My hair’s gone. Well, most of it, but not all. Which is actually more annoying than having a completely bald head, since it means that I continue to litter my hair throughout the house and over all my clothes. My hair started coming out last Tuesday, but since I avoided washing it for days, or running my hands through it, much of it was still precariously attached to my head and preserved inside the cotton beanie I was wearing continuously. Then, 2 days ago, on Saturday, I realized it was time to deal with the inevitable, but wasn’t quite sure how to do it. Had P and I been better prepared, we would have just borrowed some buzzers to shave it all off, but of course, even with weeks now of anticipation, we were not prepared. So, P. said maybe he could use his beard trimmer on the highest setting. Of course, it didn’t work, because a head is not a chin, and my bangs from root to tip were still about a good 5 inches of hair.

So, then what? I decide that maybe the best option is to comb out the hair, and that’s when I find myself in an empty newly renovated room, laying out newspaper over the gleaming hardwood. I’m standing in the center of the room, semi-clothed and vigorously combing, while P. watches from the corner offering help, alternately amused and concerned. My hair sheds off in little bunches that reminds me of falling pine needles. I look over at P. and laugh that it feels like I’m in an art gallery doing some kind of avant-garde performance art. You know the scene– it’s a bit weird, kind of grotesque, and overall absurd.

Now, four days after my second chemo infusion, I’m starting to feel back on the upswing and have a second round of experience to help inform how I might feel going forward. I’ve been told that within each cycle of chemotherapy, the side effects typically follow the same pattern, though the intensity compounds over time with wear and tear on the body. If that’s the case, then it seems that the following is what I can expect:

Day 1 (Wed)- 6+ hours at Dana Farber– IV insertion, blood draw, consultation with doctors, chemotherapy and lots of waiting; difficulty sleeping at night (possibly from steroids I’m taking), flushing the system with lots of water and fluids, night sweats, difficulty regulating temperature

Day 2 (Thurs)- Slow morning in bed trying to catch up on sleep from the activity of the night before, reading, tv watching, podcasts, afternoon walk, nap, monitoring my temperature every few hours, general recovery. 24 hours after chemo, P. also gives me my Neulasta injection, which is a white blood cell stimulant to support my suppressed immune system.

Day 3 (Fri)- Since Thursday is overtaken by the monitoring of physical symptoms, Friday becomes the emotional day. Once I realize that my body is doing OK, I start to feel down about the cancer management and the feelings of being constrained in the role of a cancer patient. I get annoyed I have to take my steroid pills, I feel resentful that most of the “anti-cancer” things I eat were part of my previous diet anyway (as in, I used to eat quinoa because I liked it, but now the stakes of every mouthful are higher). I feel tired, and then I have a sudden burst of energy. I want to work, and then I can’t concentrate. I want to see friends and be social, but then I just want to curl up in bed. I can’t tell if my mood is variable because my body has been put into early menopause, or if it’s the emotional burden of the cancer itself. On Fridays, I wonder what kind of person cancer has made me become.

Day 4 (Sat)- I wake up wanting to feel energetic so that I can prove to myself that I will get through treatment with flying colors. But wanting to feel energetic is not the same, clearly, as feeling energetic. My bones are starting to feel achy from the Neulasta injection, which is a common side effect. My muscles are also stiff, and it feels like I’ve run a marathon, without the corresponding glory or hard work. Since it’s the weekend, I want to take advantage of the time and reach out to people, but again, tiredness sets in. To maintain some kind of engagement, though, P. and I go for walks, or do some small errands.

Day 5 (Sun)- By now, I’m sleeping better through the nights, but it’s not perfect. I’m still having trouble with temperature regulation, and getting up once or twice in the night. When I wake up, I’m still stiff. I feel fragile to the touch. It slowly dissipates over the course of the day, though. Again, I don’t want to cloister myself, but also am not sure where to begin in reaching out… since I get so tired easily, I feel like I am an unreliable person to socialize with. I take walks, and again, do some minor errands.

Day 6 (Mon)- It’s a new week! The bone and muscle pain are gone. When I wake up, it’s still slow and a bit encumbered. I’m not entirely fresh and alert and rearing to go, but I want to be that way. I start thinking about how to best take advantage of feeling good and making sure that I don’t fall too far behind with work responsibilities or just staying up to date and involved in general.

Interestingly, I have to admit that it wasn’t until typing up this post that it has become more clear to me that my current challenges have less to do with physical side effects and more with the ancillary psychological effects. I started off this post thinking that I’d record the physical symptoms day by day, but in reviewing what I’ve just written, it seems that so much of the physical and the emotional are intertwined.