EC round 1 - day of infusion - demystifying the chemo day ward

Everyone on chemo has to have a first chemo appointment, where it’s all a walk into the unknown. Today was mine, kitted out with my new Bard Power Port. So I write this to try to demystify it for other newbies. The appointment was 9am and a bunch of around 8 of us were picked up on time and walked to the ward. It’s quite a large ward with a number of bays with 5 or 6 reclining chairs in each, and a smaller number of individual rooms. There were 4 people already seated in my 6 chair section (8am appointments) and unfortunately 3 of them were still waiting. Delays on chemo dispensing were backing up throughout the suite. A fairly even spread of men and women throughout of all sorts of ages. Cancer is quite a leveller.

Quite a long time passed before my blood pressure and pulse were checked and I was given an anti sickness tablet to take, plus 4 dexamethasone to take closer to the infusion. Another half hour or so later, my line was flushed and I was fitted for the Paxman cold cap. This has a blue inner plastic layer which has cold fluid going through it, and then an outer neoprene layer to keep the cold in and also tighten it all up. I was asked if I had brought a headband to protect my forehead. I hadn’t. No one had told me I needed one - apparently you do. The nurse improvised with some gauze strips.

The process is cold cap for half an hour before chemo, throughout chemo and for a period afterwards of a duration determined by what chemo drug you are having. It was 90 minutes for EC and I was told it would be 60 minutes when I get to Paclitaxel.

During the first half hour, I think some hydration went through the drip. Then the nurse arrived with 2 bumper syringes of epirubicin. It’s red, as you might guess from the name. This was manually put into the line, with the nurse sitting by my side. After this, one pack of cyclophosphamide alongside more hydration, then a second pack of cyclophosphamide. That’s the chemo all in so the 90 minute count down begins. Zoledronic acid,  which I will have 6-monthly for 3 years, went in next. Then the line was flushed and the special needle disconnected from the port. I left the unit at around 2:45.

Cold capping was less painful than I had expected. After the first 10-15 minutes, you don’t feel the cold, just slightly odd. My hair had been dampened and slathered with Nioxin conditioner beforehand. Afterwards the cap is more or less frozen to your hair, so you have to let it warm up before removing the cap. Then wear a hat or wrap yourself in a scarf to go home. I had also taken frozen gel booties in with me and wore these once the epirubicin had gone in. I had brought frozen gel gloves in too, but this was a step too far for now. I will revisit when on Paclitaxel. 

I realise it’s far too early for side effects to have hit. I went for a 3k walk when I got home, which was fine, although I needed a short snooze afterwards. I had supper early and found it tasted perfectly normal, but it’s caused a fair bit of rumbling and wind. And of course the red colour is coming out when I go to the loo. It’s less extreme than the effect of the blue dye when I had my sentinel node biopsy. Today I seem to just feel slightly spaced out, akin to jet lag from a long haul flight. Drugs-wise I have 3 days of steroids followed by 5 days of immunity boosting injections, plus anti-sickness tablets to use as needed. I also have daily calcium tablets to go alongside the Zoledronic acid, and my own tubes of numbing cream to put on the skin over the port before it’s next accessed. 

One day at a time. I am keeping a symptom diary and will add more to the blog once I have something useful to report.

  • Reading this is so helpful to know what to expect. I am starting EC on Tuesday. How are you feeling so far? I hope the side effects aren't too bad. 

  • Hi  I have been doing very well so far, this is my final day of dexamethasone, I switch to the immunity boosting injections tomorrow. I will write up a full tale of the cycle once I am through the second week. But so far no nausea, stomach problems limited to a small amount of acid reflux (solved with omeprazole), food still tastes normal. Energy levels are reasonably good too although I drove to a wig fitting yesterday and had trouble finding a parking space and found that a bit stressful. I am retired from full time work but have some Exec Board positions and have been able to keep up the work involved in them. Done quite a bit of walking, the portacath is still too sore to go running. Good luck for Tuesday. 

  • You've been in my thoughts too , I've been wondering how you're getting on too, so thanks for the update.  Good to hear and look forward to next update.  Claire xx

  • Thanks for this - it really helps to hear (read!) what to expect on the first day. Mine will be on June 4th. Hope you are doing OK.

  • Wishing you all the best. A friend who had a similar journey 2 years ago was very helpful in giving me insight into what happens. If I can help others that’s great, although of course all symptom experiences differ