Some Personal Habits Can Lead To Hairy Medical Complications

If you haven't had your breakfast yet this morning, perhaps you should postpone reading this. No, it's not a crime story, not another piece about the imminent demise of society. But I'd think you wouldn't have much of an appetite after reading about trichobezoars and the Rapunzel Syndrome.

In that special relationship you and I have developed over the years, when certain things - THINGS of a more unusual nature - come to your attention, it is this column that comes to mind.

Karin Baer, a nurse practitioner in Seattle, recently contacted me with a story about young women who have the habit of chewing their hair. This would be quite a bit more hair chewing than normally is done by young girls in their childhood. I told you, forget about breakfast this morning.

The nurse had read some pieces I wrote about urban legends - the rumored crocodiles in sewers, the rumored black market for stolen human kidneys, the alleged rumor that Bill Gates soon will own 50 percent of everything in the world. Wait a minute, forget the "alleged rumor" part in that last one.

One of the urban legends that has gone around is about a girl dying of a big hairball in her stomach from chewing the ends of her braids.

Tricho, by the way, means "pertaining to hair."

Bezoar is used by physicians to describe a "hardball of hair and vegetable fiber."

So what was breakfast going to be? Doesn't much matter now, does it?

The hairball story is one that has been labeled as false in an urban legends archive that tries to sort out these rumors. Nurse Baer begged to differ. She said a doctor she worked with had treated just such a case.

Now, it often happens with urban legends that somebody says they can provide specific names and proof of a rumor. But when you try to track down the specifics, they have a way of disappearing in a fog.

Nurse Baer said she had the specifics, and that is how I ended up talking to Dr. John Fleming, who for 27 years has been a Seattle family practitioner.

Fleming was in his third or fourth year in practice, he remembered, when a woman in her mid-20s visited him with a complaint about a hard mass you could feel in her upper abdomen. A previous X-ray hadn't shown anything unusual, and liver and spleen scans were normal.

Fleming had concerns the rigidness he could feel in the stomach was a symptom of something serious. He decided to do exploratory surgery.

Then - he doesn't know exactly why - Fleming asked the young woman if she ever ate her hair. Occasionally, she replied, just as a nervous habit.

Fleming was by the surgeon's side as they looked at her stomach. It appeared quite normal.

"We looked at each other and said, `Oh, no.' That's when I realized there was the distinct possibility there was a hairball," Fleming said. "The surgeon made a small incision, opened the stomach, and pulled out this greasy thing, the size of a small banana."

The young woman recovered, although she did feel embarrassed when told what had happened. Presumably she stopped chewing her hair.

In the medical literature, it turns out, there has been some discussion of hairballs and young women, since guys apparently don't chew their hair. Two pediatricians from Turkey wrote a paper about what they called the Rapunzel Syndrome, named after the long-haired Grimm Brothers fairy-tale heroine.

They told of a 2.7-pound hairball that was found in the stomach of a 15-year-old girl and even featured a picture. There is a reason, I've decided, why medical journals aren't for general reading.

Anyway, thanks to Nurse Karin Baer, I guess, for tipping me off to the truth about trichobezoars.

As for you girls out there who get lectured by an aunt about the dangers of chewing your hair, sometimes your aunts are right.

Erik Lacitis' column runs Sunday, Tuesday and Friday. His phone number is 206-464-2237. His e-mail address is: elac-new@seatimes.com