BYOB: Bring Your Own Bell

Today is my last infusion and it was BYOB. Bring Your Own Bell. The infusion center doesn’t have a wall bell so we are making sure I have my own little celebration.

And the day started off celebratory right from the beginning, with texts from friends and family celebrating this moment with me.

This infusion is my “last chemo” though actually it’s not technically chemotherapy. The medication is called Herceptin, or Traztuzumab, and it’s considered a targeted therapy. Patients with HER2+ breast cancer typically do one year of this medication to prevent recurrence.

But it’s another one of those survivor milestones. A big one. After today, I’m no longer considered in “active treatment” (though I have 5-10 years of oral meds to take). Today I get to ring a bell- and then more importantly, toss (read: burn) this poor white v neck t-shirt I’ve worn every third Friday morning for a year.

I knew Matt (husband), Oli (son), and dear friend Peggy were in the lobby, waiting to join me in celebration. And then we’d head to brunch with a few other friends as well. I was wearing my “brunch pants” (aka party pants).

When I walked out into the lobby I was surprised with even more of my friends, multiple bells, and pink hats that read’ “BELL YEAH!”

I was so overwhelmed by the love.

These women (and others who were there in spirit) have been with me through the hardest year of my life. What a huge blessing this has been. They came with BELLS ON, literally.

Of all the things this year has taught me, celebrating the moments & creating our own joy is the highlight. Sometimes you just need to bring your own bell.

That Little Red “1”

There’s no jolt of caffeine or energy that can mimic the adrenaline that courses through you when you see the Little Red “I” Notification.

A new test result.

It’s hard to believe it’s been a year since my diagnosis, but it has— and that makes it time for another mammogram. I’m only 12 weeks out from my last surgery, and still have one infusion of Herceptin left, and still have 5 years of aromatase inhibitors to take. And yet- it’s time.

This time it’s a 3-D mammogram (and it’s right breast only, since I had a mastectomy and implant on the left). The appointment took just 10 minutes. And then I put it out of my head for days. Packaged it neatly in that little box in my brain marked, “Panic! Cancer-related info.”

Then the day comes and there’s a little red “1” on the medical app. Heart racing, brain spinning. I think, “am I ready for this? Please please please, no cancer.” And I open the notice.

I quickly scan, looks ok. Read more thoroughly. It’s good news. No cancer. And that’s where I stop for today.

Fashion Show? Who Knew!

For the past year, i’ve been so lucky to be part of a weekly Breast Cancer Support Group. We meet online every Monday evening and share the ups and downs of this journey of cancer survivorship.

This Spring our facilitator encouraged a few of us to participate in a fundraising effort for breast cancer. We were all nearing the end of our “active treatment” phase (chemo, surgery, radiation) though many of us have 5-10 years more of cancer related medications and procedures to look forward to.

The fundraiser is for an organization called To Celebrate Life, and it provides funding to Bay Area nonprofits which provide emergency & financial assistance and direct services for underserved patients struggling with breast cancer.

The event itself is called Stepping Out*, and it’s a fashion show in which the models are all recent breast cancer survivors. I thought, “sure, that sounds like something I’d like to be part of.”

Little did I know what I’d be getting in to! This is a months-long annual effort, powered by so many dedicated volunteers, the majority of whom are breast cancer survivors themselves and former “models” for this very event. And this is the 30th anniversary of the event.

Last weekend we gathered for six hours of training on runway-walking. This weekend is another six hours, and next weekend is the dress rehearsal and the main event. We’ve discussed turns and poses and shoes and timing and staying right and doubles and chevrons….

It’s been so fun, and so life-affirming. Yes, because [as our Model Coach Lisa says] we are practicing being embodied… walking confidently, shoulders back, broad smiles on faces.

But it’s not just that. I’m drawn to these women. We’re sharing laughs at eager rose tossing. We’re appreciating each other’s newly grown chemo hair. We are helping each other walk faster or slow down (ok, that’s me- and thanks, Geri!). We are feeling the levity in the room. There is only positivity.

As I’m learning, it’s another version of the Joy that keeps showing up when I look for it. I’m so grateful for these women and for the opportunity to take a risk outside my comfort zone.

Stay tuned for Fashion Show photos after next week’s event (Saturday 9/27); in the meantime enjoy our rehearsal pics!

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* I had so much support from my friends and family along the way. I get teary just thinking about it. I can’t imagine enduring this past year without the meals, notes, errands, visits, gifts, and… the list goes on. But many women don’t have the same support, for a variety of reasons. If you’d like to support this effort for those who need assistance please check out my fundraising page. Proceeds from my fundraiser as well as the Stepping Out event go directly to Bay Area nonprofits serving women with breast cancer. Thank you!

https://wl.donorperfect.net/weblink/weblink.aspx?name=mbcc&id=102&cfifid=175

Peeking out from “backstage”

Someone may have tossed a rose too early

Tricky; a double meets a chevron

“Do we stop halfway?” The eternal question.

Methinks Zoe has done this before. #pro

I haven’t met a chevron I didn’t love.

Another chevron! Woot!

Supporting each other.

Where are the Tall Gals?

Getting ready for the super fancy double turn.

Last instructions before the full run-through.

Loving it.

Second-to-last Infusion Musings on Stress

I’m already running late; I left the house with 13 minutes to get to the infusion center which a 15-18 min drive away. My husband jokes that I think everything in SF is 10 min away (he’s not wrong. What can I say, I’m a glass half full gal…)

Of course then I hit traffic along the way. And/but I had my 432 Hz frequency music playing, which audibly reminds me to breathe. It’s a cue to pause, remind myself “this is not urgent. People run late all the time.”

Then I arrived at Kaiser (the medical infusion center), and the parking garage was slammed. I circled multiple times to find a spot. “It is what it is, I’ll do the next best thing” I told myself. This mantra works for me in most stressful situations.

