When Breast Cancer Isn’t a Lump: How I Found My Cancer

Every month on the first of the month, there’s a social media movement called #feelitonthefirst to remind women to do their self breast exams. 

I haven’t participated before, and I’m participating now with an extra reminder: don’t just to do your self exams, also trust your instincts. My cancer had no lump, and neither did my mom’s. If something doesn’t feel right, on a gut level, get it checked out.

We don’t often hear stories like mine, or like my mom’s. Most people think cancer = lump. Awhile ago, a post using lemons to show visual signs of cancer went viral, and that was really helpful in raising awareness. But I had no visual signs, nothing I could feel with my hands – and I realized that I haven’t really shared exactly how I found my cancer and what my diagnosis was like.

So. I will share the entire story, because I want to make people aware that I could, at any point, have stopped advocating for myself. I could have said, “oh, I’m sure it’ll be okay.” And the end result would have been very, very bad.

I say this not to pat myself on the back, but to give you — my friends — any amount of prompting you need to listen to your bodies, do your self breast exams, listen to your intuition, and DO NOT PUT OFF GOING TO THE DOCTOR. Yes, when I was screened I got bad news. I had to face a lot of scary stuff. But if I’d avoided it, if I’d delayed it, I would have had to face all that scary stuff — and I would likely have died, too. Early detection is so, so, so important.

My whole life, breast cancer has been a topic of conversation in my family. Before I was old enough to really understand what it meant, both of my grandmothers, my only aunt on my dad’s side, and my only aunt on my mom’s side all faced breast cancer. Both of my aunts had premenopausal cancer (considered more aggressive) and it tragically claimed my aunt Lois’ life in 1983. She was 41.

My doctors always told me that I’d need to start getting mammograms 10 years before my Aunt Lois’ first diagnosis; by that calculation, my first mammogram should have been at 29. But when I asked my doctor to begin my early screenings, I was told that recommendations for early detection had changed; research showed that increased screenings resulted in mis-diagnosis & over-diagnosis, which was dangerous. The new recommendation was that, unless you had a first degree relative (ie, a mother or a sister) who had cancer, you should get mammograms at 40 like everyone else. My dad had been screened for the BRCA mutations (a gene more common in Ashkenazi Jewish populations that puts carriers at high risk for breast and other cancers), and came up negative. I was told that I shouldn’t get early screenings. 

I accepted this until 2016, when my mom was diagnosed with post-menopausal breast cancer. I was 33 when she went through radiation & a lumpectomy, and I again asked my doctor if I could begin early screenings. “That’s a good question,” she said, “I’m not sure.” In November of 2016, we went to Hawaii to celebrate the end of my mom’s cancer treatment, with no idea that it was our last big hurrah before the Olsher Family CancerFest really swung into high gear.

At my yearly exam in March of 2017, I asked my gynecologist about early screenings again, at which point she personally put in a referral for a genetics screening; I had it done within two weeks. Let’s pause here for a moment: this is the second time I directly asked for early screenings, and I only asked because my mom had been diagnosed. As you will see in a moment, my mom’s first breast cancer diagnosis saved my life.

I was tested for around 80 genes and came up negative for all of them. Because of my family history, however, I was still considered high risk and was placed in the “high risk cancer clinic” at Kaiser in San Francisco, headed up by an incredible breast surgeon by the name of Dr. Samantha Langer. Dr. Langer was scheduled to lead a group for women with high risk for breast cancer, but the class was canceled last minute because Dr. Langer was called into an emergency surgery. I asked to be rescheduled, but her schedule was so busy that I was given the option of waiting for the next group class, or seeing Dr. Langer individually. My gut told me to see her individually. This was April of 2017, and I was 34.

In June of 2017, just two months later, I started to have a strange sensation in my left breast. It felt sort of like a tickling sensation, which I described as “milk being let down” from my years of breastfeeding my daughter. The sensation went from the side of my breast to my nipple. I felt no lumps, but I had a strange gut feeling that I should get it checked out. “I’m sure it’s nothing,” I thought, but I made an appointment with my OB/GYN and was in her office within days, on June 8. She didn’t feel any lumps. 

