By Guest Blogger, Abigail Johnston In January of 2017, at the ripe old age of 38 , I felt a lump in my left breast. I was tandem nursing my almost 4-year-old and almost 2-year-old at the time. I started taking herbs and saw my lactation consultant since I’d already had a few clogs. I always had an overabundance of breast milk, so much so that I donated over 25,000 ounces to a milk sharing group during my 4 years of nursing and pumping. My lactation consultant thought it was nothing but since the herbs weren’t working, she wanted me to see my PCP. My PCP is super chill and tandem nursed her kiddos, so she was not too concerned. Her comment was that she was 95% sure that it was nothing but since my mom was then a 14-year breast cancer survivor and I’d never had a mammogram, she sent me for a mammogram and a diagnostic ultrasound. Since we were expecting some difficulty with my dense and milk filled gigantic breasts (seriously, I went from barely a B to at least a DD while nursing and I’m 5’2”), she told me not to let the radiologist do a biopsy if there was any suspicion but to call her for a referral to a specialist. I didn’t know what to expect at the mammogram appointment but I certainly did not except to drench the machine in milk. Also, it HURT!!! The tech wasn’t very happy about milk everywhere but seriously, that crazy machine HURT!! I pumped before the scan and pumped again during a break and we got some pictures. Tech didn’t have a poker face, so I knew something was up. After the diagnostic ultrasound, the radiologist came in and wanted to do a biopsy right then. Since my PCP had already told me to call her after the mammogram, I explained that and they freaked. I was taken to three different people, including a social worker before they finally let me leave AMA. It was after office hours at this point and I left a message with my PCP’s answering service on the way home. It was a Thursday. She called me back that Friday morning after having looked at the scans and the report. I think the only explanation at this point for the fact that I was not freaking out was that I was in denial. I was convinced that everything was fine and went to the appointment with the surgeon the following Monday without trepidation. In hindsight that was pretty naive but I am thankful for a few more months without the weight of cancer in my life. The surgeon did the biopsy in her office that day, also not what I was expecting and we left with some amount of concern to wait for the results. I leaked milk from the biopsied area (at around 10 o’clock right outside the aureola on my left breast) for about a week and my kiddos thought that was pretty funny. The crazy bruising wasn’t as funny and the anxiety even less. On March 8, 2017 , we got the results of the biopsies. The suspicious lymph nodes were just full of milk but the lump in my left breast was breast cancer. Invasive Ductal Carcinoma which was ER/PR+ and HER2-. I later found out I am BRCA- but then so was my mother. At that point, we met with a medical oncologist and a radiation oncologist and started the process of drying up my milk. It was tremendously difficult and abruptly weaning both Boys was just plain awful. I felt like I was walking around with a bomb inside me. I was limping at this point, favoring my right leg — I’m not a complainer and I simply didn’t bring It up. In hindsight, that wasn’t the smartest move. We decided to do a lumpectomy and my surgery was on April 11, 2017. The surgeon was able to get clear margins and I was considered node negative since only one of the 4 sentinel nodes had some trace cancer cells. Trace cancer cells means less than 200. We hoped I would just need radiation and again waited for the oncotype results. Still naively hoping we were in the clear. Original staging was 2b. Oncotype score came back in the high side of the gray range and so we had to adjust our thinking to include chemo. Original plan was 4 rounds of AC and then 12 of Taxol. I started chemo and in the haze of the day after the first chemo treatment nicknamed the “red devil,” my medical oncologist called to say that something was wrong with my blood-work (he didn’t say tumor markers then) and we’d need to do more tests. Still naive, I didn’t get upset or exercised and I went in for a bone scan and CT scans within a few days. Took nearly a whole day and when we got the call the next morning that we needed to come in, didn’t matter what time, just come, and a sense of doom began to settle over us. The weight of all that was and all that might be was stifling. The next day, June 22, 2017 , we went to my medical oncologist’s office to find out that the cancer had spread, not through my lymph nodes, but through my blood to take up residence in all of my bones. That limp I mentioned earlier, turns out I had a 5-cm tumor in the middle of my right femur. My organs were and are clear of mets so far. My husband had insisted on coming to my appointment and we both cried and cried and cried. Life as we knew it had already shifted and now it had taken a dark turn. About a week later, on June 30th after having multiple MRIs and skeletal studies, an Orthopedic surgeon put a titanium rod inside each femur secured by 4 screws each. We also did some additional genetic testing and found out that I’m positive for the ATM mutation. I kept going with AC but we decided to leave Taxol for later. I did 10 days of radiation on my legs and my back (big lesion at L2) in July as soon as I was healed enough from the surgery. I had a full hysterectomy on September 18, 2017 and I started Ibrance and Letrozole in August, 2017 . For now, all of my mets have shrunk and I’m getting more and more limber each day. I’ve added yoga to my routine, which is really helping with flexibility. In October 2017 , we finished closing up my office and moved to Miami to live with my parents for the help and support. I’ve been able to access disability benefits and I’m trying to figure out what’s next. Becoming educated and keeping up on research as much as possible has become a little like a full-time job! I’ve added acupuncture, chiropractic, supplements, diet changes and medical marijuana to my regimen. I like to say that we’re combining the best of Eastern and Western medicine the best we can. Recently, I’ve developed heterotopic ossification in each thigh, which basically means that I have bone growing inside each of my thigh muscles. None of the bone pain I’ve been managing prepares me for this much pain. We’re working on building muscle to cushion the growing bone and there may be more surgery in my future, once the ossifications stop growing. My very first thought in June when we got the news was that I wanted to spend as much time as possible with my children. That’s what I’m doing. I’m spending time with my family and creating a new life and memories for as long as we have. Our focus is living in the present and working to maximize the joy of the time we have. I’ve got boxes started for both Boys and I’ve been working on letters and cards and mementos. I worked with a nonprofit recently called Thru My Eyes to create a video for my children to watch after I’m gone. I’ve also started a box for my husband to stash important reminders and letters. Thinking about leaving my kids sometimes leaves me paralyzed but it also clarifies things. While I’m still able, I get out of bed each day and spend as much time as I can with them. When I can’t get out of bed because of all the side effects I deal with daily, we get lots of snuggles and cuddles. This is our life now, in all it’s beautiful mess.

By Store My Tumor The most common statement we receive from people we talk to is… I wish I knew about the importance of preserving cancer cells alive at the time of my surgery. Why didn't my doctor talk to me about the option of storing my tumor tissue? Doesn't he understand my survival is everything? I have a family that I need to be here for! To answer that question- most doctors are always going to go with the standard of care treatment- surgery, chemo and radiation. They have no time and this is what they are taught to do. Anything aside from that is not known to them and they don’t want to go outside the norm. This is why a patient must take control of their own treatment. If you have a doctor that you feel you aren’t getting the right answers from, then find a new doctor. If you feel your treatment plan isn’t right for you, then ask questions. You need to be a part of your treatment plan so that you feel included in your survival and can help to ensure it. The standard of care is okay for some people but not for all. If you feel you want to take control of your treatment and personalize a treatment that is just for you then you need to do some research. StoreMyTumor can help you preserve your cancer cells and tissue alive and initiate a number of advanced diagnostics and personalized immunotherapies for example. Did you know? Hospitals routinely discard tumors post-surgery, or they may save a very small piece of the tumor preserved in paraffin, which will not keep the cells alive. StoreMyTumor preserves your cancer cells and tissue in a live, viable format. Patients can store tissue collected from a surgery or biopsies, or fluid from ascites drainage (paracentesis). Call them if you are having a procedure that may involve removing tumors or cancer cells. What are the preserved live cells or tissue useful for you ask? · Sensitivity Testing (diagnostic) - tests which drug or combination is most effective to target the tumor. Can be done for chemo therapeutic agents only, or a wider range of drugs that include chemo, targeted, and immunotherapy. This eliminates the trial and error process doctors go through and the severe side effects that accompany the wrong chemo and drug. Applies to all indications and requires Viable tumor tissue. · Genomic Sequencing (diagnostic) - checks for hundreds of mutations on the tumor and matches the right drug to mutations expressed by the tumor. Applies to all indications and requires formalin or paraffin tissue (fixed/dead). · Personalized Vaccines (immunotherapy) - stimulates the immune system to recognize and fight the cancer cells. Good to clean the body from residual cancer cells after surgery/chemo. Applies to all indications. Available in trials across the USA and internationally. Applies to all indications and requires Viable tumor tissue. · Adoptive T-cell Transfers (immunotherapy) - multiplies the army of killer T-cells that already recognize the tumor to dramatically boost the immune system’s ability to destroy the tumor. Available in trials across the USA and internationally. Applies to all indications and requires Viable tumor tissue. Personalized medicine is transforming our thinking about designing effective treatments. If you have questions, you can also set up a time for them to give you a call . Knowledge is Power! Know All Your Options! Take control! Thanks to StoreMyTumor for sharing this blog with out community!