I stepped into the elevator and pressed 8 for the top floor. Others got in and pressed 2,3,4,5, and 7. Of course they did. I tried not to sigh aloud, but I might have. (Also: why do elevators have a “door close” button when it doesn’t help the doors close any faster?)

The 8th floor Infusion receptionist is one of my favorite people- she’s always so positive. “So sorry I’m late,” I apologized. “You’re here, and it’s a clean slate!” She said with a smile.

My infusion nurse greeted me and got me set up for my second last Herceptin dose. “I remember you,” she said. “You have a great port!” (I love chemo and cancer compliments; they’re so specific and appreciative. I was also recently told I “have great ears for a short haircut” which made me giggle).

Now it’s quiet, my infusion has started. And I’m sitting here thinking about the morning and how my perspective is starting to shift. Perspective and positivity were important to me a year ago, but they are now absolutely front and center in my life. They are not just things I wait for, or hope for, or value— they are things I employ. They are no longer nouns, they have been glued to a verb. There is a centeredness that comes from noticing when I actively interrupt my own patterns of stress and intentionally choose a calmer path.

Let’s be clear— no one will ever call me a calm person!— but it’s nice to notice another silver lining to this past year.

In the chair, and with a nice view today!

And done! ONE INFUSION LEFT!!!!

Chemo Supplies: A Prep List

Starting chemotherapy is a big deal in so many ways. It’s terrifying, it’s anxiety-provoking, but it’s also exciting in a scary way. You have no idea what to expect but you know it’s the first step in this phase of your survivorship journey.

As a type A person, I had been carrying a notebook with my daily, jotting down cancer-related questions or learnings on the fly. I had a running list for each doctor plus a list for a few friends who had been through this before me.

One of the lists I ended up creating was an “Infusion Day Go Bag” list. I began this a few weeks prior to chemo as I started learning what I would need to ensure the best possible outcome.

Here’s my list; keep in mind this is specific to Breast Cancer and yours may differ depending upon your type of chemo and your personal needs.

  • Take any necessary morning meds before going to infusion (in my case an oncology pharmacist called me in advance to talk through which meds I’d take and which ones I’d pause for chemo)

  • Many people put lidocaine on their port an hour in advance to numb it. I never did, but it goes on the list.

  • Cold cap bag (includes cold cap itself and toiletries to help with putting it on. If you are cold capping be sure to arrange this in advance as these differ widely in how you use them. And practice putting it on twice in advance)

  • A long scarf you don’t care about in case you need to tighten the cold cap from your head to your chin.

  • Cold mittens and booties (similar to cold cap, but here they prevent the chemo from causing neuropathy. See links below. And get extra ice packs to switch out if you have a long session)

  • Medium sized cooler with ice packs for keeping extra ice packs cool

  • Ice Popsicles (to ice the inside of your mouth. I learned this one the hard way and got terrible mouth sores after the first chemo. It’s the same concept as cold cap and booties- protect your mouth lining! I made popsicles of ice or electrolyte water. Some nurses will bring you ice to chew on if you ask, too)

  • Heating blanket (to keep the rest of your body warm)

  • Readers if needed (my glasses sides did not fit over my cold cap but readers had more “spring” to them)

  • Books or kindle or iPad if desired

  • Cheap stylus with rubber end (to use for iPad and turning book pages when you have mittens on)

  • Air pods or headphones

  • Chargers

  • Journal and pen

  • Water bottle with electrolytes (I love LMNT, see below for discount link)

  • Snacks (the infusion center only had crackers and juice- I was on my FMD so I brought a thermos of soup or friends got me green juices)

  • Wear comfy clothes (I wore the same v-neck tee each time and plan to burn it in celebration at my last infusion! I also wore a cozy wrap sweater given to me by a friend who went through chemo herself. And wear a bra that makes it easy to access your port)

  • Change of clothes- just in case

  • Easy slip on shoes (in case you need to remove booties and use the restroom. I had fuzzy birks)

  • Beanie for post chemo (wore this after I started losing some hair- the bamboo snood from headcovera was really soft and cozy)

  • A basket or small open container where you can put all of the things you want to easily reach- and this can sit on the side table of your infusion chair. Mine contained iPad, phone, water bottle, stylus, pen, journal, and a snack.

  • Snacks for the infusion nurses. You don’t need to do this but they have a tough job and are often understaffed so I’d bring a box of donuts or bao or energy bars most times.

Most of these things I kept together as a “Go Bag” and after the second round it was like clockwork.

Supplies referenced above:

This poor v-neck tee has been pulled in every which way. But it was easy to access the port for my infusion.

Ice mittens make it very hard to do anything. But I never got neuropathy in my hands, so they worked.

Ice booties are thé worst. I hate cold feet even more than I disliked the cold cap. But I kept them on most of the time. I did experience some neuropathy towards the end of my rounds of chemo, and then became a little more rigorous in keeping them on during treatment.

Improving Chemo: My Fasting Mimicking Experience

When I started chemo, I was nervous and eager to begin treatment. There was so much to think about and prepare for— medications to take in advance, a hair-preserving cold cap to figure out, and lots of supplies needed for infusion day.

I had heard about the Fasting-Mimicking Diet (FMD) and how it could be beneficial during chemotherapy, but I didn’t have the mental bandwidth to figure out how to incorporate it into my treatment process.

After my first infusion was in the rear view mirror, I felt I had more capacity to learn something new and began looking into a Fasting-Mimicking Diet (FMD). FMD allows cells to activate their repair functions, similar to fasting, but without the severe restriction of fasting. This short-term dietary change, I found, could be potentially increase the efficacy of my chemo and also reduce the toxic side effects. Those both sounded worth looking into.

For my subsequent rounds of chemo, I decided to use the FMD, beginning two days before my infusion and continuing for one day afterwards. I used a number of sources* to build a plan for myself— understanding that most FMDs call for restricting calories to between 600-1000 per day, and focus on high fat and low protein.

Using the FMD, I noticed less nausea during my “worst” days, and overall, tolerated chemo fairly well. I also liked having something proactive I could do that could possibly help my treatment.

