My Gastric Bypass: Getting Real About Hair Loss

First, let me say… UGH!

Second, let me say… DOUBLE UGH!

Right, well now that I have that out of the way, I can get down to the topic at hand, hair loss.

The view this morning when I looked over the side of my chair.  A graveyard of lost hair I’ve pulled off my shirt over the past day or so… and that is only this one particular spot in the house. Not even the tip of the iceberg.

I have to give a bit of a disclaimer here because the hair loss issue is nothing new to me. I started noticing that I was losing my hair many years ago. After a visit to the doctor I was told that yes I was indeed losing my hair and the cause was Androgenic Alopecia brought on by PCOS.

So that’s always been bad enough, but having had WLS I knew that hair loss was a definite possibility.  Not just a definite possibility but pretty much a given.  Still, being the delusional idiot that I am, I sort of tricked myself into thinking that because I was already losing hair that one would cancel the other out and it might just continue on like normal.

No such luck.

It happens to everyone, I was not a lucky exception, it is happening to me… and it SUCKS.

Hair loss after weight loss surgery is called Telogen Effluvium.  What is this?  Well here is what I found online about the subject:

What is Telogen Effluvium?

When excessive amounts of hair simultaneously switch from anagen (growth) into telogen (dormancy) and subsequently shed several months later, the phenomenon is referred to as a telogen effluvium. Rarely are more than 50% of the hairs on the head involved. Telogen effluviums can be acute or chronic. When the shedding lasts more than six months or persistently recurs, it is referred to as a chronic telogen effluvium. Chronic telogen effluviums have been reported mainly in women. No racial predilection exists. Although telogen effluvium can affect hair on all parts of the body, generally, only loss of scalp hair is symptomatic.

What causes Telogen Effluvium?

In order to cause a large number of hair follicles to simultaneously switch from the anagen (growing) phase into the telogen (resting) phase, the body has to undergo some systemic insult. A telogen effluvium is not caused by topical medications. But because there is a required time lapse of several months between the inciting cause and the excessive shedding of hair, the exact cause of the telogen effluvium is often not positively identified.

A typical and common case of telogen effluvium would be the episode of severe shedding of hair that may occur approximately 100 days after a woman has given birth. The inciting factor is probably the abrupt hormonal changes that occur at the end of pregnancy. All of the hair grows back within a year.

Other causes of telogen effluvium include illness, major physical trauma, menopause, crash diets, severe psychological stress, major surgery (especially with general anesthesia), hypo- or hyperthyroidism, anemia’s, acute and severe blood loss, heavy metal poisoning, etc. Chronic illness such as malignancy, and any chronic debilitating illness, such as systemic lupus erythematosus, end-stage renal disease, or liver disease can cause telogen effluvium. Immunizations also have been reported to cause acute hair shedding. Even jet lag and job changes have been reported to cause a telogen effluvium. In the United States, oral medications may very well be the most common cause of telogen effluviums. The list of medications associated with telogen effluviums is extensive and includes retinoids, beta-blockers, anticoagulants, SSRI’s, non-steroidal anti-inflammatories, calcium channel blockers, etc. In any and all cases, the common factor is metabolic or physiologic stress several months before the start of the hair shedding.

So basically it’s the same thing that happens in a lot of other cases where sudden hair loss is involved like after a pregnancy, etc but I have bolded the parts that I think apply… crash diets (while I don’t consider this a crash diet, the extreme change in eating pattern and lifestyle would initially have the same affect), psychological stress (who has WLS without some of that involved??) and major surgery with general anesthesia.

This is not something I could have avoided.  I knew full well going into the surgery that this was going to happen (regardless of how much I tried to fool myself into believing otherwise) and I made the decision to do it knowing that this was in my future.

Does that make it suck any less?  HELL.NO.  It really doesn’t.  Nothing prepared me for the shock of seeing so much more of my hair falling out throughout the day.

