COVID-19: Hair is not the problem

By Debbie Kerr

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In years to come, when COVID-19 is a distant memory, we’ll share our stories about how the virus impacted us.

Most people will talk about having to stay at home and not being able to see family and friends…at least not in person. They will talk about everything being shut down. No mall, no theatre, and no social life; in some cases, no school, no work, and no regular income for individuals and businesses. Somewhere in those stories, the term “social-distancing” might be used. A small number of people will talk about the large number of seniors who died in nursing homes, the limited testing, and the shortage of personal protection equipment. And, without a doubt, at least one person will mention not being able to get a haircut and everyone will jump in to share their stories.

In truth, with the focus on hair, the battle-cry for people during COVID-19 could quite easily have been, “Give me liberty and then give me a haircut.” 

Unfortunately, COVID-19 is still a reality, haircuts are still not allowed in some places, and the focus on hair still seems a little misguided. But who am I to say? Hair loss was one of my interesting stories when I had chemotherapy but it certainly wasn’t my main focus.  I was more concerned about getting the right treatment at the right time. My focus was on beating my cancer.

And so, during COVID-19, you as a cancer patient or potential cancer patient may be worried that you’re not receiving the same standard of care, especially when you hear stories about people having their surgeries cancelled… at least for the time being. 

Non-essential Surgery
You may wonder how any type of cancer surgery could possibly be considered non-essential. The word “non-essential” almost feels like an insult when it comes to cancer. You may wonder why only some surgeries are being cancelled and, if yours was one of them, why yours was chosen.

The truth is, if your surgery is classified as non-essential, it means that you have other options for treatment. It doesn’t mean that you, personally, are not essential. 

With COVID-19 there is a new standard of care. 

Standard of Care
If there is a cancer diagnosis, multiple factors are taken into consideration to determine what your standard of care will be… whether your first treatment will be surgery, chemo, hormone therapy, or radiation. Since the standard of care has changed, some patients who would normally receive chemotherapy after their surgery are receiving chemotherapy first. Those who cannot have another treatment done first, will still have to have their surgery and is why their surgery is essential.

The Reasons for the Change
There are several reasons why the standard of care has changed to reduce the number of surgeries.  
 
The ventilation/airflow in an operating room is different than in other areas of the hospital.  In some areas of the hospital, outside of the operating room, the airflow is set up to keep contaminants (like the coronavirus) within an area (like an isolation room) so that it doesn’t spread to other areas of the hospital. In an operating room, the ventilation is set up to keep contaminants out of the room and it is considered the cleanest room in the hospital. Now, with so many cases of COVID-19, especially in certain areas of the country, it’s possible that you, as a patient, could be the contaminant within the operating room. This means that you in combination with the air circulation in the operating room could cause the coronavirus to spread.
 
Hospitals are trying to ensure that hospital beds are always available to COVID-19 patients, so if you have surgery and need to stay overnight, you are using a bed that may be needed.
 
While you are recovering from surgery, your immune system is weakened. This means, in addition to having a pre-existing medical condition, you also have a compromised immune system because of your surgery.
 
This is why, to mitigate these risks, especially when other treatment options are available, some surgeries are being cancelled, at least for now. 

Your Perspective as a Patient
COVID-19 has a strong emotional element, especially the fear…especially of the  unknown.  As a patient during this pandemic you may ask yourself some of the following questions:

• How do I stop this feeling of chaos if decisions are being made for me? I feel like things are out of control?
• Why do I have to do everything alone? How do I get emotional support? I am supposed to self-isolate, a cancer diagnosis makes me feel isolated because no one truly understands, and then I must go to all my appointments and treatments by myself. 
• Since this is a new standard of care, how do I know if the change in the order of my treatments will, or will not, impact my prognosis?
• If this new standard of care is effective, why wasn’t it the original standard of care?
• Is it possible that I could receive chemo treatments as my first treatment and find out when I finally have surgery that I didn’t actually need it?
• If people with pre-existing conditions are supposed to self-isolate because of a high risk for developing COVID-19, why is it okay to go to the hospital or treatment centre where there are other immune-compromised people? What happens if I get it?
• How do I mentally prepare for treatments when I don’t know when they will take place?
• How do I find the balance between getting the care I need and keeping myself safe?

Finding Balance
Your questions are valid. There are a lot of unknowns.  With decisions being made on your behalf, you might feel like you have been pushed onto a tightrope where it doesn’t really matter whether you fall left or right; the end result could be the same.  Your job is to find and maintain the right balance so you don’t fall and you can find the balance that will get you where you need to go. Here are a few examples, because no one (not even the person writing this post) has all the answers.

At a time when you feel like you’ve lost control, you may want to embrace new healthy lifestyle choices (quitting smoking, eating healthier, taking vitamins, exercising more). Maybe taking these actions will help you find the balance between feeling a loss of control and feeling in control. 
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The medical field is still learning new things about the virus itself just as new discoveries will be made about how cancer treatments were handled during the pandemic.  The truth is that doctors can only assess risk when they develop your treatment plan. You may never truly know if the changes to your treatments made the results better, worse, or the same as the original standard of care. The same is true of the original standard of care. You have to find the balance between “what if” and enjoying your life.
  
During your journey, even though your fear and anxiety levels are high, medical experts say the risk of being exposed to COVID-19 in a medical facility is very low. There are less people in the facility than there normally would be. Only those people who must be inside are allowed inside. Deep cleaning has been done at a level even your mother couldn’t imagine. With all these steps being taken to minimize your risk of exposure, it’s critical that you go to the hospital when you are sick. Often the results of not going are more damaging to you than if you did go.  You have to find the balance between your fear and what you need to do.
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Emotionally, remember, cancer patients are often surprised at how strong they are when they have no other choice. They do whatever they have to do in order to become cancer free or minimize the cancer’s progression. You can do that too. You have to find your own way to maintain the balance between fear and moving forward. Find the balance between looking at you and your situation and looking outward at what life has to offer.
 
If you’ve been offered chemo, instead of surgery, as the first step in your treatment plan at this time, think of it as a blessing.  If you lose your hair, you won’t have to worry about your hair getting in your eyes as you navigate these difficult times. Instead of focusing on your hair, you can focus on what truly matters.  You just have to put one foot in front of the other.