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.

Breast Cancer: Last Phase of Reconstruction

Before I get started, I have to acknowledge that I’m a little superstitious* (“I’m not superstitious, but I’m a little ‘stitious’,” as Michael says in The Office) When titling this piece, I nearly wrote “Final Surgery: the Exchange.” But I didn’t want to jinx it. I know [from my research and in taking to others] that things don’t always go according to plans with the reconstruction after mastectomy. Some people have a number of surgeries, either because of implant challenges or because of needed revisions. It felt like calling this the “final” surgery was tempting fate. So I changed it to “last phase of reconstruction” to avoid that feeling, however ridiculous. I have definitely become more ‘stitious this year.

As I’ve mentioned before, there are so many different pathways people take in recovering from breast cancer. “If you’ve seen one breast cancer, you’ve seen one breast cancer,” I’ve heard many times. Each case, stage, and grade has specific protocols.

In my case, I had neo-adjuvant chemo (neo referring to before surgery, adjuvant meaning therapy “to help” shrink tumors and suppress formation). Then a mastectomy in March. At that time, a tissue expander was inserted, with the intention of exchanging it later for an implant.

Some people are able to go “straight to implant” at the time of mastectomy. My plastic surgeon preferred to wait, allowing the body the best chance of healing and recovery, and the least chance of complications with the implant.

So I would have the tissue expander in place for anywhere from 3-12 months. If I had needed radiation or more chemo after surgery, it would have been the longer end of that time frame. But because of my pCR (“pathological complete response”) to chemotherapy (determined via labs) I was able to be in the short end of the timeframe and schedule the “exchange” surgery for 3 months post-mastectomy.

Note: seeing that “test result” of my pCR a week after the mastectomy was an out-of-body experience. I had prepared myself for the possibility of needing 3 weeks of daily radiation and 42 more weeks of chemo. I was walking up the hallway stairs when I saw the message notification and had to sit down, my legs were so weak. I reread the summary multiple times. I had my sister read it. Then my surgeon called. “Did you see the results?” she asked. “Yes…,” I said tentatively. “I don’t want to get too excited, but it read like good news?…” She laughed. “Oh yeah, get excited!!! It’s the best possible news.”

The mastectomy took 6-8 weeks to fully recover, but I was able to progressively start doing exercises after about 3-4 weeks. The doctor said the exchange surgery (to exchange the expander for the implant) would be easier than this original surgery, but I prepared mentally for a similar experience. I was so wrong, in the best of ways.

Now less than 2 weeks post-op from the exchange, I’m really mobile. I can easily walk a few miles. I have very little pain. I still need to take it easy (especially the surgical area) and can’t lift that arm completely, but it’s like night and day in comparison to the first procedure. What a pleasant surprise.

Onward!

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* “I’m a little ‘stitious” https://youtu.be/39uoolmtjSA?si=QFz6pEN7RFQ_-vKU

Just 2 weeks post- op, I’m out and about! Attended an intimate showing of ‘Annunciation’ by Lauren Groff (and an author talk back afterwards) performed by the super talented cast of Word for Word at Z Space in San Francisco. Here with Colten, my eldest, who works at Z Space.

I’m High Maintenance And It’s A Good Thing

After having a completed chemo and surgeries, I’m moving into the next phase of my life. Remission. It’s also a strange in-between era because I still have 3 months of Herceptin infusions remaining and 5 years of Aromatase Inhibitors ahead of me.

That said, my life goals have shifted from “manifest pCR” (pathological complete response) to “maintain remission & prevent recurrence.”

When you lay out all the things one should be doing to prevent cancer recurrence (please read that as dripping with sarcasm) it could be a full time job. I’ve chosen to pick and choose the things that make sense to me to maintain my physical, emotional, and mental health.

Other people may make different choices, and that’s cool too. I’m clear that health and wellness for me includes self-care, learning, adventure, risk-taking, and creativity. I’m now “high maintenance” and for the first time in my life that feels like an entirely positive thing.

I’m sure this list will evolve (it already has!) and while it may look like a lot, keep in mind I sort of added new things as I felt ready. It all started with the early waking and journaling- everything else was stacked on top of that. So if you’re thinking about maintaining remission, here’s where I’ve landed.

