Helping a Client with Trichotillomania

We recently received the most amazing review from our client Alex in Austin, Texas. We wanted to share it with you because she really describes the struggle that trichotillomania sufferers go through. We hope you find it as touching as we do!

Yelp Review from Alex S (Austin, TX):

Having trichotillomania, I have had more than just a "bad hair day", it had been more like a "bad hair life". I first visited Ricky in April 2012, just a month before I was due to gradate college. A few weeks before that, I called my mom and told her I was going to shave my head, out of frustration and what felt like helplessness because my hair pulling had gotten so bad during my last semester at college. There was no way that I could wear the hat I typically wore every day to hide my hair, underneath the graduation cap I would have to wear to receive my diploma. So, I decided that my only option was to shave my head, swallow my pride, and walk across the stage in front of thousands of people. Something that should be a proud and exciting day for everyone, seemed like it would end up being an awkward, uncomfortable, and frankly, embarrassing situation for me. If you have trich, you can probably relate when I say, after dealing with those situations my entire life, I just wanted to have a day where I could just be myself and not have constant anxiety about everyone looking at my hair, and not me.

In the past, my mother had helped me find solutions when I was younger: wigs, extensions, etc. No matter where I went, though, I don't think anyone fully understood how my disorder worked or how to provide those kinds of solutions to a person with trich. Everything I had tried in the past looked unnatural and resulted in more eyes looking at me, so I was weary to try anything else that would cost money. Finding a doctor or psychologist that specialized in treating trichotillomania has always been a pain, so I didn't know how we would ever find a hair dresser that knew that they were doing on a person like me.

Fortunately, after a lot of digging and a visit to http://trich.org/, my mom found Ricky. I was apprehensive when she first told me about him because of all the past experiences I had with wigs and extensions looking unnatural. However, after watching the videos of him doing Kristen's hair and him doing the hairpiece on the man, I was shocked at how amazing he was at it. It all looked SO real. A week or two later, I came in for a consultation and was surprised at how comfortable they made me feel. Both Kristen and Ricky both knew SO much about trichotillomania and it was almost like they could finish my sentences when I described how dysfunctional my disorder made me feel. From there, they took measurements and figured out what kind of hair would work best for me given the areas where I pulled. After my hair order arrived, I came in for the actual hair appointment and Ricky worked his magic which was awesome to watch. He matched the color of the piece to my natural hair exactly and somehow blended the hair line of it, to make it look seamless with mine. You couldn't tell where my own hair stopped and the hair that wasn't mine started. Trichotillomania can also be very unpredictable, so since that first appointment, Ricky has done quite a bit of improvisation, which never ceases to amaze me. Some months, I come back having pulled in spots that weren't covered by the hair and on opposite sides of my head - pulling areas tend to move around. Without flinching though, Ricky ALWAYS finds a way to make your hair look good and natural. He is a master of his craft.

There aren't enough words to express how wonderful both Ricky and Kristen are. If I could give them 10 stars I would. They've helped change so many people's lives, including my own, with their unparalleled expertise, professionalism, and knowledge. With their help, I feel like I can live like a normal person for the first time in my life.

Lymphedema and Weight Loss

If you're overweight, you're more likely to experience problems with lymphedema. The theory is that when your body has extra fat, those tissues require more blood vessels. This creates a higher volume of blood and lymph in the arms and chest, placing a greater burden on the remaining lymph nodes and vessels after breast cancer treatment.

Overweight is defined as a body mass index (BMI) of 25-29.9 and obese as a BMI of 30 or greater. For example, a 5'5" woman weighing 150 pounds or more is considered overweight, and she is considered obese if 180 pounds or more. There are a number of online tools you can use to calculate your BMI, such as this one from the National Institutes of Health.

Some studies have shown that losing weight can significantly improve lymphedema symptoms in people who are overweight. Talk to your doctor or lymphedema therapist about creating a diet and safe exercise plan for bringing your weight down to a healthy range. You can also ask if there is a nutritionist who can help you make an eating plan that will help you lose weight. Many hospitals and cancer centers have nutritionists on staff.  Since being overweight also increases the risk of breast cancer recurrence, it's doubly important to take steps to reach and maintain a healthy weight.

If you're at a healthy weight now, work to stay within your current range. Good nutrition and safe exercise are your best allies. 

Bandages for Lymphedema

Bandaging is a mainstay of treatment for stage 2 and stage 3 lymphedema (moderate to severe lymphedema). Bandaging involves creating a soft cast on the arm or upper body by wrapping with multiple layers. This is a main component of the larger treatment regimen called complete decongestive therapy, or CDT, and many research studies have demonstrated the effectiveness of CDT. While there aren't many studies that focus just on bandaging, the small amount of research available suggests that bandaging can reduce arm volume.

