March 2019 - New regime: diet, sleep, exercise and work

After starting chemotherapy and making contact with Heidelberg, I began to devote more time planning my fight for survival. I was determined to do everything to maximise my chances – I owed this to myself and my family.

Eating...

First of all, I had to stop losing weight, which had been dropping steadily for a couple of months down from 70kg to around 63kg. The doctors recommended a medicine called CREON, which is used to treat people who cannot digest food normally because their pancreas does not make enough enzymes due to a range of conditions, which of course includes pancreatic cancer. As explained in their website, “CREON replaces enzymes that your pancreas isn’t producing, helping you digest fats, proteins, and carbohydrates (sugars) in food”.

Second, in order to help my digestive system, and following the recommendations of my oncologist, I started to replace large meals with several smaller meals, quickly moving from a breakfast/lunch/dinner routine to a regime involving 6-7 meals and snacks. This immediately proved beneficial as the feeling of bloating and indigestion quickly reduced and the loss of weight stopped.

Sleeping...

Third, I started going to bed earlier, at around 10pm, in order to make sure I would get at least an eight hour sleep every night. The idea of focussing on my sleep came after reading the successful book “Why we sleep” by the famous neuroscientist and sleep researcher, Matthew Walker.

That book explains with great clarity that sleep deprivation is linked to numerous fatal diseases and, crucially, that sleep helps boost our immune system, thereby playing an important role in the fight against cancer.

As well as describing the results of his own studies and experiments, the author summarises some key results obtained by other researchers. An important example involving the relationship between sleep and cancer is set out in the following passage:

“Dr. Michael Irwin at the University of California, Los Angeles, has performed landmark studies revealing just how quickly and comprehensively a brief dose of short sleep can affect your cancer-fighting immune cells. Examining healthy young men, Irwin demonstrated that a single night of four hours of sleep – such as going to bed at three a.m. and waking up at seven a.m. – swept away 70 percent of the natural killer cells circulating in the immune system, relative to a full eight-hour night of sleep. That is a dramatic state of immune deficiency to find yourself facing, and it happens quickly, after essentially one “bad night” of sleep. You could well imagine the enfeebled state of your cancer-fighting immune armory after a week of short sleep, let alone months or even years”.

One of Matthew Walker’s conclusions on this topic is that:

“Poor sleep quality therefore increases the risk of cancer development and, if cancer is established, provides a virulent fertilizer for its rapid and more rampant growth. Not getting sufficient sleep when fighting a battle against cancer can be likened to pouring gasoline on an already aggressive fire.”

Of course, going to bed earlier does not guarantee a good night sleep but I found it important to at least give myself the opportunity to sleep for the required 8 hours. And, although I understand that sleeping tablets do not deliver the same benefits as natural sleep, I continued to rely on them as I found it very difficult to switch off my brain when going to bed and, inevitably, I had also become physically addicted to them after a few weeks of taking them. Nevertheless, sleeping more definitely had a very positive impact on my energy level and mood.

Exercising...

Furthermore, after dropping any form of sport and exercise as soon as I was diagnosed, I decided to go back to my gym. Having done nothing for more than a month, combined with the illness and the beginning of chemo, my fitness level had literally collapsed. My gym instructor, a great guy called Josh, was quite emotional when he saw me back in action and made a huge effort to help me start rebuilding my body from scratch.

The benefits I got from exercising were huge both from a mental and physical point of view. Going back to the gym was like regaining a bit of my previous life, which boosted my mood considerably. Moreover, although progress was quite slow, it was clearly visible – my fitness level quickly began to improve and so did my energy level.

And that was despite the fact that the therapy I was undergoing was clearly doing its best to shed whatever was left of my muscles, a well-known side effect of chemotherapy treatments. Chemotherapy also caused tiredness (fatigue), which made me want to sit on the sofa the whole day.

I decided not to succumb to that request from my body and actually go against it, believing that the more I fought fatigue, the less the number of days I would feel tired. Even on my worst days, I would get out of the house and go for a walk. Needless to say, this was not easy but my body seemed to respond well to it.

...and a bit of work

Finally, having taken a couple of weeks off, I decided to get back to work. Some people may consider this a strange move: why going back to work when you know you may have only a few months to live? In my case, the answer to this question was quite straightforward.

First of all, the kids significantly benefited from seeing me going to the office in the morning – in their mind, this was a sign that things were pretty much under control, whilst a choice to remain at home would have represented a constant reminder of my illness. Importantly, I was back from the office more or less at the same time as the children from school, so there was no sense in which by going to work I was sacrificing time I could otherwise have spent with them.

Second, it was important to give Jane some breathing space. My illness had obviously affected her as much as it did me and I thought that leaving her alone for a few hours a day would help her switch off (at least partially) from the situation we suddenly found ourselves in.

Third, going back to work allowed me to focus my mind on other things – while in the office I was able to concentrate on my tasks rather than think about my illness all the time. My colleagues were also very welcoming and very happy to see me back in action. My day to day job was not as before of course, since I focussed much less on project work (I could not possibly travel to attend meetings at short notice and did not have the energy required to work too intensively) and more on managerial issues, which I found both interesting and rewarding.