As you all know, I am an optimistic person and prefer to see the light in situations. However, after experiencing a miscarriage, it is hard not to be semi-guarded when expecting. We announced to our friends and family after the infamous end of first trimester, but I did not feel comfortable posting anything onto social media. After speaking with Brandon and thinking about it long and hard, I decided that I wanted to blog about being pregnant without a stomach as it may help many other women trying to make that tough decision about when to have their stomach removed. I know I was there back in 2014 and it was not an easy one.

I was one week out from meeting with a fertility clinic as it had been almost 1 year since our miscarriage last year. I decided to take a pregnancy test about a week before the appointment and much to my surprise, it was positive. I was four weeks pregnant. This was back in mid August.

I had suspicion that something was going on as I was able to eat some ice cream, which I shared with the world on my last blog post. This happened to me last year before the miscarriage. I was able to tolerate sweeter foods easier. That was my first sign.

I called the fertility clinic to let them know about our natural pregnancy and they still followed me for the first eight weeks. At this point, I was transferred to a high risk maternal fetal medicine clinic. During my appointments at the fertility clinic, ultrasounds were taken at the six week and eight week mark. Each one filled with nerves that we would receive bad news and then joy that things were going well.

Once I was transferred to the high risk clinic, I first met with the regular maternal fetal medicine clinic and a genetic counselor to discuss the hereditary nature of the CDH1 genetic mutation as well as how one can go about testing a fetus for the gene. We had already decided in advance that if we had a natural pregnancy the child would not be tested until it is old enough to make the decision on their own. But for those who are interested, doctors are able to test for the gene using Chorionic villi sampling or amniocentesis. At this point, the expecting parents can decide to terminate the pregnancy or keep it. It is not an easy decision for anyone, that is for sure. In Ontario, these tests are covered which adds more layers to the decision making process of IVF with PGS/PGD (costly) vs. natural (testing is covered).

Thankfully, we were already prepared for all of these decisions as my genetic counselor discussed all this with me back in the day when I found out I was positive for the mutation.

I had morning sickness from weeks six to week fifteen. It actually was afternoon/evening sickness which allowed me to get through my work day but knocked me out at night. I experienced brutal nausea from about 4pm to when I crashed at night around 8pm. I attempted vomiting hoping it would make it stop but that is one thing that I have not been able to do since my stomach removed. So it was basically like being stuck with constant motion sickness for a nine weeks. Props to all the women who have this throughout the entire pregnancy and for those who don’t, you are lucky!

Around week six, I started to develop coccyx (tailbone) pain which has progressed into right sided glute/hip pain which radiates a quarterway down the back of my leg. Thankfully, I have many great physios friends who with who have been keeping it manageable. It is a real pain in the butt!!

In week 16, I was able to feel the baby kick and in week 17, I was able to see some kicks and feel them on the outside. They say that people may not feel these things until 20 weeks or later in pregnancy but I think us stomachless people are so body aware, we pick it up faster. The baby kicks more after I eat, I am assuming because all the intestinal noises from digestion must be pretty loud in there for it. The baby is sitting on my left side and fairly low.

In terms of weight gain, I have gained about four pounds since becoming pregnant. The Ob-gyn recommended that I gain 5-8lbs by week 20. I also recently completed my anatomy scan which occurs around weeks 18-22. Again, I had some ‘scananxiety’ but thankfully, everything was normal. I have still not gained much weight and I have a small bump. My Ob-gyn was not concerned about the lack of weight gain as it is too early to tell if the baby is growing appropriately.

Anyways, I plan to keep people up to date about how things are moving along. Pregnancy post gastrectomy is not a topic that many blog about so I think this will serve as a good platform to blog more frequently again.

Hereditary Diffuse Gastric Cancer Webpage

Hey all!

Recently Karen Chelcun Schreiber (Founder of No Stomach for Cancer) started a webpage dedicated to Hereditary Diffuse Gastric Cancer (HDGC) which strongly focuses on CDH1 mutation as well as the most recent research regarding HDGC.   She works with Dr. Parry Guilford (Discovered the mutation and continues to do research for CDH1 mutations).

