Almost.

One of the most intriguing side effects of chemotherapy is hair loss. It’s the one that I have had the most controversial (I think) comments about before it’s even begun. Some comments I’ve gotten include: I probably won’t lose my hair and thinking I will is negative thinking, or even if I lost some or most of it, I shouldn’t shave it all off so I don’t look sick, or maybe I should cold cap (more on that in a bit), so I can save my hair, hair is womanhood, etc, etc.

My relationship with losing my hair due to chemo is dealt with much the same way as I have other side effects: as they come. I contend with the emotions I feel in the present, not how I think I might feel, or how others think I might feel, or how other women who have been in my place have felt. When faced with the possibility, I was curious but largely unbothered by it. So when I was presented with an opportunity to maybe save most of my hair (50-70% is what’s been touted for some people), I thought about it for perhaps a day until I realized the only reason I debated saving my hair was because I think that future me might be upset about losing my hair. But because that’s not ultimately how I land on decisions, I opted to not save my hair by cold-capping.

Cold-capping (or scalp hypothermia) is offered at my hospital though it would have been paid out-of-pocket — about $3000 all told — and is something you can add to your infusion regimen. Essentially, you wear this frozen cap before, during infusion and some time (about 1-2 hours) after. It does prolong your infusion appointments. The idea being that extreme cold constricts the blood vessels so chemo drugs are kept away from the hair follicles on your head (of course this system will not save the loss of other hair like eyebrows, eyelashes). As expected, many wearers report headaches which you may get used to. However, none of the things I mentioned above factored that much into my decision. It’s the restrictions during your entire treatment that gave me pause. You have to be very careful of your hair: no combing, no hats, no pony tails, no washing except the day of infusion to remove oils to allow the cold to penetrate easier, etc. This means surfing would be detrimental! Never mind trying not getting your hair wet, but I have had wipeouts or strong waves hit me while surfing that have fully removed the elastic of my pony tail! Having to exercise tremendous care over this hair I’m trying to save with no guarantee of it working seemed too much. I have not been one to care too much about my hair. I have had one hairstyle (long, sometimes with bangs, usually none, semi-layered) throughout my life, I don’t style it in the morning or when I leave the house, I don’t dye nor even regularly comb it. Hair’s just there. I know there is some conceit in never having to worry about hair and I am sensitive to that. But this is where my decision is based on.

I am reminded of that scene on Fleabag (great show, genius writer, she is) where she monologued to the stylist at the salon about the importance of hair:

“Hair is everything. We wish it wasn’t so we could actually think about something else occasionally. But it is. It’s the difference between a good day and a bad day. We’re meant to think that it’s a symbol of power, that it’s a symbol of fertility. … Hair is everything.” I am indifferent to everything said in that monologue. It’s just not been my life experience.

Before treatment began, I cut my hair shorter than I’ve had it since perhaps the early 90s. I assumed it was just the middle ground between my normal hair and bald, and who cares if it looks terrible on me, but I was pleasantly surprised that I quite like the cut. To further prepare, I began to purchase beanies and slouchy berets in preparation for covering my noggin from the cold. (That is if it ever gets cold. It’s been a sweltering summer for San Francisco!) I’ve prepared. I think.

I am now 2.5 weeks since my first chemo infusion. I have had to contend with nausea, dizziness, headache, diarrhea, constipation, mouth and throat sores, tingling in my fingers and toes, loss of taste save for predominantly bitter, unyielding bone pain in the first week, dry mouth, dry nose, lack of concentration, some cognitive issues (I’m thinking more brought on by anxiety) and fatigue. It has been difficult, but so far all of these I expected. When side effects come, I medicate, and I catalog, I deal.

Friday 9/23, exactly 2 weeks since my 1st chemo infusion, hair loss began in earnest. I first started noticing when we got a new kitten last weekend and I couldn’t figure out if I was all of a sudden allergic to cats, or if it was because, as I examined closely, my nose hair is looking sparse. Don’t rejoice. Nose hairs are a physical filtration system and mine is faulty. So I sneeze a lot. Gesundheit!

And there’s the underarm hair. I haven’t been shaving/waxing since I am not particularly hairy in the first place and who cares, really, but I did tug at what’s there and they came away with absolutely no resistance. So now, underarm is bald. Good riddance to that!

Yesterday as I was running my fingers through my hair, I noticed quite a lot on my hand. Once I noticed it, it became clear that there is indeed a seeming “start” to hair loss. I have taken to wearing beanies and bandannas right now to keep the hair contained otherwise I’m just tracking hair everywhere. You know what’s bothering me most today about this? That. I hate seeing hair everywhere. I vacuumed twice today and I am losing the battle. I thought that the way this will work is that I’d see a strand here and there then later (days? weeks?) the hair will come off in clumps onto my hand, and that’s when I’ll finally know it’s time to shave it.

I am not in the clumps stage. A day or two since the obvious hair loss began and it’s at the noticeably many strands all over the place stage. And already it’s driving me mad. I think this is what they mean about how it’s emotionally difficult or traumatizing every time. I am not super emotional yet nor traumatized. It’s more like fascinated, but mostly I am frustrated. I like to keep a clean and tidy house and my sheets are white, our wood floors and furniture are quite light colored against which black hair is hard to miss. I think this is what will do me in well before the trauma of hair falling in clumps (which, at the rate this is going may well be mere days from now anyway).

So I am days from shaving it all off.

I have been examining how I feel about it today and it’s unsatisfactory. I do have some anxiety about the next few days mostly because it just feels messy. Some women (people) may feel all sorts of emotions about even the thought of being forced to shave their head. I think I’ll be ok with it. Ask me again when when the day comes. As with anything about this whole journey, it is how others react that I sometimes wrestle with. It’s much the same way about telling people I know I have cancer: I feel ok, but I couldn’t guarantee how that’ll remain as I become privy to people’s reaction to it. Happy to report, almost everyone has been absolutely wonderful to me with my news: supportive, offering little to no unsolicited advice, extending help, following through… So knowing that people in my life have been unfailingly amazing, perhaps I needn’t worry. But if you were wondering what kind of reaction perhaps I could use when I inevitably lose my hair: please, no sympathy. I’ll probably make jokes. It’s ok, you can laugh. Bonus points if you have bald head jokes. Be pun-y.

The hair will be back.