The big day arrived. I felt a strange mix of intrepidation, fear, anxiety and relief. I was completely fearful of what the chemotherapy would do to me and a large part of me wanted to run for the hills rather than put myself through it but,at the same time, I knew it was a necessary evil and the quicker I got started the quicker it would be over. I had done some research about what to take with me to the sessions and had a bag stuffed full of goodies; a warm scarf and socks, snacks, a book, my iPad loaded up with Netflix episodes, ginger chews, anti sickness wrist bands, a few nice toiletries (I had received so many lovely gifts from friends of hand cream, facial mists, essential oils and lip balms) conditioner, a wide tooth comb and hairband (for the cold cap) and a warm hat to wear on the way home as my hair would be wet and head presumably a bit chilly. I was ready for anything this treatment was going to throw at me.

After making sure the children were safely installed at school Dan drove me to the hospital. He wasn’t allowed to come in with me so he dropped me at the entrance reserved for the cancer ward. It felt so strange saying goodbye to him. Here he was depositing the fit and well woman he had been married to for 15 years at a place where she was to be administered a series of poisons that would have a huge impact on her health and physical appearance. I wondered how I would be feeling when he picked me up later that day and more importantly what he would be dropping off at the doors of the hospital when I got to treatment number 6?

After being provided with a hospital issue face mask and passing the temperature test at reception I was able to enter the cancer ward. I was met with cheery hello’s from the nurses and shown to my room. As far as hospitals go, the room really was very nice. It had a window that overlooked fields and trees, an inviting looking bed, nice artwork and its own bathroom. The nurse assigned to me for the day told me that she had put heated pads in the bed to ensure I was warm throughout the treatment. As I got in I was extremely glad that I had worn fairly light clothes, it was boiling! but given that I was shortly to be dealing with the -5 degrees of the cold cap I decided that was a really good thing and snuggled in. I certainly wasn’t going to need the warm scarf or extra socks!

The nurse took my temperature, blood pressure and oxygen levels, all were good so we could proceed with the poisoning. First job was medication, I was given an anti sickness drug called Akynzeo that my nurse told me was brilliant and should prevent me feeling sick during and for a few days after treatment. Anything to prevent sickness sounded an excellent idea to me so I wolfed it down. In addition to the Akynzeo the nurse explained I would also be given steroids intravenously and to take in tablet form for the next few days that should also help with sickness and generally feeling unwell.

We then moved onto the fitting of the cold cap. Before it could be fitted I had to wet my hair and slather it with conditioner to ensure the hair was as flat allowing the cap to fit as closely to my scalp as possible.The cap comprised two separate parts, the first looked like a blue gel brain filled with water. This was the part that was attached to the refrigeration unit next to my bed that would chill the liquid in the cap to -5 degrees once we were ready to go. On top of the gel brain, to ensure it stayed as close to my scalp as possible, was a sort of neoprene scrum cap that was extremely tight fitting and made tighter via a chin strap. Once wearing both parts with the chin strap tight and secure, I couldn’t decide if I looked more like a demented waterpolo player or a patient in a Victorian lunatic asylum. Whichever was more accurate it certainly wasn’t my best look and I was suddenly extremely grateful for the privacy of my room. The nurse gave me paracetamol to help with any “pain” caused by the cold cap. I was starting to feel a bit anxious about the whole cold cap process. What was I doing adding the additional stress of the cold cap to the stress of being poisoned? Had I made the right decision or should I just be embracing a bald head and be done with it? Too late for thoughts like that, it was time to switch it on!!

I had been told that the first 10 to 15 minutes of the cold cap experience are the worst and if you can make it through that the discomfort subsides and is tolerable. That advice turned out to be pretty spot on. As the machine was switched on I could hear the gurgling of the chilled water as it filled the blue brain. It was definitely cold and I started feeling it’s numbing effect on my scalp. It got colder and colder and I began to wonder just how cold it would get. Would I be able to tolerate it after all of my bravado? I don’t even like the cold, I thought back to all those times on skiing holidays that Dan had to revive my frozen hands and feet on the side of the slopes. What on earth was I doing freezing my head in a vain attempt to keep hold of a few strands of hair? Really? was it worth it? Surely it can’t get any colder? It was really starting to feel rather uncomfortable. The thought of having to keep it on my head for the next 4 and a half hours was just starting to get the better of me when I realised all of a sudden that I wasn’t really feeling it any more. The pain was starting to subside and was being replaced by a tolerable dull ache.

