Michelle

The first time I met Michelle was about three weeks after she had had a mastectomy. She came in with her 'support team' which was her best friend and confidante.

This is what she said:

"I'm going to lose my hair because I have to have chemotherapy. I really don't want to be here. To be honest, I feel physically sick at the thought of being here. When I was told that I had breast cancer I went numb. I was told that I would have to have a mastectomy and after that I would need a course of chemotherapy.

I don't remember much of what was said - I was traumatized. But when I was told that one of the side effects of the chemotherapy treatment would be total hair loss, the floodgates opened. I could not handle those words. You know, the thought of losing my hair is the worst fear I have. That must sound so stupid, I don't know why I think this. Has anyone else said this to you?"

Nearly all my clients express this fear. I explained to Michelle that losing your hair is like losing the frame around your face. Take away your hair and you feel vulnerable, unfeminine, exposed and your self-esteem just goes.

Michelle agreed, "That's it exactly! I thought I was irrational thinking that way."

I told Michelle that her fears were quite natural and I began to explain to her what was about to happen to her hair. I could see that she was getting distressed. Her eyes were filling up with tears. She apologized for allowing me to see her like this. I said that it was a totally natural emotion - this was her worst fear after she had been told she had breast cancer. I don't think Michelle felt sorry for herself, her thoughts were for her children her partner, and then perhaps, herself.

I asked Michelle what kind of image she would like to portray to the world. She told me, as thousands of women have said before, "Laurence, I just want to be me. I am going through the most difficult experience in my life and I just want to look like me."

Michelle told me that she had two children, aged ten and thirteen. Her fear was that they would be frightened at seeing her without hair. Because I get to see my clients up to a year after their first visit, I can relate to her the experiences of others.

You must share with your children what is about to happen and tell them in a confident way:

"Mum is going to lose her hair because of the treatment that she is undergoing, but its ok, I'm going to have new hair and my hair will grow back as normal. I promise that when I pick you up from school, your friends won't notice anything different."

Hiding your hair loss from your children, who have a habit of walking in unannounced when you are unprepared, could be devastating for them. It is vital that they know in advance and they see you without your hairpiece. Kids are very resilient, providing they are told in advance.

A nice way to of overcoming their fear is to allow them to massage your scalp after your hair loss with vitamin E oil. It is a way of bonding with your children, or partner and sharing with them a lifelong memory of being with you and being a part of this temporary trauma in your life.

I looked at Michelle's hair, the shape, the colour and texture. My job was to make Michelle look no different than she is now. I explained that she would possibly go pale or flushed from her treatment, so the colour of her hair piece would be very important. The shade of her hair piece should not be different from her own hair colour but it was very important that we go for softer tones avoiding ash colours.

Next, Michelle's head size. We measured Michelle's head. It is always vital that we get this right, for if the fit is not perfect she would not feel confident wearing the hair piece. If this happened, I know she would lose her confidence and would not want to be seen in public. She would not want to socialize and carry on, as much as possible, her normal life. She would possibly withdraw within herself. That, surely, could not make her treatment any easier.

I tried on a hair piece as close as I could get to Michelle's image. I explained that in all cases the hair piece would need to be styled, trimmed and personalized. But I could not do this until she allowed me to cut off all her remaining hair.

When you lose your hair, the scalp is white, so we must be able to shape the hair piece to cover up the pale hairline.

Sixteen days after her first treatment, Michelle experienced hair loss and phoned for an appointment. When she came in I looked, and yes, it was coming out in handfuls. With her permission, I cut off all her remaining hair.

I made eye contact with her for the first time since I started cutting and asked her if she was okay. "No! But it's not as bad as I expected." She did look vulnerable - with no hair and her white scalp exposed -and for the first time, she could not deny her condition to the outside world. I related a conversation I had had with a previous client who was going through similar experiences. She had been going to the gym two mornings a week and stopped while she was on chemotherapy:

"I had to change, accept the things that I could not do. Instead, I focused on the things that I could do. The road to recovery is the future. I must not dwell on the past. I know I cannot change the past, but I can certainly change and look to the future in a different light."

Now for her new hair. I put on her hair piece and asked Michelle not to respond until I had cut and styled it. When I finished she said, "Amazing, I look like me again!" I demonstrated to her how to put on her hair piece and explained the maintenance required. Within a few minutes of practice, Michelle could put on the hair piece correctly. The rest was up to her; she now had to face the outside world. I was not going to see her for six months.