BEAM me up

So it's been a while since iv'e been on to update my progress. I apologize for that but there really hasn't been much to say. ICE treatment #3 left me in ALMOST remission. I had a 1cm nodule in my left lung that barely above background on the PET scan. Side effects were unremarkable and fleeting.

Now I'm in the pre-treatmet phase of my SCT. Basically, this week I have classes on basic and catheter care, social work consult, labs, and a trip to the clinic to see the transplant doctor. Beginning this week I will start the mobilization phase of the transplant. During mobilization phase I will be gettting a growth factor called Granulocyte Colony Stimulation Factor, G-CSF also known as neupogen injected subcutaneously every day for about 4 days before the collection partion of the transplant. More on the collection part when I actually get to that point.

The chemo I get during the conditioning phase is called BEAM

B - BCNU (carmustine) - Interfers with the growth of rapidly growing cells and causes them to die. Main side effects- interferes with platlet development,

E - Etoposide (VP-16, VePesid) - Interfers with and stops growth of cells. Main side effects- Mouth sores, disupts platelet and white blood cell production. Had this drug before during ICE chemotherapy. I thought it was the easiest to tolerate.

A - ARA-C (cytarabine, Cytosar-U) - Also interfers with the the growth of fast growing cells Main side effects- Disrupts platelet and red blood cell production, also disrupts white blood cell production. Anemia, neutropenia, bone pain, conjuctivitis and fatigue. kidney problems.

M - Melphalan (Alkeran) - Interfers with cell growth, kills bone marrow. Main side effects- Total destruction of the bodies ability to produce blood components. Mouth sores, kidney damage, black tarry stools, hair loss, infertility. This drug is supposed to be the Darth Vader of chemotherapy drugs. It's so mean that it has its own theme music. Patients are instructed to eat ice chips for an hour prior and an hour after administration to slow the infiltration of Melphalan into the epithelial cells in the mouth. The theory is that this will lessen the mouth sores.



I'll be getting my conditioning chemo therapy on this schedule:

Day -6: BCNU 300mg/m^2 IV once at 1500

Day -5: ARA-C 100mg/m^2 IV BID (twice a day) at 0800 and 1800
Etoposide 100mg/m^2 IV BID at 0900 and 1900

Day -4: repeat day -5

Day -3: repeat day -5

Day -2: repeat day -5

Day -1: Melphalan 140mg/m^2 IV at 0800

Day 0: Transplant day. 24 hours after the dose of Melphalan.

Day -6 starts the day after stem cell collection ends.

ICE is making me a crackhead

It's 3am on a Wednesday morning and I can't fall asleep. I guess I'll use this time to update this blog. I had ICE #3 starting a week ago this morning and it went off without a hitch except for some trouble with overeager nursing staff. My discharge on Friday was delayed by a couple hours simply because my nurse was flustered and made alot of "rookie" mistakes. no harm, no foul but still a little annoying. The treatment and subsequent side effects were the same as expected. moderate nausea that was moderately controlled with medication and fatigue. I got a neulasta shot on monday and expect pretty decent bone pain on, lets see.. Saturday thru monday. not too bad. As for the duration of side effects. I have nausea for about 3-4 days then it just vanished. like one minute to the next. Ive also learned to keep ahead of the symptoms. once they set in they are alot harder to get rid of than if you did pretreat them. I do, obviously have some sleep disturbance that reaches outside of the 3-4 days I previously mentioned. I have very bizarre nightmares on days 4-5 following treatment. I had them with all 3 treatments of ICE and it's part of the side effect arsenal that I have come to accept. Aside from the fleeting nausea, nightmares and periodic insomnia, ICE hasn't been that bad. BUT It's turning me into a crackhead with this no sleep business.