#FeatureFriday You might have heard from others that during your breast cancer journey, it’s best to "stay positive." After all, having an optimistic mindset has been shown to lower the risk of heart attacks, reduce stress, and generally improve life satisfaction. However, when a serious health threat like a cancer diagnosis is thrown into the mix, it’s not always that simple. Here, we’ve collected a series of articles, ranging from personal accounts to scientific literature reviews, all aimed at examining whether or not positive thinking can actually help throughout your cancer journey. The consensus? Probably not- at least, not as the miracle cure we’ve all been waiting for. However, that’s not to say that positive thinking should be completely abandoned. Check out the resources below to learn more. Positive Psychology in Cancer Care: Bad Science, Exaggerated Claims, and Unproven Medicine This literature review summarizes four main applications of positive thinking in cancer care, including having a positive mindset during care, using positive psychology methods during cancer treatment, and the concepts of “benefit finding” and “post-traumatic growth”. The last two concepts relate to a phenomenon of survivors finding positive aspects within the overall negative experiences they went through, and while there may be a mental health benefit, the reviewers found no physical or immune improvement, as many of the positive psychology studies claimed for there to be. While the reviewers agree that positive thinking can have benefits for some, with serious, often systemic illnesses such as cancer, it is difficult to expect one’s mindset to heavily influence their physiological state. Read more Impact of Attitudes and Feelings on Cancer The American Cancer Society created an FAQ-style resource for those wondering how their mindsets may impact their cancer care. They report that generally, people’s feelings and attitudes have very little to do with their actual diagnosis. You cannot think your way into getting cancer, and you also cannot think your way out of it, Oftentimes, by trying to be positive, it hides the negative emotions that someone may have with regards to their cancer, and that can prove to be more of a burden than simply allowing themselves to feel upset would be. Some things that they find may help with symptom management or stress relief include guided imagery, meditation, and meeting with a support group. Read More Smile! You’ve Got Cancer Barbara Ehrenrhich describes her breast cancer journey in relation to her trials with positive thinking. Finding herself lost in a sea of support groups, informative books, and medical advice, she turned to the positive thinking community in the hopes that it would make her experience a little more stress-free. Surrounded by messages such as, “‘Cancer was the best thing that ever happened to me’", or, “‘breast cancer has given me a new life. Breast cancer was something I needed to experience to open my eyes to the joy of living.’”, she quickly realizes that there is a less-than-positive edge to the current of positivity she was being swept up in. Read more Can a Positive Attitude Really Affect Breast Cancer Survival? The short answer is no, probably not. Not only does thinking positively not impact breast cancer outcomes to any significant degree, as shown by multiple studies, but by trying to be consistently positive when facing such a stressful situation, or hiding your true feelings when with others to seem more positive, it can often only serve to isolate you further from your support networks. By tying your mindset to your prognosis, it can lead you to feel like you are responsible for however your cancer is progressing, which simply isn’t true. But there are things that you can do to help your mental wellbeing- things like joining a support group, or getting help from a mental health professional can both help curb the stress and anxiety that accompanies breast cancer, and help decrease rates of depression and mental fatigue. Read more We hope that these resources help to clarify the often confusing relationships between mindset and physical health, especially as it relates to breast cancer. Breast cancer can come with a lot of complicated emotions, and we at SBC want you to know that it’s ok to not be ok. If you’re looking for some mindfulness exercises or a support group to join, then look no further: SurvivingBreastCancer.org has a few programs that may be able to help relieve some of the stresses associated with your breast cancer journey. Positive or not, we welcome you as you are.

By Dawn Oswald Today Today I woke up What a blessing I ate, I took my medicine, I watched TV, I ate lunch, I watched TV, I took a nap, I ate dinner, I took my medicine, I watched some more TV and then I went to bed Today I repeated that all over again Today is another day, but it is the same It’s my ground hog day Tomorrow brings a new day I am going to change today Today I will eat, take my medicine, watch TV or enjoy my new hobby, eat lunch, watch some more TV or take my dog for a walk, eat dinner, take my medicine of course, finishing a new beanie or play a game with my daughter I am changing my life I will take my life back Today I woke up What another blessing I ate, I took my medicine to stay alive, I went shopping to pamper myself, I went for a walk to be healthy again, I went to lunch with my husband (a date), I took my dog for a walk, I volunteered my time, and I ate dinner then took my medicine I chose to change my life and to do what I want and when I want Today was a good day Tomorrow will be a better day Tomorrow only comes once You can look back on it, but it won’t change Make your today count Today, then tomorrow Tomorrow will come, but how will you fill your day? What will you do with your tomorrow? Today is a blessing Tomorrow can be a better blessing

How I Discovered Faith, True Beauty, and Confidence During and After Cancer By Karen Rice Without questioning, when going through a serious illness, you learn to know what faith truly is, along with finding the true meaning of beauty and how you really feel about yourself. I know this all too well because I have experienced many trials and tribulations in my life. Through it all, I gain strength that I never knew I had, and much more confidence in myself, which led me to loving myself all over again. I had a new beginning, all on my own. After going through so much in my life, things were going well, until it happened. I had a head-on collision with not only breast cancer, but colon cancer as well, and it changed my entire outlook on life. I thought I had endured rough years before but going through cancer was the rest of the iceberg. There is nothing like it. You wonder, what in life had you done so wrong to have this placed upon you. You began asking, why me. Yet through my tragedies and all that I had to endure, it all became an awakening for me, in which I received and gain all the strength and encouragement I needed to conquer. Through it all, not only did I find the true meaning of life, I found the true meaning of beauty. Through all the chemo, radiation, the pain I endured, I still felt beautiful. I found myself looking in the mirror even more during this time, because I thought what I was dealing with would change me drastically, but as I viewed the imperfections I now have to live with, over time it got better, and instead of feeling sorry for myself, I embrace it all; I'm still among the living, who am I to complain. Whether we are dealing with an illness or any other negative feelings about ourselves, our lives, and our bodies, we need to be our on-cheering section. Through all my mishaps, I still feel beautiful and it is real. I have come to realize that even going through such a dark time in my life, I still have a life to be lived, and I am going to live it to the fullest. When I think about the individuals that are no longer among us due to such a horrific disease, I'm truly grateful, and I will no longer take my life for granted, life is precious, and we don't realize that, until we come close to losing it. When I think of the “gift of life” that was given to me twice over, I knew I did not have a moment to waste. I would never say having or going through cancer is a gift, surviving it, receiving a second and third chance at life, is the gift. Yet, through it all, I did not allow the disease to take away who I am, or what I stand for. I am a survivor, as well as an example to show that it can happen, and that I can go on and look and feel just as beautiful, inside, and out, and it shines brighter. Yet through my tragedies and all that I had to endure, I received and gain all the strength and encouragement I needed to conquer. I will say, that the areas of my body that was interrupted, will be a constant reminder I had cancer, and at times, it does bother me, I'm human, but within a moment or two, I look past it, because those areas could be covered up. True beauty is within and when you feel beautiful on the inside, it shows so clearly on the outside. Just because I had cancer, does not mean cancer had me. We as women should never allow anything, or any circumstance to steal our joy, nor our self-esteem. And I know with cancer, many times you are too weak to even think about your looks, because you're not always feeling your best, believe me, I know; but sometimes you must try a little bit, and fight past it and keep living. Through any tragedy, we are and always will be beautiful and unique! Women, we all know that our bodies take lickings, yet we keep on ticking. When I look back now and see how far I've came, I have to say, I thought right away that my cancer diagnoses was truly a death sentence, because you're not sure if you're going to make it or not. Cancer have taught me not to blink twice at life, my eyes are wide open, living life to the fullest. I also realized after surviving cancer both times, that I was about to face new beginnings, new hope, do and see more with a whole new prospective on life. I share my story with others hoping to make a positive impact on someone who is ill or otherwise, where they can proceed life in a whole new way. I am 63yrs of age now, and I am cherishing each day, each moment, and through it all, I feel that I am still at my best. I am confident with myself, as well as grateful. I am starting over, doing things I should have done before cancer. One day, after one of the many surgeries I had during my breast cancer period, and I could remember it as if it was yesterday, I experienced something so real, so peaceful, something of a miracle, that I had to write it down. I turned that experience into a poem, and I called it “Peace”. I took that poem, along with many others I had written, writing had become therapy for me. I am hoping that anyone who may have the opportunity to read my poems, get out of them, what I placed in them, they are as real as any could ever be. My most recent published book is titled, “Cancer, Yet Cancer Again, but I will not Die, before I'm Dead”. I titled it that , because I truly feel that you should not stop living, because you have cancer, and that is exactly what I almost did, when I heard the word cancer. I am a realist, a regular everyday woman, who have overcome many obstacles, which took me to writing, trying to produce inspirational stories. If I had not gone through all that I did, I would have never anticipated such. The scars and mishaps, that are now attached to my body, due to cancer, are just that, and they are symbols for someone else inspiration and hope. I am thankful, because if I had not struggled, I would not have found my true strengths. I am a true example that you can survive cancer, not once, but twice, providing you get to it in time. I am not saying all will be easy, I am not saying all will survive it, what I am saying, is to have faith, fight with all you have, then hold on. I honestly believe, when and if you survive a horrific tragedy or a horrible disease such as cancer, it is for a reason. You have a purpose, and through that purpose, faith, compassion and strength, true beauty is born.

By Denise Rodman Breast Cancer has always been a part of my life. My mother passed away of breast cancer at the age of 36. She left us just before my 2nd birthday. Losing her at such a young age encouraged me to want to grow up and be the best mom I could be. I looked forward to having children and doing all the things I had longed to do with my own mother. Coincidentally, I became pregnant for the first time at the same age my mother was pregnant with me. I had never felt so close to her even though I have no memory of her. Everything seemed to be going as planned: marriage, a child, a home and even a promotion at work. Fast forward to my 40th birthday–I had always felt some relief that every birthday celebrated was another year further from the eternal age of my mother. One night, I was sitting next to my husband on the couch watching TV. My arm had rubbed against my right breast and something felt odd. I immediately started to feel the area with my hand…there it was…a lump. I immediately asked my husband to feel it. As he pulled his hand away, he immediately said “that needs to get checked out!” The following few days were a whirlwind. First a visit to my OBGYN, who directly sent me for a mammogram and sonogram that same afternoon. Next was a core needle biopsy and a referral to a breast surgeon. Ten days after finding my lump, I was given the news that I had breast cancer. A week later, I found out it was TNBC. I immediately thought of my son. Will he lose me… as I had lost my own mother? What was I going to do? He had just turned 5 years old. I felt like I was on a freight train barreling down the track out of control. So many decisions to make and emotions to process. My older sister had shared with me that when my mother was dying, she asked if my mother would live. All the adults told her everything would be okay. After my mother died everything was not okay and my sister would never be the same, rarely trusting others. My son is quite sharp and sensitive, and he knew something was different. The phone rang more, and I would leave the room to talk privately. I would need to tell him what was going on and the changes that would be happening. I would first have a bilateral mastectomy with an axillary node dissection, followed by chemotherapy, radiation and reconstruction surgery. My son and I love to read together. I have read to him almost every night of his life and now he has begun to read to me. It is part of our nightly bedtime routine. I was never read to as a child, but I saw it happen in movies and on TV. I had dreamt of lying in bed with my son or daughter cuddled under the blanket and reading together. I researched breast cancer children’s books online and decided that is how I would tell him I had cancer. I put the pink book on the couch, and he quickly asked if we could read it together. We cuddled close and began to read. Tears began to run down my cheek. We finished the book and now he knew. I told him if he has any questions or worries to come talk to me and we would figure it out together. I know that telling children about cancer is a very personal choice. Some might feel that it could overwhelm them and fill them with fear. There might be the option to hide it or limit what children are told. For me, I wanted to be very honest with my son. I had lost both of my parents before my 25th birthday. I had learned that death was a part of life. I wanted my son to know that I was willing to do anything I could possibly do to overcome cancer and enjoy as much time as God gave me on this beautiful planet with him. For every step, I would find a book to read about topics such as mastectomy surgery, chemotherapy and radiation. We would read about it together, learn together and help each other through this. When it came time to shave my head, I even had him help. He was giggling as my hair dropped to the floor and it lightened the mood. Once shaved, he would rub his small hand over the stubble and comment on how soft it felt. He would do the same when my hair began to grow back in after chemo. This method of telling my son about my cancer might not be the standard or even the suggested. What I tell others going through cancer is you need to do what you feel is right. Trust your gut. You know your child or children better than anyone else. If they cry console them. If they get angry, tell them you are angry too. And most importantly love them and love yourself. My little family unit consisting of myself, my son and my husband fought cancer together. I leave you with a few takeaways from my cancer diagnosis and parenting: Make sure you are taking time for yourself. Like on an airplane you need to put your oxygen mask on first, before helping someone else. Be gentle with yourself. There is no right or wrong way to navigate this. Find joy in the small things. In our fast-paced world it is so easy to miss them. Look at your blessings and teach your children to do the same. Love, love your children, love yourself, love others.

