This word I like... We architect our life...
A song, a sigh... developing words that linger...
Through fields of green, through open eyes... It's for us to see.
Interanimate: To animate or inspire mutually

Wednesday, April 9, 2008

Day +91 Bad Hair Days


Yesterdays appointment went like most others in many respects. I'm not having any physical symptoms of infection or graft vs. host. However, one thing that has come down unexpectedly is my platelet count. Since the month started I went from a reading of 95 to a reading of 32 yesterday. If it gets below 15 they will need to take action, namely a platelet transfusion. I'm told the platelet anomaly is most likely a reaction to the regime of drugs I've been taking over the last 3 months. They see this kind of thing a lot. They've had me stop an antibiotic, the likely culprit. The common drug name is Septra. They also suspect Septra for my recent bout with low white counts. So now I am off the drug since last Friday. Already my white cell count has risen to 3.0 from 2.6. Hopefully by this Friday my platelet count will show an improvement. The doctors say that everything points to my drugs as the problem. Next Tuesday I'll go in for my 5th bone marrow biopsy. Another 15 minutes of frantic pillow clutching and deep breathing will be in order on that day. I wish they'd just use the same hole they poked in my tail bone last time.

This post is my official foray into chemo 'hair'. Everyone has been asking me about what happens to your hair as a result of intensive chemo. NOT! Actually no one has asked but I think the chemo hair issue is pretty interesting so I'm going to take a blond moment here and brush you up on the subject. I promise knot to bore you with too many de-tails and I will keep it straight and short. :-)
How weird is hair? Not having any for awhile adds perspective. The picture I've posted to the right of this post was taken just a day before submitting myself to a month long incarceration in the bmt unit. You can get a rather large wallpaper-worthy version by clicking on the picture. Be sure to check out the clear patch on my neck. This covers the hole where, just a day earlier, they had threaded a tube through my jugular down to a place above my heart. The reason I look pissed off is that... I usually am after surgery. Also, I had asked the barber for a trim around the sides and found myself looking like a reverse mohawk. Really though, I did not want to worry about losing my hair after chemo so I asked Cathie to chop it off in advance. We had our fun clipping it off. There were happy pictures taken too! I swear!

Here is what happens to hair during chemo.
The chemical, Busulfex interferes with cell division. Basically, in the presence of busulfex, cells trying to divide can NOT. There are over 200 different type of stem cells in the human body. They divide at different rates. This much is known: bone marrow stem cells are some of the quickest dividers. Their life span is less than 6 days. If they cannot divide successfully then they die off. This is how the chemo gets rid of the old stem cells. However! All other stem cell division activity is affected. For instance, stem cells that divide every 24 days will not be totally destroyed, only the ones that tried to divide during the 6 days of chemo. Therefore 75% of them will survive and eventually repopulate themselves back to normal numbers.
Where does hair come in? There are stem cells that create the cells that create hair. Hair stem cells divide pretty fast but not as fast as bone marrow stem cells. During chemo, many of them perish. I'm guessing that a majority of hair stem cells bite the bionic dust during chemo. It takes months for the remaining hair stem cells to recover. There is some speculation that donated bone (myeloid) stem cells may be able to differentiate 'upwards' and help repopulate other stem cell populations throughout the body. Amazing things, those stem cells.

I remember my head hair falling out over a short period of time around day +7. I hated seeing the dead soldiers on my pillow as I came back to my mechanical bed from my many trips to the boys room. So, when I took a shower I massaged my scalp and that sped up the processes. My last facial shaving was done around the same time. Funny but not all hairs are created equal. My eyebrows survived albeit thinned. Eyelashes did not take a hit. The hair on the outside of my lower legs bit the dust but much of the hair on the inside survived. My arm hair, thinned but intact. Yeah, I think I'll leave the inventory taking at that point except to say that the worst hair loss was definitely on my head and face, sans the eyebrows and eyelashes. Everywhere else got a major thinning.

My hair is coming back. This is how it's coming back; not all at once. It seems like thin hairs started to show themselves first, right above and below my lips. Thicker hairs started growing a little last week so that I felt like shaving a few days ago. Unfortunately my dreams of having my original hair color come back have been shattered. The gray is returning along with the dark brown. The hair on my head is started to show, barely. It is causing a lot of itching up there so I've taken to massaging my scalp a few times a day. Maybe this helps the hair follicles find the best path to the surface without getting hung up along the way, causing irritation.

Well, there you have it. All you never wanted to know about chemo hair loss and recovery! You heard it here first! Happy shampooing and happy health to all!

5 comments:

Katy said...

That was a pretty "hairy" commentary. I can't imagine all the changes your body is going through. You are so incredibly informative in sharing your story. I really appreciate the updates. We are all thinking of you and pulling for you successful recovery.
Katy

Anonymous said...

Jim!
I just saw the picture of your backwards mohawk hair. I think your wife would have been a lil suspicious because I put my face really close to the computer to take a look at the patch on your neck. Needless to say, our faces were really close! haha
Good job wbc's! Those plts will bounce back right away too.
Good luck on the BMB. I cringe just hearing the sound of it... =(

Still sending you positive thoughts and prayers,
June

Anonymous said...

Jimbo...
I love the pic it cracks me up. I can tell you guys were having fun while doing that! Sorry to hear about those darn plts, but we all know with how strong you are that they will be back up in NO time! You rock... keep up the strength. We love you and hope to see you soon!
Derek, Shelli and Parker... ( he likes your pic too :)

SoftwareEngineer said...

Thanks for all the hairy details. Glad to hear you will not be bald, although I'm a little jealous of all the gray (I've always wanted the gray look- like what I imagine Moses looked like or Gandolf). But the cows in the pasture I can see from my window frequently reach for the grass through the barbed wire fence instead of eating the grass in the field- ergo, I'm a cow.

You're in our thoughts and prayers,
William

Duane said...

Great explanation about how chemo affects hair. Honestly, I've never heard it explained so well! ;)

Glad to see all is moving along well, Jim! You're doing an amazing job!