Four years ago I went to the emergency room with severe abdominal pain that turned out to be colon cancer. A large section of my colon was removed, and I suffered one complication after another–excessive bleeding, edema, tachycardia, and an infection that required another minor surgery. The hospital stay ended up being just over 30 days. Recovery was slow, but steady, and it was done without chemotherapy.

At the time the surgeon felt they had gotten all of the cancer, the cancer markers were good, and there was no indication of it spreading. Some chemotherapy can cause heart issues, and I had already had several heart issues, including a 2008 heart attack, and the doctor said that chemotherapy in my case would only reduce the chance of a recurrence by a few percentage points, so we decided not to do it at that time.

In August of this year, I once again went to the emergency room with severe abdominal pain and this time it turned out to be gall stones. But in imaging the gall bladder the doctors found a spot on my liver, which they biopsied and concluded it was metastasized cancer. It was removed, along with the gall bladder, and my recovery began. This time, however, the oncologist suggested and strongly encouraged chemotherapy.

Chemo has always scared me. It has always seemed like people with really bad cases of cancer are the ones who get chemo. I’ve heard countless stories of people who are knocked out for days and who are drawn through months of it–just starting to feel better again when the next round starts. There are a number of possible side effects. It’s a process of putting powerful chemicals into one’s body to kill the cancer, but what other damage might be caused? It is a scary prospect.

The thing is, though, in my case they did remove the liver tumor and all the signs were good that they got it all. But the doctor believes that the cancer has been traveling through my bloodstream and landed on the liver from the colon. She said this was a preventative measure to stop it from landing elsewhere. After some discussion with my life partner, Brian, we decided that it was the best step this time.

A week ago I went into the clinic and the surgeon put a port in my chest. In the old days, and still today, patients would have to go in and be stuck by numerous needles to get chemotherapy treatments. The port was developed to bypass all the needles and to deliver a continuous flow of chemicals into the body through a pump that is carried in a small bag for a couple of days.

For the last week I have been nervous, fearful of the side effects of the treatments, wondering how my body will react to the chemo, just wanting to get it started and get it over with today and however many treatments are to come (they’re not sure of the number yet). Finally, I clocked out of work early and Brian took me to the clinic for my first chemo date.

My head was swimming with uncertainty, but I had come to the conclusion that this was the thing to do and that whatever effects it might have on me would be the price for a clean bill of health down the road. It was the right decision, as scary and as hard as it might be.

I had to go to the radiology oncology lab first, to have some blood drawn. We got there early, so had to wait for a bit. As we were waiting I couldn’t help but notice the almost assembly line movement of people: old women with canes, middle-aged men, young women, every age, some with fear in their eyes, others with a gentle acceptance. One after the other, waiting in uncomfortable chairs for their name to be called, and then up, and through the door into the lab. All of them greeted by a nurse asking how they were doing, and then disappearing through the door. And I understood that I was one of them, one of the thousands and thousands upon thousands of cancer patients who go through doors like that in every clinic and hospital in every city in the country every day. As I sat in a brand new, very large and beautiful clinic, it occurred to me what a big business it is, a necessary business for people like me, but a big business nonetheless.

The blood draw was done through the port, so there were no needles stuck into my arms. The nurse then connected an IV line and got everything set so I would be ready for the treatment upstairs. After taking the elevator up one floor, we turned the corner to the treatment area, I was again struck by how many people need these treatments every day. There was a long corridor, with everything an almost blinding white light as if being called to heaven, cubicle after cubicle as far as the eye could see. The woman checking us in called them bays. I was in Bay 28.

It was a little unnerving to watch the nurse’s preparation. Everything she needed came in sealed plastic bags. Out of one she put on a pair of blue gloves. Out of another she unfolded a protective gown. I thought of x-ray technicians hiding in another room while exposing you to x-rays. My god, I thought, what are they about to put into my body? It was my one moment of real panic.

The treatment itself was not very complicated. They hooked up the port and the first drug filtered into my body over about an hour and a quarter. I fell asleep several times. The nurse had talked about the feared side effects, particularly nausea. I was given a steroid and another drug that were supposed to help prevent the nausea. The other odd one was that many patients get cold sensitivity, so that touching cold things or drinking cold drinks or ice can not only be uncomfortable but cause pain. There was no suggestion of a drug for that, just advice about avoiding cold things.

After the first round was done, they set me up with a pump that will continuously infuse the chemo drugs into my system over a 46-hour period. In two days, I’ll go back to the clinic to have the pump taken off, the IV tube removed, and then there will be nothing to do with the port for another two weeks. The nurse brought in a shopping bag with numerous items to take home, as they will be training Brian and me on Friday on how to remove the pump at home, so that we don’t have to go in twice every two weeks. One of the items was like a Hazmat package, with double gloves, cleaning cloths in the event of a spill, and more. It was my second moment of panic, but the nurse reassured us that the likelihood of that happening, especially with the type of pump they gave me, was less than minimal.

I have heard that sometimes patients are fine the first couple or few days after the chemo treatment, but then the effects, especially the tiredness and weakness, begin to show So far, about eight hours into it, I have not felt nauseous, dizzy, or anything along those lines. I did have a soda with ice with my meal and I clearly have the cold sensitivity side effect. Each time I took a sip and my lip touched the ice, the texture felt fuzzy instead of solid. It was a weird sensation. After a bit I took a drink and felt intense pain throughout my jaw, which tells me I’ll be following the advice about avoiding cold foods, drinks, and even surfaces.

I don’t know what is to come in the days ahead. I’m in bed right now with a blue bag next to me that is holding a pump that is feeding me at this moment. Yes, I’m still a bit concerned about side effects that may happen over the course of the next few weeks and months. It’s the unknown. I’m concerned about this working–I don’t want another cancer to appear elsewhere in my body. Twice is enough. I’m concerned about how long recovery is going to take, because I’m getting older and I have so much yet to do in my life and I want to do it now. I also understand this process takes time. I can be patient, and I will be positive. I’ve always joked that my blood type is B positive and so is my attitude. I believe that regardless of my weakness now, any side effects that may come, whatever I have to go through, it is to make me better and to give me many more years of the things I have yet to do. I accept this. I thank my gall bladder for the blessing of its painful stones. I face these next steps with determination.