The nurse came back in to set up my IV line and start to administer the Dexamethasone steroid and fluids. The benefit of having a PICC line became immediately apparent, all she had to do was attach the IV line to one of my PICC tubes and we were all set. It felt as though I was being plugged in. The cold cap had to be worn for an hour before the chemotherapy drugs were administered and for an an hour and a half afterwards. The nurse explained that she would stay in the room with me to monitor the administration of the chemotherapy drugs which would take a couple of hours. I realised that I wasn’t going to get much reading or Netflix watching done unless I was prepared to look a bit rude and ignore her presence. Luckily she was lovely and we chatted easily exchanging information about our families and backgrounds, discussing the challenges of 2020, COVID, lockdowns and dealing with a cancer diagnosis amid all of that. Before I knew it the Dexamethasone and fluids were in and it was time for the chemo.

What happened next was reminiscent of the piping in of the haggis on Burns night. Another nurse came in pushing a sinister looking metal trolley on top of which was a tray holding 4 yellow plastic bags containing giant syringes holding the 3 chemotherapy drugs that I was to be given. I was asked by the nurse to confirm my name, date of birth and address and then she removed the first drug from its yellow plastic. Epirubicin was first up. There were two giant syringes of that and it was a pretty alarming orange/red colour. The nurse read out the number on the side of the syringe and the other nurse cross checked it against the details she had on her iPad. I was asked to confirm my personal details again as she checked that they matched the details on her iPad and on the syringe. It all felt extremely formal and very serious confirming again just how much of a big deal the administration of these drugs is. Once they were happy that I was who I claimed to be and that the drugs delivered to my room were the drugs I was supposed to be given, the Epirubicin syringe was attached to the machine next to my bed that would control the delivery of the drug. The nurse told me that not that long ago they would have to manually administer the drugs at the correct rate based on the volume you are being given, your weight etc which is all designed to ensure you do not have an adverse reaction to what you are being given. Thankfully now the machine was able to do the administration for them with a bit of careful programming. The orange/red liquid made its way slowly along the plastic tubing like a sinister snake creeping up on its prey. This was the one that was going to cause the hair loss, bugger!! It finally reached my PICC line and that was it, no going back.

Administration of the drugs was a slow careful process but the time flew as I chatted to the nurse (my chatting definitely picking up the pace as the steroid started to do its work…….poor nurse!) Next came the Fluorouracil followed by the Cyclophosphamide both less colourful and sinister looking and less in volume. Once they were in they put more fluids through the line and for the first time I was left on my own. My neck and shoulders were starting to get a bit stiff, probably the result of the cold cap but other than that the cap really hadn’t bothered me. I was expecting to go home full of stories of the horrors of the cold cap, how awful it had been and how I’d had to dig deep to tolerate it but the reality was that it had been fine. With the exception of that first 10 minutes it had been totally bearable. I made the most of my last hour in the heated bed. Going to the loo attached to my line and the cold cap was interesting but I managed it. Luckily I had been warned of the effects of the Epirubicin so wasn’t alarmed at the bright orange colour of my wee, only at the speed that it had become bright orange!

I was brought some lunch which I had chosen earlier, a tuna sandwich, soup and a fruit salad. Whilst I was munching that I was visited by the pharmacist who gave me a rather large bag filled with drugs; Dexamethasone for the next 3 days, Metoclopramide to be taken if I felt sick, Movicol sachets as the steroids can cause constipation, Pyridoxine as my blood tests had shown I would be susceptible to developing sore hands and feet and finally a syringe of Pegfilgrastim to be kept in the fridge until 2pm the following day and then injected into my stomach to boost my bodies white blood cell production. This is required as the treatment kills white blood cells as well as cancer cells so my white blood cell count would take a battering reducing my immunity levels. They also gave me another Akynzeo to be taken the morning of my next treatment. I was also given a cancer treatment record book which contained details of the treatment I’d had and a section for me to record my side effects. It contained a rather alarming traffic light section detailing the circumstances in which I should seek the assistance of my medical team and those in which I should call 999 and get myself to hospital. Another reminder of how serious these drugs are. I decided that I wouldn’t read all the details but keep the book for reference in the event anything untoward happened.

Well so far so good. I actually felt pretty good and the drugs had been administered without any problems so fingers crossed that remained the case. Taking the cold cap off was interesting, the blue gel brain was frozen onto my hair so I had to leave it a while to warm up slightly before carefully taking it off without ripping out my hair (the irony of that happening!!!).

I felt pretty good as I hopped into the car to go home. No sign of sickness or a the “chemo fog” that I had read about. I could have driven myself home I thought but it was nice to have Dan driving me whilst I talked at him all the way home……..steroid power……..poor Dan!!!!