On June 26, I had my scheduled individual appointment with Dr. Langer. As a reminder, this is a breast surgeon who does early detection for a living. She told me that I had a 20% risk of developing breast cancer in my lifetime due to my family history alone. She told me that I likely carry a genetic mutation for cancer that hasn’t been discovered yet, given that I was the only woman in my family not to develop breast cancer. She told me that I should be screened early. She told me I could opt for a preventative double mastectomy, if I wanted. She told me that I’d have breast MRIs and mammograms alternating every six months. She warned me about the number of false positives, and that at some point, it was likely that someone would see something “funny” on a screening and I’d have to go back for a follow-up screening. She warned me that this can be very anxiety provoking.

Then I asked her to examine my left breast, because that odd sensation never went away. She didn’t feel any lumps.

On Friday, July 7, 2017 I had my first screening – a breast MRI. Then the following Monday, July 10, Dr. Langer personally called me. “As I warned you about, they saw something ‘funny’ on your MRI, and I’d like to schedule you for a diagnostic mammogram and ultrasound on Friday.” Here’s what that means: they’d seen something not right (“funny”) on the MRI, and now were planning to use other imaging techniques to see if the “funny” thing showed up again, or if it was an anomaly with the MRI. If they saw the “funny” thing on the mammogram and ultrasound, too, I’d have a biopsy. For what it’s worth, lots of women get all the way to the biopsy and do not have cancer.

I remember sitting at the conference table at Red Tricycle, where I was the Marketing Director, telling my CEO and our Editorial Director that I’d be out of the office that coming Friday afternoon. That I was sure it was nothing, but I was a little nervous.

The diagnostic mammogram was no big deal. I’d never had a mammogram before, and it didn’t hurt. The mammogram tech took a few extra images than she would have for a regular mammogram, told me the doctor would interpret it for me, and then sent me to wait for the ultrasound tech.

Two ultrasound techs, who were extremely kind, examined my breast using the ultrasound before the radiologist came in. They pointed out various “calcs” they saw on the image (which I now know means calcifications – white spots on the image that are totally normal but can sometimes mean early stage cancer). Then the doctor came in and quietly examined my breast in the same way the techs had. I said, “Dr. Langer said you would know if I need a biopsy or not. When will you know?” He was very grave when he said, “I already know.” He set down the ultrasound  probe and said, “do you want me to be frank?” I looked at him and said, “yes, please.”

“What we are seeing can be nothing other than cancer.”

What they saw in my screenings was not “funny.” It was cancer. Cancer that took up such a large part of my left breast — from under my arm all the way to my nipple, exactly where I’d felt those sensations — that I would need to have my entire breast removed, no matter what. A mastectomy. There was no way to only remove the lump because I had no lump. PLEASE HEAR ME: I HAD NO LUMP.

My initial diagnosis was DCIS (ductal carcinoma in situ, or cancer cells in the milk duct) with no evidence of invasive cancer (cancer that has spread outside the duct). Stage 1, maybe even Stage 0; but because of the size of the area involved, they wouldn’t know my stage for sure until they removed my entire breast during surgery and had it analyzed by a pathologist.

My story does not stop here, though.

(I know, you’re probably like, “Sara, this story has about 3,000 words already, how is it not over and why in the heck are you giving us every detail?!” And the reason is this: Women need to know. Women need to know that not every cancer starts with a lump in the shower. I want you to know every bit of this because it could save your life, or the life of someone you know. When you think to yourself, “I think I heard about a woman once who had this weird tickling sensation – maybe I should get that checked out.” Or when a friend of yours casually mentions in 10 years that she has a strange sensation – you can say to her: “Sally, go get that checked out right this minute.” That’s why.)