By Andrea Magni www.diverightincoach.com acjmagni@gmail.com I am a master of reframing … Reframing is an important skill as it takes you from a place of zero choice to being the master of your own destiny. There is a legend that Amazonian women would remove their breasts to make them a better archer and warrior. It isn’t true and yet for some breast cancer survivors it is: removing their breasts makes them much more able to fight and live on. As we navigate our treatments there are some well-meaning people who will refer to our breast surgery as a “boob job” or they’ll comment on how sore their boob job was when trying to let you know they “understand.” Our Breast Cancer survivor group meets once a week and we have no agenda. One week I discussed the fact that breast surgery was an amputation and it resonated so deeply with everyone. When I had my double mastectomy they hollowed out my body from one rib cage and armpit to the other. All the flesh under my skin was removed. I had implants placed over my pec minor muscle and under the pec major muscle and stitched into place. This was not an augmentation or “boob job”. My breasts have changed so much over my life, from pre-puberty, adolescence, young adult, overweight, pregnant, breast feeding, and after. When I learned I had breast cancer and had opted to have a double mastectomy I grieved. I grieved for the loss of naiveté and the innocence of life. I was not sure then if my cancer had spread, all I knew was I wanted to take the most extreme action. My 2.0s as I affectionately call the upgrade (only an upgrade in that they’re not trying to kill me), are big. 34DDs. I did not ask for them to be this size. The surgeon made her mind up while I was on the table. I believe she could have gone smaller but she looked at my almost 6 foot frame and thought I “could handle the scale”. There are some downsides to this: tops do not fit like they used to. The size makes them heavy. None of my old bras fitted and I have to wear bras with serious construction permits and broader straps. There is a reason the DD’s have special sections in the bra store. My breasts do not mold into the bra – the bra has to fit perfectly and even then after several hours the implant squashes my skin into the bra frame. I was hoping to be able to go bra free every now and then and this is not really possible. They are simply too large. Thankfully Sports tops are helpful. The positives still outweigh the negatives: I have breasts, they do have feeling (and this is wonderful), I did get some new lingerie, they allow me to talk about breast cancer in a refreshing way. I love the 2.0s very much. Best 2.0 moment: a few weeks after surgery we were staying at my Dad’s house and he was reading the kids and I a bedtime story. My daughter was tucked up next to me and leaned in, put her head on my chest, she looked up and said “mommy does this hurt?” I pulled her closer and said “no, it feels wonderful”. Second best 2.0 moment is how good they look in a halter neck bikini! See? Silver lining! What do you want to see differently in your world? Maybe I can help with perspective and reframing. Reframing puts the responsibility of choice back in your corner. For example: “my doctor says I have to exercise or I will have a heart attack. So I guess I had better go to gym.” Or you could take ownership of the idea and say “I want to be well and make better choices for my body. I want to go to gym”. Coaching to reframe is a powerful cognitive tool that helps develop perspectives that better serve your goals. www.diverightincoach.com acjmagni@gmail.com

By Ilene Kaminsky Morning yawns and stretches its arms To part the curtains of night. Tired midwife to light from From her expectant horizon The earth inches towards her morning. Clean, cool fingers weave threads Of sweet perfumed wisteria and more Unnamable long forgotten blooms. Clean and combed through dew damp air. Buds nodding on their stems, Draw blood from my veins with thorns Like cat claws after a scare. Suddenly clouds burst and showers fall To save dry backyards and crops Now cut away from the view unguarded From natures reach over treetops. Lost years and fences already raised Desperate for mending and tattered. Puddled earth evicts worried worms, Plucked by late rising birds from their Broken homes. While in my solitary confinement, Within an escapable white picket fenced Yard, I wave farewell to school busses And to the workers who clean up the world. Alone to remember cubes and corners Push pinned photos, plaques of platitudes, Email boxes and bustling buildings Where tight schedules and bright slides Bore like radiation into the heads of Departments of the thoughtless and benign. My wooden porch now a port of call for Rain long overdue for such late afternoons. I’m stuck in an everlasting April spring day. As sprinklers timed soak the lawn The sun’s last rays motion with Long, scolding fingers at Now unknowable faded faces Trapped like tonight’s fish for supper In this morning’s papers. Laid out on a communal table Where wisdom and innocence Convene to discuss the current Events of still births and deaths. Hands engaged with wild gestures Waving forks and spoons for effect - Interrupting pointless chatter to flatter And cut meat from a fatted calf. Everyone silenced by politeness, Sliced right through the art of the matter. The evening’s news flickers Behind shades of taffeta mmllooookmm Hiding shadow boxes inside windows. Like a sober fly in a glass of whiskey Wet wings legs spinning drowned The hands of its god take it down. I walk with solitude as she unwraps Her arms thick with compassion Beckoning me inside for consolation. Using one wave to cast away Anyone who might see me crying. We sit together on a dark park bench Watching every creature under suburban Skies that all fit on a single broom stick. If no one bothers then no one counts Things yet unseen, like angels Atop a pin head. Yet we must believe That stars still sparkle until the dark unveils Who’s home and left behind To sing unearthly cries of grief. Arched branches bow green Soft leaves shake and flow From willows left weeping While night whispers to me: Please save us all. As the trees fade to black, Wind whips at my face. From the fringes, howls Break into my mind. I can no longer breathe hidden and weak In the between With these heavier things.

By Vicki McDonald I have been living with metastatic breast cancer since 10/13/17.  Diagnosed at age 46 on what I would later learn is Metastatic Breast Cancer Awareness day. I am a Mom of 2 successful adults and 2 teenagers and a Grandma to one beautiful granddaughter. I have found strength and courage I didn’t know existed  while on this roller coaster. Treat. Scan. Repeat. For the rest of my life. I am forever in some sort of treatment to survive. I know I am fortunate. I have made it past the terrifying statistics. I am still  on my first line of treatment. I have found there are advantages of having your mortality looming overhead like a black umbrella- I have been creating messages of love for each child in case I miss out on special events- I want them to forever feel me “cheering for them”.   I have learned to find something that makes me smile everyday. I appreciate nature and friendships so very much. I have made and unfortunately lost many new friends all over the world in support groups , beautiful young ladies stolen from us too soon . We need more research. Less ribbons.  In life it’s not if will be tough, it’s when .  I am not afraid of dying, I fear the  heartbreak of those I will be leaving behind. Have a story to share? We'd love to hear from you! Your voice becomes someone else's thriver's guide! Learn more on how to share your story!

