All I can Do is Smile


Keto Life: Week 3 (and then some)

Let’s start with some administrative items: November’s blood work & oncologist call occurred without incident. All blood marker levels are within in the normal range — my CA-125 was slightly elevated, but my HE-4 was down a significant amount. (No, I cannot thank the diet for that yet since the tests were done about 4 days after starting keto.) I’ll do another round of blood tests and a CT at the beginning of January.

Last week & weekend, I traveled up to Northern California for my BFF’s birthday. Any fears about staying keto-friendly while I was up there were quickly abated by her texts and emails — with food questions & answers, as well as menus for the restaurants at which we’d be eating.


Despite the preparations made, it was still hard, and I fell out of ketosis while I was there. I made simple “mistakes” that messed with my net carb intake — namely, a cappucino (damn you again, milk) and too many nuts as snacks.

I laugh because I thought to myself, “I’ve SO got this.” #smug

I have SO NOT got this.


It’s becoming annoyingly clear that measuring and tracking everything I eat is going to be required longer than 2 weeks. (COME ON. I just want this to be EASY. But yeah, we’ve already talked about the easy way and the right way, right?) Even more annoyingly, I’ve recently realized my food tracker does not differentiate between total carbs and net carbs.

Sidebar: Total Carbohydrate – Dietary Fiber = Net Carb

This is a big miss by MyFitnessPal, because I’m limiting my net carbs, not my total carbs. For instance, 78g of carrot has 7g total carbs, but 2g of those are fiber, so REALLY, I’m getting 5g of net carbs. Two grams makes a big difference when all you’ve got to work with each day is 25.


I’ll be exploring other options. (UGH.) Since I already meal plan, I’m thinking I may just create my own tracking system with the nutrients figured out after I grocery shop. This will also allow me to pre-portion everything, and make grabbing food quick and easy — both for myself (my phone reminder to eat is helpful, but it’s not going to make the food for me) and Kenji (who leaves most mornings at 5:30am and doesn’t have time to portion out from larger dishes). (Plus, he makes the coffee each morning and that’s WAAAAY more important than feeding himself.)

Speaking of quick and easy, I found a keto-friendly meal delivery service! (Seriously, where would we be without the internet?!) Our first 6 meals arrive today, and I’m hoping this will help in overall preparations. It’s not inexpensive, so we’ve committed to not eating out as long as we’re getting them.

The experiment continues, as does the search for information and advice. I’m working on a separate post with the science behind this for those of you who are interested. And apologies to friends in person who have to hear me talk about this ALL. THE. TIME. It’s (obviously) one of the main things on my mind right now.

Happy Thanksgiving to everyone! Eat some pumpkin pie, green bean casserole, and mashed potatoes for me. Gobble, gobble.



Things & Stuff: October Edition

And with one thing and another, October is nearly over.

This past month felt more like *real* life than any other since chemo stopped. It’s almost as though I can pretend that nothing at all happened and life has always been this way, right?


My work on mind, body and spirit continues! I joined a 30-day Bikram yoga challenge at the beginning of the month, and though I was sick twice (Damn you, immune system! Will you get with the program already?!), I have completed 15 days. This is FAR more than I’ve ever done in this span of time, so I’m already counting it a win. And the fact that I count it as a win, makes me count that as a win, because frankly, a year ago, I would have beaten myself up for not doing all 30 days. Or, when I had to miss 5 days in a row the first time I was sick, would have just quit altogether, telling myself that it wasn’t worth it if it wasn’t perfect.

Fuck perfection.

It’s an impossible standard. Something I am finally understanding.

Hello, my name is Jessica, and I am a recovering perfectionist.

This weekend dawns a new era. One where bacon rules and bread is non-existent. That’s right! Keto life begins on Sunday. Well, actually Monday since we’re grocery shopping & meal prepping on Sunday. I’ve been doing a ridiculous amount of research in preparation for this moment. Except, I completely forgot to order the blood tests, so I’ve put the ever-industrious Kenji on that task. (See, look at me go, releasing control.) It only takes 24 hours to get into ketosis, but the note I’m seeing often is that the first month basically blows. I keep hearing about the “keto flu” — so it’ll be interesting to see how this all plays out.

