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Chemotherapy Hair Loss: When Breast Cancer Becomes a Very (Un)Hairy Situation

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Because I seem to be the poster child for chemotherapy side effects (i.e. I've experienced all of them), it didn't come as a complete shock to me that hair loss was next on the list. The second (or maybe the third or fourth) shoe has dropped ...

For the past three-plus years, I have worn my hair short. Really short. I used to have long, long hair -- all one length past my shoulders. However, between blow-outs, straightening treatments, updos and split ends, maintaining it became too much.

Fast forward to FBC (f-bomb breast cancer). Being bald-bald-bald was -- I knew -- inevitable. Hair loss occurs because chemotherapy targets all rapidly dividing cells -- healthy cells as well as cancer cells.

Hair follicles are the structures in the skin filled with tiny blood vessels that make hair. They are some of the fastest-growing cells in the body. When not in cancer treatment, hair follicles divide every 23 to 72 hours. But as the chemo does its work against cancer cells, it also destroys hair cells. Within a few weeks of starting chemo (in my case two weeks), a person may lose some or all of the hair on his or her body.

There really is no known, proven prevention for hair loss due to chemotherapy. Attempts have been made (and continue to be made) to reduce hair loss by using tight bands or ice caps. These techniques were thought to reduce the blood flow to the hair follicles, thus limiting the chemotherapy exposure. Unfortunately, these techniques did little more than cause headaches and have been abandoned by most people. This fall there was a lot of publicity around a new type of ice cap. I didn't entertain the thought because I didn't feel like the potential return was high enough for me. So, I reconciled myself with the fact that I would, indeed, lose my hair. Fine. Just one more aspect of FBC.

For the past two days, my head has been prickly and itchy which, I assumed, were the precursors to hair loss (BINGO!). The best way to describe the feeling is that it felt as if I had worn a hat all day, from morning until night. When I took said hat off, my head would need a really good rub to get rid of the prickles and itches. You know that feeling?

In addition to the prickles and itches, I had clumps of hair coming out in my hand. Clumps. Big clumps with absolutely no pattern whatsoever. Not so cute and quite freakish.

My friend, Dr. Marisa Weiss (founder of breastcancer.org) said: "There are studies that show that for many women, losing their hair is worse than losing a breast. That's because you can conceal the loss of a breast, but hair loss is so obvious and apparent."

I don't know if this is going to be the case with me, but I do know that hair loss is a big f-bomb.

So, with this unsolicited outpouring of hair follicles, I knew it was time to shave my head.

Why would I choose to shave my head? For the following reasons:

  1. To give me a sense of control. FBC is causing this, but I can do something about it.
  2. To get rid of the prickles and itches.
  3. Rather than wait for the patchy fallout, I wanted not only to be proactive, but also to share the experience with girlfriends. I knew that being with girlfriends would mean a lot of laughter (better than the alternative) and dropping a lot of f-bombs together.

I have to admit that, despite my planning and sense of control, I was surprisingly nervous about it.

However, an amazing girlfriend lovingly planned the entire event. She asked the owner of a local barber shop -- whom I had never met -- if he would stay open late for me and shave my head in a private atmosphere. What an incredible gift.

I had one rule for the evening: no crying. I wanted to focus on the absurdity of the entire situation and find Silver Linings in the form of humor (and anything else that popped up) while doing the deed.

We went to Montecito Barbers. It is a real, old-fashioned barber shop complete with a barber shop pole. Added bonus: he had done a "chemo coiffure" before, which was incredibly comforting.

One of the first things the barber told me was that he had sterilized all of his equipment so that I need not worry about any problems or infections, which was so thoughtful, sensitive and smart.

Before my barber actually started, I asked him if he would give me a Mohawk. Why? Heaven only knows. Perhaps to add a little humor. Or maybe it's because I spent my adolescence in the middle of Indiana during the '80s when seemingly everyone (including boyfriends one, two and three) had mohawks. The barber chuckled and said, "Sure, whatever you want." To mohawk-ville I went. Buzzzzzzzz.

When it was all done, I actually felt relieved (Silver Lining). I made it. I did it. Another hurdle. As is the case with everything in life, anticipation is far worse than the reality. I now have a bald head. It's as simple as that.

Now, I'm not quite feeling like "bald is beautiful" (on me) and I would much prefer to have my own hair. However, I did leave Montecito Barbers feeling that "bald ain't so bad."

Actually there are many more Silver Linings here:

  1. Friendship. I am forever grateful to my girlfriends who went with me, supported me and laughed with me.
  2. Montecito Barbers.
  3. Humor. Humor. Humor. (It sure beats the alternative!)
  4. Hermes scarves!
  5. No waxing, shaving or plucking.
  6. Respite from washing, blowing and styling hair (time savings: 5 minutes/day).
  7. Having my head shaved gave me an appetite. I doubt that there is a clinical reason for this, but it made the husband and my oncologist very happy.
  8. A great wig.

Better a bald head than no head at all!

- Seamus MacManus

Wishing you all a very happy, hairy, Silver-Lined day.

To read more about Hollye's holistic and humorous journey over, around, above and below breast cancer, please visit her blog, Brookside Buzz (www.brooksidebuzz.com). You may email her at hollye@brooksidebuzz.com.

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