I ended up doing a 4 day FMD that was 600 calories, using an avocado-berry shake in the morning, a vegetable blend soup for lunch, and a leek and cauliflower saute for dinner. I never was too hungry and could imagine myself starving the cancer cells so they’d be stressed enough to be eradicated by the chemo.

Obviously I’m not a doctor nor a nutritionist, but as a patient I found the FMD useful. I did end up having a complete response to my chemo which I attribute in part to my dietary changes that included the FMD before each infusion.

I plan to continue using FMD as a way to reset my body at a cellular level, probably every 3-4 months. I just completed a 5-day FMD using Prolon, and will likely use this again at some point. I’m continuing to learn more about this and will add a post later when I have more remission experience with FMD.

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*A few of the many sources I used to learn about FMD and build my own menu:

One Year Later / Lara 2.0?

Today is exactly one year since my diagnosis. I remember— it was a Monday, and I took the call between meetings. I can picture where I was standing in the house and the quality of the light near my desk.

Yet here I am. It almost seems like a lifetime ago. I’m sitting on my sofa, in front of my fake fireplace, another warm glow, and enjoying a cup of coffee. Thinking about how much has changed.

A year ago, Anxiety lived with me 24/7. It set up shop and probably helped me power through the whirlwind of doctor appointments. It certainly kept me on task with researching my disease and what could help. It made me singularly focused.

Now, I have a new appreciation for peace and acceptance in my life. The simple phrase “it is what it is, you’ll do the next best thing” has become my mantra. I’ve also learned to regroup when I feel Anxiety knocking at my door; I move, I breath, I listen to 432 Hz. My therapist told me “anxiety lives in the future” so I work on connecting to the present. As a cancer survivor there will always be the “what if” question of recurrence- but fearing it doesn’t change a thing about what is or is not. And so the more I can choose things that bring me joy, the better I’ll feel, and the more connected I’ll be.

A year ago, and before my diagnosis, I may have been considered a high-strung person. I’m driven, have high expectations of myself and others, and wanted everything to be the best it could be. And there’s nothing wrong with any of that, in my opinion. Except that for me, this often created a level of stress in my life that was unhealthy, despite how “healthy” a person I was.

Now, I’m working hard on prioritization, increasing my perspective, and using my empathy in a new way. This means I’m asking myself “in the grand scheme of things, does this matter?” And “what’s the most important part about this?” And other similar queries. I can actually feel the lowered frustration and the increased access to humor and joy.

Sometimes I wonder how different I feel to others, now. Do I still seem like “Lara”, the one they’ve known?

I’ve heard versions of this from many cancer survivors- there’s an in-between phase. You’re not the old you, but you’re not done processing what you’ve gone though. The new you is still developing.

Stay tuned for Lara 2.0. We hope you’ll like the upgrade.

Just a photo of the Bay. Seemed appropriate.

Swimming For The Win

Yesterday I swam for the first time in more than a year.

I had been awaiting the “all clear”after my most recent reconstruction surgery. My surgeon had initially said to wait 12 weeks, but at my 10 week post-op appointment I was told I was good to go.

This would normally be very exciting news, but it’s extra exciting given that my glute and joints don’t seem to appreciate my other regular workouts. Swimming it is!

I felt like I was packing for an adventure as I gathered my goggles, found my swimsuit, and packed toiletries. I even remembered my flip flops. Woohoo!

I jumped in thinking, “let’s hope this is good…”

It was SO GOOD. That crisp water feeling, the smooth pull, the rhythm. The gliding.

Oh! And the other swimmers. I used to be bothered by people who went slow in the medium lane, or fast in the slow lane, etc. Now I’m just happy to be there, to be moving without restriction. I felt so much gratitude in swimming that even my thoughts were kinder. Fascinating!…and I plan to cultivate this new aquatic mindset of mine. I had a feeling that this year had taught me more patience and perspective and this is a tangible example.

I used to swim at least one mile each time I was in the pool. I knew that wouldn’t happen this time, and was curious how far I could go/ how long I could last. I hadn’t even finished my usual warmup set when I sensed that “noodly” (as in, wet noodle) tiredness setting in. My inner monologue was conflicted:

Me: “you’ve got this, Farrell!” (Always maiden name when sports-related pushing)

Also me: “Lara! Don’t be stupid. You finally found something you can do. Quit while you’re ahead!”

Yup, me: “You can definitely do one more set. Tiredness is not the same as pain. Let’s go!”

Me again: “Yeah, but- how sad will you be if tomorrow you can’t work out?”

It was that last thought that got me. I’m sort of famous for what I call Enthusiasm Injuries. (Why do 60% when you can do 100%? Well, because our bodies were not meant to go full throttle at every moment). So I stopped and called it a day. And patted myself on the back. So mature, Lara. Look how you have evolved this year.

Post-swim, walking home from the Stonestown Y through Stern Grove park. Pool-hair-don’t-care.

Normally I’d cringe at a 22-min swim. But I’m literally celebrating it, and I feel great the day after this workout.

Joint Pain Sucks :-)

I’m sitting in the sauna, trying to get comfortable. Yes, I have my phone with me. Because sometimes self/care looks like 432Hz Miracle Tones on Spotify while you manage your to-do list and reflect on your current situation. :-)

Current Situation: I’m cancer free, I’m in remission, and the Bell’s Palsy from nearly 5 months ago is probably 75% better. I’m eating healthier than ever, I no longer drink, I move & workout every day. I take a ton of supplements (debatable I know, more on that later). I have about 2 hours of other self-care I do each day to maintain my remission and help my facial recovery.

By no means am I sharing this to for a pat on the back. I’m merely mean it feels like hard work- but worth it. I’ve always been a physical person and my bodily wellbeing really impacts my mental, emotional and spiritual self. I’m nearly done with my active treatment (only two super easy chemo infusions left, woohoo!).

And I have been really looking forward to swimming and running and other endorphin-creating movements. I’ve been counting down the weeks from my most recent surgery.