My Morning Ritual (approx 3 hours)

• Wake Up (between 5:00-6:00 am, or when my whoop shows a “green recovery”, whichever is first)

• Make Green Tea (incorporating antioxidants and delaying my first coffee)

• Get Morning Sunlight (I’m obsessed with good sleep and thus helps our circadian rhythm) for 10-15 minutes. If I’m being honest, though, this is the piece that already feels hardest to maintain and so it may fall off when I return to work.

• Do Mobility (stretching exercises from Keir at Foghorn Fitness) for 10 minutes

• Journaling, with coffee (I use the Huberman prompts: 5 gratitudes, today’s highlight, something you regret/resent, less of, more of) for 15 minutes, en français. I love a good double-duty activity and journaling while practicing written French is very satisfying.

• To Do List & NYT puzzles (this is my reward for journaling- planning my day which clears my head, and then doing connections, mini, and wordle with my sisters)

• Workout (if at home, 20-30 min of strength or yoga. If working with my trainer, Keir, it’s 50 min of breath work, mobility, and strength. It’s a highlight of my week!- see pic below)

• Take meds & supplements (a whole category of its own, sadly)

• Bodywork (Cancer related: lymph scar cording stretches, lymphatic flow exercises, sensory retraining, scar tissue manipulation, wave plate. Bell’s palsy related: warm compress, facial massage, red light therapy). This all takes 30 minutes, at the least.

• Take a French lesson (one of the silver linings of chemotherapy and subsequently taking a leave of absence from work was adding in an hour of French conversation with my new tutor on Preply. She’s fun and encouraging and it’s keeping my brain engaged, once each week).

My Afternoon Add-Ons:

• Drink LMNT water (my fave way to stay hydrated and have better recovery scores. I’m a giant fan. See below for a link)

• Go for a walk (depending upon timing- anywhere from 15 min to 3 hours).

• Enjoy a “snack” of AG1 drink (A great way to include greens and boost cancer-fighting capabilities)

• Get Acupuncture (I try to squeeze this in 2-3 times each week to help with nerve stimulation for the Bells Palsy. It will be harder to keep up this frequency when I’m back at work, but thank goodness for San Francisco Community Acupuncture- they’re affordable and also open into the evenings)

Evening Ritual (approx. 2 hours)

• Creativity time (for me, this is generally early evening hours, and includes drawing or writing. Both help me feel peaceful and productive, so I squeeze them in when i can!)

• Breast Cancer Support Group (I’m beyond grateful for this group of women and our fabulous facilitator. I remember at the beginning thinking “I don’t need a support group, I have enough friends.” Ha! How wrong I was. Through one of my best friends, I was connected to my Monday night support group, and I haven’t looked back since. We commiserate, we cry, we share, we learn, and we laugh together. It’s so important to be with people who inherently and viscerally understand).

• Listen to 528 hertz while doing a warm eye compress (a dear friend sent me this audio and I love it; I listen for 10 min with an eye mask to help my post chemo eyesight and also my Bell’s Palsy)

• Take rx & supplements (it’s so fun I do it twice each day)

• Skin care (just my regular pre-cancer routine, but I now consciously use the time to add in more facial massage to stimulate the muscles on the side affected by Bell’s palsy)

• Lymphatic Flow exercises (once you’ve had cancer in your lymph nodes, you obsess about them being able to clear toxins)

• Read in Bed (I have been working with a phenomenal health coach from Zero Breast Cancer, and she’s helped me identify many of these routines. Especially getting to bed by 9:15. I’m not even ashamed to say I love a 5:30 dinner reservation and I’m a pumpkin by 8:30 pm)

There’s nothing I want more than to maintain remission… so most of this feels like something I get to do and I choose for myself. These things fuel me and bring me joy through self-care, learning, and creativity. And yes, it might be high maintenance… and that’s empowering.

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Resources mentioned:

LMNT: Use this link for a free Sample Pack of electrolytes http://elementallabs.refr.cc/larahitchcock

Whoop: Get a free trial when you join with my link: https://try.whoop.com/larahitchcock

Working out with my trainer and coach. He’s helped me not only with regaining my physical strength, but also my mental toughness and wellness approach throughout the cancer journey. Photo: Keir Beadling & Foghorn Fitness.