By Abigail Johnston I began my experience with breast cancer in March of 2017 and experienced the pink soaked month of October a few months after we discovered that I’d been Stage IV or Metastatic from the beginning. In October of 2017, I was just weaning myself off of a cane after walking with a walker for some weeks after the surgery that placed titanium rods inside my femurs. It was an honestly a hellish few months and I’d not yet come to terms with having to close my business and trade the life of a busy business owner for the life of a forever patient. I was feeling the loss of so much, a literal loss of identity and I was drowning. I struggled, a lot, with the concept of awareness and the celebrations of survivors who were in the position that I wanted to be in – looking forward to getting back to their life they had before cancer. A few short months prior, that’s where we thought I would be and yet when I was told in June of 2017 that cancer would indeed end my life, all of those expectations were blown out of the water. I’m not sure I can articulate how hard it was to have been told I had cancer, adjusted and assimilated as best I could what would happen, only to be told a few months later that I was terminal. The first time I saw the ribbons splashed all over a retail store that October of 2017, it was the post office and I was still bald or mostly bald from chemo. When I saw the cheerful banner and how the clerks attempted to sell a page of ribbon stamps to each person in front of me, I desperately wanted to leave. But I was mailing something for the closure of the business, something to do with one of the accounts I had negotiated closing early because we’d had to cease operations and I needed it to be postmarked that day, so I gritted my teeth and kept my spot in line. As I made my way to the front of the line, dreading how each person eyed my head, some with clear pity that made me want to punch them, some with weird speculation that also made me want to punch them, and some dismissively …. Yep, wanted to punch them too. I was in quite a mood to eviscerate someone when I got up to the clerk to mail my package. I could see the indecision on her face as she rang up my order, eyeing my head and asking careful questions about what I was mailing and why, and when we got towards the end, she said something about the breast cancer beribboned stamps. Probably whatever was on their script, with a gesture towards my head. It was clear I was a cancer patient to her and she made the question a bit more personal. Despite the seething rage that is still oh so close to the surface, I managed to ask politely how much of the funds I would pay for the stamps would benefit cancer-havers. Honestly, someone should have given me a medal. Gold medal worthy performance, it was. But, after all my restraint and politeness and swallowing of the urge to throat punch each of the people in the post office that day, she didn’t know. She didn’t know if any of the funds used to purchase the pink stamps would benefit anyone except the post office. Even though she was asking me to buy the stamps with some sort of canned marketing spiel about helping those of us with breast cancer, she didn’t know how purchasing the stamps would actually do that. Before you start to think I hate the post office, let me just say that I don’t. I buy stamps regularly and have been horrified at the attempts to undermine the necessary part of our democracy system that the post office has become. I have even received medication in the mail at times during my treatment for MBC, so it’s not the post office itself that was at issue. What was at issue for me is that breast cancer was being used to sell something and, as far as the employee I was talking to was concerned, the benefit to the breast cancer community wasn’t known, wasn’t celebrated, and likely wasn’t happening. She did throw in a few comments about how raising awareness about breast cancer helped people get their mammograms, helped people remember to do self-exams, helped the population at large in some way. That’s clearly not a help to those of us who already have a diagnosis – that distinction wasn’t something that employee thought about nor most that I’ve spoken with since then. And that’s when I lost it. I don’t remember all that I said to her that day, but it wasn’t all that nice and it was intense, at least for me. None of that “awareness” helped me, I actually did find my tumor with a self-exam and I was already Stage IV. I didn’t have any issues getting a mammogram once I felt the lump, but my insurance company wouldn’t have covered it otherwise for two more years because I was only 38. I was tandem breastfeeding at the time I found my lump, and with me having found a lump they wouldn’t have wanted to do the mammogram anyway. None of the platitudes or the marketing spiels or the “awareness” or the pink ribbons every where will help those of us with MBC. The fact of the matter is, approximately 10-12% of us are diagnosed at Stage IV from the beginning despite doing everything those marketing campaigns promote. Then, 20-30% of those diagnosed at an early stage will progress to Stage IV despite doing everything their doctor’s tell them to. When you see the ribbons this October and beyond, please #ThinkBeforeYouPink. Don’t buy a beribboned item just because its October. Check with the seller, find out what will happen to your hard-earned dollars. When you find out that no individual with breast cancer will actually benefit from your purchase, consider taking the same amount of money and donating it to metavivor.org , where 100% of the funds raised are allocated to research that benefits those of us who are Stage IV.

By Karla Mans Giroux My Story: From Cancer to Consciousness – Healing from MBC I consider myself an optimist, a cancer thriver, and a longevity geek (I plan to live to 100…healthy & sane of course!). I’ve had two experiences with cancer…one that is currently ongoing, but I’ve never let it define me. Change me? Yes. Define me? No! The Backstory I was diagnosed with breast cancer in 2003. I was 37 years old and had a 5-year-old and 2-year-old at that time. As you know, or can imagine, it was a frightening time, and while I did my research and took control of my health, I did not make the lifestyle changes that I could have to ensure it never came back. I took a conventional approach and underwent a mastectomy with free-flap reconstruction (a tummy tuck was the silver lining). Lymph nodes were involved, and they found another spot of cancer that was previously undetected. Chemo and radiation were next. I also took Tamoxifen for 5 years as recommended. I believe that my positive mindset helped me make it through treatment relatively easily, despite painful neuropathy in my hands. For me it was pretty much over and done in 9 months and I went back to my “normal” life. Since I thought I lived a healthy lifestyle I figured that was the last I would see of cancer…and I certainly hoped and prayed for that. When I hit my 10-year “cancer-versary” I really felt safe! The Metastatic Diagnosis However, 11 years out from the original diagnosis I found the cancer had metastasized to bone. It was November of 2014, and I had an MRI to diagnose an issue in my leg. Turns out the issue was not in my leg. It was metastatic cancer on the spine that was blocking a nerve pathway which pinched that nerve and caused numbness and collapsing of my leg. The cancer was back, and it had spread all over my bones – spine, hips, pelvis, ribs, collarbone. I did not know how I would survive this, but I quickly returned to my conventional oncologist to work out what could be done. Since it seemed we caught it early and it responded to hormone therapy, I was feeling hopeful. A biopsy was attempted but was not successful. Therefore, the oncologist recommended we treat it as if it were the original cancer - ER/PR+ - and I began taking anastrazole in December 2014. By February 2015 ibrance was on the market and so I switched to letrozole with ibrance. The numbness in my leg receded very quickly and my “leg issue” was resolved. The Healing Begins Since this was serious stuff it called for a lot more than I had done before. I was older and wiser and was not giving up my goal of making it to my 100th birthday! I knew better, and I did better. I left no stone unturned. I hired a cancer coach and she helped me clean up my diet, my home, and my lifestyle. I learned how to manage my stress and take better care of me. I became a very inhospitable host to cancer. The changes to my diet were not drastic for me because I had recently done a real food challenge and eliminated sugar, dairy and processed foods. I also stopped drinking alcohol and eating red meat. I ended up losing so much weight that people feared the worst for me. After a few months, I learned how to eat well without eating meat, refined wheat, dairy or sugar, and I put a few pounds back on. I also worked extensively with a therapist to work on my feelings of lack. I uncovered reasons for that lack and suppressed emotions and worked on releasing a lot. I learned to believe that I am enough just as I am. From Conventional to Integrative Care My conventional oncologist didn't believe I needed to do any of the additional things I was doing to support my health. He would tell me to “go eat a brownie” or “have a margarita”. When I would ask about supplements or things I felt would help me stay strong and healthy, he would tell me I could “waste my money” if I wanted to and referred me to the "Integrative Medicine Department"...which was in a different building two blocks away. Not so integrated if you ask me! I didn’t feel supported in my efforts to do all I could to stay in the best possible health and manage this disease. My conventional oncologist just wanted to put me on the latest drug protocols and leave it at that. I was not comfortable leaving it in the hands of conventional medicine alone. Then In late July of 2016, a liver tumor showed up, so I found an integrative oncologist. I scheduled an initial consultation and liked what I heard. This doctor agreed with the conventional protocol I was on, with a slight tweak, and had so much more to offer. He supported my diet and lifestyle changes but also wanted to ensure that I was on a supplement regimen that would put my body in the best possible state to support my health and beat cancer. I continued ibrance and added faslodex. Within six months the liver tumor was fully resolved! My integrative doctor encouraged me to engage in a more routine exercise plan, provided nutritional support and ran a terrain panel every 4 months to determine what food and supplements my body needed to be in the best health to keep cancer at bay, and he really made me feel like I would make it to my 100th birthday just as I’d always planned. I have felt so supported and feel that I have really found a partner in my health and wellness journey. I am proud and pleased to say that there has been no evidence of disease (N.E.D.) since 2016 (4+ years)! Ok so technically I can only say that about my CT scans since the bone scans are classified as “stable”. They show “scarring”. However, I know that what they see on the bone is just that, scarring. The proof is in the improvement of my “leg issue” and no new growth. I know that a big part of my healing came from the integrative approach that I took and from utilizing the 10 healing factors from the book Radical Remission by Dr. Kelly Turner. When I found the book, I just KNEW that I would live to see my 100th birthday like I had planned. I had already implemented many of the factors – strong reasons, empowering, changing my diet, supplements, positivity, social support, spiritual connection, exercise – check, check, check. It was all life changing and so supportive and inspiring. I believe that we all inherently know what our bodies need, and I wish that others knew this too. There is huge need for integrative care. I became a certified Radical Remission Health coach so that I could help other. I love to share the healing factors, from Dr. Turner’s research, and help people learn that there is so much more they can do to help themselves heal. Never let anyone take your hope.

The Second Time Around By Hilary Hamilton The tricky part with Metastatic Breast Cancer (MBC) is figuring out how to navigate the journey the second time around. In 2015, my diagnosis was Stage 2, with a five-year survival rate of 92 percent. I liked those odds. I knew treatment would be hard, but there was an end in sight. I had 14 chemotherapy sessions, six surgeries, a double mastectomy, and 29 radiation treatments -- all that to be cancer-free. Or so I thought. On January 29, 2020, a CAT scan showed tumors in my lungs, liver, and lymph nodes in my chest. On that day, my old cancer-free life left me and. Aa new one began. I am no longer a breast cancer survivor; I am Stage IV, with a 5-year survival rate of 22 percent. I wouldn't say I liked those odds. It's all I thought about when I woke to the moment I went to bed. Even though my oncologist reassured me that many of her patients live with MBC for years, the idea that this cancer is terminal, robbing me of precious time with my kids, husband, and family was so profound that I felt like I was drowning. With any new pain or ache, I was convinced it was spreading to my brain and bones. In the glow of my laptop, I'd pour over the Internet searching the signs of METS in the brain and bones until the wee hours of the morning. I'd then put on a cheery face, marching forward with a tight smile, keeping it together for my three kids. It's been eight months since my MBC diagnosis, and I've had eight cycles of a targeted therapy drug, Ibrance, combined with Faslodex shots. While fatigue is my new companion, the treatment is more tolerable than before, except for the two giant horse shots I get in my rump every month. I've grown to appreciate the nurses' steady hands as their latex fingers hold the glass syringe for two longs minutes that it takes for each injection. The good news is my treatment is working. My tumors are shrinking, and my latest scans showed the four tumors in my liver are down to one. The lesions that covered both lungs like inkblots are now 65% gone. I can breathe a little easier, literally and figuratively. There are still some dark days where the fatigue consumes me, and I am tired just walking upstairs. I worry that my cancer has become the backdrop of my kids' childhood. I don't want them to look back and remember a mom who was always tired. When I start to spin out, I remind myself that I am not my thoughts. I remind myself that I'm breathing; I'm living. All I have is now, and in this now, I'll listen to the whisper of my soul that says you will be okay . I can live in fear or faith. I chose faith. I am grounded in the reality of my illness, but buoyed by hope. I'm ready to learn what this cancer is here to teach me, the second time around.

