Hair today… Gone tomorrow

In my previous blog, I shared how my chemotherapy plan involved four biweekly cycles of Epirubicin Cyclophosphamide (EC), known as the “red devil,” followed by four more biweekly cycles of a different chemotherapy drug, Paclitaxel. After two months on EC, it was time to transition to Paclitaxel. Just before my first dose, an alarming situation unfolded in the chemotherapy suite at Sussex Cancer Centre. The person receiving treatment next to me had a severe reaction, and the medical crash team rushed in. It was a terrifying experience, reminding me how unpredictable the body can be in response to chemotherapy. Nurses were particularly attentive, encouraging patients to report any unusual symptoms like chest pain or flushing.

Given my anxiety about the situation, my chemo nurse offered extra reassurance by staying with me for the first 30 minutes of my Paclitaxel infusion. After that, she left me with an emergency red button to press if I needed anything. I was incredibly grateful that my body didn't react badly to the treatment. However, I did experience a strange sensation at the start of each Paclitaxel cycle, almost like “ants in my pants.” This was caused by the dexamethasone I’d received before the chemotherapy to help prevent reactions. Initially, it made me feel restless and agitated - so much so that I actually fell off my chair the first time it happened! Fortunately, this feeling didn’t last long.

Once the Paclitaxel was administered, I was able to relax and feel at ease, relieved that I wasn’t experiencing any severe reactions. During the long 6-7 hour infusion sessions, I kept myself occupied by reading on my Kindle, listening to music, browsing social media, or colouring in a colour-by-numbers book. Compared to the shorter 4-5 hour EC sessions, the longer Paclitaxel treatments meant I had to pack plenty of distractions in my chemo bag. As my treatments progressed, I found myself napping during the sessions, thanks to the antihistamines that helped lower the risk of reactions.

Maintaining a healthy diet throughout chemotherapy was essential to support my body as it repaired the damage caused by the treatment. This was a challenge, as I often felt nauseous and exhausted. Despite this, I made sure to focus on eating enough protein, staying hydrated, and getting out for short walks or doing light exercises like Pilates and yoga. Over time, I noticed a clear pattern: resting when I was fatigued often made me feel worse, while pushing myself to get outside helped boost my energy.

One of the hardest parts of chemotherapy was losing my hair. It felt like a visible sign of my illness, and it hit me harder than I expected. I had prepared for it by cutting my long, wavy brown hair into a pixie cut before starting treatment, but when my hair began to fall out in clumps after just two cycles, it was still a shock. I had tried scalp cooling during my first couple of cycles, but it didn’t prevent hair loss for me. However, it was worth attempting. The initial 10 minutes of cold was the hardest, but I acclimated to it, especially with the comfort of a heated blanket and a cup of tea from my chemo nurse.

Though I had bought wigs in anticipation of hair loss, I never ended up using them. It just didn’t feel like “me.” If someone had told me at the start of my journey that I’d confidently go out without a scarf, beanie, or wig, I would have been sceptical. But by the end of my four-month chemotherapy regimen, I embraced my bald look and found confidence in it.

My eyebrows and eyelashes almost made it through the EC cycles, though they were thinner and required makeup to define them. Unfortunately, they didn’t survive the Paclitaxel cycles, and I lost them as well.

If you're about to begin chemotherapy, here are some practical tips that might help make the journey a little easier:

• Take it one day at a time. Try not to worry about what’s ahead, focus on getting through each day as it comes.
• Bring a support person to appointments. Having a family member or friend with you can be invaluable for emotional support and note-taking, as medical visits can feel overwhelming.
• Be cautious with body fluids. After each treatment, your body fluids are considered toxic. Follow your chemo nurse’s guidance, flush the toilet at least twice and avoid intimate contact for 24-72 hours post-infusion.
• Expect frequent blood tests. Your medical team will monitor your blood regularly to check how your body is responding to the chemotherapy drugs.
• Prepare for immune-boosting injections. If you need to take G-CSF injections to support your immune system after treatment, you may find injecting them into your thighs easier than your stomach, especially if you're needle-phobic.
• Hair loss extends beyond your head. In addition to losing scalp hair, you may also lose your eyebrows, eyelashes, and nose hair - leading to a runny or occasionally bloody nose.
• Your nails may change. Some people experience brittle, discoloured nails. Using a product like PolyBalm may help strengthen them.
• Combat oral thrush naturally. Eating fresh pineapple or melon for breakfast and drinking mint or ginger tea can help soothe your mouth.
• Manage mouth dryness and soreness. Sipping iced drinks and sucking on ice chips can provide relief.
• Taste changes are common. Food might not taste the same, and in later cycles, you may temporarily lose your taste buds. Acidic, sharp flavors like lemon juice or balsamic vinegar can be more noticeable. The good news? Taste usually returns about a month after finishing treatment.
• Chemo brain is real. You may experience forgetfulness, mental fog, or fatigue, sometimes even struggling to finish sentences. The upside - you can blame it all on chemo brain!
• Protect your eyes. Without eyelashes or eyebrows, your eyes may become dry, itchy, or watery. Sunglasses can help shield them, even in winter.
• Daily walks can be beneficial. Moving your body helps improve circulation and supports digestion.
• Socializing safely is possible. While some people self-isolate during treatment, others find fresh air and human interaction essential. If you go out, be mindful of your immune system, days 7-10 after treatment are when you’re most vulnerable to infections. Wear a mask in crowded places and avoid sick people when possible.

Always check with your oncology team for personalized advice, and if something feels off, don’t ignore it... call the medical hotline. It’s better to be safe than to assume it’s "just the chemo." Stay aware of your body, and take care of yourself.