What Do I With My Head?

^^^ Spouse jokingly advocated for this look

With chemotherapy looming, it appears that hair loss is both inevitable and fairly predictable.

Much of what I read about one of the drugs I will be taking says that hair loss occurs 12-14 days after the first dose.

While there is something available called a Cold Cap to attempt mitigation of hair loss, it doesn’t sound like it works well enough to bother. The principle is that you freeze your scalp – and, presumably, hair follicles – while the chemotherapy drugs are being infused and the cold-induced blood vessel restriction “protects” the chemotherapy drugs from entering the blood supply to the scalp.

(Sidenote: this principle is also applied to icing the hands and feet before chemotherapy to prevent peripheral neuropathy. I am 100% doing this).

Data from the Cold Cap therapy suggest that about half of women lose only half of their hair.

This also means that for half of the patients, it doesn’t even work that well.

Anecdotal information from several patients who have Cold Capped seems to be summarized as follows: it didn’t work but they were glad they tried it.

Considering that you have to start icing your scalp an hour or so before chemotherapy starts, plus you have to keep caps on dry ice, PLUS you have to swap the caps out every 30 minutes AND it apparently causes a continuous ice-cream style headache, the end doesn’t seem to justify the means.

Will I wear a wig?

I downloaded this picture to my phone. It is a Cameron Diaz wig that is currently on sale for $305.

I’ve never worn a wig before.

Well, maybe as part of a Halloween costume when I was a kid, but it’s been a while.

Wigs seem to come in several hair types (real human hair, high quality synthetic, low quality Halloween-types, etc) and wildly varying price points. They also are definitely a Try-Before-You-Buy item, meaning that blindly ordering the above number and hoping it both fits and looks good is not advised.

One surprising thing that I am learning from other cancer patients is that many of them bought wigs but ended up not wearing them.

The reasons: itching, discomfort, feeling overheated, and the fact that a wig still looks like a wig, so why try fooling anyone?

But here’s the thing: Baldness is the sine qua non of cancer. Nothing screams “Cancer Patient” more.

There are two situations where I am most nervous and make me want the option of wearing a wig.

The first: around patients. Patients who are aware of my situation have almost universally shown an outpouring of support and love. To my knowledge, no one has fired me as their physician due to my diagnosis.

Or at least my staff has done a superb job of hiding it from me.

Still, I get it: it could be potentially scary to put your trust in someone who is clearly going through a health crisis. Will I be there for their appointments? Darkly – will I die halfway through their treatment?

The second: for my kids.

If I am honest, my biggest fear is that my kids will feel shame or embarrassment about how I look.

While neither have specifically expressed this, they are both tweens and I am sure they already see their parents as mortifying enough without tacking on the baldness.

Two options I am considering:

  • A partial wig from my own hair. Chemo Diva makes something called a Halo Wig using your own hair. Their website shows it best, but basically this is a tight cap with hair sewn around the edges. You need to wear it with a hat but it is your own hair poking out from below. The appeal of this is that it is your own hair and the turn around time is quick (around a week). The cost is roughly $400. You send them at least 7″ of hair and it must be hair that has been cut, as they cannot work with hair that has been collected after falling out. From a timing standpoint I could theoretically have my first chemotherapy infusion and then get my hair cut in the limbo period between treatment and anticipated hair loss. Because they only need 7″ of hair and mine is longer, I could also get my hair cut shorter now and still have a cute-ish short cut (and less hair to clog drains throughout my house when the time comes.)
  • A whole wig using my hair. Compassionate Creations is a company that specializes in this. The obvious upside is that you can have a wig made from your own hair, but there are serious downsides. Cost is one – this wig is roughly $900 – but that’s minor compared to the long delivery time (8-10 weeks) and the fact that you have to cut your hair all the way to the scalp to send them as much to work with as possible. The fine print on their website also says that few people send enough hair to craft an entire wig. Typically 2-3 heads of human hair are needed for a single wig. They offer the option of supplementing what is sent with their stock of synthetic hair or sending hair from more than one person.

Coincidentally, there is one person in my life who might have enough hair to make a wig:

^^^ And this was AFTER getting nearly 8″ cut.

Trixie’s ponytail is thicker than a baby’s arm. Her hair is a pretty caramel color and has almost never even been blow-dried, much less processed to within an inch of its life like mine.

Last week I jokingly suggested that she cut and donate her hair to my wig effort.

I could immediately tell that I’d called this wrong.

A look of fear crossed her eyes.

“Mom, please don’t make me cut my hair.”

Tears sprang.

I felt terrible.

I retracted the comment and tried to write it off as a joke, but the damage was done.

A few days later I saw her measuring her hair.

I re-iterated that I did NOT want her hair, but I still feel like some old fairy tale witch who’s trying to steal the Essence of Youth from a maiden.

And in the end, I am not going to go the Compassionate Creations route for a very practical reason, namely the delivery time of 8-10 weeks. My chemotherapy is expected to be around 12 weeks. This means I would (hopefully) be almost finished with treatment by the time a wig arrived.

Maybe I’ll make do with this instead:

I think I could rock it.