At first, your lymphedema therapist should do the bandaging for you while teaching you the right technique. Some therapists provide an instructional DVD or written directions to guide you. The process starts with an inner liner made of stocking-like fabric or gauze, also known as a stockinette. The liner would be placed over the arm and hand after moisturizing the skin with a gentle lotion such as Eucerin or Curel. Try to avoid lotions with anything that could irritate the skin, such as perfumes or dyes.

In most cases, padding made of polyester, cotton, or foam would be placed over the stockinette, followed by multiple overlapping layers of short-stretch bandages. Short-stretch bandages look like the Ace bandages you might get at the drugstore, but they're much less stretchy. Generally, there would be more layers further down on the limb and fewer layers higher up, creating graded pressure that helps fluid move up and out of the arm. The bandages should feel snug but not tight.

Bandaging is also an option for lymphedema of the chest or trunk, as short-stretch bandages come in all sizes. Bandaging is a reductive therapy, meaning it makes the limb smaller. When your arm is bandaged, your muscles are "held in" by the multi-layer soft cast every time you use your arm. This is known as working pressure. When you do any prescribed exercises with the bandages on, or simply use your arm as for normal activities, this working pressure creates an internal pumping action that moves fluid out of the tissues and into vessels of the lymphatic system. The bandage cast helps prevent fluid from flowing back into the limb, and it also softens the tissue under the skin. This is why bandages are an important treatment for lymphedema that is causing moderate to severe swelling and/or soft tissue changes.

It is recommended to work with a certified lymphedema specialist to create a tailored plan to treat and manage your lymphedema. We have several certified lymphedema specialists on our Ricky Knowles Hair & Wellness team. Our therapists will work with you to address any problem areas and our certified compression garment fitter, Kristen, can create custom compression wear to help you improve your condition and mobility.

To schedule a free consultation, call a RNHW team member at 713-623-4247 today!

What you need to know about BRCA gene testing

What is BRCA gene testing?
Everyone has BRCA genes that produce tumor-suppressing proteins. But risky BRCA1 and BRCA2 gene mutations leave a person more susceptible to cancers, including breast and ovarian cancers. BRCA testing is used to determine whether a person has such a mutation, which can be inherited from either parent. Each child of a parent who has a mutation in one of these genes has a 50 percent chance of inheriting the mutation.

What does the test entail?
BRCA gene mutations are detectable through DNA from a blood or saliva sample. It usually takes about a month to get results once your sample is sent to a lab for analysis.

What does a positive result mean?
A woman's lifetime risk of developing cancer is “greatly increased,” if she has a harmful BRCA mutation, according to the National Institutes of Health. About 12 percent of women will develop breast cancer at some point compared with up to 65 percent of women who inherit a harmful BRCA1 mutation. Other cancers are linked to mutations in BRCA1 and BRCA2, including fallopian tube, abdominal and pancreatic cancers. Men with harmful BRCA gene mutations face higher risk of prostate cancer.

How common are high-risk BRCA gene mutations?
The likelihood of carrying a BRCA gene mutation is extremely low for people with no family history of breast or ovarian cancer. Only about 10 percent of all breast cancers and 15 percent of all ovarian cancers can be traced back to inherited genetic mutations.

Who should take the test?
Because BRCA gene mutations are relatively rare, many doctors agree only those who have specific family patterns of cancer should consider the test. Such patterns include having multiple family members who have been diagnosed with breast or ovarian cancer, especially at a young age; cases of male breast cancer; and two or more cancers in one family member.

For anyone thinking about such testing, experts strongly recommend genetic counseling by someone who is experienced in cancer genetics. Counseling can help assess the need for testing in the first place, as well as facilitate discussion about what kinds of decisions a person faces once she gets her results.

What kinds of decisions should you be prepared to make?
A person who finds out she has a BRCA gene mutation faces some difficult decisions. Some women choose enhanced cancer screening, beginning with regular mammograms in their 20s, for example. Others choose risk-reducing surgeries like mastectomies or the removal of the ovaries and fallopian tubes. People also consider chemo-prevention regimens of drugs and vitamins to delay or reduce cancer risk. Finding out you have a harmful BRCA mutation indicates a higher risk for your siblings, too, so what you learn can affect multiple family members.

How much does it cost?
Some insurance companies cover BRCA testing, which can range in cost from hundreds to thousands of dollars. The National Cancer Institute urges people to contact their insurance companies to discuss cost before getting the test. For those without insurance, some genetic testing companies offer free or discounted pricing for individuals who meet certain medical or financial eligibility standards.