“The Banana is Ripe”

I’ve always been a wear-my-heart on-my-sleeve sort of person. An extrovert. I don’t think I’ve ever been accused of holding back on what I thought or how I felt. I love talking with people, and I’m at times quite animated. (Cue husband joking about how soft-spoken and quiet I am)

But that changed this year. Having cancer feels like something you don’t go around talking about. The same goes for Bell’s Palsy. In fact, I initially wrestled with versions of shame or embarrassment as I wondered “what might I have done that contributed to this?”

You also refrain from talking about cancer because want to save your conversation partner from the sheer awkwardness of learning about your diagnosis and not knowing what to say. (Sure I might have cancer, but this unsuspecting friend now has to respond to me having cancer!)

All that to say I decided early on in my diagnosis to focus squarely on my “I am where I am” mantra and only shared about my cancer (and similarly, my Bell’s palsy, more recently) if and as needed. I wasn’t hiding it, but I was definitely not broadcasting it either.

But then I was surprised to wake up a few days ago, ready to share my journey. As in, it was 4:30 am and I had lots more writing thoughts in my head and the desire to put them out into the world! Now! Quickly! (I felt like “the moment has arrived. The banana is ripe.” by David Shrigley. See below for reference)*

Up until that moment, I had been writing more privately, publishing blogs only for myself to see or to share with a particular person who had asked about an aspect of breast cancer. That was fine, I was just being helpful. But It felt super scary to actually publish or share more broadly.

But I’m headed back to work in two weeks, it made sense to close one chapter as I opened the next. Goodbye to Patient Lara, and Hello to Work Lara. (I can hear my family now. They joke that their favorite version is “Vacation Lara.” That gal is fun, I’ll admit)

And so I moved forward with sharing. I posted something on instagram. To my surprise, over the next few days, I received tons of messages from people who had a family member dealing with cancer, or were in the middle of making tough cancer-related decisions, .or had experienced Bell’s Palsy…. And on and on. We all have stuff we carry, and some eras are harder than others. Knowing your experience can be helpful to someone else’s journey is such a gift.

And the unexpected bonus? Once you put it out there, by choice, you are liberated. And a ripe banana is so sweet.

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* a friend & colleague recently sent me something from Shrig Shop, and I’m obsessed with David Shrigley’s art. I’ll do a separate post on what she sent (it had a big impact!) but in the meantime this piece is exactly how I felt when waking up that day- “the moment has arrived. The banana is ripe.” https://shrigshop.com/collections/david-shrigley-cards/products/david-shrigley-postcard-the-moment-has-arrived-banana

This art by David Shrigley (of Shrig Shop) speaks to me. As does a lot of his work. Check it out, linked above.

By All Means Move At A Glacial Pace

I just rewatched The Devil Wears Prada the other night, introducing my teens to critical early 2000’s pop culture.

in doing so, I was reminded of one of my two favorite quotes** from the movie. “by all means move at a glacial pace,” snarks Meryl Streep as the character of Miranda Priestley*. “You know how that thrills me.”

That’s what Bells Palsy feels like. A sloth. A snail. A Glacier.

Progress is so slow that you often wonder if you are fooling yourself. (Is my smile better today? Or do I just want it to be better today?) You start neurotically asking your husband and sons to look at your lips or your eyebrows or your cheek, too confirm or deny progress.

Something that has made me feel better (and feel seen) is listening to the audiobook by Sarah Ruhl. She documents her journey with Bell’s Palsy over the course of 10 years of her life, in her book Smile: the Story of a Face***. I highly recommend for anyone experiencing Bell’s Palsy. Her dry humor sheds light on the idiosyncratic nature of this affliction.

Thank goodness for humor and for being seen.

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Favorite quote from TDWP *https://youtu.be/GMTU-LUESgA?si=9ekvebSHTbmLtVsi

Other favorite quote from TDWP **https://www.facebook.com/TheWorldOfMirandaPriestly/videos/1825706234332002/?fs=e&s=TIeQ9V&mibextid=wwXIfr&fs=e

*** Smile by Sarah Ruhl https://share.libbyapp.com/title/6056140

A photo from a few days ago, once again a neutral smile for the camera. It was a little harder at that moment- wind and cold can exacerbate the tightness on the unaffected side and the immobility on the affected side. It’s felt a little glacial this day!