The mission statement:

“To support Hereditary Diffuse Gastric Cancer (HDGC) translational research that leads to improvements in the health and well-being of those affected by HDGC, and to provide relevant, reliable information and resources to help individuals and families understand their risk, make informed decisions, and advocate for themselves.”

I think this is such a great organization as the funding and donations to this group go directly to research for HDCG.   My hope is that there will be a better way to prevent HDGC for people with CDH1+ mutations than removing your stomach in future years.

Check it out:

Hereditary Diffuse Gastric Cancer

Stomach Cancer Awareness Day

Hey all!

Today is Stomach Cancer Awareness Day and I will be attending the 2nd Annual Stomach Cancer Conference in Toronto. There will also be a live cast for anyone unable to attend but interested in the information presented.

If you are going to be there today. Come say hi!

Ice cream

It has been just over two months since my last blog post. Time sure does fly! We are having a real summer here in southern Ontario – hot and dry. I have been spending much of this summer studying for an exam that involves progressing my diagnostic skills and treatment skills as a physiotherapist. But that is a whole blog in itself. Needless to say, I have been a little MIA from the blogging world.

But I’m back for another reflection post.

One food that I have always loved is ice cream. I have mentioned it many times in previous blogs and purchased the biggest cone to eat prior to saying farewell to my stomach. Not only is it delicious but often, eating a cone is associated with a fun social outing with friends or family.

Unfortunately, I still do not tolerate it well in larger quantities (i.e. greater than 1/4 cup). So every time we stop for ice cream, I am faced with a decision – eat it and risk feeling unwell (usually bloated, fatigued, and rapid heart rate) or kindly pass and often take a few licks off your husband’s or friend’s cone.

I came across a quote that states, “you miss 100% of the shots you don’t take” and I am not a person who likes using the phrase, “I can’t”.

Last night after a nice dinner with friends in Toronto, we stopped at an ice cream place called, “Bang Bang Ice Cream and Bakery“. They are a small ice cream shoppe that makes home made ice cream and apparently has some of the best ice cream sandwiches downtown. Once again, I was faced with the decision to pass or to try. This shop had a small 4oz size cup.

“You miss 100% of the shots you don’t take”

I ordered the 4oz cup of mint ice cream. Was it the best ice cream I’ve ever had. Yes. Was I scared to eat it. You betcha. Did I feel bad after? Surprisingly not as bad as I had expected.

Life is too short to pass on the things you love. Life is too short to be afraid.

You miss 100% of the shots you don’t take.

Happy August everyone!

Four years wiser – 4th Gastrectoanniversary

Today I celebrate four years without a stomach and my annual gastrectoanniversary blog.

I’ve been MIA from the blogging scene over the past few months. Where have I been? I’ve been busy living. Honestly, my life is becoming so much more normal that I find it difficult to find unique gastrectomy topics to blog about these days.

This past year I have been working on overcoming two ongoing issues since surgery – Fatigue and Sugar.

On Sugar

About a year or so ago, I decided to man up and try sugary foods and various breads that I previously not digested well and surprisingly I could tolerate a lot more than what I had originally thought. I grew tired of being afraid of feeling unwell and that I didn’t want to live out the rest of my life missing out on things I may be able to tolerate but was too afraid to try. So in the safety of my own home, I started experimenting with various foods/beverages. Thankfully, I was able to tolerate a lot more than what I could tolerate a few years ago.

So after four years, I can eat a small slice of whole grain toast with peanut butter for breakfast. I don’t pass on cake or pie. And I can eat a whole donut over 45 mins and not feel terrible. The key to my success is pacing and portion control. At this point, I will try anything and just pace through it and 85% of the time I’m fine. The other 15% I’ve passed out on the couch.

Donut time!

On Fatigue

I work a healthy 30 hours a week and have not bumped it up for the past three years. To those who may not know, I work as a physiotherapist in an orthopaedic clinic performing manual therapy on patients throughout my day. I’d classify it as a physical job. Twice a week I start work at 11am and I have been careful not to do anything too strenuous before work for fear I would burn out by the end of my work day.