But my newest ailment, joint pain, has thrown me for a loop. It’s a real doozy.

if you asked me a few months ago, I would’ve said I could handle a side effect like joint pain*. (Joint pain?!?! Whatever! No biggie! Just power through it!) But it is shockingly, annoyingly painful. And shockingly ever-present. And annoying to talk about.

Getting veggies out of the bottom drawer of the fridge? Ouch. Doing squats? It hurts AND I need to brace with my hands. Getting in and out of the car? WHAT THE HECK. (See? Annoying to listen to someone talk about.)

Let me also acknowledge that I know I’m lucky to be a cancer survivor and I’m lucky this is what I will deal with. AND it still sucks.

So now what? Well that's the question. It doesn't seem like there's a clear straightforward answer, other than not taking the medicine that prevents cancer recurrence and/or taking HRT which is considered contra-indicated for me. Bah. So I'm doing my research. I’m continuing to move. I'm trying some things. Let's see what I find.

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*The joint pain comes from two main sources- being slammed into menopause after chemo, and from taking aromatase inhibitors to prevent my body from incorporating any remaining estrogen-since my cancer was “estrogen receptor positive.”

A long walk to Fort Funston this weekend, in hopes that movement is therapeutic for these sad, silly joints.

Things Can Only Get Better

Today started with literal rays of sunshine. There’s something about this time in San Francisco… Late August through October, when we start to see a hint of “real “summer it just makes it easier to joy (yes, I made that a verb).

I arrived at my personal training session to find golden light, illuminating the view of downtown and dancing off the Golden Gate Bridge and the Bay. Not too shabby a way to begin a workout.

The workout was great, as always, and I had my best breath work yet. It feels great to be feeling strong again.

It also feels great to have some weights lifted off my shoulders. The main milestone on my mind was a brain MRI. Because I developed Bell’s palsy soon after chemo and my surgery, there was a question about possible spread to the brain having impacted my cranial nerve. However my tissue expander from the first surgery contained a magnet and therefore excluded MRI as a possibility to exploring this. Now with my implant safely in, I could have the MRI to [hopefully] rule out any structural brain issue.

I had the MRI yesterday, and while driving home from it, got the “you have a new test result” notification. Heart racing. Internal monologue: Do I pull over and open this now? Am I ready? It is what it is, Lara. You’ll always just take the next best step. Knowing is better than not knowing.

Spoiler alert: my brain is normal. Yay!!!! And I had thought it would be, but the trauma response of this stuff is so real- you want to be positive and manifest a good result, and at the same time not set yourself up for disappointment (or worse, “jinx it”). So I’m smiling wide this morning- partially because the Bells Palsy is improving every week- and partially from sheer relief.

Another weight I’m making a conscious effort around is being back at work. I love what I do, and I’m so very glad to be back. AND I’m clear now that I need to ensure any work stress stays where it should- and that I focus on the real priorities. I think this will make me an even more effective leader. Cancer and this year’s journey has been a blessing of perspective.

My perspective now: things can only get better. (Cue Howard Jones)

Lovely light at this morning’s training session. (Presidio Tunnel Tops)

Post-Chemo Growth aka Halloween Hair

I’ve recently realized that the “awkward stage” my hair is in is perfect fodder for Halloween costumes.

It’s now maybe two inches long in most places, grey/white down the middle, and stands up straight off my head with little coaxing.

My first thought was to play on the color and do Cruella De Vil (101 Dalmations). But next I realized the puffiness lends itself more towards the evil kid from The Incredibles (“Buddy”). Or maybe the Heat Miser? (I’m surely dating myself on that one.)

I’m now finding this all very funny and sourcing all possible characters. More options needed. Please advise. All submissions will be reviewed with the utmost attention.

Cruella De Vil- I can rock the white streak. And my remaining Bell’s palsy may work for her evil grin.

Buddy from the Incredibles. My hair does exactly what his does, would just need some red spray color. The body suit is debatable, but I love a good cape. And the eye mask?- awesome.

I could certainly pull off the hair but I think the nose would give a clown vibe, and that’s too creepy, even for Halloween.

Joy & Pain: Joy is More Fun

I thought it was the run. Simple. A run brings me joy.

Last week, my younger son and I decided to be accountability buddies for running. We’d head to Ocean Beach once a week to train. Our first session was a giant success- he felt great and so did I. While running, I started to think… “I’m back.” I felt a bubble of joy travel up my throat and nearly giggled while running.

It’s easy for me to get excited. I like thinking about possibility. It’s the “taking it easy” or employing restraint that is my challenge.

While my brain is excited to run and do ALL THE THINGS, I have to remember that I’m only 5 weeks out of a second surgery and also, my body is sort of falling apart.

Back tightness, hip pain, the beginnings of plantar fasciitis, and oh the JOINT PAIN. It’s like I’m a 50-something trapped inside a body with the joints of a 95 year old. Bah! Pain is so mundane.

But then- my smile is returning. The Bell’s Palsy is slowly but surely getting better. This brings me so much happiness I can overlook the “ow!” each time I put my left foot forward.

But I’m slowly discovering there are other physical things that are bringing me joy.

I’ve been using battle ropes with my trainer, Keir- and I love the feeling of trying the move. And then sort of getting it. And then actually getting it. It keeps me silly and trying and wanting more. Joy in the trying and the growing and the achievement.

And I’ve started using The Class- a platform with workouts and classes that engage the heart and mind. I can’t tell you how many times I’ve found myself smiling while dancing or moving to the beat- this practice is special.

And a beach walk with friends, talking about our lives and what brings us joy. how to focus on it in our every day lives. We started a shared list of these things- which in and of itself brings me joy. I guess this is what people mean when they talk about “being present.”

And most interestingly, I’ve started paying attention to what joy feels like in my body:

It’s like suppressing a giggle.

It’s a warmth.

It’s seeing your kiddo happy or grateful.

