As I mentioned a bit earlier, Sam’s first readmission to the hospital was for low sodium and also for weight loss.  Note: Sam has always been a long and lean body type, since the day he was born. He never had any “chubby baby” photos or “chubby thighs” or “chubby cheeks.” 

Before getting leukemia, he was 6’1 inches tall and a strong 165.  He worked very hard, over the course of the last year, to do strength training with the goal of making the 2005 Palo Alto Soccer Club National Premiere League team.  And he made it! But that same strong, lean, muscular body is not the common body type for leukemia. And so it started catabolizing his muscles because his body fat is so low.

So he dropped from a healthy and strong 165 lbs to a low of 138 on July 28. 

And in comes “healthy eating for chemo” which turns “healthy eating for soccer” on its ear. 

After Sam was admitted on 7/12, he was 10 lbs lower than when he came home on Saturday 7/9. That was tough to hear as we’d been doing our best to feed him (but understandably, his tastebuds had changed with the chemo and he didn’t want the same flavors that he’d previously craved: for example, chocolate and sweets were down on the list and savory was at the top).  

So Dr. Lacayo says “eat like Michael Phelps when he is preparing for a competition: 5000, 7000, 10,000 cals per day — you can’t eat too much. And whatever you like, just add fat and salt to it.  Do you like olive oil?”  (Dr. Lacayo *loves* olive oil 🙂)

Sam’s small stomach, however, had other ideas so we had to gradually expand its capacity over time (he’s never been a huge eater either — never had that “hollow leg” phenomenon that many teen boys have).  

So I Googled “what is the fast food with the highest sodium and highest fat?”

Guess what the answer was?

Spicy Chick-fil-A chicken sandwich! 460 cals, 19 grams of fat, and 1670 mg of sodium.  And 28 grams of protein.

I bought 2 and brought them to the hospital and they were promptly gobbled down :) (and some how an extra chicken biscuit got thrown in my bag too — great! The more salt and fat, the merrier on this healthy eating for chemo plan 🙂)

So started our daily trips to Chick-fil-A (for a few days). 

And while that was the fun part of the “healthy eating for chemo” plan, the not so much fun part was being limited to 2L of liquids per day (because his body was getting rid of too much sodium — thanks vincristine (chemo medicine). As Sam’s BFF said to him when he heard this news, “I drank 2 L before getting on the plane today (he was traveling with his family in Europe).” 

Sam is of a similar mind: he has no problem drinking water. The nutrition team at LPCH wasn’t as experienced with how to create a high nutrition density meal plan for a high metabolism, athletic build, teenager with B Cell ALL (which is not surprising — most of the ALL patients are ages 5-9 and have higher body fat. That population has a harder time drinking water, it turns out, so their expertise is understandably more in that domain). 

He even had to add salt tablets to his daily medicine regimen: 8 salt tabs per day 😞

Sam hit his nadir of 138 lbs on July 28 and a nadir of 128 sodium (needed to be higher than 135) and has been on the upswing ever since, thanks to the attention of all the team at LPCH, thanks to our friend Chun Hua for making homemade dumplings and other delicious Chinese food, thanks to an appetite enhancement and sodium tablets medication, and thanks to Sam’s efforts (tracking his calories, tracking his water intake, tracking his weight). He weighed in at over 150 this morning. Hooray!

And the liquid restriction was lifted earlier this week too — Sam was *so* happy.

And the appetite enhancement medicine was removed from the line up on Thursday so yay for that too (which equates to 15 fewer pills per day — a significant amount). 

Take that leukemia!

#TeamSam