I’m Going Through An Awkward Phase

Sometimes you just have to not take yourself seriously.

I have been thinking about my adolescent years and how every now and then I hit an awkward phase.

That’s me again, now. But at 51. And maybe “awkward” is just that necessary step on the path back to normal, good, or great.

My hair is growing out after chemo. It’s just longer than my ears on the side but won’t stay tucked. And there’s a giant middle section that is shockingly white. Like, Cruella Deville white. And I can only keep it back with headbands or tiny barrettes, like a stylish toddler.

My face is partially paralyzed from Bells Palsy. I look like The Joker when I laugh. And I have to wear a protective single goggle when I’m in the wind/outdoors. But at least now at week 10 I can function normally again with eating, speaking, and drinking. There was a very funny stage around week 4 when I was used to the Bell’s Palsy but still struggling to pronounce certain letters. My family was driving to Palm Springs and singing to a great playlist. Free Fallin’ by Tom Petty came on- and F’s were the hardest letter to say!- so we all belted it out, sans F’s.

And I still have a port in my chest. I joke that I’m part Cyborg. (The port stays until I finish my final Herceptin infusion in October). I honestly don’t even think about it anymore but remember a time that this felt devastating to have in my chest. But this port has make it possible to get chemo and labs whenever needed without decimating my veins/arm.

Maybe after you accept the Awkward, it’s not so bad. Because it’s also Progress.

Awkward = Progress. Short white hair, half-wrinkled forehead, and protective eye goggle. But I’m out for a long walk, not even 2 weeks after surgery, and I can at least give a smirk. Woot woot!

Bells Palsy Update: Week 10

Before I get started, did you know that 1 in 60 people will experience Bell’s Palsy sometime in their life? That’s much more prevalent than I would have expected. It’s believed to be triggered by inflammation to the facial nerve, brought on by stress, fatigue, being immunocompromised, or by a virus.

I had what is considered a “dense” case meaning it was fully or nearly-fully paralyzed at diagnosis.

I’ve done very regular acupuncture (2-3 times per week, starting at week 2), daily red light therapy (starting at week 3), and warm compresses (mostly in the first few weeks but also anytime my face feels especially cold or tight). After the nerve started firing more, I was able to add in some facial exercises (to “practice” regular movements) which I do daily as well.

So if you or someone you know is experiencing Bell’s Palsy, here’s my update as of 10 weeks in:

Overall: At rest or in normal conversation, my face is nearly normal. If you study it closely you’ll see differences and that there’s a slight pull to my left [unaffected] side. However, it’s still very obvious when I smile wide or laugh. And for some reason in photos, it looks awful. I can look at my phone pre-selfie and arrange my face to look nearly normal with a small smile, but the photo always comes out with my face really distorted. But emotionally, I feel 1000% better about my progress to date. I feel a little more like myself each week.

Brow/Forehead: it still looks like I had Botox on one side only (the affected side). When this started, I couldn’t lift my right brow at all. Now, the inner part of the right brow lifts when my left brow lifts. And I can crinkle part of my right forehead. Who knew that I’d WANT to see forehead wrinkles?

Nose: I can now breathe out of my right [affected side] nostril. That was not the case when this first started! I try very hard to nose-breath only so I’m grateful to have this function [mostly] back to normal.

Eye: I can close my eye 99% but can’t squeeze it shut yet. During the daytime it’s getting so much better- I can see clearly now most of the time, which is a significant reduction in frustration. At night I still help it stay closed by covering my eye with a square of glad press & seal (yes, it’s quite the look!) and my sleep mask. The bottom lid is just starting to be able to tighten, so I’m paying attention to this progress as it will help with my smile as well. Baby steps!

Cheek: Ahhh, Cheek, you poor thing. This is probably the last area to regain feeling. Being able to squint helps raise it when I attempt to smile, but I have to focus on it- it’s not natural yet.

Mouth: it’s funny, there’s been so much improvement here but yet so much more to go. I can see movement now when I say “eeeee” and my lips can pucker more when I say “oooooh.” I now can eat fine, drink without dribbling, and use a straw. (Whenever I share this, I feel like Wesley* from The Princess Bride when the giant says, “You just shook your head! Doesn’t that make you happy?”)

