6:45 AM
Alarm. Coffee. Shower. The holy trinity of "I'm about to sit in a hospital chair for 6 hours." Getting ready for Cycle 4, Day 1. I've done this enough times that there's a routine now. Wear comfortable clothes. Layers, because the hospital is either an icebox or actively on fire. Bring water. Don't eat much—the anti-nausea drugs mess with appetite anyway, might as well skip breakfast.
7:30 AM
Drive to the hospital. Traffic is shit. This is always the part where I'm alone in my head for 45 minutes, which is both necessary and genuinely difficult. Think about how many times I've made this drive. Think about how many more times I will. Don't think about that. Just drive.
8:15 AM
Hospital. The nurse checks me in, records my weight (down, but not in a good way), blood pressure, temperature. All normal. She's asking about side effects from last cycle. "Any neuropathy? Any nausea? How was your energy?" I give her the abbreviated version because the full version would take 20 minutes and she's already got four more patients.
8:45 AM
Pre-meds. Small IV cannula in the crook of my arm. They run through saline first. Then we start: dexamethasone (steroid that will make me anxious), ondansetron (anti-nausea), and phenylephrine (to keep my blood pressure stable). I can feel them going in. There's a chemical taste in my mouth immediately. This is the part where I remember this is all actually happening, not just a routine.
9:15 AM
Cetuximab. This is monoclonal antibody therapy. Takes an hour, slow drip. My nurse explains (again, because it's protocol) that this can cause allergic reactions. I could break out in hives, my throat could close, my blood pressure could plummet. "Just let me know if you feel anything unusual." The lovely paradox of chemo: everything is unusual, so how would I know?
Mostly I just sit there. People-watch. The woman next to me is on her last chemo cycle (you can tell by the energy, somehow—there's an end in sight). The guy across from me is on his first (nervous, reading his phone obsessively, checking the time). Two other people whose stories I'll never know.
10:15 AM
Cetuximab done. Now: Atropine. Which is its own fun experience. It's meant to prevent a specific side effect of Irinotecan (the big one that's coming). But atropine side effects include dry mouth, dilated pupils, and a weird heart-racing sensation. I'm sitting there feeling like I've had too much coffee and can't blink properly. My vision is slightly blurry. This will pass.
10:45 AM
Scalp cooling. This is meant to reduce hair loss. They put a cap full of cold liquid (really cold) on your head and keep it there for the entire chemo infusion plus 30 minutes after. This is supposed to reduce chemotherapy reaching the hair follicles. Sounds good in theory. In practice: imagine the world's worst ice cream headache that just... doesn't stop. Fifteen minutes in and I genuinely want to take it off. After 20 minutes it's unbearable. But you keep it on because the alternative is losing more hair, and apparently my bald ego isn't ready for full chrome.
11:30 AM
The big one: Irinotecan. This is the heavy hitter. 30-minute infusion. The nurse marks the IV line, checks and double-checks the dose (protocol, safety), and starts the drip. I can feel it going in immediately. There's warmth in my vein. My bowels make a sound (this drug can cause brutal diarrhoea—they've already warned me). Within 10 minutes I'm doing the cold sweat thing. Temperature feels normal, but I'm soaking through my shirt. This is normal. This passes.
By minute 20 I'm nauseous. The anti-nausea meds are working but not completely. It's the weird queasy feeling that's not quite nausea, not quite vertigo. I close my eyes and focus on breathing.
12:30 PM
Irinotecan done. Head cap comes off. My head is cold, my hair is damp from sweat, I'm exhausted. But we're not done yet. There's saline flush, then the Irinotecan pump attachment: "Bob." Bob is a small portable pump about the size of a Nintendo Game Boy. It contains another dose of Irinotecan that I'll carry around for the next 46 hours, gradually infusing. Bob is coming home with me.
1:00 PM
Hospital canteen strategy. I'm meant to eat (medication adherence, staying nourished). I attempt a meal. I'm trying to stay keto-ish (I have opinions about nutrition during chemo). The hospital options are: chips, pasta, or deeply unappetising salad. I have the salad with some nuts I brought. It tastes like nothing. The nausea is still there, lurking.
The nurse sees me push it away. "You don't have to eat if you can't." The permission is welcome. I just drink water instead.
1:45 PM
Discharge. They check the Bob attachment is secure. Instructions: keep the pump close to your body, sleep with it, don't get it wet, watch for any leaks or discomfort. Call if the line gets blocked. It won't, it never does, but always might. I'm fitted with a discreet carry pouch designed to keep the pump against my body. I look absolutely ridiculous. I also don't care because I'm absolutely wrecked.
2:30 PM
Drive home. Someone has to drive you home from chemo. This is my wife. She's been reading a book the whole time. I get in the car and she just knows: "Rough one?" Doesn't really matter what I say. It's always rough. We drive home mostly in silence.
3:00 PM
Home. Sofa. Bob attached to my chest under my shirt. The steroid is kicking in now—I'm wired and exhausted simultaneously. My phone is buzzing with messages: "How did it go?" "Thinking of you." "Let me know if you need anything." I don't have the energy to reply to all of them, so I don't. People will understand. Hopefully.
5:00 PM
Kids are back from school. Do I explain that dad isn't really available today? Do I try to act fine? Usually it's a compromise: I'm present but a bit quieter than normal. They get it. They've done this four times now. That breaks my heart a bit, but they're handling it better than I am.
7:00 PM
Dinner. I can't eat. I try anyway. A few spoonfuls of something soft, then I'm done. The anti-nausea meds mean I'm not actually throwing up, but I feel like I might at any moment. The dexamethasone means I'm anxious about everything. Bob is poking into my ribs. Everything feels slightly wrong.
10:00 PM
Bedtime. Bob comes with me. There's a specific way you're meant to sleep with a chemo pump attached to your chest, but mostly I just try not to roll over on it. Sleep is happening sporadically—the steroids mean my brain won't shut up. I'm lying there thinking about treatment cycles, scan results, whether the nausea will be better tomorrow, whether any of this is actually working.
Tomorrow Bob comes off. The day after that I'll probably feel worse. The day after that I might have 48 hours where I feel almost human before the cycle starts building again.
Outfit rating: Bum bag, Crocs, and hair that's somehow both falling out and conditioned to perfection. Absolutely couldn't care less how I look. Comfort is everything.
This is Cycle 4, Day 1. Four down, eight or so to go. Same time next week, all over again.
Not glamorous. Not inspirational. Just real.