Who can help?
There are myriad resources for people considering BRCA gene testing, including the Cancer Information Service at the National Institutes of Health (NIH) and many nonprofit organizations. Live and anonymous online chatting is available from the NIH weekdays from 8 a.m. to 11 p.m. ET (5 a.m. to 8 p.m. PT at http://livehelp.cancer.gov. You can also call 1-800-4-CANCER.

Top 10 Foods for Healthy Hair

1. Salmon
Besides being rich in protein and vitamin D (both are key to strong hair) the omega-3 fatty acids found in this tasty cold-water fish are the true superstar. Your body can't make those fatty acids, which your body needs to grow hair. Omega-3s are also found in cell membranes in the skin of your scalp, and in the natural oils that keep your scalp and hair hydrated.
Other options: If salmon doesn't thrill you, you can also get essential fatty acids from fish like herring, sardines, trout, and mackerel, as well as avocado, pumpkin seeds, and walnuts (see below for more wonderful things about walnuts.)

2. Walnuts
These are the only type of nut that have a significant amount of omega-3 fatty acids. They're also rich in biotin and vitamin E, which helps protect your cells from DNA damage.
Other options: Try using walnut oil in your salad dressing or stir-fry instead of canola or safflower.

3. Oysters
Oysters are rich in zinc, a lack of which can lead to hair loss (even in your eyelashes), as well as a dry, flaky scalp. Three ounces has a whopping 493% of your daily value. You can get some zinc through fortified cereals and whole grain breads, but oysters can boast a good level of protein too.
Other options: Get your fill of zinc with nuts, beef, and eggs.

4. Sweet Potatoes
Sweet potatoes are a great source of the antioxidant beta carotene, which your body turns into vitamin A. It also helps protect and produce the oils that sustain your scalp, and being low on vitamin A can even leave you with itchy, irksome dandruff.
Other options: Carrots, cantaloupe, mangoes, pumpkin, and apricots are all good sources of beta carotene.

5. Eggs
A great source of protein, eggs are loaded with four key minerals: zinc, selenium, sulfur, and iron. Iron is especially important, because it helps cells carry oxygen to the hair follicles, and too little iron (anemia) is a major cause of hair loss, particularly in women.
Other options: You can also boost your iron stores with animal sources, including chicken, fish, pork, and beef.

6. Spinach
The iron, beta carotene, folate, and vitamin C in spinach help keep hair follicles healthy and scalp oils circulating.
Other options: Try similarly nutrient-rich dark, leafy vegetables such as broccoli, kale, and Swiss chard.

7. Lentils
Tiny but mighty, these legumes are teeming with protein, iron, zinc, and biotin making it a great staple for vegetarian, vegans, and meat eaters.
Other options: Toss other beans such as soybeans (the young ones are called edamame) and kidney beans into your soup or salad.

8. Greek yogurt
Cruise the dairy aisle for low-fat options such as Greek yogurt, which is high in hair-friendly protein, vitamin B5 (pantothenic acid -- an ingredient you'll often see on hair care product labels), and vitamin D. Emerging research links vitamin D and hair follicle health.
Other options: Cottage cheese, low-fat cheese, and skim milk also fit the bill.

9. Blueberries
Exotic super fruits may come and go but when it comes to vitamin C. C is critical for circulation to the scalp and supports the tiny blood vessels that feed the follicles. Too little C in your diet can lead to hair breakage.
Other options: Kiwis, sweet potatoes, tomatoes, and strawberries.

10. Poultry
This everyday entree is extraordinary when it comes to protein, as well as hair-healthy zinc, iron, and B vitamins to keep strands strong and plentiful.
Other options: Lean cuts of beef are another good source of lean protein.

Looking for other tips or products for healthy hair?  Contact our Ricky Knowles Hair and Wellness team at 713-623-4247, and we'd be more than happy to help you!

Scientists A Step Closer to Treating Baldness

Scientists have moved a step closer to finding a treatment for baldness in men and women with the discovery that it is possible to grow new hair follicles from human skin cells. The new test results are the first breakthrough in 40 years of research into finding a way to regenerate the structures in the skin that cause hair to grow and could lead to radically different therapies for hair loss. Scientists have struggled for decades to to replicate human hair follicles in the laboratory, but the new techniques prove they can be stimulated to grow in skin tissue and made to produce hair shafts.

The researchers claim that instead of the current method of transplanting hair from another part of the body, patients' own skin could be used to produce an essentially never-ending supply of hair follicles for transplant operations.

One of the study's lead authors, Professor Angela Christiano of Columbia University said, "This approach has the potential to transform the medical treatment of hair loss. Current hair-loss medications tend to slow the loss of hair follicles or potentially stimulate the growth of existing hairs, but they do not create new hair follicles. Neither do conventional hair transplants...Our method, in contrast, has the potential to actually grow new follicles using patient's own cells."