I’m meeting with a dietician next week, who I’m hoping will be a guide in this process.

Interested at all about what I’ve found? You can view my folder of goodies here. Yes, there are spreadsheets. What’s annoyingly necessary in all of this is a strict documentation of what you’re putting in your body. It’s all about the macros. *sung to It’s all about that bass*

I’ll be honest. We’ve been indulging these past two weeks as we prepare to say farewell to bread and fruit. Pizza, pita, sourdough toast…. I’ll miss you friends. I’ll try to post regularly on how it all goes!

Work continues to be great and every day brings something different. My little card business side hustle got some great exposure at the Bike MS Bay to Bay Tour last weekend. Everything continues to be groovy.

Happy Halloween to those celebrating! I’m going to be a sleepy person — and by that, I mean, I’m not getting out of my PJs on Tuesday. #workfromhomelife



Things & Stuff: September Edition with Added Science!

First off, I cannot believe it’s nearly October. Time, she is flying! Kenji and I had a discussion recently around perception of time and how it changes as we age. We figured out that a 50 year-old’s perception of a single day is just over a week to a 1-year-old. Put *that* in your pipe and smoke it.

We’ve regained a sense of normalcy this month, with my being back at work full-time. I have never been more grateful to work, love what I do, and feel like I’m making a difference. My brain is happy to have something else to focus on 8+ hours each day.

We’re preparing for another diet change in November. Ever hear of the ketogenic diet? There’s compelling research in mouse models on how it affects cancer growth, and currently, there are nearly a dozen human studies being done. There’s strong anecdotal evidence in human studies with small sample sizes, so we’re going to give it a whirl. Remember that thing about focusing on the things I can control?

Some of the research we’ve looked at:
Nutrition & Metabolism, 2015: The glucose ketone index calculator: a simple tool to monitor therapeutic efficacy for metabolic management of brain cancer

Redox Biology, 2014: Ketogenic diets as an adjuvant cancer therapy: History and potential mechanism

Nutrition & Metabolim, 2011: Effects of a ketogenic diet on the quality of life in 16 patients with advanced cancer: A pilot trial

Nutrition & Metabolism, 2007: The calorically restricted ketogenic diet, an effective alternative therapy for malignant brain cancer

PLOS, 2013: The Ketogenic Diet and Hyperbaric Oxygen Therapy Prolong Survival in Mice with Systemic Metastatic Cancer

The author of the above study was on Joe Rogan’s podcast (episode #994), and talks extensively about the ketogenic diet.

It is a huge shift, and unfortunately, not one you can ease into. This will require the metaphorical light switch — starting November 1, that switch is on! We’re using the month of October to do more research, understand what foods are complimentary or not, and savor our carbs one last time. There’s also the matter of added tests to monitor ketones in the blood, as well as supplements to replace what’s missing from the diet (namely, nearly every damn fruit that exists).

You’ve probably heard of Atkin’s. Atkin’s is based on the ketogenic diet, which most people find difficult to follow. The keto diet has shown efficacy in childhood epilepsy, where traditional treatments have failed (tons of research has come out of John Hopkins around this). The make-up of the diet is 90% fat, 8% protein, and 2% carbs.

Because I have no gall bladder, processing that amount of fat is problematic, so we’re looking to apply the modified ketogenic diet — which increases protein intake to 65%-70%. Carbs stay the same.

Essentially, the point is to bring your body into a state of ketosis — where the body’s cells use fat for its energy source instead of sugars. Cancer cells cannot do this, so the thought is they starve and die.

Both my oncologist and breast specialist are lukewarm (at best) about diet making a difference in cancer volume. I get it. There’s no definitive evidence (yet), so they can’t exactly say, “Yes, do that and your cancer will go away!” However, my former oncologist is positive about it and even participated in a meeting a few weeks ago in Portland with a naturopathic oncologist who counsels on this very subject within the Kaiser system. I’ve inquired if I can be connected with someone like that in Southern California, or if I can do virtual counseling with that person in Portland.