If I had any advice for someone just beginning the Bells Palsy journey, it would be to measure your progress in weeks or months, not days. Expecting daily progress is a recipe for frustration. Like any diagnosis, it’s hardest at the beginning. And don’t hibernate- while it’s hard to feel comfortable (and not self-conscious) around others, it’s neurologically important to interact with friends and family- it helps your brain make the connections needed to heal.

*https://clip.cafe/the-princess-bride-1987/you-just-shook-head/

A photo from this week. I might be “brave” enough to post a neutral picture like this, but I’m not yet ready to share any with other expressions. I think when I’m closer to fully healed I’ll feel more ready- when I’m not currently experiencing it.

Breast Cancer: the Backstory

It all started about ten months ago.

On Monday September 9, 2024, I got the call. “It’s cancer,” she said. “Are you somewhere you can sit down so we can discuss what this means for you?”

But let’s back up a few weeks. It was mid-August, and I had just said goodbye to my college sophomore, Colten, who was moving back to Boston for the year. My husband, Matt, was helping him. My high school sophomore, Oliver, was out with friends. While taking a shower, I noticed a small lump in my left breast. “That’s weird,” I thought. There was not a matching lump on the right. Thinking I was certainly overreacting, I messaged my obgyn just in case. I had a clear mammogram at the end of January, so I wasn’t too concerned. I didn’t even tell Matt when we spoke- it seemed unnecessary.

That was Friday, and by Monday morning my doctor’s office had called to book an appointment. A few days later I was seen. The doctor agreed that she felt something, but that it was quite small. “How did you even notice this?” she asked. I [delightedly!] told her about my new favorite body wash from my trip to France- Nuxe, which is very silky (10/10, highly recommend)- and that I hadn’t even been doing a self exam, just washing as usual when I slipped over the bump. She booked me for an ultrasound and possible biopsy, “just in case.”

I still felt pretty sure it wasn’t anything, but I told Matt. We agreed it was good to do the biopsy just to know for sure that everything was ok.

The appointment started with a mammogram. The tech returned, saying we needed more views- just what you want to hear after your breast has already been smooshed a few times... In my gut, I think this is when I knew- this wasn’t a good sign.

The tech then escorted me to the biopsy room. The ultrasound tech began to explore the area. When he moved over to my armpit, I knew again, at a deeper level, that this was a bad sign. I tried to breath slowly and stay calm.

The doctor came in after a few minutes to tell me they would move forward with a biopsy next- and did I want to do it now or book a separate time? By this point, I was shaking convulsively and realized I wasn’t really hearing what he was saying. I asked him if I could have a few minutes and called my mom. It was September 4th, her birthday. I quickly explained my situation. My mom is an RN and a genetic counselor, having worked at a cancer hospital for years. She agreed it made sense to do the biopsy right then and even spoke to my doctor with me to ask some questions. We biopsied two areas; my left breast and my left armpit (lymph nodes). This was a Wednesday. I would hear back within a week. Agonizing.

On Monday September 9, 2024, I got the call. And I knew.

That call was a deluge of information. Matt and I cried. I called my mom and cried. I called my sisters and cried.

Triple positive breast cancer, stage 2. Agressive. But very treatable.

And then I pulled myself together and jumped on the rest of my work calls for the day.

Mid-week, after I felt I could do so without crying, I texted & talked with my closest friends. They were each immediately there for me in ways that made me cry the hardest; it felt like a heavy load to share and they immediately helped carry it.

In the following weeks, I would make great use of my project management skills, my relationship building expertise, and my advocacy experience. Navigating cancer healthcare is a doozy. I got very good at it.

I would rely heavily on humor, sarcasm, and sheer will to power through each day. Keeping yourself from falling apart and those you love from crumbling under this new weight feels crucial.

I would come to have a new appreciation for what anxiety is and the havoc it can wreak. Every day I would audibly gasp multiple times as I remembered, again and again, that I had cancer. It was the most jarring thought I’ve ever had, each time.