By Linda Hansen I never worried about breast cancer. No one in my family ever had it, so I was sure that I was low risk. I got annual mammograms, and they were always clear. None of my physicians ever said anything to suggest that I should be concerned. After all, I was low risk. When I hit menopause and had horrible hot flashes that kept me from sleeping, my doctor suggested hormone replacement therapy (HRT). I knew that HRT increased the risk of breast cancer, but the doctor said I should try it. After all, I was low risk. Soon after starting HRT, the hot flashes stopped, and I was soon sleeping again, and able to function. I wasn’t worried about HRT’s impact on breast cancer because I was low risk. Two years passed on HRT, and I kept getting annual mammograms that were clear. I didn’t worry, because I was low risk. I tried to do some exercise and eat reasonably well as I got older. Then again, I live in a state known for deep-fried cheese and bratwurst. Even so, in May of 2010, when I was 54 years old, I decided to try jogging. I was surprised to note that every time my right foot hit the pavement, I felt a brief pain in my right breast. I wondered what it was, but because I was low risk and I’d had a clear mammogram just five weeks earlier, I didn’t worry about breast cancer. When I got home from jogging, I checked my breasts while in the shower. I didn’t feel anything unusual, but that was expected since I was low risk. I got out of the shower, and as I applied deodorant, I noticed that a dent appeared in my right breast as I raised my right arm. When I put my right arm down, the dent went away. I was sure that it wasn’t breast cancer, but I was curious about what it might be. Rather than doing a typical exam as instructed by my doctor, I squeezed both breasts from the sides. I noted that the right breast seemed denser than the left. Although I knew I was low risk for breast cancer, it was time to call a doctor. The following morning I met with my gynecologist and explained my symptoms. He did a breast exam, and I showed him how I found the density. He said he could feel what I described, and told me he would be right back. I wasn’t concerned, after all, I was low risk for breast cancer, but I was curious. The doctor returned a few minutes later, holding a piece of paper. He handed the paper to me and told me that I had an appointment with a breast surgeon Monday morning. The paper contained all of the details. Although I was low risk for breast cancer, I was starting to get concerned. I didn’t tell anyone about what was happening with me, as I knew my family and friends might worry even though I was certain that I would be fine. Monday morning I went to the hospital to meet the breast surgeon. She examined my breasts and told me that I needed an MRI. The hospital would not schedule the MRI until they were sure my insurer would pay for it. For three weeks my doctor argued with the insurance company about the need for an MRI. Finally, it was scheduled. If you’ve never had a breast MRI, you’re missing a real treat. A wooden structure was placed on the “bed” of the MRI. It looked like a cornhole board but had two holes across the top rather than one. I was told to open my hospital gown and lie on the board so that my breasts hung through the holes. A tech reached underneath and tugged on my breasts to get them in the position that she wanted. I’m from Wisconsin, so I’ve spent time on a dairy farm at milking time. As the tech pulled my breasts I did the first thing that came to mind: I let out a long “Moo!” My breast surgeon hung the MRI film on the light box at my next appointment. I didn’t need any medical training to know that something was wrong: one breast appeared nearly black and the other appeared white. Looking at the films, I asked “Other than breast cancer, what could this be?” She responded bluntly. “I think you have breast cancer, but I can’t be sure until I biopsy it.” I was stunned. Didn’t she understand that I was low risk? This couldn’t be right. But eventually I learned that breast cancer doesn’t care if you’re low risk, and low risk doesn’t equal no risk. Life as I knew it quickly changed. I was diagnosed with stage IV breast cancer in June of 2010. I opted for aggressive treatment and more than 10 years later there is no evidence of disease on my scans. I’m doing well and enjoying every day. Carpe Diem !

By Courtney Proctor July 2012 – July 2013: A Year of Misdiagnosis I was 28 years old and otherwise healthy with no history of breast cancer on either side of my family when I found the lump in my left breast and I told myself it was probably just a cyst. However, I was on the heels of an immensely challenging 11-year period of seemingly random health issues -- including multiple emergency surgeries, a spot of skin cancer, and 3 lost pregnancies -- so I had trust issues with my body to say the least. I made an appointment with my OBGYN to have the lump checked and held my breath, really hoping for a respite from health issues. My doctor did a physical exam at the appointment and with assured confidence told me it was just a cyst (spoiler alert: it was cancer). To say I was relieved is an understatement. I practically skipped out of her office, feeling comforted that I wasn’t facing yet another life changing health crisis. A few months later I started to feel more tired than usual, which I largely wrote off by telling myself it was just because there was a lot going on at work. Then one day, about 6 months after I first found the lump, I was in a fitness class and I noticed that my left armpit was a little sore. It kind of felt like razor burn or sun burn, and it ached a little. The sensation continued but initially it was inconsistent – it would be there for a couple days then my armpit would feel normal for a week or more. I had an annual exam with my OBGYN coming up in a few weeks so I tried not to feel too uneasy about it, telling myself I’d have her check it out at the appointment. Looking back, I think how naïve I was not to have known it was a huge warning sign given the lump in my left breast. But I didn’t know much about breast cancer or lymph nodes and I didn’t think a lump in my breast would be associated with armpit pain….and I certainly did not think I had cancer! At my annual exam, my doctor rechecked the lump in my breast and noticed it had grown. I was crazy impressed that she could tell just from feeling it that it had grown, because it wasn’t noticeably larger in size to my untrained, layperson fingers. She seemed unconcerned about the growth, hypothesizing that it was a type of cyst that may grow and shrink with pregnancy. A cyst that does party tricks…doesn’t sound too menacing. When I told her about my newfound armpit soreness, she felt my armpit and said she didn’t feel anything amiss, but I could tell she was slightly concerned and she suggested I visit a breast specialist just in case. By the time I was able to get in to see the breast specialist a couple months later, the soreness in my armpit was more prevalent and consistent. It felt swollen and irritated quite often and a palpable lump had formed in my armpit. It seemed like the specialist had looked at my chart and already concluded the lump was a cyst before he even saw me. He barged into the exam room I was waiting in, and without asking me anything he felt the lump in my breast and exclaimed that it was indeed a cyst. This type of cyst, he said, will continue to grow and grow until you remove it. So, he recommended that I have it removed but he didn’t want to dampen my summer plans with a pesky cyst removal (summer is a big deal to Michiganders 😊) and he suggested I schedule the surgery for the fall. Super cool, another surgery. Can’t wait. He was about to get up and leave, washing his hands of me until fall, but before he did I told him about the pain and lump in my armpit. He felt my armpit and then he said one of the most utterly unbelievable things anyone has ever said to me. It was confusing and seemed suspect at the time, and now that I know what I know about breast cancer, it’s nearly impossible to believe the conversation went down like this…but down it went. This breast specialist told me the lump in my armpit was a lymph node and the only reason I could feel it is because I had less fat on my body relative to others. The explanation didn’t make sense to me because the amount of fat on my body hadn’t changed much in years and my armpit had never felt this way before, so I didn’t understand why my lymph node chose to make itself known now. I must have had a confused expression on my face because he went on to say that if I had more fat on my body the fat would cover the lymph nodes and I wouldn’t be able to feel them. Pretty sure the look of bewilderment remained because he continued, saying that if I felt around in my right armpit, I’d probably feel a lump there too. With that, he stood up, turned around and walked out of the room. As I sat in the exam room, with a sinking feeling in my gut and lingering confusion, I reluctantly probed my right armpit hoping I would indeed feel a lymph node. The search returned nothing. No lymph nodes to be felt. It was getting harder to convince myself that everything was ok, but a breast specialist who sees women with breast cancer daily had told me my I was fine, that this breast lump was not threatening and could wait. So I should be feeling good, right? A couple months later I was taking a shower and felt multiple lumps in my breast. I was shocked that seemingly overnight so many lumps had formed that I couldn’t tell where one ended and another began. I got an appointment with an RN at my OBGYN office for that same day. I was scared, but the emotion that was even more present in my consciousness was frustration and annoyance that I was once again heading to a doctor office. The RN felt the lumps and she said it’s probably a type of cyst that grows in clusters, like grapes. But she ordered an ultrasound to be sure. That ultrasound is what finally lead to a correct diagnosis. The ultrasound results were concerning (obviously!!!), so I went for a mammogram which again came back as concerning and lead to a biopsy. 5 days after the biopsy, and 364 days after first seeing my OBGYN about the lump, I got the call confirming I had breast cancer. I was 29 years old. When I heard the words “I’m sorry, it’s cancer…”, my world stopped and everything I had been trying so hard to control came crashing down. Cancer Stats Stage 3 invasive ductal carcinoma, ER+/PR+/HER2+, BRCA negative, cancer found in 9 lymph nodes Treatment Plan and SO Many Decisions I was able to see an oncologist the day after I got the diagnosis, and everything moved quickly from there. My oncologist recommended a mastectomy, 6 rounds of chemotherapy, Herceptin and Zoladex, and 25 radiation treatments after chemo. She said that as long as my body responded to the chemo, I had a very high chance of survival. There was a part of me that felt grateful to hear the prognosis, but an even larger part that was so immensely terrified about what was to come it felt too risky to feel hopeful. The fear and uncertainty were overwhelming, and the decisions I had to make were dizzying. Would I have a lateral or bilateral mastectomy? Since the cancer was hormone receptor positive would I have my ovaries removed or get a pill shot into my stomach every month to put me into menopause? Would I do the recommended 6 rounds of chemo with all the possible long term side effects? Then there was the decision about radiation and working during chemo or taking a medical leave. And reconstruction decisions after getting through treatment. I felt like I was drowning under the weight of all these impossible choices with impossible to predict outcomes. I wanted answers. I wanted certainty. I wanted to know how I would get through it all. I wanted to know how it would end. Of course, I couldn't know so I tried to take it one decision at a time and make the most informed decision I could. I ultimately had a left mastectomy initially, completed the recommended chemo and radiation, did the monthly shot of Zoladex for a year then had a right mastectomy and my ovaries and fallopian tubes removed at the time of my breast reconstruction surgery. Choosing to Change From the moment I got the call telling me I had cancer, there was one thing I knew without a doubt. Given the way my life had been going - survival meant change. If I wanted something other than the dis-ease, illness and loss I had been experiencing I needed to change. Instead of continuing to run myself into the ground trying to change my external circumstances I had to change from the inside. Thankfully, I was able to take medical leave from my job during chemo so I could finally heed the battle cry of change my body had been shouting. Trying to figure out how to change my life felt overwhelming and I didn't know where to start, so naturally I did the only thing I knew how to do really well - research and data gathering. I read books, listened to seminars and trainings on mindfulness, meditation, Ayurveda and other holistic healing modalities, and what I learned blew my mind wide open. I had always been intrigued by the wisdom and practices of eastern traditions, but I hadn’t put anything I’d previously learned into practice consistently. That wasn’t an option for me anymore…I had to find a way to lessen the stress and pressure I had put on myself. So I started meditating regularly and using the procedures and side effects of treatment as a laboratory for my newfound mindfulness practices -- and to my giant surprise, it worked! Pain was more tolerable when I paid attention to it and stopped resisting it- seriously who would have thought?!? Tough emotions I had habitually buried for fear of being swallowed in their intensity were cathartic and actually shifted into acceptance or peace when I could be present enough to ride the whole wave of the emotion as it ebbed and flowed. I learned how to be aware of my thoughts and focus my attention and having that awareness allowed me to see the stories I was telling myself that caused unnecessary fear and anxiety and gave me a choice to let the story go without getting wrapped up in it. Of course, I still had many moments of anxiety, despair and poor me -- after all I was bald from chemo, a uni-boob (as I lovingly referred to myself for the year between my mastectomy and reconstruction) and recently thrust into medically induced menopause while battling cancer! I mean, I was bound to have some super crappy moments. But I was present with my emotions and held myself and my experience with compassion and acceptance as best I could even during those dark times. As I continued to practice being present, I realized that I no longer desperately searched for the "other side" of cancer, my mind wasn’t constantly wandering to the what-if's and the how-will-life-be's. Instead, I had many moments of acceptance, surrender, peace, and gratitude every single day. It felt amazing, but also very unfamiliar. Contemplating this unfamiliar sense of stillness one day, I silently wondered what am I feeling and I heard a voice in my head respond with "Home….you've come home." When I let go of the death grip I had on all the qualifiers of how life needed to be in order for me to be happy and ok, I found my center, my true self, and it felt like coming home. I felt a belonging and recognition -- like ahhh, there you are, I've been searching for you but I didn't know it was you I was searching for! That sense of being home, being in my center, is the gift I received by allowing cancer to wake me up to my life, and I continue to carry it with me 7 years later. Yes, I still get knocked off course. Yes, I have REALLY hard days and I'm as far from perfect as the next spirit in a human suit. But I catch myself quickly (most of the time) if I get knocked off center and more importantly I know how to get back home. I can definitively say that I don't want cancer again, and I can just as definitively profess that I am grateful for the experience because I learned so much about life and about myself. I have far more tolerance for uncertainty and change, resilience for days, trust in myself and the flow of life, and an inner knowing that I am supported and exactly where I need to be. You are loved, you are supported, and you matter. Much love to you. ____________________________________________________________________________ Courtney Proctor is a Certified Spiritual Life Coach who helps women clarify what they truly want, reconnect with who they really are and step into their fullest potential. She is also a HeartMath® Certified Mentor and offers individual and group classes for building resilience. You can learn more about her services at atmancollective.com or send an email to courtney@atmancollective.com.

