Cold Cap: From Rapunzel to Rambo

Once we know I need chemo, I meet with my oncologist for the second time. He’s an extremely personable and energetic Kiwi at one of the top places in London. He informs me that they have these “really great” cold caps that you can use throughout chemo to try and keep your hair. He looks at my thick wavy mane and determines I am an excellent candidate.

Afternoon tea at the Athenaeum

“Get yourself a bob,” he twangs. “With all that hair piled on top of your head the cold will never reach your scalp and it won’t work.”

Okay. So I decide to chop it. I had had long hair for well over ten years because the last time I cut it short was when I was a summer associate in Paris. I take the tube to my Hampstead hairdresser, waltz in and blurt out “hi I have cancer and need chemo so you have to chop off my hair.” Followed by a toothy smile.

He looks at me, pauses briefly, sighs and then sets to it. Very cool. No drama.

There is something liberating about cutting your hair and knowing that it won’t really matter if you aren’t thrilled with the results. You have to do it so you do it. And well, the ends were a little crunchy from years of highlighting and dyeing to conceal a generous sprinkling of salt in my pepper.

I emerge from the salon, the new me. Send pics around and everyone claims to like it — even prefer it — to my old hair (I hope later the same is said about my new vs. my old boobs but as we know from my last post that’s a tall order).  But I digress…

I consider the cold cap. How it works is: they put a plastic cap with below freezing liquid in it on your head and this reduces blood flow to the area which prevents the chemo from reaching the hair follicles. I am told best case scenario my hair will probably thin at least 20% even with the cold cap.

I conduct personal research.

Of my cancer buddies who tried it, each gave up after one or two tries because (a) it was excruciating to have a below freezing cap on your head for hours (shocker) and it gave them migraines and/or (b) the smell of the conditioner they slathered on to prevent the cap from sticking to the hair nauseated them (delightful).

Chemo for me consists of four doses of AC (doxorubicin a/k/a “the red devil” and cyclophosphamide) followed by four doses of Taxol, each given every two weeks on a dose dense regime. So sixteen weeks of treatment in all.

Here’s the catch: if the cold cap works and I retain a good amount of hair through the first half of treatment, I will have to switch to a weekly dose of Taxol for the second half and tack on four extra weeks. Why? Because Taxol when given biweekly is done on a slow drip over three hours and you cannot tolerate the cold cap for that long.

Then my friend Beth raises the possibility of a scalp metastasis if the chemo drugs do not reach the scalp. Shit.

I ask three top oncologists on two continents about this possibility. They say that scalp metastases are rare but it is a theoretical risk.

I do some math:

Freezing cold thing on my head (with loads of icky-smelling conditioner) + 12 weekly treatments vs. 4 biweekly for 2nd half of chemo + possibility hair will fall out anyway + possibility of not killing some little fucker hiding out in my scalp = NO WAY JOSE.

Sorry, but it just isn’t the honey badger way.

I inform my oncologist and the nurses at the chemo treatment suite that, no, in fact, I do not wish to try the cold cap. “Are you sure? You know your hair will fall out, don’t you?” Umm, yeah. I kinda got that. Thanks. I’m not putting that thing on my head. Fuggetaboutit.

It is just hair. It will grow back. And this way I get to go all GI Jane when it starts to fall out and maybe try out a mohawk, at least for a few minutes. Come on, you know you have always wanted to try the ‘hawk.

So I do my first chemo with my perky bob sans cold cap. The treatment suite is pretty swanky. One level under ground but cleverly designed with skylights so it is sunny (when there is sun in London) and nice white leather adjustable chaises longues. People bringing round tea and biscuits. Free wifi. It ain’t a bad place to be, really. If you have to be there. I feel like Dr. Evil in my own little underground lair (except with skylights).

A nice lady comes by who is visiting a friend having been through chemo herself. She has a cute short hair cut. “You should really cut your hair short before your next treatment,” she offers. “It’s easier if it isn’t so long when it starts to go.” I agree. I’ve been warned that when it starts to go, it goes FAST.  And I don’t want to be pulling out long pieces in the tub or walking down the street on a windy London day and have the bloke behind me get a mouthful. Ew.

So a couple weeks later, off I jaunt to Hampstead for new hairstyle numero dos.

This is the shortest lasting hair cut of my life. It lasts exactly five days. On the fifth day I shower and pull out about one quarter of my hair. I am prepared for it, as much as one can be, but still it is disconcerting. I make my husband come deal with it. He does, no questions asked.

The next night I rally the troops, sanitise the shaver my cancer buddy friend lent me, get the shears and get busy. I enlist the girls. Bill is skeptical about their involvement. “But that way it will be fun and silly.” I explain. “You can’t just have mommy show up with a shaved head.”

Although this may seem to represent great wisdom and creativity on my part, I have come to this conclusion after our five year old burst into tears following each of my new haircuts, shrieking “I HATE it! You look POOPY!” And proceeded to bawl and spit (seriously) and carry on. Luckily I have a good sense of humour and thought this was funny, especially when after an hour both times she came up and said I looked great.

I let Isabel take the first whack at it with the shears. No turning back. After a while I start to resemble a concentration camp victim. Bill and I don’t like that part much. So it is time to speed up the process and whip out the shaver. Strangely, I enjoy it. I feel powerful. I do feel like Demi Moore in GI Jane (except taller and I’m not getting paid millions). At Isabel’s suggestion, we do a mohawk.

After snapping a few pics for posterity we shave off the ‘hawk (my hair is falling out so quickly we kind of have to — otherwise I totally would have kept it for a while).  This is London, after all. No better place to be an anonymous nutter (that’s “crazy person” for you British English challenged).

And there we are. The cold cap can suck it. Because I am killing this look.

The best part? Charlotte comes up to me the next day and says “Mommy, bald is your best look.”