Victoria Yost was just 23 when a diagnosis of non-Hodgkin’s lymphoma overshadowed a promising singing career and the mothering of her three young children. With the chemotherapy came loss of weight, her eyebrows, and her long, dark hair. Then came radiation treatments, when hospital technicians marked her face with crosses to guide them in placing the machinery.
Now 39, Yost recalls being inside the radiation equipment awaiting treatment, and glancing at her hands. Her nails were still strong and beautiful — the only thing left, it seemed, that affirmed she was still feminine, still a woman.
That impression stuck with her through the years and shaped her decision to start a new career. In June 2002, Yost graduated as a nail technician, bringing to her new field a passion and empathy that springs from those dark, difficult years.
“Emotionally, you feel unattractive, unworthy, unwanted,” says Yost. “People who are sick need respect.”
Respect, a sympathetic ear, and human contact are among the many gifts that good nail techs offer all their- clients. Likewise, clean instruments, careful treatment, and a gentle touch should be routine in your practice, but become even more important for your clients with cancer.
Medical Conditions Vary
Although some clients may maintain beautiful nails during the treatment process, others may see their nails go through unpleasant changes.
Portland, Ore.-based dermatologist Dr. Phoebe Rich says nail techs may encounter different conditions among their clients being treated with chemotherapy, depending on what type of cancer they have and which medications they are receiving. Conditions include:
- Brown bands and onycholysis caused by chemotherapy drugs
- Brittle nails that easily bend or break
- Some medications can cause blisters around the nails, especially the toenails
- Temporary loss of the nail
In addition, one of the most important side effects of cancer treatment is weakening of the patient’s immune system, putting them at high risk for infection. “Extreme care must be taken [not to break the skin], especially when performing pedicures,” Dr. Rich says.
Manicure clients should always ask their doctors about nail care, especially if they like to wear acrylics, says Nadene Ashdown Bruders, a cosmetologist and teacher who volunteers with the Look Good...Feel Better program for cancer patients. The technician should also ask the client what medication she may be taking. “Any medication really can change your nails,” Bruders says.
Although many techs report their clients continue to wear acrylics during treatment, you should be especially cautious to apply them correctly. If water gets under them, an infection can set in more easily than with other clients and cause damage to the nail bed.
“Nail polish is fine,” Bruders says. “The only thing is when the client goes in for her treatment, a lot of times she’ll ask you not to have it on a couple of your fingers. This is so the doctors can watch the oxygen supply in her body.” [by seeing the nail bed color]
“We Are Way-Underpaid Therapists!”
Although technicians must be mindful of the medical aspects of their clients’ cancer, the clients themselves usually come to their appointments with emotional and social needs as well.
“They can come here and have therapy,” says Jan Knox, co-owner of Just Nails in Frederick, Md. “In busy salons, there’s no communication, no socialization. I think our clients come as much for the social aspect as to get their nails done.”
Yost uses her intuition to read her client’s mood when she comes in the door. “Try to be non-judgmental. Sometimes she won’t want to talk because she doesn’t feel good,” Yost says. “But if it’s a good day, maybe you need to be all ears. Put on some upbeat music and let her talk. She might not get out much.”
San Diego nail tech Tracey Ousley found that emotional responses to cancer run the gamut. “I had one client with a double mastectomy, and she just wanted to be treated like there wasn’t anything going on She talked about it very matter-of-factly, then I had to guide the conversation off to other topics,” Ousley recalls. “Then I’ve had others who really want to talk about it and you become a sounding board.”
In Yost’s trompe d’oeil-painted salon in Fond du Lac, Wis., she tries to think of extra touches that will make her clients with cancer feel better — subdued lights in the waiting area, luxurious extras, soft music. She rents space to a massage therapist who offers lymphatic massage — great for cancer patients because it helps move toxins out of the body.
Remembering that the weight loss often associated with cancer can leave clients trembling with cold, Yost keeps an electric heating pad by her manicure table with towels stacked on top of it. While she works on one hand, her client can slip the other between the towels to keep warm.
At her cozy booth at Snipz Full Service Salon in San Diego, Ousley takes extra time to give a gentle hand massage, while being cautious with the client’s skin made fragile by medication. She knows her appointment may be something for her client to hang onto while everything else in life is falling apart.
“Sometimes the family doesn’t acknowledge what we are to the client, but we know,” Ousley says. “We are way underpaid therapists.”
Caring for Very Sick Clients
Personal bonds that begin in the nail shop have led Yost, Knox, and Ousley to the bedside of clients who become too sick to come into the shop.
A client with pancreatic cancer asked that Ousley come visit her in the hospital, “I think she knew she was dying and she wanted something that was part of her normal routine,” Ousley recalls. “I just changed her nail polish. I brought in something I knew she would like. And I rubbed her hands, legs, and feet. People want that familiarity of touch with someone they’re familiar with.”
Yost has made such visits a personal mission, working with local doctors and clinics to locate people who need her unique form of ministry. In December, she worked with a local family whose 4-year-old boy is struggling with cancer, giving manicures to the boy’s mother and 8-year-old sister.
“There are so many people out there who need help,” Yost said. “Some people just want someone to spend time with them.”
When one of Ousley’s long-time clients passed away with pancreatic cancer in 2001, she felt depressed. “I had been seeing her since I was 18; she was one of my first clients,” said Ousley, now 40. “I lost more than just a client; I lost a friend.”
It helped her work through her feelings to go to the funeral, Ousley said. And she continues to see the woman’s sister. “Just the other day her sister was in and I told her how I missed her so much,” Ousley said. “Your clients can be healing for you, too.”
The Last Manicure
It’s unusual, but not unheard of: a client who has been coming to you for so long, who is so in love with her beautiful nails that she asks you to give her one final manicure — the one for her funeral.
“Everyone in America needs to know that this service is available,” says Noella Charest-Papagno, a pioneer in the field. “It’s a remembrance of the loved ones. They [the families] have a good closure later on.”
The field of beauty services given to a deceased person is called “desairology,” and is usually done by the funeral home.
However, it is legal for a nail technician to do this work; check with your state board for any regulations specifically concerning desairology. Papagno’s Beauty Caregiving and Desairology.
Center offers distance learning and registration for licensed nail technicians interested in the field. Papagno offers a designation form that the salon client can sign and which the family can later use for the funeral home — but Papagno warns that the nail technician may have to overcome resistance from the funeral home.
At the El Camino Mortuary in San Diego, funeral arranger Andrea Limon said the family can let the funeral home know about any special arrangements they want to make for the deceased person’s nails or hair. In such a case, Limon says, she would talk to the beauty professional about the situation first. “Once we determine that they’re OK with the idea of working “on a deceased person, they just come in and perform whatever job they’re coming in to do,” Limon says.
The work can be done in the repose room, instead of the preparation room where the body is actually embalmed, Papagno says.
In her book, “Handbook of Desairology for Cosmetologists Servicing Funeral Homes,” Papagno describes the simple steps for applying nail polish. She suggests using a white nail pencil under the nail when using a clear, pale pink or beige polish. If the deceased person has arthritis, the hands may curl up; ask the funeral director to help you hold the hand flat.
Acrylics can also be applied if one or two extensions are missing or if they need a fill, Papagno says. However, a technician may not have enough time to do a full set before the viewing.
Cosmetologist Nadene Ashdown Bruders fixed the hair and did the nails of a deceased client many years ago, and cautions that feeling the cold face and hands of a person who used to come to your shop can be unnerving. “I would never want to do it again,” Bruders said.
Trina Kleist is a freelance writer based in San Diego.
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