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October 22, 2003Lose hair, lose identity?Coping with effects of chemo after breast cancerByRecord-Eagle staff writer The first time Ann Beuerle came face to face with her bald head and sunken eyes, she was shocked into tears. "I remember I looked at myself in the bathroom mirror and I looked so ugly," said Beuerle, who was diagnosed with breast cancer nearly a year and a half ago. "I looked so sick, and I didn't feel that sick. I hate to compare it to the Holocaust but that's kind of what it was like because you don't look at all like yourself without hair."
"They're devastated. For a lot of women the thought of losing their hair is a lot more difficult than losing their breast because it's something on their outside, something people see," said Wendy Kanoza, owner of Crowning Glory in Traverse City. Nearly 40 percent of the clients at her small wig shop on Eighth Street are women dealing with fallout from chemotherapy or radiation, Kanoza says. And more and more of them these days are younger. For the past 26 or 27 years it's been her calling to make their search for a wig as painless as possible. "When they're told they need to find a wig it would be like somebody told you you have to walk through a room naked," she said. "It's humiliating. They feel like they're going to be exposed, naked. So we just try to do everything we can to make them feel comfortable." Sometimes that means being the target of a woman's anger, she said. And sometimes it means just lending an ear. "It's private in here. They can cry if they want, which a lot of them do," she added. For Kanoza, the most rewarding part of the job is helping women find the best fit and look they can among her inventory of 175 to 200 wigs - boosting their self-esteem in the process, and freeing them from anxiety about that part of their lives at a time when they have so many other things to worry about. Wigs are no longer the "poodle perms" they used to be, she said. Most models today are natural-looking, light-weight synthetics that can be custom-fit, cut, styled and frosted to look just like the real thing. "We do a lot of detail work to make it look more like their real hair," she said. "One lady in particular had on her own hair a gray streak off-center from her face. How can you find a wig like that? So we got her a wig and took off the dark color in that area and made it the same shade of gray so people who saw her every day thought that was her (natural) hair." For Beuerle, 65, a retired high school and college teacher who lives in Suttons Bay, picking out a wig was especially important because she would be wearing it at her son's wedding. "There were a lot of people I hadn't seen in years and I wanted it to be as close as possible," she said, adding that the naturally curly brown wig flecked with gray went virtually unnoticed by most of the guests. That doesn't surprise Kanoza, who tells her clients that while their hair is important to their self-image, most people don't judge them by it. "People don't identify you with your hair, they identify you with who you are on the inside," she said. Not all chemotherapy results in hair loss, said Laurie Patrick, an oncology patient educator at Munson Medical Center, where she provides patients with information about their illness, treatment and resources. And not all women are devastated by the side effect. "I have met lots and lots of women who don't care," she said. "They just want to throw a baseball cap on. And on the other end of the spectrum I've had women telling me that's the worst side effect they can deal with." Patrick said women undergoing the most frequently used chemotherapy for breast cancer can expect to experience significant hair loss two or three weeks after the first treatment. She advises them to begin shopping for a wig soon after their diagnosis to have more time to become comfortable with it. She also encourages women to consider cutting their hair shortly before or after the first treatment to help prepare them for hair loss and to make thinning hair appear fuller and thicker. "If you get your hair cut shorter, you've already made one change," she said. "It's sort of taking a baby step toward it. And it's certainly easier to clean up." Contrary to popular belief, she said, hair doesn't fall out in clumps or patches but in strands. "Some women will say off the bat it doesn't worry them so much that they're losing it, it just drives them crazy to have to pick hair off their necks and sheets and pillowcases," she added. Beuerle knew exactly what to expect after a repeat mammogram revealed a stage two tumor in May of 2002 - and not just because of what she'd heard or read. "I had a younger sister die of another kind of cancer that was unrelated so I had gone through radiation and chemotherapy with her," she said. "I knew that approximately 17 days after chemo, my hair would start falling out and that's what happened." Nevertheless, she said, she was unprepared for the reality. "My hair was something I treasured because it had just been easy hair to take care of," she said. "Really and truly, losing the hair was worse than losing the breast." Beuerle managed to cope with her loss with the support of family and friends, and by reminding herself that hair grows back. After the initial shock of seeing herself bald, "I got a grip and just went on," she said. "Because what choice do you have?" Like many other women undergoing cancer treatment, she also learned to use scarves to camouflage her baldness and keep her head warm. Creative scarf techniques are just one of the things cancer patients can learn through the Look Good Feel Better Program of the American Cancer Society, said Sandy Grushesky, coordinator of patient services for the organization's northern Michigan service area. The program also provides a free cosmetics kit with moisturizers and lotions to combat dry skin and the pain of hair loss, and assistance with make-up and wigs by a specially trained local cosmetologist. In Traverse City, sessions are held as needed at All That Jazz Salon, she said. Other American Cancer Society resources include free "wig banks" from which women can choose a new or recycled wig, flannel-lined "comfort caps" and other head gear, and a 24-hour toll-free line women can call for advice from registered nurses specializing in oncology. Some health insurances may also pay for a wig or "cranial prosthesis" with a prescription from a primary care physician or oncologist. The cost is about $150. Despite their fears, Patrick said, many women will start to re-grow hair even before chemotherapy ends. And most will notice good hair re-growth between six and eight weeks after treatment. "One thing I tell people is to be aware that their hair will come back after treatment, and sometimes it comes back better - less gray, thicker, fuller, curlier," she said. "For many people that happens."
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