I.C.E. Cycle 1 – 10th April 2017  

• Diagnosed 14th Feb 2014 Hodgkins Lymphoma stage 4
• Biopsy to right neck Feb 2014
• Bone marrow & Lumbar punch March 2014
• P.E.T. Scan March 2014 (P.E.T. Number 1)
• Chemotherapy ABVD Commenced 13th March 2014 Ended 14th August 2014
• P.E.T. Scan April 2014 (P.E.T. Number 2)
• Declared Chemotherapy Steroid induced Diabetes Type 2 May 2014
• June 2014 Bleomycin (The B from ABVD) attacked my right lung
• P.E.T. Scan Oct 2014 (P.E.T. Number 3)
• Radiotherapy @ 40gml Grey to right side neck Nov 2014 to Dec 2014
• Given 6 weeks to live following Radiotherapy Dec 2014
• Ultrasound Fine needle aspiration March 2015
• P.E.T. Scan May 2015 (P.E.T. Number 4)
• Tonsillectomy & Biopsies to throat July 2015
• P.E.T. Scan Oct 2015 (P.E.T. Number 5)
• Oct 2015 Partial Remission (Cancer cells present but not active)
• Diabetes Type 2 Cleared
• Full Remission Feb 2016  
• P.E.T. Scan May 2016 (P.E.T. Number 6)
• Biopsies to throat & base of tongue July 2016 
• P.E.T. Scan Oct 2016 (P.E.T. Number 7)
• Suspected Kidney failure Nov 2017 & new Lymphoma site to middle spine
• Biopsy to lower spine Lymph Nodes Feb 2017
• P.E.T. Scan March 2017 (P.E.T. Number 8)
• Declared relapse both HLD & NHL urgent  rescue procedures required

Meeting with Oncologist 29th March 2017 – The news was bad. All samples taken were positive for Lymphoma. A team of specialist had a conference via Skype and decided that this was life treating. Urgent medical intervention was to commence with the following:

3 cycles of R-ICE chemotherapy followed by a Stem Cell harvest, followed by BEAM Chemotherapy followed by Stem Cell Transplant.

This task is so big it had to be handled by two hospitals and two full Oncology teams one based in Cork (where I live) Bon Secours and the second based in Dublin (167 miles away) St James. St James took the lead in all procedures.

The treatment was classed as an Emergency Rescue Regime for Non Hodgkins Lymphoma

R.I.C.E Chemo

R – rituximab,

I. – ifosfamide,

C. – carboplatin

E – etoposide phosphate.

R-Ice Chemo is designed to kill all cancer cells in the blood, plus white cells, stem cells and production of stem cells. I will go under 3 cycles, each cycle takes 3 days in hospital followed by 18 days of no Chemo then cycle 2 18 days of no Chemo then cycle 3

Cycle 1

Admitted to hospital the day before chemo 9^th April 2017 for blood test urine test etc. Got good to go ahead and commence Monday at 11am 10^th April 2017.  Had a PICC line surgically placed into my left arm (this is basically a long tube inserted into a vein that ends up close to your heart.) a discomforting procedure that takes about 40 minutes from start to finish.

Then back to the room to commence. Firstly I got an anti nausea injection to cover 3 days. Then two small bags of steroids followed by a 3 hour infusion of Etoposide (the E in ICE) followed by 1 hour Carboplatin (the C in Ice) and that was it for day one. All was good, drank about 3 ltrs of water and slept well that night. I was aware what day 2 would bring. Due to the server level of Chemo the medical team had to tackle protecting my kidneys and my bladder (known side effect is server bladder damage) So I had 2 hours of Mensa followed by 24 hours of Ifosfamide (the I in Ice) and 24 hours of Mensa at the same time. To say I did not sleep that night means I stayed awake. So the 24 hours commenced at about 3pm Tuesday and ended at 3:30pm Wed – followed immeadiately by 2 hours of Etoposide. I then has infusions every 3 hours for 20 minutes a total of 9 hours.

So Thursday 13^th my doctors came to see me. They were more than happy with me. Apart from elevated blood sugar (Previous chemo resulted in becoming Type 2 insulin depended diabetic, cured myself of that in Oct 2015). Constipation that they felt was mild. But good to go home.

PICC Line was removed as risk of infection too high. Lots of warning about blood sugar levels, temperature, high risk of infections, server constipation and a lot more.

Before leaving the hospital my liaison cancer nurse came in and went through everything that was going to happen. And of course a multiple list of medication.

The medication included an 8 day self injection course of Neupogen GSF – these injections stimulate new stem cell production at an accelerated rate – self administered (not a problem after been a diabetic for over a year) – stomach tablets, anti nausea tablets, anti biotic to protect lungs, kidney tablets and a number of viral protect tablets

And the planned next visit 1^st of May 2017 for admission (18 days from last date) to commence Cycle 2 over 3 day from 2^nd May.

Appointment for PET Scan set 15^th May 2017. Followed by meeting on 23^rd May in St James team in Dublin (lead team for Stem Cell)

Appointment set for final ICE Cycle 3 to commence 24^th May.

Appointment set for Stem Cell harvest 6^th of June 2017

ALL Dates subject to change.

So finally released on Thursday 13^th of April after Cycle 1. Got home and felt the old familiar feeling of fatigue. I had fatigue after ABVD and once you have experienced chemotherapy fatigue then you will know whats its like. But the fatigue from ICE is about 100 times worse. However I managed it, went to bed when I felt it coming got back up as it eased back. Then the injections of Neupogen GSF and yes it causes bone pains and lots of them, properly every bone in the body. Other side effects included Peripheral Neuropathy (sensation of numbness and tingling in hands and feet) this never fully went after ABVD but it did get more server for the week after ICE. Temperament was not good but could be controlled. Found it extremely difficult to sleep. But that was about it. I was capable of walking, driving and cooking.

As I have decided to write this as a day to day experience then today is Thursday 27^th of April. 5 days left before I start all over again