The best conditioner for the hair is natural sebum or oil that is present on the scalp. The main purpose of conditioners is to apply the ‘sebum’ where it is needed, which is generally at the ends of the hair rather than at the roots. Conditioners also make the hair smooth and shiny, and decrease the electrical charge that tends to make it frizzy. Some conditioners also contain protein which penetrates into damaged hair and temporarily mends the damaged surface.Chemical processing causes significant damage to the hair’s outer coat, which is called the cuticle. The cuticle is what makes the hair smooth and shiny, and stops frizziness. Once the hair has been permed, dyed or even excessively blow dried, the cuticle is destroyed, and split ends occur. A good conditioner will cover each hair with a film which replaces the function of the cuticle. If conditioners are not used often enough, the hair tends to become dull and frizzy. On the other hand, if they are overused, the hair becomes greasy and limp.Chemically-processed hair will benefit from a conditioner which contains protein. This will penetrate the hair shafts, protecting them until the next wash. Conditioners which you leave on your hair can also be used to make the hair less frizzy and shinier. They can also temporarily mend split ends.Conditioning treatments, which are left on the hair for a prolonged period, usually about twenty minutes, penetrate the damaged cuticles better and often make the hair appear healthier. These can be used once a week as a ‘treatment’.
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Headaches are extremely common. In most cases, headaches bother the person who has them far more than they bother the physician who treats them. This is because headaches rarely indicate severe or progressive disease. Most headaches occur when the muscles that cover the top of the skull contract. These headaches, called tension headaches, occur off and on in everyone. They go away either by themselves or with simple drugs such as aspirin, acetaminophen, ibuprofen, or any of a multitude of drugs that contain combinations of these drugs. A less common but more painful type of headache, called a migraine or a cluster headache, results when the arteries of the scalp contract. These headaches may be severe, may involve only one side of the head, and may occur along with nausea, vomiting, and changes in vision. Such headaches tend to recur and often require prescription drugs that relax the contractions of the arteries. Another common cause of headaches is a generalized illness such as influenza or infections in the sinuses or ears. Sinus headaches are especially common in people with HIV infection, who frequently have sinusitis. Finally, headaches may result from certain drugs, including AZT, trimethoprim-sulfamethoxazole, rifampin, ketoconazole, amphotericin B) and acyclovir. All of these headaches go away by themselves, leave no impairment behind, and do not indicate any serious underlying disease. Certain headaches, however, require a doctor’s attention. Like other focal neurologic symptoms and like fever and stiff neck (see below), headaches can be a symptom of an infection of the brain or the meninges. Headaches associated with infections of the brain or meninges have the following characteristics:1. They are unusually severe or last unusually long.2. Either the character of the pain or the location of pain makes the headache different from headaches the person usually has.3. They occur along with problems with vision.4. They occur along with weakness of an arm or leg, with dizziness, or with impaired coordination.5. They occur along with stiff neck, nausea and vomiting, or extreme lethargy or sleepiness.6. They are severe and occur along with an unexplained fever. The major infections that cause such headaches in people with HIV infection are toxoplasmic encephalitis and cryptococcal meningitis. Both these infections, as well as a multitude of other infections of the brain and meninges, are relatively easy to diagnose. They are also treatable. A less common cause of headaches in people with HIV infection is lymphoma.*131\191\2*
A spinal cord injury is a very visible disability. Unlike a person with diabetes or heart disease, you cannot hide your condition. A wheelchair or crutches, and any changes in physical appearance, are immediately apparent to others. The ease or difficulty of adjusting to disability depends not only on your own emotions and actions, but on other people’s reactions to your changed appearance.How you look to others is likely to be on your mind from the early days of rehabilitation. And how you cope with social responses to your disability is important to your success in living with a spinal cord injury.
StigmaPeople with visible disabilities are often stigmatized by cultural beliefs and language and treated as if their disabilities were a mark of disgrace, social inferiority, or moral or mental abnormality. Such prejudice generally arises from fear or anxiety. To ward off their own feelings of vulnerability, many people use stigma to separate themselves from “those disabled people” and thus to feel protected and secure, certain that they could never be “one of them.”Unfortunately, this prejudice is manifest as discrimination in jobs, education, and socialization, as will become more apparent when you leave the hospital and attempt to reenter the “real world.” But even during your inpatient rehabilitation, you need to understand that fears of social rejection and concern about how you look to others are based as much in social reality as on your own anxieties and altered self-esteem. Even if you feel great about yourself, others may be awkward, uncomfortable, or frightened by your disability.
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