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Laser Therapy

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It was less than a month after the diagnosis when my dermatologist, Dr. Silvia Garcia, told me that she was going to prescribe also 7 sessions of laser therapy.

By then I was already getting the cryotherapy, the cortisone, the minoxidil (the 2% solution and I was still waiting for the 5% solution that was brought by my sister) and the placenta lotion and shampoo. On top of that I was running and taking the flower therapy to control my anxiety. The Zoloft was still yet to arrive.

So, there I went, to the physiotherapy department of the Clinica Central Cira Garcia (where, as said before, most foreigners get medical attention in Cuba). A very nice doctor (whose name has slipped my mind) booked me for 7 consecutive laser therapies.

The Laser Therapy, according to what I have read on the Internet, consists of laser light applied to the affected area in order to alter the cellular function. Some of the documents I found in my web research said that this treatment has proven to be effective in the treatment of all types of hair loss (not only alopecia areata). But there are also other websites that say that the efficiency of the laser treatment is yet to be proved.

Anyway, there was nothing to loose (other than time).

So starting on April the 8th I went to Cira Garcia for 7 consecutive appointments for my laser therapy. Each time, the doctor applied the laser light over the bald spots for several minutes and while doing so I felt absolutely nothing.

During the 7 days I didn’t see any immediate result and actually the spots kept growing. The doctor explained that the result was not going to be immediate, that I had to wait. Patience again was the key word.

Not depressed… but in need of antidepressants

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This is seratonin, the neurotransmitter that Zoloft inhibits and that plays a role in the persons mood.

This is seratonin, the neurotransmitter that Zoloft inhibits and that plays a role in the persons mood.

Since the very first day I discovered my bald spots and I called my brother (the neurologist) in panic, he suggested that I should start an antidepressant regime. He said that for my case the best medication was Sertraline (commercially sold by the name Zoloft).

My first response at that time was that I was not depressed; actually I was very happy having just returned from a very nice vacation. Still he said that such medication would help control the anxiety that was causing the alopecia areata and the panic and the extra anxiety that resulted from the hair loss.

The following morning before going to the beach I looked unsuccessfully for the medication in two pharmacies close to our place. They didn’t have it. Then I talked about it with Carlos (my psychiatrist) at the beach that morning and he recommended waiting, not to take medications right away. I decided to wait.

But four weeks after the diagnosis I decided that I was going to find and take the medication. My mood swings were not many but they were very drastic. I could easily go from happy and optimistic, to sad and devastated, to anxious and terrified in any day.

After three very bad days I told Carlos that regardless his opinion I was going to follow the recommendations of my brother. At that moment he agreed that taking the drug could be beneficial in my case.

So I called every pharmacy in Cuba just to find that there was no Sertraline at the time in the coutry. Nevertheless my sister was visiting in a few days and she brought it with her.

The first few days after taking 50 mg of Sertraline in the morning I struggled with some nausea (pretty severe the first day) and also with some drowsiness.

But after more than a month on Zoloft I feel fine, the side effects are gone and I haven’t felt sad or anxious in several weeks, I feel optimistic and happy. My husband says that he could immediately tell when the drug was taking effect, because overnight I stopped talking about my hair all day long.

Grieving for our hair

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Me, some years ago, with the hair I miss so much!

Me, some years ago, with the hair I miss so much!

Lately, since I discovered my bald spots, I have been thinking way to much about hair, about what it means, about what would I do without it, about how to fix my situation and about how much this disease has disrupted me.

I have been remembering a lot an episode with my friend Inocencia, in Houston. She had breast cancer and she underwent a successful mastectomy, radiation and chemotherapy and after several years she is still cancer free.

As it usually happens in these cases, during the chemotherapy treatment she lost all her hair. Unlike me (with alopecia areata), Inocencia was battling a deadly disease; one that could have easily taken her life. She knew that the hair loss was a result of the treatment and therefore it was temporary. She was certain that the hair was going to grow back. That is a certainty that patients with alopecia areata don’t have; we know it is likely the hair will grow back but we don’t know it for sure, we don’t know when it could happen, we don’t know when the bald spots will stop growing and we don’t know if we would loose our hair again once we have recovered.

I read once that the only certain thing about alopecia areata is its uncertainty.

Going back to Inocencia I remember well a conversation we had with a mutual friend, Sandra. Inocencia was happy the treatments were over and the hair was slowly growing back. Still she was wearing a wig. We asked her to show us her new hair and she did. She removed her wig and showed us her bald head filled with little hairs starting to show. She looked beautiful!

After that she told us that the worst part of her illness had been loosing her hair, it have been even worse than loosing her breast.

I was stunned. How can someone be focusing in the hair (that will come back)?! Instead of her breast (that will never come back)?! Or the illness (that could come back)?!

It was just beyond me, I couldn’t understand it. Besides, she looked beautiful bald.

After the first night, the first day and the first week carrying my bald spots and doing everything to conceal them I have understood (the hard way) the importance Inocencia gave to her hair. The breast is not visible, neither is the cancer, but the baldness is the first thing someone will notice… it is the first thing that tells the world that something is not right.