So, back to me: here I am, with cancer in my left breast and no option other than having my breast removed. I wanted to have my surgery done by Dr. Langer in San Francisco. I had a feeling about her and I wanted her to do it. I opted for a double mastectomy. The left mastectomy wasn’t an option; the right mastectomy was preventative. I never wanted to go through this again.

My surgery was scheduled for September 14, 2017. During the time between my diagnosis and surgery, I continued to feel that sensation of milk being let down, and I started to have another gut feeling that the cancer was changing. I felt where the cancer was and still felt no lump – but it felt a little different. I can’t describe how; it just felt like the lumpiness of my breast was lumpy in a different way. I wouldn’t have noticed it, I don’t think, if I hadn’t known there was cancer there. To be clear, I was not zen about this. I was anxious. But I also knew that the only thing that could be done was already scheduled to be done; they couldn’t move my surgery up. So I waited, knowing that we would know a lot more about the cancer once the surgery was over.

When I woke up from my double mastectomy, my mom was there. I asked her if the cancer had spread. She said, very sadly, that yes. It was in one of my lymph nodes.

For those of you who aren’t as well versed in cancer as I am now, the lymph system is essentially the door to the rest of the body. It is what helps your body drain its waste, and once a cancer cell gets into the lymph system, it can start to reproduce in other parts of the body. Cancer that has spread to other parts of the body is called metastatic, or Stage IV cancer. At this time, there is no cure for Stage IV cancer; there is only living with it until your body can’t live with it any longer.

So to put a point on it: My cancer was spreading before it was forming a lump anyone could feel. After the pathology came back, they found a 1.2 cm lump. I had a teeny, tiny tumor, the size of a pea, and cancer that was already spreading to the rest of my body. I strongly believe that, had I waited to find a lump, it would have been too late. As it was, I was Stage 2a.

Fast-forward to January of this year; I am in the middle of chemo treatments, and my mom, who has moved in with us to help care for my family, mentioned a strange “burning” sensation from the top of her breast to her nipple. I will not tell her story as it is not mine to tell, but she advocated for herself as I advocated for myself. She refused to accept “no” for an answer when she was told by a radiologist “we don’t do mammograms for pain” and she had a follow-up screening after a mammogram came back negative, in part because her gut told her to. Keep in mind, she’d already had cancer in her left breast, and the first time was nothing like this – this was a new experience for her. As a result of her persistence, she was diagnosed with aggressive breast cancer in her right breast and is currently undergoing chemo herself. (If you are the praying type, please keep her at the top of your list – this has been brutal for her.) And also: SHE DID NOT FEEL A LUMP.

Breast cancer looks like a lot of things. It feels like a lot of things. But sometimes, it doesn’t look like anything. You can’t feel anything with your fingers. Everyone gets breast pain, so I’m not saying you have cancer if you have pain. I am saying that you should never listen to someone who says breast cancer doesn’t cause pain. Because sometimes it does.

I recently passed the one year anniversary of my cancer diagnosis. On that day, we moved to new city. We began blending our family with my boyfriend’s and looking to the future. We are doing this because I will survive breast cancer. I will survive cancer because of all the times I could have given up and I didn’t. Instead of facing a very high survival rate, I could be planning my daughter’s future without me in it.

Follow your intuition.

Making Peace with Cancer

Today was my last day of radiation, and for all intents and purposes my “active treatment” is over. No more chemo, no more radiation; the hardest part of this “journey” is (hopefully) behind me. I keep thinking I should be celebrating or feel more of a sense that things are over.

I realized this afternoon that I don’t feel like cancer is over because I don’t think cancer ever ends. And I don’t mean that in a depressing way. I just mean that cancer has become a part of who I am, and there’s no putting it behind me. You can’t ever be done with cancer, because it changes who you are, fundamentally.

The word “survivor” implies that the thing you survived is now over.  That was hard, but I survived it. Like it’s a marathon or something. The truth is, at this point I am no closer to or further from death than anyone else is. I have faced my own mortality a lot younger than most people, and I’ve learned a heck of a lot as a result. But every day I go to bed alive, I have survived, just like you have.