Well, earlier this year, I decided that I wanted to do more with my mornings and started pushing back my rise time and doing more with my mornings. I knew there would be an adjustment period where I would feel tired but my body would adapt and I’d even out. My good friend, coffee, would also be present to help me through. Currently, I am able to wake before 8 am with enough time to get some jobs accomplished before work. I’m working on pushing it back to 7:30 am to have a more consistent wake time throughout the week. It goes to show that if your mind is ready, your body will eventually figure it out. I require power naps every now and then but overall, my energy level has increased and I’ve gotten a lot more accomplished.

Other updates

As for my weight update, my weight remains fairly stable at 117-118lbs. Although I am only off of my pre-surgical weight by 7lbs, my body shape has changed. I’m leaner and carry my weight in different places. Reading through last year’s post, I’ve managed to maintain this weight throughout the year. I am beginning to think I’ve levelled out. The only issues is that my mind still thinks I am my old size and I constantly pull clothing sizes that are too large even four years later!

I want to make a quick mention about the importance of iron supplementation and monitoring levels post total gastrectomy. My iron level has been slowly dropping over the past few years and for the first time this year, my iron was at a low enough level to affect me physically. It felt like I hadn’t slept for days. I just kept pushing through figuring it would pass but it did not and after a week and a half I caved and went to see my family doctor. She ran some blood work and I now know I need to take my iron supplement daily. Once I started taking it daily, my energy levels improved almost immediately. Previously, I was taking it every few days thinking that was good enough. Apparently not!

From an unsuccessful IVF cycle, to a miscarriage, to facing your fears, this past year has been filled with many learning experiences that have helped me become more resilient and wiser. Year four has gotten me even closer to my pre-gastrectomy self and I believe this time next year I’ll be that much better.

Olympic fever

I love the Olympics – especially the Winter Olympics.  Many of the sports carry considerable amount of physical risk, whether it be the laser sharp blades of the speed skaters, the speed zipping  down a steep hill, flying stories above the ground, and of course sending yourself head first down an ice track on a small sled.

I also love the stories of all the athletes as they have spent many years training for this moment when the world watches and cheers.

Obviously, I follow and cheer a lot more for our Canadian athletes and last night I witnessed a truly inspirational story.

Last March Mark McMorris was seriously injured while snowboarding backcountry.  He hit a tree and fractured his jaw, left arm, pelvis, multiple ribs, ruptured his spleen, and collapsed his left lung.  It was shocking to the nation and many of us followed his story as he fought to recover.

Fast forward to Pyeong Chang 2018.  Just under one year later. Men’s slopestyle.  Guess who’s back? Mark McMorris.  He laid down three amazing runs to land him a second Olympic Bronze.   Oh and did I mention he broke his femur in 2016 and has a rod in there?  

From Olympic Instragram post – Feb 11, 2018

And then there’s Denny Morrison.  He recovered from a bad motorcycle accident in 2015, suffered a stroke in 2016 and is back competing in long track speed skating.  

These stories are so inspirational as it demonstrates many things.  Perseverance.  Determination. Attitude.

If they can overcome challenging life experiences, so can we. 

But first….coffee

I have never enjoyed coffee as much as I have over the past three and a half years and counting.   Maybe it’s because it’s easier to drink than water. Maybe it’s because it wakes me up. Maybe it’s because it helps me poop.   You may be thinking TMI but you know it’s true.

I mean, other people love coffee too, but there’s just something about drinking coffee without a stomach.   The caffeine goes to your brain fast, real fast.    Curious to know if it was just me or if it was a stomach-less thing, I decided to do a mini-poll among my stomach-less friends and we all decided that coffee is just great.  By the way, I don’t have a huge sample size to back this up (four people to be exact) but I’ve also seen on the support groups that I follow that those who can tolerate this wonderful beverage also love coffee.