But after about three weeks, I started to be able to move forward. I’d never fully get used to the idea of having cancer (what?!? No. That is so off-brand for me) but I understood that it didn’t matter. It is what it is. I am where I am.

The next weeks and months are now a blur, looking back. There was genetic testing, more biopsies (two more spots were found- changing my plan from a lumpectomy to a mastectomy, something I grieved for a long time). All sorts of blood tests, CT scan, and an MRI biopsy (0/10, do not recommend). Then chemotherapy (6 hours of infusions each time) from October through January. A mastectomy in March. And then final reconstructive surgery at the end of June. (Oh and for fun, sprinkle in a case of Bells Palsy at the end of April, which is still slowly resolving now in early July).

So it’s been a lot. And the journey continues. I’m cancer free (biggest yay ever! I had what’s called a complete response, which also yields better survival outcomes & reduced risk of recurrence later) as of March, and to stay in remission I’ll keep getting infusions every 3 weeks into October 2025 to complete a year of Herceptin (a chemo-like medicine that targets the HER2 receptors from my triple positive breast cancer, and keeps it from recurring). I’ll also soon be starting aromatase inhibitors which will target the hormone positive (ER, PR) factors of my cancer, again protecting against recurrence. I’m not looking forward to that phase (it will be 5 years long!) but I’ve really learned to cross each bridge as I come to it.

Cancer has changed my life, no doubt about it. Lots of negatives and challenges. But to be honest, I look back on the last ten months and I’m grateful for everything I’ve learned and who I’m becoming and most of all- my dear friends and family who I’ve grown closer to through it all.

August 2024- the weekend before my diagnosis, blissfully unaware, with my dear friends Kim, Karima, Moira, and Peggy.

September 2024- my sweet sister Melissa dropped everything to be with me at my first oncology appointments. It was a super scary time and her humor and flexibility and knowledge of the medical landscape helped me stay calm and focused.

March 2025- post-chemo and just before my first surgery. Whether she’s in SF or we’re texting from afar, Michelle’s humor and love and dear friendship brightens my days, daily.

March 2025- my sweet sister Kristen flew out to be with me for my surgery. What a phenomenal support she’s been this year and Best Nurse Ever.

March 2025- My husband, Matt. My rock. All his best qualities have been put to good use this year- his humor, his caring, his patience, his grit.

March 2025- my 16 year old, Oliver. This kid has experienced my cancer as the backdrop of his sophomore year in high school, and has shown nothing but compassion and empathy. What a champ.

June 2025- the weekend before my final reconstructive surgery, again with my college friends. So grateful for Kendra, Peggy & Moira- these women I’ve now known and loved for 33 years! And love that they put on a “serious face” in solidarity with my Bell’s palsy (I can’t really smile, currently).

July 2025- Colten & Oliver have been a huge source of humor for me as I recover from both my last surgery and Bell’s Palsy. They feed off each other, seeing who can make me laugh harder. Such joy.

Bell’s Palsy: Not As Much Fun As It Sounds

It happened the day I thought I had my life together.

I had completed my new, post-cancer morning & evening self-care routines- three hours’ worth of yoga, strength, breath work, journaling, and more- and was so excited to move forward with my clean slate. “Look at me,” I remember thinking. “I’m on the upswing, feeling good, cancer-free, and will be returning to work in two weeks!” Famous last thoughts.

That evening, while laying on the couch and watching a movie with my husband and my son, I became aware of the fact that I couldn’t blink my right eye, and that it was watering like crazy. I stood up and went to a mirror- and saw that not only did my right eye not close, but the right side of my mouth was drooping and could not smile or move. “You’ve GOT to be kidding me,” I thought.

And then it dawned on us that I was possibly having a stroke. I called our advice nurse and jumped in the car to go to the ER.

It wasn’t a stroke. That was the good news. But Bell’s palsy is a facial paralysis of idiopathic nature. Meaning, they don’t know what brings it on. But it’s often caused by stress, fatigue, being immunocompromised, or by a virus. In my case, probably some combination of most or all of those as my body recuperated from chemo and surgery.

