B.E.A.M. Chemotherapy 6th July 2017

Diagnosed Hodgkins Lymphoma Stage 4B 14^th Feb 2014 – Stage 4 Multiple Lymphoma 2017

Please keep in mind when reading this that Chemotherapy & Stem Cell Transplants effect everyone in a different way, this blog tells you how I was effected by the treatment

St James Hospital Dublin

Due to a slight infection in my PICC line it had to be removed on 28th June, this has delayed treatment by 48 hours but i was admitted on the 5th

Everything since the 9th April has been done to prepare for these 7 days, all the ICE chemotherapy up to the stem Cell harvest on the 6th June. The is no B plan this is it a real “do or die” situation.

B.E.A.M Chemo

B.E.A.M is a high-dose chemotherapy treatment. It’s given before a stem cell transplant. A stem cell transplant allows for a much higher doses of chemotherapy.

B.E.A.M is named after the initials of the chemotherapy drugs used, which are:

• BiCNU ® – carmustine
• Etoposide
• Ara-C – cytarabine
• Melphalan.

B.E.A.M is basically a rescue regime and an extremely aggressive therapy. It is aimed at destroying anything in the body that can regenerate. Specifically bone marrow stem cells. The course is split over 7 days and I will not only be confined to hospital but completely isolated. The isolation includes everything even down to the conditioned air in the room. Have no doubt this type of Chemotherapy can kill a person

I will have BEAM over a period of  six days and one rest day before the stem cell transplant There will be a countdown to the day fot the stem cells, which is called day 0:

• On the first day (day minus 7), I will get the carmustine as a drip (infusion) over two hours.
• Over the next four days (days minus 6 until day minus 2),I will have cytarabine twice a day as a drip And also have etoposide once a day
• On the next day (day minus 1), I will be given melphalan
• Day Zero I will have the stem cells as a drip into the PICC line a minimum of 24 hours after the melphalan has finished. These are the stem Cells that were harvested on 6th of June

This is all been done in St James Hospital Dublin

Once I have the Transplant then the clock starts again as day 1, it is expected that by day two I will be on morphine. Chemo can be painful but when you kill all regenerating cells and then dump 60 million harvested stem cells back into the body it is like a gigantic war starting. Basically the stem cells will attack the Chemo drugs and at the same time retrigger bone marrow production. The expected result is that everything from my mouth to my bowel will blister – they suspect that by next weekend I will be unable to eat or drink for at least 72 hours. But this team are really excellent and I believe we will do it.

The mental build up to this has had its difficulties. But I am only human so it’s allowed. 6 weeks since last Chemo and 4 since Stem Cell harvest- I have been quiet tired since harvest due to low blood counts but just high enough to avoid a blood transfusion. I walk a couple of miles every day and/or cut the grass, clean house etc. There is no way I could have run a business during ICE or even now. Recovery according to my doctors has been incredible but I really want to push this harder.

For BEAM I have put on 5kgs in weight, I tend to do this prior to Chemo and this time I feel it’s needed. By the end of this therapy I will be unable to eat due to mouth soars and difficulty swallowing- they plan to use IV for fluid and vitamins with morphine for pain

Day Minus 7 Thursday 6th July 2017. Here goes. Started day with blood samples & then on for a PICC line. As explained in my cycle 1 of ICE a PICC line is a line going from a vein in my arm to my chest, they are used for advance chemotherapy as I will be spending most of the next few weeks on various drips, these included BEAM, steroids, transfusions, saline, antibiotics etc.

And the first Chemotherapy drug is: BiCNU carmustine… the B in BEAM

Green covers for the chemotherapy drugs in Dublin as against the purple in Cork & my haircut is complements of ICE Chemo. Wow that just felt like three days of ICE in one hour. This is seriously strong I feel like I could fall asleep right now. And I did for 12 hours straight 🙈

Day Minus 6 Friday 7th July 2017. Two lots of Chemo today starting with etoposide  two lots over 4 hours plus cytarabine for 1/2 hour also have etoposide tonight for about an hour. This will be replicated for 4 days so it’s minus 6 to minus 2 exactly the same. Not as much anti nausea been used.

 
Staff here is St James are fantastic. Everything runs like a well tuned and oiled machine. Like myself they prepare for the worst and hope for the best.  This is only the start.