Accepting that cancer has been part of your life is scary. Once it’s been there, it never leaves, and there’s a real loss of control there. There is no going back to “normal.” Normal is gone now. Cancer changes who you are, physically and emotionally, forever. Something you did not choose changed you forever, and if you don’t like how it’s changed you or you don’t quite know how it’s changed you, it can be a real struggle. You cannot ignore it, and you have to find a new identity. You can fight that, but it’s the truth. At some point, you have to make peace with cancer.

I have found peace in my cancer diagnosis, because I truly believe that my purpose in life is to conquer some really hard stuff, so that I can help other people do it, too. It has changed the way that I approach my life for the rest of my life, and I am so grateful for that. It has made me more comfortable in my skin.

Every moment that I have, I am living to the fullest. And I don’t mean that in the cheesy inspirational-quotes-on-Facebook sort of way. I mean, if I am laying around on the couch, I am 100% laying on the couch. I am totally okay with that choice, and I am really enjoying it. I am not making myself feel guilty for what I “should” be doing. If someone else has a problem with my laying on the couch, I truly don’t care. My life is much easier and more peaceful now that I’ve mentally gotten out of my own way.

And quite honestly, I have cancer to thank for that.

 

The featured image is me on the radiation machine (a photo Bear captured covertly, as it was totally against the rules). Crazy, right?

What Happened to My New Relationship When I Was Diagnosed with Cancer

bear1

Have you ever noticed how quickly people fall in love during action movies? They’re brought together during times of extreme stress, and at the end they live happily ever after, simply because they survived a hijacked bus or a zombie apocalypse.

But the truth is, healthy relationships aren’t based on surviving a common disaster. What happens when you get off the bus and Macho Man doesn’t help out around the house? Or you try to have a kid, and you realize that you can’t stand his parenting style?

There are other pitfalls to relationships that start this way, too. When you don’t like someone’s behavior, it’s easy to attribute it to their heightened level of stress. “Oh, I really wish Macho Man would stop shooting people . . . he’s not a killer, though, he’s just being chased by the FBI, it’s not his fault.”

But sometimes (in fact, most of the time I’d venture to guess) people show their true colors during times of stress. If someone calls you names because they’re having a hard time at work, they’re probably a dick.

The truth is, a lot life is dealing with stress. Work is stressful, money is stressful, kids are stressful. At some point in a long-term relationship, you have to face the death of a loved one. One of you might face a life-threatening illness. If your partner’s behavior makes the situation worse instead of standing beside you and working cooperatively, you’ve got a problem.

When you get married, you pledge to care for one another “in sickness and in health,” hoping that the “sickness” part doesn’t get much worse than a man-cold. But in my case, I’d been dating Bear less than a year when I was diagnosed with breast cancer. We hadn’t taken any oaths.

I’m not sure how I expected Bear to react to my diagnosis, but he had a much stronger reaction than I expected. In part, I think my own denial made me think “this isn’t really cancer, so why is everyone so upset?” I know him and his values, so I didn’t expect him to leave me, but I definitely didn’t expect his immediate level of total dedication.

The first things he said to me the night I was diagnosed were: 1) I will find you beautiful, no matter what, 2) You will not fight this alone.

Since then, his sense of humor, positivity, and kindness have helped keep me afloat. When I was trying to eat a mostly plant-based diet, he brought me a bouquet of vegetables instead of flowers. He slapped a “Fight Like a Girl” sticker on the back of his car and sports a “Fight Together” shirt. He made me a boob cake for my 35th birthday (laughter keeps you alive!) and helped my 7 year-old daughter shave my head after I started chemo. On my hardest days, he has helped me to set small goals so I feel like I’ve accomplished something – which makes long, tedious days much easier. He’s helped me physically recover from surgeries, has attended every appointment, and has made sure that I feel supported every step of the way. He has never assumed to know what I am going through, and has allowed me to process this in the right way for me, without telling me what I “should” be doing. I can imagine that, in and of itself, is difficult.

vegetable-bouquet-for-cancer-patient

To me, though, what he said to me the night before my double mastectomy really sums up the kind of man he is. He took a long walk with me, held me as I cried, and said, “I don’t want you to worry that this will affect how I feel about you. I’m not here for what you look like, I’m here for you. You’re going to have scars, but I’ve been thinking about it, and I actually think that’s pretty cool. Every scar tells a story, and the good thing is that I get to be part of your story.”