The above aphorism is commonly attributed to the French philosopher Voltaire. Voltaire was the pen name under which the author, François-Marie Arouet published a number of books and pamphlets in 18th century France. He was a key figure in the Enlightenment, and notably was quite controversial in his day, due largely to the critical nature of his writing. His work drew on the many essays of Aristotle, Confucius, and other classical philosophers, who advanced, among other things, the principle of the “golden mean” which counseled against extremism. Let me explain this theory by using simple math. The 80–20 concept explains it this way: it commonly takes 20% of the full time allocated to complete 80% of a task, while to complete the last 20% of that task takes 80% of the effort. Another way to look at this theory is 20% of your surroundings (people, obstacles, health issues) yield 80% of your problems, and the corollary effect should thus allow us to focus on the greater good of 80% VS the 20% obstacles to our wellbeing. With that in mind achieving absolute perfection may be impossible, and any increase in effort will result in diminishing returns, thus any further activity becomes increasingly inefficient. So you may be asking “where are you going with this.” To my many breast cancer friends and loved ones I offer the following: We do not need the perfect when we can thrive with the good. Seeking the perfect in writing, art, cooking, appearance, relationships, health, etc., may be harmful to our ephemeral wellbeing. Keep in mind that you beat cancer by how you live your life. Therefore it’s best to live that life on your own terms.

By Donna Barrett I am a breast cancer survivor. I have been cancer free for two years. But it’s been a lonely, scary and fearful two years. While my mastectomy was able to remove the tumor and all signs of cancer, my journey did not end with that first surgery. I was never a breast girl. Since my teen years, I’ve always been a very tall, very skinny, lanky girl. My breast size was an A cup, attempting to be B’s as I grew, but failing miserably. I learned to accept my small breasts early on. I embraced fashion and style that fit my long, lean, flat features. I could proudly rock a deep-V cut top or dress that would make J-Lo proud. When I gave birth to my daughter, I found new respect for my breasts as I embraced the miracle of being able to nourish my newborn with mother’s milk. Breast feeding was never easy for me, but it became a necessity. When we discovered my child was allergic to all forms of formula, cow, goat, soy, I was the mommy milking machine. I fed and pumped the white gold until she was 18 months old. When the milk was gone, and she could sustain herself on other calcium rich natural foods like broccoli I was grateful to return to my little A cup breasts. Fast forward to Indian Summer of 2017. Now in my 50’s, while my style was age appropriate, I could still wear a bikini with pride. This awareness and respect for my body and my tiny breasts, is how I was able to save my own life. Only 11 months after an all-clear mammogram, it was when I was removing my bathing suit in the bathroom, when I noticed in the mirror, a one-inch round discoloration under the skin of my right breast. Upon closer examination, it felt like a cyst. It seemed to appear out of nowhere. I didn’t panic. It was just a cyst, I thought. However, I immediately contacted my OB/gyn office and requested to move up my previously scheduled annual exam. I even pressed to see if someone could see me the next day. I’m forever thankful, they did squeeze me in to see their Physicians Assistant. While I was in that office for an exam, this alert PA was able to schedule a mammogram at the Swedish Breast Center in Seattle that same morning. The mammogram results were significant so that they scheduled a biopsy for that afternoon. Within 48 hours of my noticing this dark discoloration on my breast in the mirror, I got the diagnosis: Stage 1A Invasive Ductal Carcinoma in Situ. Invasive Ductal Carcinoma is the most common form of breast cancer. Common? Believe me, hearing the word, carcinoma, does not feel common. It is unfamiliar. It is frightening, like the shadow of death just did a fly over. Beyond the fear, this was my own body attacking me and this becomes so personal, I’ve never felt so incredibly alone. I’m a planner, and so I began my plan of attack. Like a “World War Z” zombie virus, I needed to get this cancer cut out of my body as soon as possible. Meeting with the breast cancer surgeon, I was given options. Option one was lumpectomy plus lymph node biopsy, then 6-8 weeks daily radiation and chemotherapy pending lymph node results. Option two was single right mastectomy with no radiation and the lymph nodes could be taken during the same surgery. I was also offered that an implant could be inserted during same surgery directly after the mastectomy. As a multi-tasker by nature, this was an option I liked and so I took it. The next part that was even more stressful than the diagnosis was waiting for the surgery. That was the longest 7 weeks of my life. I never asked, but I guess when your “only” Stage 1, there isn’t any rush to the operating table to save your life? I politely didn’t ask, and just assumed this was the norm. I’ve now learned, that with a cancer diagnosis, never assume and don’t be afraid to ask questions. I had no experience with this and in my own personal head space, I couldn’t even think of who to ask for advice. I did the Google everything about IDC. Read every page of the National Breast Cancer web sites, Mayo web sites, WebMD and more. What I didn’t know to ask the surgeons is where they would do the incision to remove my breast? When you do a mastectomy, what tissue remains intact? I know the answers now. My tumor was on the very top of my breast right next to my nipple. They cut the incision diagonally across the main part my breast making for a highly visible, 6-inch slash across my breast. The implant used was the perfect size to match my remaining left breast. However, as the skin was stretched over that “perfect” implant, it was a tight fit. After the surgery, I was given nitro-glycerin cream to rub over the skin to keep the blood circulating and basically, alive. Once home, I had help from my sister to care for my dogs and do basic home chores. I felt pretty good and was very mobile and not really in any pain. Then we got the lymph node report. The cancer was not present and thus, did not metastasize. No more cancer. They got it all. I felt so lucky. Recovery seemed like a breeze. Then 10 days after the surgery, and 1 day after my sister left, I dropped a tissue. As I reach down to pick the tissue up from the floor, my upper right pectoral muscle exploded in pain and began to swell into a baseball size hematoma. The pain was excruciating. I went to the ER and was admitted overnight for observation. As I still had one drain tube, they were able to confirm the internal bleeding stopped and decided to not operate. However, the pectoral muscle remains rigid and swollen still today. But the story doesn’t end here. This was the first post-surgery complication. 45 days after my mastectomy and implant reconstruction, the scab of my giant incision began to fall off. In hindsight, after having multiple surgeries since this, having a scab were the sutures where should have been a red flag. As the scab fell off in the shower, I looked down at my breast. Like unzipping a zipper, I could see the implant through a two-inch open seam. That scab was the only thing keeping my incision closed. Having since moved for my job, I was no longer in the same city as my original surgeons. I ended up at the emergency room at Mayo Clinic in Phoenix. Discussions occurred between Mayo ER surgeons and my original plastic surgeon. They decided to remove the implant and not replace it at that time. This was now the second complication. Now, as I mentioned early on, I am not a breast girl. I decided I would give flat a chance and applied for the insurance to get a breast prothesis. I also, spent many a night, just wishing I had done a double mastectomy and decided to go flat originally. But, there just wasn’t anyone I felt I could ask or talk too. The original cancer surgeons don’t even give you advice. The plastic surgeon’s goal is to make you look the same, normal, as if you never had cancer. It is easy to fall into the latter’s guidance because all you want post cancer is to get back to normal. After this second complication, I needed a break. The Mayo plastic surgeons explained many options to me which included a spacer to stretch the skin then replace with implant, DIEP-flap reconstruction using parts of your abdomen, or the latissimus dorsi flap which uses parts from your back. I took a year to decide. I mentioned I am a lean, athletic body type. Thus, there wasn’t a lot of fat available in my abdomen nor on my back. I chose the spacer for stretching skin and then inserting a small implant a few months later. After the spacer is inserted and the doctors ensure you are healing, the spacer is slowly filled with a saline solution to begin the process of stretching the skin. The first two saline fills went well. The third fill is when things began to go wrong. While earlier hematoma had hardened my pectoral muscle, that muscle was still muscle and it was pulling the spacer higher into my clavicle bone and pressing it into my rib cage. I basically had a giant saline filled boob sitting about 3 inches higher than my remaining left real breast. Imagine going to work, going out to events, trying to disguise this monster boob, which entailed making the left boob look as big. I felt eyes on me all the time, wondering if I had a horrible botched giant boob job. Complication number three is now in the books. This monstrosity had to come out. More surgery. With careful consideration, I finally decided to do the DIEP flap reconstruction. The surgeons convinced me there was enough tissue in my abdomen. But this is an 8-hour surgery. My fear of being under anesthesia and on an operating table for that length of time is frightening. Driven to be normal again, I went for it. When I woke up in the Critical Care unit at Mayo, the most vivid recollection was the pain in my elbows. Why the elbows you may wonder? During this surgery your arms are laid stretched out flat as if you are laying on a cross, for eight hours, and not moved thus getting stiff and sore. The abdomen was injected with a painkiller and as the skin was used for a portion of my new breast, so there was no feeling in my stomach. Additionally, the new breast with the tissue, skin, vein and artery from your abdomen is too new to feel anything. I was numb everywhere except those elbows. With DIEP flap the surgeons and nurses check on your new breast blood flow to make sure the borrowed vein and artery work in their new-found home. You also have a catheter as you cannot move to use a bathroom. If you’ve never had a catheter before, then I will spare you from describing it. Let’s just agree it’s gross. After a day once the catheter is removed, the nurses become drill sergeants getting you up and out of bed and walking. Nothing prepares you post DIEP flap surgery then the first time you attempt to stand up. You can’t stand UP, literally. There’s no give in your abdomen and so you begin your hall laps looking like the hunchback of Notre Dame. I was once again, full of fear. What had I done? I was certain I would never stand tall again. At 5’11” my mother always taught me to be proud of my height, stand tall and never hunch. It took me many weeks before I could stand tall again. 6 months post DIEP flap, the scars on my abdomen aren’t healing very well and they may have to do more surgery there. The new breast scars and how the tissue lays aren’t perfect either. I don’t have matching breasts, but I have two breasts now. I have my original made by God, and I have what I like to refer as my “Franken-boob” created by man. My previously flat stomach is even flatter. And I can still manage to rock the bikini. As for my love for low V-necks, that may take more time as the breast scars are still highly visible. As a breast cancer survivor looking back my surgical history post mastectomy and reconstruction complications, I had to keep telling myself, “look, you beat cancer; they got it all; and you are the lucky one.” Through genetic testing at Mayo, I found that my breast cancer was not genetic. The oncologists believe I may only need the estrogen blocking therapy, Exemestane, for 3 years, not 10. I’m know I am one of the lucky ones. It’s hard to explain to others who have never or will never have breast cancer. While I was never one who cared about the tiny size of my breasts, and never saw a need to increase their size when I was younger, I feel now that this cancer has brought too much attention to my breasts. They're just boobs. It’s been a little over two years since my breast cancer diagnosis. It’s exactly 849 days when this unplanned journey began forcing me to become a little obsessed with my health, my breasts and my body. My body is not perfect. My boobs are not symmetrical. My stomach has huge scar stretching from hip to hip. These are just physical scars. These will diminish over time. As I am writing about my breast cancer journey today, on this rare palindrome date, 02/02/2020, which is when a date reads the same backswords and forwards, I’ve decided I don’t need to wait for the next palindrome to occur in 101 years to put this cancer journey behind me. It’s been a scary and fearful two years. It’s time to begin the healing my inner scars and leave the cancer behind me. It’s time to seek out new, happier journey. To start new journeys where I know I am lucky enough to explore because I am still cancer free and I intend to keep it that way.