Day Minus 5 Saturday 8th July 2017
same regime as yesterday. I am allowed to walk the hallways in the hospital but from tomorrow on that may stop as my immune system is gone completely & my baseline blood levels are low.

But all in all I’m handling this okay, they are long days starting with blood test at 6:30am and the Chemo finishing at 10:30pm. So it’s old army style warefare I sleep & eat whenever I can & return to the battlefield, the battlefield been the hospital bed. My gut feeling here is I am winning the war with the final battle now at hand.  3 years and 5 months this has taken.

Just a couple of topics I would like to share with you. Firstly the cover photo of the double doors – this is actually the first set of double doors to enter the ward, behind these doors are another set, after you go through these there is a nursing station where the check to see if your on a visitors list, then it gets even tougher to enter the treatment wards with another double set of doors behind which are yet another set. But these doors can’t be opened at the same time, the inner section is air conditioned. When you through these doors you will meet the nurses who take care of the patients & be under no illusion these nurses will decide if you can see the person or not, no ifs no maybes they decide. To enter the individual rooms there are more double doors, you must close one before you open the next one, this is to protect the person in the room – without any natural defence system the victims are completely open to infections and anything even a cough could kill. As the regime continues I find myself wanting to stay in the room more.

Second topic. There are a large number of people reading these blogs, ranging from friends to victims & family members of victims. One of the readers a young lady just 19 years old & Stage2B HLD is awaiting a PET scan next week following first line treatment in LA, this lady has also wrote a number of blogs primarily in relation to awareness of swollen Lymph nodes but what caught me was a comment she made prior to even seen a doctors. She felt deep inside that she was been attacked by cancer, I remember thinking something similar weeks before the Lymph Node swelled. Could it be that our bodies warn us and we simply ignor it, could it be our brains early warning system triggering an alert.  Awareness is everything and regular screenings are vital. If doctors catch you at stage 1 or 2 your chances of survival are massively increased. Listen to your body and mind……..

Day Minus 4 Sunday 9th July 2017 <<<<
at of yesterday so no real updates. Think my blood counts finally falling as I’m quiet tired

Day Minus 3 Monday 10th July 2017 Last day for the B.E.A  today,  tomorrow I get the Melphalan (there calling  it the push I’ll explain tomorrow) I am starting to really feel the effects of these drugs. Tiredness and sudden loss of appetite. But when I’m not on the Chemo drugs I do tend to get out for a walk- about 5 times a day. I am not in full isolation yet (not permitted out of room) I should have been isolated from Saturday but my blood counts are still high so I’m allowed to walk the corridors. Extra anti sickness are been used from today and lots of mouth wash. The mouth and throat are the first main targets after cancer cells by this Chemo. I may have already mentioned this but the staff here are wonderful. This is a split 21 individual roomed Ward further split into two units. From the Professor to the clearer they are all gentle caring dedicated people, I am always amazed at how they do it, I know I’m seriously ill but I’m also very strong but there are some critically ill people on these wards, I’m on the Red Ward  which is basically for critically ill victims, I serious hope to keep my strength up. Right now it’s 11am and I have just covered the first hour with 3 hours to go, then a break till 10pm. The Stem Cell transplant is now 72 hours away.

Day Minus 2 Tuesday 11th July 2017

Day started at 2am for blood pressure test now every 4 hours, then 6am for blood test. The throat and mouth have finally become soar so I’m on initial pain killers and BMX (BMX is a mouth was you swallow that is only made in hospitals here in Ireland, it helps soothe the mouth & throat.) I think there is benylin in it, I had this during Radiotherapy in 2014 and it really helps. Bone joints pains are everywhere. So 11:45am commenced 4 hour drip of Saline to prep me for the last Chemo drug. 4pm the Chemo finally arrived, two big 50ml syringes – the Chemo is injected into the line with the saline but the saline is pumped at high speed. It’s basically not nice. I will know the side effects later tonight or tomorrow

So that’s the Chemotherapy done. Next is the Stem Cell Transplant which happens 36 hour

Day Minus 1 Wednesday  12th July 2017
Today is a day off after aggressive Chemo for 6 days and Transplant tomorrow Thursday 13th