He wants to be part of my story of survival. And he is.

If I’d had any remaining doubts about him (which I did not), his actions during this process have solidified that I have found a Unicorn.

Cancer, as much as I hate it, has shined a spotlight on all aspects of our relationship and forced us to support and understand one another in ways that life wouldn’t have required us to do for years. We’ve had to talk about uncomfortable things, deal with really complicated emotions, and be empathetic to the other person’s needs.

Bear doesn’t have a big ego, and he doesn’t like attention. So I share this not because I think he will love it (guaranteed he will turn bright red), but because as a partner he has shown up for me every day, and I am so grateful for him. I wish that every cancer patient had a partner that is half as amazing as he is.

Last Valentine’s Day, he told me he loved me for the first time. This Valentine’s Day, I will have my last chemo infusion with this man by my side. This man, who has shown me with his actions every single day that he loves me.

I may be right in the thick of breast cancer treatment, but I feel like the luckiest human on the planet to have found this man. I am so grateful.

Happy New Year from the Cancer Patient: Here’s What I Have to Say

holiday-cards-2017-front

You could fill stadiums and football fields with the stuff I don’t know. I am terrible at names, for example. I am one of those ignorant people we’re ashamed of who can’t name most of the people in power. Math (especially common core) is not my strong suit.

But what I do know is this:

There are good people in this world. So many of them. There are people who are truly selfless. They don’t do kind things because of the likes they’ll get on Facebook or because they get something out of it. They do it because they are generous, good people.

Since my cancer diagnosis, these people have come out of the most unexpected places. My babyhood best friend. Someone I didn’t know well from high school. A lovely woman I met on a press trip to Hawaii. The group of women I blogged with a decade ago. Moms at school I never even spoke to. There are countless community programs run by volunteers who really, honestly care about the people they serve.

Other people have shown up in ways I never would have expected. Friends who sneak food into your refrigerator and arrange get togethers so you don’t get depressed. Friends who leave a bag of unicorn-themed things on your doorstep, bring scarves for your head, an incredibly expensive wig, and lemon treats because they heard you’ll lose your tastebuds. Friends who say truly thoughtful and caring things to me, online and in person, to lift me up.

And there’s the people you hope will stand by you – your parents, your aunt, your partner – who go above and beyond every single day. Who support you as your hair falls out, you melt down, or you simply don’t know what to do next.

Cancer has shown me that I will never be able to properly thank all of the people who have done kind things for me. That the two survivors who work at Charlie’s school will never know how much their thoughtfulness means to me. That there’s no way to describe how much the weekly cards from my boyfriend’s parents brighten my day every single time. That my cousins, aunt, and two close friends will never know the gratitude I feel every time I put on one of the scarves they gave me.

This is not because I don’t thank them – of course I do – but because I truly can’t express just how much it means. To know that you are cared for, and thought of, by people who expect nothing in return.

Since this journey began, and I began sharing my experience, I’ve been told that I have inspired people. But all I’ve done is share my experience. What is truly inspiring to me is the absolute breadth of giving I have witnessed, with no ulterior motive. It truly has changed my life and inspired me to be a better, more generous person myself.

Before I had cancer, I didn’t know how many amazing people I’d surrounded myself with. I didn’t know how to let people help me. I didn’t know how to let other people carry me. I thought I was the helper, but all this time I’ve not known the first thing about what truly giving is.