It’s a well-timed meme from your partner.

It’s a poem that invites and resonates.

It’s a shared belly laugh with a friend you haven’t seen in a while.

It’s finding something funny in a very quiet room (this is my experience of church as a child)

It’s an eager peacefulness.

It’s surprise mixed with love and beauty.

I was recently meditating, and the guide reminded us to categorize thoughts as thinking or feeling, and then let them go. I had the thought that I was “getting really good at this meditation thing” and then immediately had the thought that “it was pretty funny that I was thinking about being good at not thinking.” That bubble of laughter that arose in the back of my throat is my favorite version of joy.

So I’m focusing on mitigating the pain, but I’m even more focused on experiencing the joy. It’s just more fun.

Battle rope view. Presidio Tunnel Tops.

Running with my kiddo, at Sunset Dunes. He left me in the dust and there’s joy in that, too.

Beach walk with friends, discussing joy. Ocean Beach.

Cardio Flush with The Class, so much joy. Smile returning!

Preparing for Your Mastectomy- A Timeline

I just had another conversation with a friend planning her mastectomy. It’s wild to think that in the five months since my own surgery, I already know four friends or acquaintances who will soon go through this as well.

The first thing I’ll say is- you’ve got this. It’s hard, physically and emotionally, but you can do it. You truly just take it one step at a time, and then it’s over before you know it.

Depending upon your situation, you may have more or less time to prepare. Because I had neoadjuvent chemotherapy, I had a lot of time to think about my surgical options (too much time, frankly; I worried about it before it was practical to do so).

I ended up having a single mastectomy with a tissue expander inserted, and then three months later, an “exchange” surgery to remove the tissue expander and insert the implant. I’m five weeks out from that second surgery now- feeling great- very active (running, jumping, but no pushups yet).

The surgical plan you have will be tailored to your specific situation or treatment. I’m sharing my own experience here, along with the resources I found helpful. And thanks to a conversation with a friend, I’m doing so in chronological order of the weeks leading up to the surgery(ies) for ease of planning. You can adjust the timeline as needed, or compress if you have less time.

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Two Months Before Surgery

Schedule Dental Work: if you’re due for a cleaning near the time of your mastectomy, it’s recommended to push this forward or back. Even a regular cleaning can disturb bacteria and increase chance of surgical infections. As soon as I had a ballpark date for my mastectomy, I scheduled a cleaning for six weeks prior.

Arrange for Help: I knew I’d need physical help and emotional support right before and after my surgery. My sisters and my mom took turns coming to stay with me, and covered nearly two weeks of support. I’d say the minimum is having someone with you from the day of your mastectomy through the next 3-5 days. I had a single mastectomy, which means I could still use one arm, and it was my dominant hand. I could do a few basic things. But if that were reversed or if I had a double mastectomy, that would have been even harder, making a helper even more important.

Discuss Plans With Oncology Surgeon & Plastic Surgeon: this is probably a no-brainer, but these doctors are there for you; they should provide your options and perhaps recommendations, and together you will come up with the best plan for you. Despite this, I remember experiencing a very low point when I felt so discouraged- choosing between “no good options.” At the urging of a mentor, and because I had so much time, I shelved the decision-making until the procedure was closer (after I completed chemo). When I resumed thinking about it, I ultimately chose to go single (v double mastectomy) and silicone (v saline implant) and not touch/augment the other breast. My rationale was that I was making the best decision for me for NOW. I could always later make a new best decision if needed. (Breast cancer does not “spread” to the other breast- if I were to get cancer on the right side, it would be a new primary cancer, and that would be a new decision to make.)

To get to this plan, I asked a LOT of questions. (So many that when I woke from my second surgery, my surgeon reported to my husband that I was doing great and “already her asking questions.”) I also talked with a number of women who had been through this process- there’s nothing more helpful that hearing someone’s personal experience. See far below for some of the questions I discussed with my doctors.

One Month Before Surgery

Be Done with Dental Work (see above).

Discuss Supplements: my breast care team had a nurse navigator and doctor who spoke with me in advance about supplements I was taking, and which to avoid for the week prior and after surgery. Things I paused included tumeric, vitamin C, magnesium, protein powder, and my AG1 greens drink. I resumed them all a week after my surgeries.

Determine Implant Type (if applicable): since I decided to use an implant I needed to confirm my choice of silicone or saline. Some people are able to/choose to use their own body’s fat to reconstruct the breast, and some choose to not reconstruct and remain “flat.” I knew my first choice was implant and my backup plan was flat. That said, a week prior to surgery I saw my plastic surgeon and changed my mind; I ultimately ended up with a saline implant and i’m very happy with my choice. There are pros and cons to each of these options, as you’ll learn. It’s a personal choice.

Order Medical Chair (optional): in retrospect this may have been overkill but I’m still glad I did it- I rented a post-surgery recliner that also pushed forward to assist with standing. The first few days of sitting down and standing up can be scary and painful, and this really helped. I also slept in the chair (fully reclined flat) for a few weeks at night so that I had my own space and couldn’t be bumped) many people choose to get a foam wedge pillow instead of this chair to provide the same assist function.

3 Weeks Before Surgery

Order Supplies: there are just a few things I found incredibly helpful:

  • Camisole or surgical bra: ask your surgeon what they want you wearing immediately post surgery. Mine prescribed a camisole like this- sized up so as to support but not constrict. I wore this for 3 weeks (until drains came out). Therefore I bought two so one could always be in the wash. (camisole https://a.co/d/aiJO5fo )

  • Front closure sports bra: after the drains come out, you will be thrilled to be rid of that camisole (or whatever they have you in). You’ll need something supportive and that snaps in front. Over the head is out of the question- your arms may still be functioning like a T-Rex. (Bra https://www.anaono.com/products/rora-pocketed-front-closure-bra)

  • Drain belt: this was a life saver for showers! I’d still need someone standing outside the shower to assist handing me things, but the drain(s) were secure and I wasn’t worried about accidentally pulling them out. This is otherwise a real fear during the first two weeks. (Drain belt https://a.co/d/3Z7KDxZ )

  • Wedge pillow: I bought but didn’t use, since I had the recliner.

