My Sister’s Keeper- a novel
I recently enjoyed reading a novel by Jodi Picoult My Sister’s Keeper ,which touched on several medical themes including cancer, genetic engineering, organ donation ethics, and medical autonomy.
The story is about Kate, an adolescent who as a toddler developed a rare form of leukemia, and has spent the majority of her life either in the hospital getting treatment or recovering from them. After yet another chemotherapy regimen, she has lost her hair.
One day her mother, Sara, offers to take Kate and her younger sister Anna to the mall for a day out. Kate refuses.
“Don’t say it. Don’t tell me that nobody’s going to stare at me, because they will. Don’t tell me it doesn’t matter because it does. And don’t tell me I look fine because that’s a lie.” Her eyes, lash-bare, fill with tears. “I’m a freak, Mom. Look at me.”
Sara looks at her and says, “Well, we can fix this.”
“She walks out of the room followed by Kate and Anna. She finds a pair of ancient electric grooming clippers, plugs them in, and cuts a swath right down the middle of her own scalp.
“Mom”, Kate gasps.
With another swipe of the razor, Kate starts to smile. She points out a spot Sara missed. Anna crawls onto Sara’s lap. “Me next,” she begs.”
As Sara later remembers:
“An hour later, we walk through the mall holding hands, a trio of bald girls. We stay for hours. Everywhere we go, heads turn and voices whisper. We are beautiful, times three.”
Alopecia- hair loss
You’ve known people who lost their hair due to cancer chemotherapy-you may even be that person. The medical term is anagen effluvium, which means hair loss during the anagen, or active phase of hair growth. 65% of people who receive chemotherapy will lose their hair.
Fortunately, anagen effluvium is reversible; the hair usually grows back in 1-6 months. While waiting, sometimes women wear wigs, while others wear colorful scarves and turbans on their heads. And some simply do as Kate, her mother and sister did- show their heads proudly.
Stress and hair loss
Telogen effluvium is similar, except this hair loss occurs during the telogen or resting phase. It is not a myth that stress can cause hair loss. Any type of physical, mental, or emotional stress can cause hair to fall out. Probably the most common stress that precipitates this is pregnancy. Others include
- serious illness,
- disorders of the thyroid, kidneys, or liver,
- iron or zinc deficiency.
This hair loss is also reversible with the hair usually growing back within 2-6 months after the condition resolves or is treated.
Genes and gender
The most common type of hair loss in both men and women is considered a “normal physiologic variant”- that being androgenetic alopecia. It tends to run in families, hence the “genetic” connotation. As many as 50% of men and 30%-40% of women may experience hair loss with increasing age.
There are two forms. (click on the links to see an illustration.)
Male pattern hair loss– affects the temples, front, and top of the scalp
Female pattern hair loss– causes diffuse thinning on the top and sides of the scalp
Two treatments are approved by the FDA.
Minoxidil- a topical solution applied daily to the scalp, causing increased hair growth within 6-12 months, and is used indefinitely. This is effective for both men and women.
Finasteride is a pill approved for use in men only, if minoxidil does not work. It can have undesirable side effects which limit its use.
Another option for both men and women are hair transplants.
Less common causes of hair loss
Trichotillomania results from repeatedly pulling, twisting, or twirling the hair. Treatment is difficult.
Trichorrhexis nodosa results from trauma to the hair, including excessive brushing, tight hairstyles, and use of heat and chemical products on the hair.
What to do if you are losing hair
If you experience unexplained hair loss, see your doctor for an evaluation. It’s best not to assume that it is just a hair issue.
It is especially important to determine if there is some underlying condition, such as a thyroid disorder, that needs treatment.
Consider your family history. Have your grandparents, parents, or siblings experienced hair loss?
Evaluate your lifestyle to see if there are nutritional, traumatic, or stress factors that may contribute to hair loss. Remember, these may have happened as long as 6 months ago.
Consider the way you care for, style, and wear your hair; do these traumatize your hair frequently or excessively?
Arbonne carries hair care products that help keep our hair healthy and attractive.
FC5– everyday basic care for all hair types
Pure Vibrance- especially for hair that has been colored but any hair type will benefit
My Sister’s Keeper by Jodi Picoult was also made into a major motion picture starring Cameron Diaz, Abigail Breslin, and Joan Cusack.