These people have inspired me and have shown me a generosity that I will absolutely never forget as long as I live. Yes, cancer has changed me. But what has truly changed me is seeing the people in my life for who they are. Good, good people.

Thank you.

I May Be Having an Existential Crisis

For the past few days, I’ve barely been able to control my panic. Something happened the other day in the bathroom. I was passing by the mirror, and I saw my chest. I’ve seen my chest in the mirror a hundred times since my surgery, but something about it really upset me this time. Instead of facing it, I swallowed the panic.

The panic keeps trying to surface. It has something to say, but apparently I have no interest in listening to it. This morning I touched my head and more hair fell out. Panic. Swallow.

We got a very new and peaceful aquarium. Yesterday I was sitting on my hygge couch, staring into the aquarium at the crabs and fish, and all of a sudden I thought, “am I going to die? Will I sit here as I die and watch this peaceful scene and die quietly?” Is that how my story ends? You can say no, but you don’t actually know.

My daily life consists of making it through. Some people work through chemo, and I can’t imagine having to do that, because making it through is all I can do. Taking walks, trying to drink water despite my mouth feeling like it’s coated in something slimy…these things are all I can do. And it is hard to imagine coming out the other side of this and not just “making it through” every day. I am so completely overwhelmed by CANCER that I can’t handle even the most simple of tasks.

I am in pain from the chemo and my email is overflowing. I am supposed to answer these emails from kind people. I can’t. I can’t bring myself to do it because of the panic. I feel like I might start screaming. I am screaming on the inside even when I am not screaming on the outside. Screaming on the outside feels like it would take too much work, which is maybe the only reason I don’t do it.

How do I get to the point where life goes on? Part of me wonders if I might die because I can’t imagine what it will be like to live on the other side of this. When I thought about my future, I didn’t envision myself as an 80 year-old with breast implants sitting in a rocker. Attempting to reconcile this future I didn’t imagine for myself is part of what makes life so totally confounding right now. How is it even possible that I will go through the rest of my life with these scars across my “breasts”? How can I possibly reach 80 when, at 34, I had cancer?

Cancer cut my life in half. Before cancer, I cared about work. I cared very deeply about meeting my goals and worked really hard to meet them. Now my goals feel stupid. Who the hell cares how many clicks we get, how much money we make? On Facebook I see e-books for people looking to get quick results from advertising, or guidelines about when to post inspirational quotes to get in front of more people. Who cares about bento boxes for kids’ lunches or holiday cookies? Who cares if anyone clicks on any of this shit?

I don’t have cancer now. We cut it out, didn’t we? But it could come back. Even if I don’t have any breast tissue left, it could come back somewhere else. We don’t know that it won’t. How do I go forward with my life knowing that I can’t trust my own body? Is the pain in my lower back because I’ve been sitting wrong? Or is it cancer in my bones? How do I go forward knowing that my friend thought she needed to see a chiropractor and get a stand-up desk, when in reality this horrible illness had returned, and that was it: Stage IV? Now she’s gone.

Panic.

You know the joke, “why did the chicken cross the road?” No one thinks this joke is funny, because it seems too obvious. But last year my friend Michelle blew my mind when she pointed out that the answer is actually really deep: “To get to the other side.” If the chicken successfully crosses the road, he’s on the other side of the road. But if he gets hit by a car, he’s on the Other Side.

I was walking my whole life on one side of the road. Doing my thing, living my life. And then cancer came, and it made me cross the road, and I’m praying I get to the other side instead of the Other Side. I can’t stay where I was, thanks to cancer. But I’m confused. Because everything here looks the same, but everything is different.

My child is in the variety show at school and there are things to be done. I have to pay my rent and I have to pay the electricity bill. I have to pack school lunches and I have to figure out how to do it all without screaming.

None of these things matter. How do I go back to a life where I’m finding things to write about that will get “clicks”? As a fellow marketing friend of mine said, Amazon grows and grows and grows, but why? What is the point of any of this? More than a half million people work for Amazon, day after day, toward the common goal of growing. All their meetings, their phone calls, their emails, their daily stress . . . it all centers around growing the company, but WHY?! To what end?