  • Easy to Wear Tops: Button down shirts or zip front items are your best friends for the next few weeks.

One Week Until Surgery

Prep Food: what do you eat that you can prepare in advance? My sister made a bunch of jarred salads that were very easy for me to access after she left. You won’t be able to reach up to shelves higher than your shoulder, initially. For me that meant moving some food, but also moving plates and bowls and cups.

Prep Your Area: I had a little station near my recliner with my notebook, chapstick, coaster for coffee, water bottle, phone charger, and a little bell/chime to call for help. I also setup a medication chart to track when I took pain meds. Lastly, you’ll need to clear your drains multiple times a day, so there was a space for those supplies and that tracker as well.

Mentality: Hope for the best, and know there may be setbacks. Your surgical team will do their best and you just keep taking the next step and making the next best decision. Pretty soon this will be in the rear mirror!

Day of Surgery

Follow all Instructions: your breast care team will give you instructions for cleaning/preparing your skin for surgery, as well as what not to eat before your procedure.

Prepare for Departure: I found the ride home from my surgery to be the most painful part of the entire process. Make sure you can take pain medication as close to leaving as possible, and make sure your driver knows to be gentle with turns and bumps.

Get Some Rest: when I returned home, I immediately went back to sleep for hours and then basically all night. I woke nearly every hour. However, the second night I slept ten hours straight and felt great by day three.

Three Months- Twelve Months Later

Exchange Surgery: since my procedure involved a tissue expander at the time of mastectomy, I had a “exchange procedure” three months later. I had mentally prepared for something similar to the mastectomy, but have been overjoyed to find that the exchange is much simpler. I was up and about the same day as the surgery and easily able to walk during that first week post procedure, with nearly zero pain. I am now five weeks out and have nearly full range of motion. For some, the tissue expander may remain for up to twelve months based upon other treatment factors. I’ll share that after a month or so, I got very used to the expander and almost didn’t notice it. Other than the feeling of having a Tupperware lid in your chest!

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Questions for Plastic Surgeon

  • What are all my options for procedures and for reconstruction?

  • Can you clarify the timeline for each procedure?

  • What are the risks associated with each procedure?

  • How are regular check ups covered with implants? What scans are covered?

  • Am I a candidate for nipple sparing?

  • Am I a candidate for sensation sparing?

  • What happens if I gain back weight that I lost during chemo? What if my reconstruction is then imbalanced on one side?

  • What supplies do I need in advance of the mastectomy?

  • What considerations should I think about if I have radiation?

  • If I had a double mastectomy, is there a world where I would do one at a time or does everyone do them both at the same time?

  • Could I go straight to implant at the time of mastectomy or do I need to have a tissue expander and why if so?

  • Implants have a lifespan of 10 years, do you find that patient tend to keep the implant for 10 years or is it more or less?

  • Will I be able to resume all sports that I previously was able to do like running and jumping?

  • How specific is the sizing? (I was a small B, but I am now a larger A, how do you determine the final size to use?)

  • What complications might I run into during surgery and what choices might you then need to make? So I can make them now in advance.

  • Is there a way I can see example photos of each procedure?

A week after my mastectomy, on my way to post-op checkup.

The Next Five Years

I just started the next 5 years of my life.

I added a tiny golden pill to my morning repertoire. Letrozole (aka Femara).

It’s an aromatase inhibitor, otherwise known as a “hormone blocker.” This will lower estrogen levels in my body by blocking the enzyme aromatase, which produces estrogen.

This adjuvant treatment (a treatment given after the primary treatment to lower the risk of cancer recurrence) is used with hormone receptor-positive breast cancer.

My cancer was “triple positive”; estrogen receptor-positive (ER+), progesterone receptor-positive (PR+), and human epidermal growth factor receptor 2 positive (HER2+). While this is considered an aggressive cancer, mine was caught at an early stage and the receptor positive status makes these additional treatments (like letrozole) possible and necessary.

It’s very weird to think about being on a treatment for the next five years of my life. There’s also something nice about making assumptions about the next five years, after the scariness of the last year.

I am worried about the possible side effects (joint pain, mood changes, osteoporosis, and more). I’m worried because some people have said it’s the worst part of breast cancer treatment. But I also feel determined to show these side effects who’s the boss. (Me. I’m the boss.)

I was going to end my thoughts there… and then my superstition crept in. so I’ll say this; I know this could be a hard road for the next five years. I may have real bummers of side effects. I may need to change prescriptions or fiddle with doses. But I GET to do that. I’m going to try to focus on the opportunity. And feel free to remind me of that if I get cranky.

The foggy steps of Edgehill Mountain earlier this week. Feels appropriate; I’m starting a journey and cannot see very far ahead. But it leads somewhere.

The Countdown Begins

It’s a foggy Friday morning. I’m sitting in a grey pleather recliner that matches my view of the city. There’s an IV dosing me with monoclonal antibodies that target HER2 proteins. Though I’m in remission, I’ll continue this treatment for a full year to reduce the risk of breast cancer recurrence.

You’d think this could make for a bummer of a morning. Not so!

Firstly, this view! I’m so grateful to look outside while having my regular infusion. Earlier in my treatment, when I had 6-hour long chemotherapy infusions, I was always stuck in a hallway chair with a view of the wall- because it was one of the only chairs that could accommodate the “cold capping” I needed to do in hopes of maintaining my hair. My current infusion doesn’t cause hair loss, and is only 45 minutes long, every 3 weeks.

Secondly, my infusion nurse. I’ve had the same nurse for the last 4 infusions and she just brightens my day. It’s amazing how one person can make you feel so cared for in a system with so many patients.

