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Multiple Myeloma

Weight Gain After Stem Cell Transplant

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My oncologist said this would happen. More specifically, he predicted this would happen following my autologous stem cell transplant (ASCT or just SCT).

At my 100-day post-stem cell transplant appointment, conducted as a virtual appointment thanks to coronavirus (we weren’t calling it Covid yet), my oncologist said, “Let me tell you what is going to happen to you.”

It seems that most people go through a series of fairly specific steps as they recover from the initial devastation of a stem cell transplant. It was curious to note that many of those steps matched the steps of puberty, oily skin, acne, increased libido, but much faster. At the end, he predicted my appetite would come back stronger than before the transplant, and that it would be important to manage it to avoid excessive weight gain.

I heard, but tuned out that last part.

weight gain after sct scale

Gaining Weight After SCT

At the time, I was almost 40 pounds lighter than before the stem cell transplant, down in the 170 pound range.

Playing ‘will I throw up or won’t I throw up’ with every single thing you eat will do that to you.

That worked out to me being 30 pounds underweight. (Actually, if I had more muscle, the 40 pound difference could all be healthy, but we’ll get back to that if it ever matters.)

Now, 14 months after my SCT, my weight is back up to about 214 pounds.

Healthy Weight Following SCT

As a 6′ 2″ adult male (down from 6′ 3″ thanks to kyphoplasty), 214 pounds is not out of the range of healthy weight. Unfortunately, I’m still stick-like, skinny in my arms and legs. All of the weight is in what is becoming a cartoon-like belly.

My former “fat pants” only fit me if I button them under my belly instead of at my waist. And by fit, I mean, I can button them and the crushing compression of the waistband will eventually stretch out enough that I can wear them. I’m sure my waist is something like 42″ instead of 36″ but I refuse to buy anything bigger.

The solution is a combination of weight loss and strength building in the form of exercise.

Post-SCT Exercise Program

If you’ve just come off of SCT, please, please, please, check with your doctors and physical therapists before you dig into anything other than minor exercise. There is a point where you are too fragile to do real exercise. Make sure you are past that before you go out and try stuff.

For me, getting in some real exercise is long overdue. I’m still weak, and I shouldn’t be. I’m still easily fatigued, and I shouldn’t be. I’m still anemic even though I haven’t had a drop of chemo in over six months. I need to start exercising, and not just counting a bit of incidental walking as exercise.

So, here we go. I’ll be doing two things. One recommended by doctors and health professionals, and one not.

The first is ramping up an exercise program based upon walking at least 10,000 steps per day. This will be a combination of walking outside thanks to improving weather, and some nice trails around my house, and using the treadmill that we bought when the pandemic shut everything down. As I build up this stamina, I’ll move forward to running.

Do not run until your docs say it is OK. Myeloma can screw up your bone density and running is already tough on your bones.

I will also incorporate some weight lifting in the form of basic exercises using our 5 lb, 10 lb, 20 lb, and 30 lb dumbells.

Those two things together should work to build my strength and endurance.

Post-SCT Diet

The not-recommended thing I will be doing is a crash diet. Dietitians and doctors hate crash diets, but I hate waiting more. If I can’t see this belly shrinking, then I’m just going to start hating everything and give up.

So, crash diet it is.

My current plan is protein shakes for breakfast and lunch and some sort of plain protein (salmon, chicken breast, and so on) with salad. I will ignore all advice beyond this.

The truth about dieting is that doing anything is better than what you are already doing. Salad dressing is not what makes me fat. Fruit is not what makes me fat. Steak is not what makes me fat.

Eight Oreo cookies at 9:00 pm makes me fat. Eating as much pizza as I possibly can makes me fat. Eating piles of potatoes swimming in butter and sour cream makes me fat. Eating three bowls of Frosted Flakes makes me fat. Chicken wings, nachos, beer, candy, cookies, chips, and so on, makes me fat.

Ironically, just stopping the above would probably be sufficient to make me lose weight, but unless I’m on some sort of militant regimen, my brain won’t fight for me and kick those things out.

This is true of most humans, which is why saying “Don’t eat carbs” becomes a successful diet while the equivalent, “Don’t eat junk food and so much bread” doesn’t get any traction among most people. The more squishy your diet is, the less likely you can make your angry face and say no to your cravings. This way, when I break down and have a baked potato it won’t really hurt me.

Yoga

I should probably throw in some yoga too because my flexibility is non-existent, but for now I’m only committing to the exercise and diet.

If I can get my body back into a useful state, we’ll worry about tricking it out, but for now, the belly goes. Everything else is a luxury for the future.

And, when you have cancer, the future is everything.

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