There’s so much noise, so much superfluous shit and so little of it is important. On this side of the road, I’m looking at all these things I used to look at every day – the bills, the variety shows, the work goals, the office gossip – and I’m seeing it differently. I’m swallowing my screaming. Because even though I know these things are stupid, I know that no matter which side of the road I’m on, they’re still there. And they will be until I’m on the Other Side.

And I don’t want to go there.

 

Dear Body, Who the Hell Are You?

A few days ago, I was in the shower and realized that I have not washed my “breasts” since my surgery. When I’ve seen the plastic surgeon to have my tissue expanders filled, he has cleaned the incisions, and otherwise I have not touched them. Despite the fact that they are totally healed, I had the sudden realization that I am afraid of them. They don’t belong to me anymore; they belong to my plastic surgeon. He knows how to take care of them, and I don’t think I do.

And like my “breasts,” I am afraid of the rest of my body as well. My chest, now fitted with a chemo port, belongs to my oncologist. In fact, the rest of my body, considering it does weird things now, belongs to her as well. It hurts in places it never hurt before, and I don’t know if those pains are normal. I find myself asking questions like, “does that mean it’s infected?!” or “is this normal?” on a daily basis. I am waiting for my scalp to start tingling and my hair to fall out. I question what medications I can take and whether it’s safe to wear deodorant. Whether I can use my arms to take out the trash, or if it’s now too heavy and will put me at risk for lymphedema.

I have always been very in touch with my body. I knew what it needed, and I knew when something was wrong. That’s how I ended up finding my own cancer. This unfamiliarity is, well . . . unfamiliar. And scary.

I used to wonder what kind of person can wear a bralette. The answer, now, is me. The tissue expanders feel like a too-tight circular underwire bra I can never take off. I can’t sleep on my side and have only recently graduated to sleeping flat on my back for a portion of the night.

There is something simultaneously freeing and terrifying about no longer needing the an $80 underwire from Nordstrom. On one hand, it’s a simple and positive change to a wardrobe staple: a bralette is significantly cheaper and more convenient than a 32G underwire. On the other, those ridiculous bras were part of what I knew about my body. They sucked, but they were familiar.

This body, the one that wears a tank top with a shelf bra, is not a body I know. I will have to learn about it all over again, and I might as well not start now. So many things about it are temporary: the tissue expanders, the effects of chemo. This is a temporary body, one that isn’t working properly right now. It’s in the body shop (ha), and in a year will come out the other side different.

Even after the chemo, the radiation, and the surgery to replace the tissue expanders with implants, I’m not sure I can trust the stitched-up “final” product. Radiation leaves a 20-30% chance of losing one of my implants in 1-3 years due to complications. And if I don’t have those complications, the implants will need to be replaced at some point, as they’re not meant to last forever.

Before my surgery, I took some photos of my old breasts. I didn’t want to regret not having done so. But when I looked at the photos after I’d taken them, I was a little horrified by them. “Yikes,” I thought, “those are enormous.” The idea of new, perky breasts sounded sort of appealing in that moment, even if I’d never have any sensation in them again.

Little did I know that I’d be losing my sense of security along with those breasts. My sense of knowing my own body. All that’s left of that body is a photo card marked “BOOBS.”

I’m not sure how to feel about that.

A Letter to Bernard Tyson, CEO of Kaiser Permanente, from a 34 Year-Old with Breast Cancer

Dear Mr. Tyson,

Last night, I spent 20 minutes on the phone with a pharmacist who called me to make sure that my pain needs are covered. Between surgeries and chemo, I had a whole lot of meds from a whole lot of doctors, and he wanted to make sure that I had everything I needed, and that I knew how to take everything that had been prescribed.

There are a lot of problems with healthcare in this country, and I am writing to thank you for running an organization that I see as part of the solution, and not part of the problem.