Breville Barista Touch with a shout out to “My Gut Feeling”

In November of last year, Brandon and I decided to treat ourselves to a semi-automatic espresso machine as an early Christmas gift to each other.  Since then, I have developed a greater respect for baristas and better understand why my Starbucks coffee may cost $6.  Thanks to YouTube, I have been able to become my own barista – spending countless hours learning about tamping, grind size, brew time, frothing, and or course latte art.

Besides the benefits I listed earlier, consuming coffee has other health benefits.  A recent study published by the British Medical Journal concluded that consumption reduced mortality from cardiovascular disease, coronary heart disease and stroke (1).  It also reduced the risk of developing specific cancers such as prostate, endometrial, melanoma, non-melanoma skin cancer and liver cancer (1).   Consuming coffee also reduced the risk of developing type II diabetes, gallstones, gout, and renal stones (1).  Heck, it even reduces your risk for developing liver conditions such as cirrhosis by half! (2).  When it comes to your brain, it may reduce the risk of developing Parkinson’s disease, depression and Alzheimer’s disease (1).  Women post total gastrectomy should be aware that it may increase the risk of fractures due to calcium absorption; however, if you add calcium (milk or cream), you may help reduce the effects (1).

Cheers!

Besides the physical health benefits, there are other psychological benefits associated with coffee. It’s associated with many good times.  I’ve had many great conversations over coffee with friends and family.  I will also rarely blog without a coffee beside me.  Oh and it played a large role in getting through six years of university.

So for those who have made it through their total gastrectomy, can tolerate coffee, and love it as much as I do – go reward yourself with a sweet coffee machine. You deserve it!

References:

1. Poole R, Kennedy OJ, Roderick P, Fallowfield JA, Hayes PC, Parkes J. Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes. BMJ [Internet]. 2017 [cited 2017 Nov 22];359j5024. In: Ovid MEDLINE(R)[Internet]. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=medl&NEWS=N&AN=29167102

2. Kennedy OJ, Roderick P, Buchanan R, Fallowfield JA, Hayes PC, Parkes J. Systematic review with meta-analysis: coffee consumption and the risk of cirrhosis.   Aliment Pharmacol Ther [Internet]. 2016 [cited 2016 Mar];43(5):562-74. In: Ovid MEDLINE(R) [Internet]. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=med8&NEWS=N&AN=26806124

 

 

Did we just become best friends? A 3.6 year update

Since my surgery, I have been scanning my facebook support groups as well as instagram hoping to find locals with CDH1+ who also had a total gastrectomy. Given that the CDH1 genetic mutation is rare, the chances were slim that I would find someone. But I kept searching #CDH1, #totalgastrectomy, #nostomachforcancer hoping I’d find somebody.

In March of this year I found a post on Instagram from another person with the CDH1 mutation who also had their surgery with Dr. Swallow at Mt. Sinai in Toronto. I was pumped. I sent her a private message that went something like this, “Hi there, I also had my stomach removed by Dr. Swallow at Sinai in 2014 as well as my mom in 2010 due to the CDH1+. I wish you the best of luck in your recovery!!!!”.

Heather’s Instagram post

A few days later I heard back from her. Her name was Heather and at that time she was recovering from a post operative complication from her total gastrectomy. She had her surgery on May 6, 2016 – almost an 2 years after mine. After sharing some personal stories about how we found out about the CDH1 genetic mutation in our family, we realized that we only lived an hour apart. A meeting was definitely in order.

Due to Heather’s post op complications as well as my unfortunate IVF and miscarriage misadventures, our meet up was delayed; however, we finally managed to connect in person on October 20th.

What were we going to do? The fall colours were in full blast at that time and my hometown is known for waterfalls and hiking. So, we decided to go for a hike and then get food (obviously). As soon as Heather arrived, we immediately hit it off. Heather’s story was one of sadness and triumph. Her mom had lobular breast cancer 8 years ago and survived. Unfortunately, she developed diffuse gastric cancer and by the time it was detected, it was metastatic and too advanced to do surgery. During this time, her whole family was tested for the CDH1 mutation and her and her aunt tested positive for the gene. Heather decided to have her total gastrectomy. Her immediate recovery was much better than mine. She only spent a few days in the hospital versus my 10 day run. But later dropped a significant amount of weight and needed to be re-admitted to the hospital. Sadly, during this time, her mom passed away.