I was told that light cases of Bell‘s Palsy could resolve in 2 to 3 weeks and more significant cases could take 3 to 9 months. Ever the optimist, (can one will their facial nerves to move? If so, I’ll do it!) I focused on the idea of 2 to 3 weeks and met with a physical therapist who specialized in facial movement. She let me know that there wasn’t much to be done until the nerve decided to start firing on its own. Until then I could use warm compresses and do acupuncture. And red light therapy couldn’t hurt.

So I added these to my daily & weekly routines. I became an acupuncture connoisseur, going 2-3 times each week.

I was surprised to find that Bell’s Palsy felt more depressing and lonelier than going through chemo. For the first month, it was hard to even speak (and ironically, it was very hard to say the B in “Bells” and the P in “Palsy” as I was explaining my situation to people. I’ve decided whomever named it had an evil sense of humor). And I’m normally quick to laugh, but a big smile immediately feels weird and “pulls” your face to the unaffected side. Which means joy turns to frustration in an instant.

Eating was also frustrating. I gained a healthy appreciation for all the behind-the-scenes work the tongue and inner cheek do while we eat, since mine weren’t functional on one side. Similarly, drinking was a disaster; my coffee mug looked like a crime scene… and don’t get me started on using a straw.

The biggest impact was that it affected my “good eye “ (the one with much better vision). With Bells Palsy, you can’t close your eye all the way as the top lid doesn’t go all the way down and the bottom lid doesn’t tighten upwards. Therefore the eye is perpetually dry and you have to constantly use eye drops and ointment, which makes everything blurry. That means it’s hard to read. It’s hard to watch TV. It’s hard to even see your to do list.

The only thing I could do that didn’t bother my eye or mouth- and that brought me some level of peace- was yoga. Even going for my usual walks was complicated because any wind (hello, San Francisco) bothered my eye. I had to wear a clear single goggle when outdoors, which always makes one look & feel cool and trendy…

At three weeks with no real progress, my doctor and I decided to schedule a CT scan to make sure the cancer hadn’t metastasized to my brain. The ideal scan would have been an MRI, but since my post-mastectomy tissue expander contained metal, this wasn’t an option. A CT scan could show potential problem areas, but if it did, I would still need an MRI to distinguish if it was cancer. So, we decided to opt for the CT scan as a start. I was beyond relieved to get the results that there was completely normal brain structure and no need for the MRI.

At four weeks out, I was able to squint my eye a little bit and clench my smile a bit. At six weeks out, I could fully blink, albeit delayed in comparison to my other eye. Now, at 2.5 months, I can smirk on the right side and start to raise my right eyebrow. Friends and family tell me that in regular conversation you almost can’t notice it. It’s when I laugh, or when someone takes a photo, that it’s very obvious. So now all photos of me have a serious face or my hand covering the affected side of my mouth (see below).

Overall, Bells Palsy is a pretty demoralizing affliction. It is hard to look at yourself and feel like, well, yourself. I’ve learned over the last two months to be more patient and gentle with myself than ever before. And I’m just chalking it up to another challenge of this year. But the year ends soon… take note, Bell’s Palsy, your time is nearly up.

Find yourself some dear friends who don’t care about your serious face in a silly photo.

Controlling My Controllables

A week after my mastectomy, I got the great news that I had a pathological complete response (pCR) which means I am cancer-free. It’s amazing news, and I’ve been reflecting a lot on my journey to get to this point.

Besides the obvious challenges, one of the less visible impacts of having cancer is that you’re suddenly this patient TO WHOM things are happening. There is a significant loss of control over your own life and how you spend your time or make your decisions. You can feel like you are always waiting for the next thing to happen.

But there were times when I was able to wrestle some control of my “controllables” and make decisions that felt empowering for the moment or for my future. And while there’s no way to know exactly what combination of behaviors resulted in my particular pCR, I felt good about engaging in them as a beneficial practice. To be clear, a pCR is a GIFT from the universe, and/but these are some things that can make it more likely.

1. Quit Alcohol- I haven’t had a drink since the week before my diagnosis (7 months ago). Friends have asked if I’ll continue avoiding now that I’m cancer-free… and I’m pretty sure I’ll stay the course. I’m much more aware of all the things contributing to cancer and it doesn’t feel “worth it” to me. There are other things I’d rather relax my “rules” on. That said, no judgement- we all need to decide which things fall into the “never” or “occasionally” categories.

