post updated March 13, 2021
My Sister’s Keeper– a novel
I enjoyed reading My Sister’s Keeper ,a novel by Jodi Picoult, which touched on several medical themes – cancer, genetic engineering, organ donation ethics, and medical autonomy.
Kate, an adolescent who as a toddler developed a rare form of leukemia, has spent the majority of her life either in the hospital getting treatment or recovering from them. After yet another chemotherapy regimen, she 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.”
Also a movie
My Sister’s Keeper by Jodi Picoult was also made into a major motion picture starring Cameron Diaz, Abigail Breslin, and Joan Cusack.
(These, and other links in this post are affiliate links, used to generate revenue to fund this blog. )
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
The most common form of diffuse hair loss is telogen effluvium which occurs during the telogen or resting phase. Stress can cause hair loss, it is not a myth . 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
- major surgery
- serious illness
- disorders of the thyroid, kidneys, or liver
- Vitamin D deficiency
- anemia due to iron deficiency
- malnutrition or rapid weight loss
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
Alopecia areata is an autoimmune disorder. it may cause
- round, bare patches on the scalp
- complete scalp hair loss
- hair loss on other body areas
Hair may spontaneously regrow in up to 30% of mild cases. When treatment is needed choices include
- topical corticosteroids
- topical minoxidil
- anthralin
- oral janus kinase inhibitors
More info is available from the American Academy of Dermatology
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?
Lightstock photos at this affiliate link
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