That’s all for this month — and frankly, I think it’s plenty. XO


Shingle all the way

The holiday season is upon us!

Just kidding.

Sort of. (I’m sure Costco will have their Xmas display any day now…) It’s just I like a punny title and that’s all I could come up with today. Bear with me, as today is the first day it doesn’t feel like I’ve been punched in the face.

So yeah, I got/have shingles.

On my face.


This time, it occurred in and around my left eye. Also this time, I addressed it FAR SOONER than I did the last time (11 years ago now), so I’m calling this a win, even though getting shingles is definitely, definitely NOT a win.

So much for heading into full-time work with a smooth transition from vacation land. We had a rough travel day coming home, which was followed by many sleepless nights as I got back on the California clock. Turns out, sleep deprivation really messes with your immune system, among other things. My eye had been bugging me since our travel day, but I assumed it was from some rogue piece of sand irritating my eye. Upon closer inspection in the mirror a few days later, I immediately knew what I was dealing with.

And immediately said to myself “FUUUUUUUUUUUCK.”

And then promptly got my ass to urgent care.

The receptionist (bless her heart) red-flagged me so I got in right away (I had barely picked up my magazine of choice from the waiting room when my name was called) and my self-diagnosis was confirmed, much to my chagrin. A course of antivirals was obtained. (Valtrex, which not only treats genital herpes, but also herpes of the eye, which is exactly what this case of shingles is. Fun fact.)

Ophthalmology wanted to see me as soon as possible and OF COURSE the department upstairs didn’t have any availability, but a location in Anaheim did, so off I went. From there, I received 2 more prescriptions and upon filling them, discovered one required compounding and wouldn’t be ready for an entire week. Not exactly helpful. So an alternative was suggested by the doc, aaaaaaand that alternative was not available at that particular pharmacy. Or any other pharmacy that was remotely near where I live.

But it was available in Downey.

Tour de Kaiser facilities, ho!

I got to Downey, got my meds, and then got to remember why I don’t do anything north of Tustin on a Friday afternoon. Southern California rush hour, you are so cruel.

In any case, I’m on the mend, I’m totally fine, and there will be no lasting damage to my eye. It’s a pretty bitching shade of bloodshot right now, so it’s a good thing I work from home.

In other (more important) news, the latest CA-125 looks good and this whole “holding pattern” thing seems to be working. I meet with my oncologist as well as my breast specialist next month and there will hopefully be nothing to report, except that everything is the same and we continue to march on.

Work starts on Monday (!!!!) and I’m excited and nervous all at once. I’m enjoying these final days as a Lady of Leisure (ha), but I can’t wait to have some structure in my day that isn’t dictated by a chemo schedule. Onward we go.

The Journey of the Warrior

“This is it.

The journey is learning that pain, like love, is simply something to surrender to.

It’s a holy space we can enter with people only if we promise not to tidy up. So I will sit with my pain by letting my own heart break. I will love others in pain by volunteering to let my heart break with theirs.

I’ll be helpless and broken and still — surrendered to my powerlessness.

Mutual surrender, maybe that’s an act of love.

Surrendering to this thing that’s bigger than us: this love, this pain.

The courage to surrender comes from knowing that the love and pain will almost kill us, but not quite.”

– Glennon Doyle Melton (yep, still reeling from Love Warrior. Read it already.)


On life after trauma

I saw this reposted on Instagram, and it’s pretty damn close to explaining my sentiments as I go through this.

From @bymariandrew:

I’ve been trying to draw something about living through a traumatic experience for a while, but it’s a really sensitive and complex topic, so I’ll just focus on this one part of my own personal experience:

The common conception is that you’re just so grateful to be alive afterwards, but that conception implies that you’re the exact same person you were before trauma. Same person, now with a new lease on life.

In fact, living on the other side of trauma feels like being a different person altogether — and a person who doesn’t quite belong anywhere.