I know I am not going to die from alopecia areata, I know that it is likely the hair will grow back, but still I am grieving for the lost hair. I understand now.

 

Got to run!

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maraton

Me, crossing the finish line of my first (and so far only) whole marathon, in 2005.

The same Saturday of Veronica’s wedding (March 23) I called my mom at night. She told me that se had talked to my brother (the neurologist) about my situation, about the Alopecia Areata. She told me that my brother had said I needed to run.

I have been a runner for a good part of my adult life. For many years I ran every single day, even if it was just for 15 minutes. Something lacked in my day when ever I missed a run.

Nevertheless for the last few months I haven’t run much and I have actually let weeks and months go by without doing it.

The reason I gave myself for not running was the cough I battled and that apparently was a result of a strep infection (the one I am treating with penicillin), an injured toe (now healed), the pounds I gained and that made me feel heavy while running, and the fact that I was overall out of shape mainly because… I was not running.

It is a vicious cycle: not running made me a worst runner and made me want to run less.

Havana doesn’t help either, I live in a city where there are no good places to run. My favorite is the esplanade of 5th Avenue (5ta Avenida), but there is no shade, lots of smoke coming from old cars, traffic noise and very hard ground.

The issue here, according to my brother, is the endorphins. Basically I have got my body used to this morphine-like substance for years and then just stopped.

Endorphins (“endogenous morphine”), according to Wikipedia, “are endogenous opioid peptides that function as neurotransmitters. They are produced by the pituitary gland and the hypothalamus in vertebrates during exercise, excitement, pain, consumption of spicy food, love and orgasm, and they resemble the opiates in their abilities to produce analgesia and a feeling of well-being.”

So, my body could be resenting that daily endorphin “high” and therefore getting stressed and reacting in a way that was making my hair fall out.

Marathon

Me, finishing a half marathon, some years ago.

This is actually a well researched fact: runners do experience a “high” and one can assume that if a regular runner (like me) stops running (like me) he or she could experience withdrawal symptoms.

It made perfect sense. After the talk to my mom I called my brother and he told me: “you got to run again.” Immediately after hanging up I put my running shoes on and I went out for a three mile run. It was difficult, I had to stop several times and walk, but since then I have been doing it every day, even if it is just for 20 minutes and I have to say that after a month I am starting to feel again the benefits of the exercise: that daily energy, the regular doses of endorphins, a slimmer and stronger body, a clearer mind, and an overall sense of wellbeing. This may help my hair grow back.

 

The bald spots are growing!!!

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Me and Veronica, on her wedding day, when the only thing I could think about was my hair.

Saturday March 23 was Veronica’s wedding day. She is my friend and housekeeper and I was chosen by her to be an official witness at the ceremony.

The day started with me baking some pecan tartlets for the wedding reception and then I had to wash my hair. Anyone that has read previous entries of this blog and anyone that has heard me complain about my hair problem know that washing my hair has become a nightmare. I don’t like it, it terrifies me, it gets my anxious… I do not enjoy it at all.

So I jumped in the shower and washed my hair. I felt so much of it fell from my head and when I came out of the shower I could see the bald spot on the top of my head looking at me from the mirror. It looked huge!

I got closer to the mirror and turned the lights on and yes, the spot was definitely bigger. I know that my dermatologist told me to avoid the mirror, not to look and the spots and stop paying attention to the hair that falls in the shower. But I can’t, I need to see and I rather see now than find a surprise in the future if the spot keeps growing.

Still, when we left to the wedding my bald spots were the only thing on my mind. I told my husband, Jeff, that I thought the spots were growing. He told me that I needed to calm down, “thanks for your support,” I said ironically, even when I knew that he is right, and that what I need is to calm down and keep doing what I am doing. I know I have to be patient, it is just so hard.

Later that day, after the wedding, we went to play tennis with some friends. Before arriving to the court I was still feeling down, depressed and worried, but the exercise worked its magic and after two hours of tennis I was smiling, happy, and enjoying life again

Penicillin… could it be an infection?

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On the day of the first cryospray therapy I got the results of the blood tests the doctor had ordered. It turns out that everything came back normal, everything but a throat culture test that revealed the high presence of streptococcus. It is true that my usually healthy self had been fighting a lingering cough for a big part of 2012 and the whole month of January of 2013. It started on March last year (more than a year ago) and it has been going on an off.

Back then I would have cough fits that would keep me awake, something really unusual for me. Still I didn’t pay a lot of attention to it and treated it mostly with over the counter cough syrup and medication that would at least let me sleep. The cough went away after two months or so, but not totally, and then in came back in January. Well, apparently it was due to a sinus infection caused by these bacteria.

I asked the doctor if this could also be the cause of my Alopecia Areata. She said that the lingering infection could have caused stress to my body and contributed to the onset of the Alopecia. That is, she said, on top of any other stress that is present in my life right now.

In any case she prescribed three penicillin injections, one each month. I have already had two and, I don’t know if it is because of that, but the cough is over (for good, it seems); I am also combining that with sinus saline washes.

Probably this won’t cure the Alopecia, but at least it would help me get healthy overall, and that can only be good.