I’ve been a Kaiser member since my teens. I have always appreciated the ease of dealing with Kaiser; if I have a problem, there’s a clear number to call for advice, and all the doctors are in one place. I’ve also always seen Kaiser as very innovative: I was given acupuncture and biofeedback as part of a trial for migraine headaches at Kaiser San Francisco in my early 20s. I had my daughter at Kaiser Walnut Creek in 2010, where the staff is full of midwives and there are birthing tubs. We paid $200 for my entire delivery and hospital stay, and every one of my daughter’s well checks have been free. As it turns out, she needed hearing aids, and her visits with a top notch audiologist (shout out to Dr. Madory in Novato!) are fully covered. I have always been thankful for how easy everything is, and I’ve always felt that I received quality care.

But in June of this year my appreciation for Kaiser reached a new level when I was diagnosed with breast cancer at age 34. I felt something strange in my breast starting in April, and immediately went to my OB/GYN.

I have a family history of breast cancer (two aunts, two grandmothers, and — last year — my mother), and Kaiser completely paid to have my genetic testing done. Everything came back negative, but I was still put in a High Risk “Clinic” where I was given access to a talented breast surgeon in San Francisco (Dr. Langer) and started on a regimen of early screenings. Dr. Langer took time out of her extremely busy schedule to explain early screenings and personally called me when my baseline MRI came back “funny.”

Dr. Christopher Cappelen, a radiologist in San Rafael, was the one to do my diagnostic ultrasound and biopsy. He was the one who had the very unfortunate job of, at 4 p.m. on a Friday, telling a 34 year-old single mom that what she had wasn’t “funny:” it was breast cancer.

I laid there on that table, tears streaming down my face, telling him cancer wasn’t part of my plan, and he was so, so kind. I look back on it now, and I know that the ultrasound techs knew something was very wrong when they brought me into the screening room, but they thoughtfully explained the number of people in the room in a way that was designed to not scare the crap out of me. I was technically alone, without a single member of my family, but they gave me comfort in a way that I can’t describe. Dr. Cappelen talked to my parents on the phone and explained what was happening. I can’t tell you how much this meant to me, and how much anxiety it relieved over the coming weekend.

It is now November, and I have had a bilateral mastectomy with tissue expanders inserted, and just finished my first round of chemotherapy. When my chemo is over, I face radiation and at least one more surgery. I am Stage 2a. If I hadn’t gotten an early screening through Kaiser, I would likely not have lived through my 40s. What a terrifying thought.

Everyone from my extremely talented plastic surgeon Dr. Gurjala, to the nurses in the hospital in San Francisco (especially Michelle, Vera, Jimmy, and AJ), to the entire staff in the San Rafael chemo clinic, has treated me like a human being. My oncologist, Dr. Greyz, is so forward-thinking that she “prescribed” walks with tweeting birds because studies show this helps chemo patients, right alongside my chemo drugs. Your breast care coordinator, Vicki Landes, has provided me with emotional support, free resources, a support group, and a heart pillow for after my mastectomy. Your advice nurses have made me cry with their empathy.

It is abundantly clear to me through every step of this horrible, horrible experience that people at Kaiser honestly care about me, and that as an organization you are truly working toward an ideal healthcare model. The payment plan you provide at zero percent interest was another shocking discovery I made that relieved a suffocating amount of stress for me.

I am sure that not everyone has had the best possible experience with Kaiser (I mean really, read the comments section of anything, people have complaints about rainbows these days), but I wanted you to know that I, for one, have. I wanted to thank you and tell you that I trust Kaiser’s doctors and nurses, and I wouldn’t want to go through cancer with any other health insurance.

Health care in this country is a mess, Mr. Tyson, but I recognize how lucky I am that I have Kaiser, and I am immensely grateful.

Thank you to you and every single Kaiser employee who has treated me with respect and kindness. Because of early intervention and excellent health care, I’m going to beat this.

Sincerely,

Sara Olsher

The featured image is a photo a snuck of my breast MRI. Syonara, cancer.