By Rebecca Santos I never thought I'd be diagnosed with breast cancer. And why should I? I'm 27. I have no family history. I'm not a carrier for the BRCA genes. I'm healthy and active. But still, here I am. I hope to be a voice that raises awareness that breast cancer can happen to healthy young women too! This year has already had so many surprises, but breast cancer has been the most challenging surprise yet. I'm a Latina first generation college grad who got accepted into medical school in February, got engaged in March, and to my surprise, was diagnosed with Stage 0 Breast Cancer (DCIS) May 27, 2020. While it was hard to process my cancer diagnosis, I was not surprised because I had spent a year having my symptoms being dismissed because of my age, health, and family history. My symptoms on my left breast : During the first six months, I had a large mass on my lower left breast that was so painful, I had to stop wearing bras. I had a scab with discharge coming out of it, sometimes yellowish-clear and other times red. I was told it was most likely an abscess and was given medication, but my symptoms never went away. I also felt a piercing pain coming through to my nipple and my left breast was sensitive to touch. Telling my family and friends that I had cancer was difficult because I didn’t want to burden them with fear or worry. Everyone cried, but they were all supportive and positive that I’d get through this. Losing my breast wasn't as difficult to process as having to lose one nipple (TMI), and having to explain that to family/friends along with why I chose to remove both breasts...but I focus on the positives and what matters is that I am alive and well! I cannot stress the importance of getting a second opinion! Mainly because you want to be confident in and comfortable with the surgeon who is  doing one of your most life-altering surgeries. My first breast surgeon gave me the news that I had cancer and the choice to keep my “healthy” breast. They didn’t explain my condition or their plan of action the way that I expected. In fact, the 8 minutes I sat with them was not enough time to explain very much at all about anything. As a result, I went for a second opinion and it was a completely different experience. This breast surgeon spent over an hour explaining to my family and I the type of breast cancer I had and what it meant, gave us a detailed course of action, pamphlets with information, and was empathetic that I had to face this at such a young age. I already had my mind made up to have a double mastectomy and my new breast surgeon agreed that it was best for me because although I only had cancer in one breast, there was no guarantee that in the future I wouldn’t get cancer in my other. Had I kept my "healthy" breast, I would have had to take a medication called Tamoxifen, which has a very extensive list of negative side effects. (Disclaimer: according to my oncologist, I was not a candidate for this medication because my cancer was not genetic and both breasts were removed, so there would be no benefits for me.) Lastly, I'd live a life of mammograms and screenings every six months for the rest of my life ! Not to mention, I'd live in fear and worry of getting breast cancer again. Almost three weeks after my diagnosis, I had a double mastectomy and expanders put in, on June 15, 2020. While my breast cancer was Stage 0 (DCIS), my cancer cells were grade three (cancer cells that look abnormal and may grow or spread more aggressively ) . While I was told I would not need chemotherapy once they confirmed that the cancer had not yet developed into invasive cancer, I was told that I may need radiation. Now with medical school starting so soon, I had to discuss all of the what-if’s with my team of doctors and began to overthink and fear the possibility that I’d have to miss a semester of medical school or possibly have to delay my start for another year. Now that the cancer is out, t he chances of cancer reoccurring are extremely low and the negative long term side effects of radiation are not worth it in my case. I decided that I wouldn’t let any of this stop me from achieving my dream of becoming a doctor and due to COVID-19, my medical school classes will start online, so not only will I get to stay home and fully recover, I won’t miss a day of medical school! It's not how I imagined starting medical school, but I've seen God's hand through all of this and know that He'll be glorified! I hope to be a voice that raises awareness that breast cancer can happen to healthy young women too! Awareness and early detection are so important, so never ignore your symptoms! Know your body, and if something’s off, GET IT CHECKED OUT!

By Nicole Mancini Originally published in Crabbies, Jellies, and Iron by Susan DiPlacido. First Ironman Nicole Mancini has always loved running. She has found memories of her dad taking her to the track where she would ride her bike as he would run. Then, as she took it up, it always helped her clear her head. In 2015 she did her first 5K, and while there she noticed Athletes Serving Athletes, which is a non-profit that empowers those with disabilities to compete in mainstream running, and, at the time, triathlon events (ASA has since limited their scope to running events.) Nicole was impressed and intrigued. Thus, began her athletic and helping hot streak. She signed up to become a running wingman and began with 5K events. Meanwhile, she watched as some of her teammates trained for wingman positions in triathlons. Nicole didn’t even know how to swim. But something that silly wouldn’t stop her. She started swimming at the Y and attended ASA’s triathlon camp while competing on the run portion in a sprint tri in 2016. She watched as the founder of the group trained for Ironman Boulder with an athlete, and Nicole thought it was a great gift. She did her first Olympic and half distance in 2017 and was ready to sign up for her first 140.6. On December 21, 2017, Nicole was officially diagnosed with invasive early stage breast cancer. She had already endured numerous scans, tests, and mammograms to get to the diagnosis. Hormone therapy began the next day and she underwent surgery on February 28, 2018. She had a double mastectomy and her hormone therapy is still ongoing. In May of 2018 she raced Chattanooga, 70.3. In 2019, she also raced Eagleman and Atlantic City 70.3 just two weeks prior to IMMD. Though she has a small circle of supportive training friends, the long demanding training hours made her husband and 11-year-old son think she was a little nuts, and the schedule was a bit frustrating for the family at times. But she needed to do this race. Cancer is chaotic, and she wanted the structure and routine of training, . She had been drained of her spark and passion, and she was looking to reignite that! She wanted to find herself again. Training was particularly hard on Nicole’s body. She also battled a possible Lyme disease scare and enlarged heart. She was often sick, her hair fell out, her joints ached, she suffered night sweats, and insomnia, heart palpitations, and drastic mood swings that further exasperated tensions in her home. But she persevered and kept on going. She had to take some days off, but she didn’t quit. The jellyfish were a concern for her, because she’s been stung before and reacted very badly. In fact, she cried on the morning of the race. But if everything else didn’t stop her, jellyfish weren’t going to either. She suffered multiple stings, had to reapply cortisone several times along the way and her feet got swollen and purple. All through the run, painful blisters continued to worsen. She promised herself should would never do another Ironman again. Team 360 which is an organization similar to ASA was manning the aid station at the bypass. Nicole knew several people there and their hugs and cheers, along with pictures of their athletes, were just the inspiration Nicole needed. Quitting wasn’t an option. She had to do this to show others that it is possible. She wanted to inspire someone else, to give her friends who are struggling in chemo something to look forward to. To prove to others that they’re capable of so much more than they think. It was her 1 year and 7-months cancer free anniversary. She made it through that. She had been looking to reignite her spark. Something must have sparked in her that day because she set that race on fir and successfully crossed the finish line. She didn’t just find herself at the end, she found an Ironman. And plenty of others have found something else through her: Inspiration .