Thirdly, I’m meeting a dear friend from high school afterwards for a walk and lunch. I can’t wait. She’s also been a huge support to me along the way with her knowledge of both genetics and the cancer landscape. With my first set of infusions- the hardcore chemo- I would have had to rush home and sleep. These residual infusions are a cinch in comparison.

And lastly- the countdown has begun! After today, I only have four more infusions until I complete my year of Herceptin (Trastuzumab). I can’t wait to ring that bell.

A foggy view but a sunny heart.

How to Support Someone in Cancer Treatment

I just got off the phone with a loved one- and her dear friend was just diagnosed with breast cancer. Since my diagnosis just ten months ago, I’ve unfortunately already had a number of calls like this.

She was thinking about how to be supportive; what is needed and how she can show up for her friend. She knew just how much i appreciated the way my friends rallied around me, and wanted to do the same.

As we know, no two cancers are alike, and no two breast cancers are like. Her friend will have a specific treatment plan and protocol, which means her needs for support will be specific to her.

That said, there are some great ways to be emotionally and physically supportive of a person going through cancer treatment.

The initial weeks or months after diagnosis can be rife with anxiety. At the same time the person is wrestling with the reality of having cancer, there’s a steep learning curve in navigating the logistics and processes of the healthcare system. And there are lots of appointments and ongoing tests- each with waiting times for results.

What I found helpful at the beginning of my cancer journey :

  • Developing a Game Plan: two of my closest friends invited me (and my husband) over to dinner to discuss how they could help us approach my journey. I remember initially thinking that I could just handle it myself, with Matt. But my friends’ initiative did a few things- it normalized discussing my cancer with them, it gave us the opportunity to share and learn, and it concluded with them facilitating a meal train and communication channel with other friends. This was immensely helpful for me and for Matt, who could then focus on other ways of supporting me.

  • Providing an Escape: my friends were also super consistent in reaching out to me. We went on lots of walks, and at the beginning phase of diagnosis or treatment, it’s so important to stay social. I found that my initial instinct was to withdraw and hibernate, but I always felt better after getting out. Sometimes a dogged friend- persistently reaching out-is what you need.

  • Checking In: sweet texts and notes and flowers dropped off on my doorstep made such an impression on me. These all felt like virtual hugs. Each time, I felt a surge of love and gratitude, knowing I had people in my corner.

  • Understanding Their Mindset: I’m generally a person who likes information. I research everything. But I found that at the beginning, I was simultaneously wanting information and terrified to seek it online. Hearing it from a human (doctor, friend who had gone through it, or friend with knowledge) was the only way I could tolerate new information. Statistics were especially scary (a number of times I asked my sister to do online research and share the overview with me- just the helpful parts). This later changed, and I became ravenous for information [from all sources, including online] about what I could do to ensure success in my treatment. It’s critical that friends and family understand your fears and don’t get ahead of where you are in your journey.

After a while, I settled into my new reality. I started to understand the landscape. For me, this was probably 3-4 weeks after diagnosis. What I found helpful during my cancer treatment journey:

  • Invitations: walks, coffee, etc. While I was conscious of my compromised immune system, outdoor activities with friends kept my spirits up.

  • Humor: friends sending funny notes or texts kept me laughing. When I was nervous about getting a port in my chest (for chemo infusions) one friend asked me when I was headed to Portlandia. Another sent me an actual “cancer card”- to be played whenever I wanted to get out of something. Making fun of the situation was quite helpful and made me feel less lonely.

  • Remembering Dates: Friends and family remembering my infusion dates or other milestones felt, especially loving. Little messages of strength were inspirational. And not having to tell people day-of that I needed moral support was refreshing. My family members & a few close friends even each flew out from other states to be with me at various junctures in my treatment.

  • Continuous Thoughtfulness: My friends and family went above and beyond. So many friends sent meals or gift cards. Some left flowers on my doorstep. Some sent thoughtful packages, including things I’d need to endure chemo or a “my favorite things” box. One sent music for my walks. Some took over our carpool shifts for soccer practices. Others connected me with friends who could help with various facets of my treatment. Some even sneaked (snuck?) past nurses into my infusion appointments with food and smoothies!

And there was so much more. While this was an incredibly tough year, it was the help and support of my friends & family that I’m most grateful for…And what made this a beautiful year, too.

My house has been filled with flowers this year- a visceral reminder of the support from my friends.

The Cat That Brought Me Joy

Let’s first start with context: I’m not a cat person. I’m barely a dog person. I’m really a piglet person. Baby pigs make me giggle. Someday, I’ll have a pet pig

But I digress. That’s not what this is about.

It was mid-May, and I was 3 weeks into my Bells Palsy horror, while still recovering from my mastectomy. I was pretty low. Looking at my own face was depressing. I had been hoping that I’d have one of the “short cases” that resolve in 2-3 weeks. Having hit 3 weeks with no real improvement, I had to resign myself to the fact that this could take 3-9 months.

I was devastated. Trying not to be, but I was. Nothing felt good, nothing was easy. I could barely see out of my affected eye.

Then the mail & packages came for the day. One was tube-shaped, and I was trying to remember what I had ordered that would come in this format… nothing came to mind.

I opened it. And immediately laughed aloud. My body filled with joy. Even with my crooked smile. I felt giddy.

It was a poster of a green cat, with THE MOST DELIGHTFUL phrase that resonated so deeply. “This huge cat has been assigned to you. You must accept this situation and find joy in it.” (See below for photo and link to the artist, David Shrigley)

I couldn’t immediately tell who it was from, but did a little sleuthing and wasn’t surprised to discover the gift came from a long time friend and coworker. She shared that she sent it on impulse but then wondered if it was a bit too bold. I told her I think the boldness and humor made it the most perfect thing- exactly what I needed.

I had it framed and it’s now the first thing I see when I wake each morning. It reminds me of three things 1) there is always joy, even when things are shitty; 2) sometimes the low times are really just fodder for laughter; and 3) if you have an impulse to send someone a note, gift, message, whatever- DO IT. It could be the thing they most need.