When I decided to write about my surgery and my experiences afterward, I made a promise to myself that I would share it all, even the really shitty bits.  For me, that’s what this is, a really really shitty bit.  I can’t say I’m entirely comfortable with sharing it, I find this a little embarrassing and it makes me sad, but it’s my reality… and who knows, if you are reading this and are considering having WLS it may be yours one day too.

I’ve decided to take photos and share what it’s like because before my surgery I read a lot of people talking about hair loss but very few of them really shared.  Who knows what hair loss is to different people, how much they consider to be bad. I wanted to see photos and they were very few and far between.

Today I had Xander take these photos after I put the conditioner in my hair in the shower.

Yeah, not the most smiley photos but really, who would be smiling at a time like that?  I just congratulate myself on the lack of tears, because we all know what a weepy weeper I am.

To some women with longer hair this may look somewhat normal, but this is not what I have been losing in a day, this is what I have been losing while conditioning my hair.  It does not include the hair I pick off my shirt all day, the hair that disappears down the drain, what I see floating around on the floor, the hair all over my pillow in the morning or the pile I pick out of my brush every day.  Unfortunately, what you see in these photos is only a fraction of the hair I seem to be losing each day at the moment.  All of this comes out while conditioning my hair and I think I’m done shedding for the day, only to see gobs more come out ten minutes later when I’m coming my hair out after the shower, and then more again all over my clothes a few hours later.  It’s like a nightmare.

I am now almost three and a half months out from surgery and it has been like this for almost two weeks now.  I’m not sure how long it will last, if this is as bad as it will get or if it’s just the beginning. There is no way for me to know at this point… but what I do know is that it feels horrible.

I think this is especially bad for me because my hair was so thin to begin with.  Having already had problems with hair loss for other reasons, losing not only more, but a lot more at once, has left me scared to death that I’m going to go bald.

You can see in the photos that the hair on top is particularly thin, this is most noticeable when my hair is wet and it is worse on the crown.  The bulk of my hair loss from the alopecia happened on top but I notice now it is coming out from all over.  I can only hope that the bulk of what I lose now will be from the sides and back and that the hair loss on top will be minimal.  Otherwise, well… I’ve not decided what I will do yet.

From what I’ve read the bulk of the hair loss happens between 3-6 months after surgery so I am right on schedule. They SAY that after the 6-9 month point the hair starts growing back.  Will that be the case for me or will my alopecia interfere with that?  I honestly don’t know and I’m afraid to ask at this point because I’m not sure I would be ready to hear that none of it is going to come back.

All I have been able to think about when I look into the future after the surgery is going home to Canada in October and being a completely new woman.  Stepping off the plane and hearing my parents gasp when they see me at a weight I’ve not been in as long as any of us remember.  Now I’m realizing that I may be going home without a head full of hair, and how am I going to feel about that?  It sort of takes away from the initial excitement of showing off.  Not that my family will care, of course, but I will care.

I know, how vain, right?  There are people all over the world who have real problems, but these problems are real to me because they are mine.

I’ve tried really hard to stay positive through this experience.  After all, I did make the decision to do this knowing that all of these things were likely to happen.  Still, as I said, there is no preparing for the way you feel when they do finally happen.  I am hoping that no matter how it turns out with the hair loss that I will find a way to get through it with a smile on my face, whether it’s wearing a wig or getting creative with headbands… but I think there will always be an underlying insecurity and sadness that goes along with it.

There is one thing I’m incredibly thankful for, something that may be the ONE thing that gets me through this… and that’s having a husband that I know, without a doubt, will love me regardless.  I could be bald as an onion and he’d still go out of his way to try to make me feel beautiful and loved… so really, it’s not all that bad is it?  Not as long as I have someone like that by my side.

In the end, even with this hair loss speed bump that I am dealing with, I have absolutely zero regrets.  I feel like I need to add this after you spent the time reading me whine about it because while this may suck for me at the moment, there is so much more positive that I am getting out of my surgery and so many ways that it makes me feel wonderful.  This one thing does not cancel all of that out.

NO REGRETS!