ANDREA EISENMAN
I was very frustrated with what was happening to my appearance.
Hair Apparent: The Mane Difference–Autumn 2002
BY ANDREA EISENMAN
One of the most glaring differences that I am aware of between the sexes after transplant would be the increase in hair growth, also known as being hirsute (hair suit!). It seems to be more obvious in women (and more unwanted). It is usually the result of post transplant anti-rejection medication. But not everyone I know has been affected by the medications as I have. For me the hirsutism is annoying but nothing compared to constantly being short of breath and worrying if new lungs will come in time. So the venting that follows is written with that in mind.
After my transplant one of my big concerns, aside from staying healthy was, do I bleach, wax or shave my face? After being in the hospital for roughly seven days and taking cyclosporin, it had given me a moustache to rival Yosemite Sam and side burns that Elvis, were he not dead, would kill for.
Originally I had been taking a different immuno-suppressant immediately after transplant. It was called prograf (a.k.a. FK-506) and is usually prescribed for people with cystic fibrosis (CF) because it is easier to digest than cyclosporin, which is oil based. I was told by the nurse coordinator that female transplant patients prefer prograf because it does not promote facial hair growth as much as the other medications.
The reason for the switch to cyclosporin started about six weeks after the transplant. I was having severe headaches and eventually had two horrendous seizures. For each one I was rushed by ambulance to the hospital and given an anti-seizure medication. Eventually it was realized, after an MRI and a two-week hospital stay that the prograf was causing swelling in my brain, which caused the seizures. So good-bye, prograf. On to cyclosporin, which can also cause seizures but seems to work better with my chemistry.
Other female patients had warned me that hair will grow everywhere, in places I’d never thought hair could grow as a result of post-transplant medications. Curiously, men never mentioned copious amounts of facial hair or otherwise to me. Initially on prograf, I did not notice a marked difference in hair growth until taking the cyclosporin.
After about one week in the hospital and starting the new medication, I was aghast at the mustache I was growing. Not only was it dark but really coarse. I had to wear it well as I had no beauty products to battle it. But the moment I got home I tried to diminish it as well as the terrific sideburns and lovely soul patch I was sporting. A MasterCard commercial came to mind. “Facial hair bleach: $4.79, Good pair of tweezers: $8.99, Upper and lower lip wax at a salon: $20.00. Being a werewolf and able to breathe: Priceless.”
I knew I was being a little obsessive about the excessive hair growth. It was just another thing to deal with after getting accustomed to all the new drugs and therapies. But…I was alive and starting to feel good. So I had to keep it all in perspective. After all, prior to transplant, I had to use oxygen all day long and wear a nasal cannula sticking out of my nose. I just wanted to look as good as I felt.
Men, of course, also experience increased hair growth from the immuno-suppressants, but since it is not abnormal for most of them to shave their faces, why complain? And as a bonus, those that are going bald get new hair on their diminishing pates. With me, the hair on my head started falling out! As that was happening, it also started to get darker and coarser. I had seen some people’s hair texture change after transplant but my hair was starting to rival a steel wool pad if not contained in a hair tie with hair goop.
I was very frustrated with what was happening to my appearance. I spoke to my doctors and although they were sympathetic they had no answers. They could not say whether this would improve with time or if I would have to wear a wig and constantly dip myself in Nair®.
Since our society is very image-conscious, it is difficult when one feels dissatisfied about one’s own looks. This unwanted hair growth was affecting my self-esteem. I felt uncomfortable when I thought people were staring or looking at my face. Not a good way to be in the world.
It has been almost two-and-a-half years since my transplant. The hair on my head has stopped falling out in clumps. I make every effort to control my facial hair by waxing, bleaching and tweezing if necessary. I also sometimes wax my legs because the effects last longer than those of shaving. Let’s just say, I could furnish a dog with another fur coat after I am done with the waxing strips on my legs. All this hair is just another annoying side effect of the medications. One positive note is that my eyelashes that have always been long are now thicker and longer. Not much, but I’ll take it.
On a more personal note, there have been other side effects that I have noticed from taking the transplant medicines. I doubt they have an effect on men. One would be that my menstrual cycle was thrown off completely. For me, menstruation lasted three weeks instead of the usual four to five days. It was literally very draining. I was constantly light-headed and afraid to drive or be by myself for fear of passing out. It was recommended that I take yet another medication, an oral contraceptive, to regulate my periods and decrease the bleeding. It worked but caused other side effects. It worsened both my hypertension and edema so that I had to increase my blood pressure medication and diuretic.
Researchers in the broader fields of medicine are realizing that men and women are affected differently by medications. Some medicines that work for women to treat heart disease do not work for men and vice-versa. Most medical trials used to be performed solely on men. Now this is changing because doctors know that, aside from reproductive health, men’s and women’s bodies differ in how medications are processed. It seems similar here that some of the medications taken for anti-rejection purposes after transplant can affect women in ways that men are simply immune to. I am not just talking about additional hair growth. But rather hormonal shifts caused by the medications that may create the hirsutism and the menstrual problems that affected me.
I do not want anyone to think that I take this gift of new lungs/life for granted. I am extremely grateful to my donor and her family for their selfless and generous gift. I am able to see these problems in perspective and sometimes laugh about them. I will never be as hairless as I wish to be. Thankfully I am alive, healthier than I have ever been in my life and trying to live life to the fullest. I mention these minor things here because sometimes they start to add up and get frustrating. That said, knowing the side effects of anti-rejection medication, I would do it all again without a second thought.