Week 5 on Piqray

After consulting with my oncology NP, who also consulted with my oncologist, I decided to try taking Metformin, to see if it would positively affect my glucose (and insulin) levels. I can say that it did have a positive effect on my glucose. There was pretty much an immediate improvement! I am looking forward to getting the results of my blood tests for this week. I’m quite happy to see average levels of under 100.

Mid-week, Week 2 on Piqray

Glucose seems to be doing relatively well. Today I saw a peak of under 105 and a low of about 70. That’s pretty good compared to a week ago. I’m thinking of asking for another fasting insulin test, just to see if its still high. I’m wonding if (especially if its still high) that’s what’s dropping my ketones. I’m having trouble getting them above 0.6 at 24 hours fasted. I am thinking of doing a 48-hour fast (with eating some pepperoni and cream cheese at 24 hours – since I have to have some food with my meds) to see if I can kick things into gear again. I’d love to drop my peak glucose about 20 points, and the lower end around 10. My “ideal” range used to be under 100, with under 90 being common. I’d sure like to get back to that. I’m not really stressing on the low ketones. Maybe I’ll move taking the supplements from in the morning and at night to morning and afternoon, and see if that makes a difference. They are kinda expensive, so I want to make a bottle last as close to a month as I can.

Lab Results (3m comparison)

So, I just got some lab work done. I’ve got a series of labs I have run every 3 months. It gives me a good idea of what I’m doing and how the different systems in my body are functioning.

The low A1C is good! Doc isn’t worried about the cholesterol total. He did say that my HDL went up (“that’s good”). The fasting insulin being up isn’t good, but our guess is that it’s an artifact of taking Piqray. Both cholesterol ratios look good!

JAN 12, 2020OCT 8, 2019July 18, 2019
Fasting Insulin25.45.22.4
A1C4.34.94.7
Estimated Glucose779488
Cholesterol 225186198
HDL Cholesterol 1047478
LDL Cholesterol Calculation 10683110
Total Cholesterol: HDL Ratio 2.22.52.5
Triglyceride 7414650
Triglyceride: HDL Ratio0.711.970.64

Next Steps

So, I had an appointment with the NP who works with my doctor today. Things are going forward with the plan we already had in place. That is to say, start the Piqray. Now, the “Big 3” side effects of Piqray are:
1) High blood sugar
2) Rash
3) Diarrhea

The treatments are fairly simple. To treat the high blood sugar (non diabetics have had sugar levels in the 300-400+ range) Metformin is given. Now, Metformin is a generic name for the medication. The brand name is Glucophage, which I like. If you don’t know what it means, it is: gluco (sugar/glucose) and phage (from Greek: eating), or at least from as far as I can determine that’s what it means. Like how autophagy means “self-eating”

To treat rash, Claratin (Loratadine) is given preventatively.
To treat diarrhea, Imodium is recommended, as needed, but not proactively.

I am currently wrapping up a 72 hour fast, as I type this, with about 2 hours or so to go.

Fasting graph, for this 72hr fast (not quite completed)

I’m thinking that my numbers, while great, are not as slow as they have been on long fasts because I was not drinking green tea (unsweetened).

After this, I’m going to keep a close eye on my glucose, via the CGM and fingersticks, as I’m starting my new medication. I’m hoping that I am one of the few that don’t need Metformin. But I plan to track my glucose first, to see what it does, and then take the Metformin only if necessary. Because I have a CGM and do fingerstick tests I can easily keep on top of it, rather than just waiting for a week to do my labs.

On a side note, the pharmacy that supplies the Piqray sent a nice welcome kit. It’s far better than the kit I got with anything else!

Welcome Kit

Stay tuned for updates as to what my glucose does!

Looking Back at 2019

I’m sitting here writing this, around 11pm on 12/31. It has been quite a year, with the journey really starting in July 2018.

I’ve been taking Transfer Factor Plus (TF) for most of my time in chemo and treatment. I can see from my CBC blood tests that the TF has been a good addition to my treatment. It didn’t always bring my white cell counts up above the low-normal line, but it did keep it from going too low. I do know that when I talked to my oncologist about it she said that almost all the people who were taking Talzenna had to have dose reductions because of their white cell counts going too low. I did not have that problem at all. I do intend to continue taking the TF as it supports my immune system. TFs are an immune modulator, which is to say that it can either boost or suppress the immune system as necessary. Chemo is toxic by nature and really hard on the immune system. It is wise to do everything possible to safely boost your immune system so that you stay healthy.

I’m happy to still be here, doing well, and being relatively healthy despite my cancer diagnosis. My oncologist is equally pleased with my health, all things considered. She is quite surprised and pleased that I don’t have any of the common complaints that people on chemo have. I am not fatigued (despite caring for 4 children), I have a good appetite, and am basically in good health (not sick).

I have had ups and downs in my treatment, however. Some of the treatments have worked better than others, namely the chemo. The more targeted therapies have been more hit-and-miss as to their effectiveness.

I am looking forward to 2020 and the healing that I will receive in Jesus’ name!

I do need to mention that I do sell this product, and I do believe in it. My sales link can be found here

PET Scan #7

IMPRESSION:
1. Improved left axillary lymphadenopathy and hepatic metastasis, as
evidenced by decreased size and FDG uptake, with demonstration of new hepatic lesions.
2. Mixed but overall mildly progressed osseous changes.
3. Stable mildly FDG avid left breast findings.
4. New 1 cm right hilar focus of FDG activity. Recommend attention on
follow-up imaging.
5. Stable cutaneous and subcutaneous nodules consistent with patient’s
history of NF1.

The Plan:
So, overall, the results aren’t too bad.  It’s still not as good as we’d like to see (meaning significant decreases and nothing new), but it’s not bad either.  There were improvements in some of the cancerous areas of my liver.  The plan is to stop IV chemo, as its fairly toxic (as all chemo is) for the amount of improvement that has been seen.  The plan is to start a combined injection and oral therapy.  The injection is something that will prevent the cancerous cells from taking in estrogen, or at least preventing them from taking in as much estrogen.  The pill is a targeted therapy, intended to seek out PIC3CA mutations.  The biggest side effects of the pill are high blood sugar (my doctor isn’t worried about this, as I’m eating low carb), rash, and diarrhea.  If my blood sugar happens to get high it would be treated with metformin, a medication commonly used in diabetics to treat hyperglycemia (high blood sugar).  The rash can be treated/pre-treated with an anti-histamine, like Benedryl or loratadine.
I had been expecting to have one more cycle of chemo before seeing my doctor, but she called me on the 26th to discuss the plan.  This is the same plan that we were going to implement after the January office visit, so its not like it was something unplanned.  I had actually expected to be starting it after the PET scan anyway.  It hadn’t been possible to get an appointment before January.