It’s isolating, and is often accompanied by feeling of being a stranger even to one’s own body. It’s not the same Mari who is now just happy to still be here, it’s a Mari who has lost some trust in the world and herself and has a hard time talking about it.

In my experience, it’s frustrating to anticipate a swell of gratitude that may take years to set in, and it’s lonely trying to explain that it hasn’t happened yet.

I’m grateful for the wisdom that come with a brief visit to hell on earth, but it doesn’t exactly look like a new lease on life. Post-traumatic growth is certainly real, but complicated. Journaling helps. Nature helps. People help.



30 Days & What Have We Learned?

It’s been nearly 30 days since my last post. I’m constantly amazed at how time seems to pass in the blink of an eye. There’s much to report, so let’s get this party started, shall we?

Most importantly, we met with my oncologist today and are now officially in “wait & see,” or as I’m going to call it “go forth and conquer” mode. My CA-125 levels continue to stay in the normal range. This is a blood test I will get monthly, in addition to another cancer marker, called HE-4. There’s a small chance that the CA-125 won’t be an accurate predictor of cancer volume, however so far, it has been. That’s where the HE-4 blood test comes in. It’s just another marker for ovarian cancer that we will monitor closely. I anticipate getting a CT scan in September (3 months since my last scans in June), where we’ll track any growth (or not) of the cancer in my pelvic area (currently contained within a lymph node). Prophylactic surgery on the breasts is currently on hold, but I’m still working with a breast specialist to monitor that area of my body.

I will likely live with ovarian cancer the rest of my life and it will be treated as a chronic illness. This reality forces a shift in… well… everything.

That’s where the energy of the past 30 days has been focused. It has meant, in my words to Kenji: “no more fucking around.” My diet has to be on point. My exercise has to be consistent. And my mental health has to be under control. These are the things that I have control over that affect cancer’s growth. It’s my intention to do everything in my power to keep that growth at bay, and to learn to let go of those things that I can’t control.

Frankly, it’s hard work.

The past 30 days have had three main goals: eat well (gain weight!), reduce stress, and exercise. I’m proud to say I’ve put the work into each of these areas and am already seeing gains.

The reduction of stress has been one of the more difficult areas of growth. I continue to see a therapist, and I’ve added a meditation practice to my day. I’m using an app called Headspace to help guide me, as well as track my progress. It’s been hugely beneficial and it doesn’t hurt that the voice guidance is an Australian dude. (Sexy voice = more willing to listen. Ha ha ha. Hey, whatever works, right?)


Fitness has come easier than expected. Sure, there are days where I have to drag ass to make it happen, but I ALWAYS feel better afterwards. I started with 10-minute intervals on the elliptical and have increased to 25 minutes. I also began a courtship with the bicycle two weeks ago, first riding 7 miles, and last weekend 12. I can do laundry without needing to sit down for extended periods of time. I can cook a meal. These things I took for granted now mean the world to me.

After my stint in the hospital, my weight was a startling low 117 pounds (a number I can’t recall seeing since well before high school). My diet has been focused on whole foods, reduction of processed sugar, and just plain eating enough each day to sustain my body and fuel my muscles as I increase activity. Because we were already implementing these dietary changes into our lifestyle prior to my recurrence, this has been an easier shift to continue. Honestly, the hardest part when first coming home was simply eating enough. Thankfully, we’ve passed that hurdle.

I have another 30+ days before I return to work full-time, and my intention is to cement the aforementioned habits and refine them (particularly where diet is concerned). Being able to focus solely on myself has been weird, but wonderful. Mostly because I’ve never done so before in my lifetime. It’s a great reminder that when we take time to care for ourselves, we are then able to bring the best version of ourselves to the rest of the world.

I’m treating myself with grace and kindness and finding it to be exactly what I need. It’s not easy, but it’s worth it.



How quickly things can change

Hello dear friends and family…

Last week the BFF came into town and I had a decent amount of energy after Day 1 of Round 2. We had lunch with my MIL, bought weird masques that moisturize your face AND make you look like a cat (those crazy Japanese)….