But you wouldn’t know about this sad story unless you talked to Heather about it. She was the most positive, optimistic, and outgoing person. You also wouldn’t realize she lives without her stomach as she is a mother, farmer, graphic designer and small business owner. She owns “Feeder Flower Farm” focusing on growing specialty cut flowers as well as running holiday workshops.

We spent the whole time gabbing and sharing stories that we both forgot to take any pictures of us hanging out that day. We decided that we needed to meet up again. This time with our husbands and family.

Brandon and I drove up to Heather’s neck of the woods. We were going to go for a hike as well that day. But plans quickly changed. We met their dog, Zelda. Jay, her husband and their wonderful almost three year old son, River.

My Link costume from Halloween 2015

Jay was wearing a Zelda t-shirt. For those who know me, know I love Zelda. Zelda was also special to them. We all gathered around and sat in her living room and drank delicious coffees. Brandon was the centre of attention as their cat and River all surrounded him. I noticed that they had a PS4 with a stack of video games and an X-box. Gamers. For those who know Brandon and I, know that we also are big into video games. If that wasn’t enough, I noticed that they had a shelf filled with board games, BUT not just regular board games, highly strategic ones that cool nerds play. Board Gamers. We had more in common than just having the CDH1 genetic mutation and missing a favoured organ.

Our boardgame shelf

We ended up bailing on the hike (since it was cold and gross out) and ended up playing a board game, chatting, and eating delicious food. It was a wonderful Sunday afternoon. Just before we left, Heather and I remembered, we must take a picture! It was the first but definitely not the last.

Myself and Heather – Nov 12, 2017

The thing about CDH1 genetic mutation is that it sucks. It really sucks for so many reasons. When I was diagnosed, I told myself that I may not understand why it happened to me but the answers would become clear as my life moved on. This has been all true. The past four years have brought many positive things into my life, and now I can add Heather and her family to my list.

Stomach Cancer Awareness Day – Nov 30th

Today I had the opportunity to attend the first annual and first in Canada to focus on Stomach Cancer conference.  It was organized by “My Gut Feeling” which the first not for profit organization in Canada dedicated solely to stomach cancer.   Similar to “No Stomach for Cancer“, it was founded by two stomach cancer survivors who realized that there wasn’t much information out there on stomach cancer nor a place to network or with patients, survivors, or caregivers.   It was founded in 2016; however, I stumbled upon their web page earlier this year.

I am part of many groups on facebook that provide support to those who have had partial or total gastrectomies or the CDH1 gene mutation.  Many people ask questions and they are from all over the world.   The great thing about My Gut Feeling is that they can help Canadians navigate the health care system and offer support as well as spreading awareness and advocating for Gastric Cancer in Canada.

I learned many things today and heard many personal stories. The thing about attending these conferences is that they always pull on your heart strings.  You hear personal stories from survivors, caregivers, or patients and it reminds you of where you’ve been and how far you’ve come.  You hear talks from medical professionals who push to advocate for stomach cancer research where there is very little funding.  You meet others who have been through similar situations and you realize that you aren’t alone.  Oh, and you usually get a lot of breaks with food because you know a chunk of people in there don’t have a stomach.

There are many more wonderful things that I could share about this conference as it was so fantastic; however, I wanted make a quick blog post before bed and it is about an event I learned about which is occurring this Thursday in Canada.

My Gut Feeling has organized a Stomach Cancer Awareness Day on November 30th.  In honour of this day the CN Tower in Toronto will be lit up periwinkle blue.  So will the city hall towers and the Toronto sign.  Not only that, the city halls and landmarks in Victoria, Vancouver, Edmonton, Montreal, and Halifax will light up as well.

If you are near any of these landmarks, I ask that you snap a photo of yourself near it with #MGF365 to help raise awareness about stomach cancer.