“This Huge Cat” by David Shrigley. Check out Shrig Shop- His work is so delightful. https://shrigshop.com

Have You Enjoyed Your ‘Time Off?’

“Have you at least enjoyed your time off?” And, “What did you do while you were on leave?”

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The short answer? Yes, I enjoyed it, at times. And no, it was awful. Both are true. The longer answer? Well, how much time do you have?

I’ve started fielding a few inquires like these as people learn about my diagnosis & that I’m headed back to work next week. I know they are meant as conversation and are asked with curiosity or love. And they are tough questions for this cancer survivor, for many reasons.

The thoughts racing through my head are always: are they asking for a surface level answer, a listing of my activities? Or more introspection, with my personal learnings? Or, really- can they handle my gut response to these questions?

I initially took time off work to finish my chemo and recover from two surgeries. Just when I expected to return to work, I developed Bell’s Palsy which set me back two months. I’m now cancer-free and partially recovered from Bells, so I return to work next week.

And when I hear these questions about what I did/how I spent my time, I ask myself: what did I do with this time???how did I stay productive while I had cancer? What did I do other than spend months putting toxins into my body? Or during the subsequent months while I recovered from that attack, other than restoring my microbiome and nails and hair and skin and face and heart and bones and spirit and brain and bloodwork? Or, maybe I could have been more productive when I was immobile from surgeries, or when I couldn’t see during initial Bells Palsy (ok, maybe not that one). Or perhaps in general, over the months, while in waiting rooms for doctor or care team appointments? Or those days while I waited for test results, paralyzed with anxiety?

My guess is most people don’t mean any of this when they ask those questions. It’s like asking someone on maternity or paternity leave if they enjoyed their “vacation.” We’re so programmed to be productive that any sort of time off feels like there should be an outcome, and asking about it is just meant as a form of showing interest and care.

And on the receiving end, it’s easy to think that you’re being asked about production, outcomes, and activities, even if it isn’t what’s intended (or maybe that’s just me and my conditioning).

At first I tried to answer the questions literally, but each time wound up feeling there wasn’t “enough to show” for my time away from work. And then I felt bummed- both unproductive and like I’d wasted time.

But I quickly realized. The purpose of my time off was to HEAL. And I did that. And that was actually really HARD. I’m a cancer survivor. That is the answer to this question. That’s what I did, that’s 1000% how my time was spent.

And so now I’ll be answering the question more introspectively. I am saying:

  • I was healing (and am still healing)

  • I have learned how to practice living with ease (ok- a work in progress, this one!)

  • I have reset my personal priorities (joy, learning, risk-taking/adventure, creativity, self-care)

  • I have changed my habits to support my continued remission

  • I have spent more quality time with friends and family

  • I am in the process of growing into a better me.

There! That’s what I’ve done with my time off. And it took lots of time and it has been hard, but yes- I’ve thoroughly enjoyed it.

Visited the Dahlia Dell in Golden Gate Park. It’s a great destination for a hearty walk, which I’m committed to daily. I also just adore dahlias- they are so joyful- and so varied. I’m committed to being delighted, daily.

Enjoyed the Ruth Asawa Retrospective at SFMOMA with my son, Colten. Spending time with my college kiddo while he’s home fills my heart.

Why I Love Nuxe

(And no, I’m not sponsored by them… but hey Nuxe, I’m available, lol…)

I was doing my facial therapy for Bell’s Palsy a few minutes ago and thinking about how grateful I am for these products.

I’ve been using Nuxe since 2022 when I was in Paris and Monoprix employee suggested it. I use their face wash (great for sensitive skin) the face/hair/body oil, and their makeup remover; and more recently the body wash and micellar water.

Breast Cancer: If you read my breast cancer backstory you know that the Nuxe body wash is the hero in my diagnosis- the literal reason I found a lump. The mammogram did not catch it. My body wash did. It’s satiny and smooth and decadent to wash with, yet super reasonably priced. 11/10, can’t recommend highly enough!

Bell Palsy: And now the Nuxe face/hair/body oil is serving a second purpose for me. With Bell’s palsy, you’re supposed to do facial muscle massage* a few times a day to encourage blood flow and stimulate nerve function on the affected side. This can get pretty rough on your facial skin, so I’ve started doing it with the Nuxe oil. Quelle différence! Now it’s a pleasure to do and my skin is glowing, and it also helps me lessen the soreness and stiffness I had resigned myself to accepting.

See photo for my three staples. Missing are the micellar water and makeup remover, which I need to order more of!

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*facial massage for Bell’s Palsy: https://www.facialpalsy.org.uk/video-library/massage/

And I’ve started adding gua sha for Bell’s palsy, and I like this routine: https://www.tiktok.com/t/ZT68ncd7g/

A Little Salty

“The cure for anything is salt water: sweat, tears or the sea.” -Isak Dinesen

I have always loved this quote. For its references and simplicity. But throughout this past year it resonated more, and metaphorically so. It was placed centrally on my manifestation board where I viewed it daily.

To sweat meant to try harder, have grit, push past comfort zones. (Ironically this was very not literal; I didn’t sweat at all during chemo. I learned later that this is in fact a thing.)

To have tears was to experience real grief, and to allow myself to be  supported by others. (And then yes, also literally; my eye watered like a fountain with Bell’s Palsy. This is also a thing).

And, oh, the Sea. My favorite place ever. It’s where I have always come to see the big picture, to be in a state of ease even when there’s turmoil.

I love being salty.

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Speaking of salty, I love my LMNT electrolytes and use them daily on my hikes. No sugar (great for my remission) and they taste delish. Use this link for a free sample pack! http://elementallabs.refr.cc/larahitchcock

Ocean Beach, a 2-mile downhill stroll from my house, and my usual haunt.

Colten was my beach buddy this week. He may attend college in Boston, but his heart is in SF.

I always love a good fog view. San Franciscans fondly call it “Karl,” and it makes any beach walk feel fresh and inspirational. A few of my drawings this year have focused on ocean & fog views.