I look totally normal and not like something from your nightmare

She cooked and cleaned, and all around was delightful to have. Duh. I was sad to see her go Friday night. So sad in fact, I landed myself in the emergency room. (I’m KIDDING Hil. It’s okay that you left when you did!)

Let me back up.

For Day 8 of Round 2, I got the pleasure of a blood transfusion because I was anemic. I received two units, one of O- and one of O+ (I’m O+, anyone who is O- or O+ let me know so you can donate your blood to me should I need another transfusion. They usually require 10 days lead time). Then I received my regular chemo.

The nurse kept going on about how I was going to have all this energy and to take it easy (ha), but when Saturday came, the opposite was true. I spent the day sleeping, getting very angry with Kenji each time he woke me up to eat, or to walk, or to eat some more. In hindsight, this was the best thing for me (yes, Kenji, I admit it) and I felt a bit better on Sunday.

My brother came by to color easter eggs, where we learned it’s far more fun as kids who don’t have to set up and clean up afterward.

Mostly though, I was just cold. I couldn’t get warm. Chills constantly, so much so, that I kept taking hot showers to get my core warm.

So, when it was time for my white blood cell shot at the nurse’s clinic, I went with base layers on and a beanie. And a scarf and a jacket. When the nurse checked my vitals, I had a 103-degree temperature. I blamed the beanie and took it off, waiting 5 minutes and we tried again. Only 102 this time. Protocol dictated that we notify my oncologist and then off to the ER I was to go.

They made me remove my many layers, put on one of those bullshit gowns and gave me a sheet to cover me. Turns out, your body has chills when it has a fever as well as when you’re cold. So I had to lay there shivering, while they took every possible test and bodily fluid from me to see where the fever was coming from. Then, they gave me some Tylenol to bring the fever down, and general antibiotics to start killing whatever may be causing the fever.


Giving thumb’s up because what else could I do? I felt fine minus freezing my ass off in that room. And yes, the rest of the hair is gone. It was coming out every time I did my hair. This is easier to manage. Watch a time-lapse video of me shaving my head. (Kenji got the spots I missed.)

After waiting for initial test results, which all came back clear, the on-site doc made the call — they were keeping me overnight for observation. Which technically, wasn’t “being admitted” in Kaiser-land, whatever that means. Some of the cultures that were taken (throat, brain — er, I mean, nose) would take a few days to come back, so I was to be in the hospital until they did so. (All I know, is we only paid $180 for three days at the hospital, so I think “observation” gave us a discount. I’ll take it.)

All that being said, being in the hospital sucks.

Your ass is constantly hanging out of your gown, they’ve got you on an IV for fluids so you have to pee every 2 hours, and the constant machine beeping due to my IV placement was a crazy-making. The nurse on my LAST DAY finally showed me how to reset the IV. Would’ve been helpful two days sooner!

But seriously, the staff at Kaiser are incredible. Every single person I encounter there is courteous, kind, and wants to help in any way they can. They kept apologizing that they couldn’t figure out where the fever was coming from.

They nailed down that everything was clear yesterday (April 18) and spoke with my oncologist, who mentioned that sometimes the chemo itself can cause fevers.

Well, hell.

I meet with him tomorrow, so we’ll go over what the plan is moving forward. I’ve already got my trusty thermometer to check my temp daily (98.9 today) and keep a better eye on that.

And now I’ve got 15 days off. Hoping for more energy as the days go by, but I’m glad to have made it through that latest ordeal. Leaving the hospital for home made me SO happy.

Shout out to my mother-in-law for staying with me both nights since Kenji had to be on the road by 5am both days, and that’s hard to do sleeping like shit in a hospital room where you aren’t the one in the bed. My support systems makes my cup runneth over.

So, we’re on our way back up! We’ll see what tomorrow’s appointment brings.

Sidenote: I’ll be adding new chemo times and visitation hours to the schedules soon! Be sure the check in and sign up if you’re able!