2. Record everything- whether you’re a paper person/notes app/google doc user, this is the time to start keeping notes. I jot down everything about my cancer. It started the day of my diagnosis- and I still do this. I record doctor and care team conversations, names and phone numbers of medical assistants, questions that arise for each provider, daily side effects, and more. And I refer back to these journals a lot, and it helps me feel like I’m on top of things and also advocate for myself with doctors.

3. Adopt Stricter Nutrition: if you search for cancer-free cooking or eating plans you’ll find lots of great information. I personally took most of what I learned and applied it; no added sugar, no red meat, very limited dairy, no white starches, lots of antioxidant veggie and fruits, and much more plant based proteins like lentils, chickpeas, and other beans. I would have defined myself as a healthy eater before cancer, but I can see and feel the difference these changes have made.

4. Strengthen Your Body: I experienced what felt like very antiquated messaging to cancer patients in chemotherapy and throughout the treatment journey- like “stay strong but don’t over exert yourself” and “take it easy and conserve energy.” Yes, chemo Is really difficult and creates so many side effects that get in the way of fitness. But I really learned to appreciate the maxim that “action precedes motivation” and found that every time I walked, worked out, or even stretched I felt better. I started working with a personal trainer who has helped me focus on breathwork, strength, and mobility (and other than the cancer, I am now getting back into the best shape of my life- thanks Keir & Foghorn Fitness!).

5. Focus on Sleep & Recovery: I’ve been obsessed with my sleep quality for years. And I had figured out a great regimen before my diagnosis. But the persistent anxiety and physical side effects of chemo wreak havoc on sleep, and I had to really regroup in a number of ways in order to recover during treatment. I upgraded my sleep hygiene; no screen time before bed, phone charged in living room at night, earlier dinners, cooler pajamas, weighted blanket, sleep mask, and ear plugs. Then I did a lot of advocacy and followup with my oncologist and primary care physician to ensure I had prescriptions that supported sleep. This is work in progress but probably impacts every area of my life- well worth obsessing over.

6. De-Stress Your Life: a few weeks into my diagnosis- before I even started chemotherapy- I heard someone talking about “dis-ease” and how the opposite is to “live with ease.” That really resonated and I started making a concerted effort to prioritize being ease-ful, and to not sweat the small stuff. I’ve revisited this idea over my treatment journey and built on it as an intentional practice. Studies show the detrimental long term consequences of stress, and being diagnosed with cancer feels like a wake-up call on this front.

7. Focus on Priorities: as a result of actively trying to live with ease, I also took the opportunity to think proactively about my personal values and priorities. Besides reactively removing stressors, what to I want my life to be proactively comprised of? For me, it’s learning, adventure, challenging myself, self-care, and creativity. I’m making a concerted effort to ensure my days, weeks, and months contain these things that bring me joy.

8. Accept Help: It sounds cliche to say, but this was (and is) a hard one for me. My friends and family have been incredibly generous in all ways and it’s hard to not feel indebted or needy. I’m used to doing things myself, or asking for help in a more planned, curated way. But that’s a luxury I no longer had, and it’s been such a beautiful blessing to feel the support and love from my community. It has made the last eight months bearable and at times, even joyful.

9. Get a Little Woo-Woo: After a cancer diagnosis, I found I was more open than ever to things I had previously considered “alternative.” I started really honestly practicing meditation (as opposed to going through the motions every now and then). I also took time to create a manifestation board, which houses my priorities and things that inspired me and my ultimate goal (pathological complete response). And I tried (and loved) sound baths and reiki sessions. All of these things lowered my stress levels and helped me feel empowered.

10. Take Your Time: There are points in the journey where time becomes an issue. When I was diagnosed, all the appointments and navigation felt like a part time job for a while, and acknowledgement of that felt important to normalize. Then midway through chemo, I realized it was starting to take longer for me to recover from each round. I had been working but taking a few days off after each infusion- and finally made the decision to take a leave of absence to focus on recovery. My supervisor and CEO and work colleagues were incredibly supportive. And between each phase (chemo, surgery, reconstruction) I’m finding myself getting impatient to be recovered- once again I need to allow myself time heal and process the experience.

I’m sure there will be more learnings along the way, but that’s it for now.