A few months ago, Dr Charley from Cancer Tamer (cancertamer.org) contacted me at Survivingbreastcancer.org about teaming up and participating in a rafting trip scheduled for August, to celebrate life. Little did I know that a day on the river would change my life! Invitations went out to breast cancer survivors, thrivers, caregivers and advocates. The rafting trip served as a bucket list item for many participants, regardless of age. The itinerary read: Meet at location at 10am Rafting from 11-4 (lunch included) BBQ afterwards Simple. Straight forward. It sounded good. My caregiver, William, and I signed up. We made the 5-hour drive from Boston to central Pennsylvania and within minutes of being ensconced in the mountains, we heard the rippling sounds of water rushing by. After an introductory session we began buckling up our safety vests and our adventure began! 25 inexperienced thrivers and caregivers (though William would argue he is experienced) jumped into the rafts, paddles at the ready, final instructions received. We entered the water, and the current moved us quickly downstream. The river carried us away from our launch site and there was no turning back! Within minutes of starting our rafting journey we hit our first section of rapids. Our guides say it was a class two, but by the size of the waves splashing directly onto me, it felt like much more! The air was warm, the water refreshing, and women between the ages of 30 and 80 were splashing one another, smiling, and giggling like we were all 13 years old again and on a summer camp adventure! The beauty of the trip was the absolute judgment free environment. Though we all came from different walks of life, breast cancer unified us, and we established a strong bond that day on the river. The trees lining the riverbed provided fresh air for us to breathe in hope; the clouds above provided shade and coverage from a hot sun and protected us along our journey. The river was high from several weeks of rain, and cradled us as we cascaded over the ebbs and flows of the Lehigh river. The River derives it’s name from an old Lenape descriptive and means “where the forks are”. As you navigate this beautiful river you get to choose one fork or another for safe passage. As breast cancer survivors and thrivers we too get to choose from various “forks” in our medical care, nutrition options and exercise regimentations. I know how strong rivers and currents can be, the power of water, waves and rapids at the beck-and-call of mother-nature. And there we were, just as powerful as the water that carried us, fierce, strong, and courageous women who are not letting treatment nor a first or a second diagnosis of cancer defeat us. What stood out was the vibrant community forming; the immediate friendships that developed and the camaraderie and spirit these beautiful women showed. The power on the water that day was magical – breast cancer thrivers enveloped by mother-nature - two force that are undefeatable. Want to join us at our next event, check out our upcoming events for breast cancer awareness month! Hope to see you there! Xo, --The SBC Team

Now that I am on the other side of my treatment I have been much more open to reading about other people’s experiences with cancer and their treatment. A lot of people talk about their “new normal”. I have been trying to figure out if I have a new normal yet.  But it made me think, did I ever have a “normal”?  Life is full of ups and downs. When I was little I was convinced that the Brady Bunch was a “normal” family that I aspired to have. At the time it was just me and my mom, so I was on the lookout for a single dad with 5 kids. Specifically 3 boys, one girl old er than me and one younger so I could be a big and little sister.  Eventually I realized that probably wasn’t a realistic family goal for me to have, so I adjusted my view of a “normal” family. Growing-up in California, I have learned that a family is a family and no two are the same.  As I grew up, like everyone, my life was a series of unexpected events. I didn’t get into classes I wanted, friends turned into enemies and then friends again, I changed colleges twice, relationships started and ended (luckily, I did find the right person at the right time), I got my dream job that wasn’t so dreamy and changed jobs again and again. Each time there was a change, whether it be personal or professional I didn’t stop and define a “new normal” I just kept going. What else was I going to do? Just sit down and stop? That’s just not how I work.  Back to my cancer treatment. There was nothing normal about it. In fact, I am a firm believer that no two treatments are exactly the same because everyone is different, the support system for everyone is different, doctors do things slightly differently and patients react differently. That’s not to say that hearing about similar experiences isn’t helpful, it is, I’m just saying that there is not a “normal” way to experience it.  So, what’s my point? Just as there is no “normal” in the rest of life, I don’t think there is a right way to define your “new normal” at least not for me. For me that would mean looking at and analyzing things that I think I missed because of my cancer treatment or things that I might not be able to do right now as I still heal from the experience. The worst for me is thinking about the things I can’t control that might be in my future. So for me, my “new normal” is just going forward. Not defining things, not setting-up expectations or boundaries for what I can and can’t do. Just going forward adjusting and adapting on a daily basis as I have always done.  This might not work for everyone, but for some, I hope it might help. Breast cancer was just another thing that life threw at me that I had to figure out how to get through. And I did get through it. It’s time to move on and enjoy my family, my friends and the life I have.  PS: My husband and I decided to have only one child and we love her and are so proud of her. Thank goodness I got over my Brady Bunch phase :)

I was 39 when I was diagnosed with breast cancer -Stage II infiltrating carcinoma and 49 with breast cancer -Stage IV metastatic breast cancer. It was May 2010 when my world was shattered. I had divorced my husband the previous year and felt totally free for the first time in my life. I was healthy, loved to exercise, and was eating healthy on most days. I was working as a nurse in a pediatric office in Littleton, Colorado. My son was a couple of years away from graduating high school. Life was great. I have a family history of cancer and I started performing self breast exams in my twenties. In April 2010, I felt a lump in my breast and saw a dimple over the spot where I felt the lump. As a nurse, I knew the signs and symptoms of breast cancer, but for some reason my mind wouldn't accept it. As I think back, I felt like I couldn't have breast cancer because I didn't have health insurance. After the divorce, I couldn't afford it. But God made a way. I qualified for Komen funds, which saved my life. I was blessed to have the best surgeon and oncologist on my team. They gave me all the information I needed to make an informed decision. Sadly, I was miles away from family and friends, so I went into deep prayer and made the decision to have my breasts removed. As I sat on the exam table and told the surgeon my decision, I felt strong and sure. But as soon as he exited the room, I broke down and cried. It wasn't fair. I was the girl who raised awareness for breast cancer survivors, and now I was that girl. Ironically, five years later, my sister would insist that I write a book detailing my journey. I hesitated in doing so because it was my personal business, but she hit me with, "It's about giving God the glory." So, I self-published the book, "Seriously God, Am I That Girl?" Writing the book ended up being my therapy. I poured out all the details regarding chemotherapy (its side effects) and my reasons for stopping it and stopping hormone therapy as well. I completed two of the four rounds of chemo and stopped tamoxifen after a few months. On chemo, I felt like I was having a heart attack, and regarding tamoxifen, I just didn't like the side effects. I did end up removing my ovaries. In 2012, my PET scan was clean, and I moved to Atlanta to be closer to family. I found an oncologist and in 2015 was given the "all clear." I was determined to take advantage of my second chance at life. I worked and traveled to many places that were on my travel list. Since I loved traveling so much, I became a travel nurse. Again, life was great! I took an assignment in Dallas and Tucson. While in Tucson, I had this feeling of wanting to help women in a different way. I was ready to leave nursing after twenty years and try something new.  I love my family, but moving back home was not part of my life plan. We have our plans and God has his. So, in September 2019, I moved back home to Mobile and opened a painting studio, Her Timeout, in January 2020. The stress I was under opening this business saved my life. A lymph node in my neck began to swell. This one symptom would lead to an urgent care visit, PCP visit, scans, oncology visit, and a biopsy. The result, stage IV breast cancer. I was ready for God to take me. I couldn't. I didn't deserve this. I was a good person and this wasn't fair. My family was so concerned that they threatened to come break into my apartment if I didn't come out. After two weeks, I started chemo. My new oncologist had read my old medical records and he was ready for me. No quitting. He was stern. He told me that he could treat me, but I had to do my part. I wanted to see my future grandchildren, so I put on my big girl panties. I was ready this time for the side effects. I started taking daily vitamins, B vitamins, plain, coconut milk yogurt, raw garlic, and drinking plenty of water. I meditate and do yoga. This time around, I'm grateful to be home with family and friends. Instead of writing another book, as they suggested, I decided to blog about this journey. The title, of the blog is "Her Timeout." I honestly believe that when God gave me this name back in Tucson, it was not intended for a painting studio, it was his way of getting my attention to slow down. He was trying to save my life. What's next? I have to complete 6 rounds of chemo; less if my scan comes back clean, per my oncologist. Then monthly, hormonal injections until my oncologist "says so." I'm ready to walk in divine health because I deserve the best. I'm focused on healing my body and getting back to life! There's a big world out there to explore. God placed a work in me when I was born, and I must continue my journey to fulfill my purpose.  I have too many dreams to give up!

By Kandace From Survivor to Conqueror I ate well. I didn’t smoke. I didn’t do drugs. I was a marathon runner. I was too healthy to be sick…. March 2011 It was one of those California mornings: overcast and gloomy. When I looked outside, I saw that it was actually raining…Oh well I thought… It’s just going to be one of those days…There’s no way it could get worse…Boy was I wrong. ​ You see, I belong to an unique club…Where One out of three people in the USA belong to… but it’s a membership no one wants to be a part of… that you cannot quit from…and I don’t want YOU to be a member of… Today I am going to share with you all how I received my club membership, my connection with the doctor and club life... ​ I was training to qualify for the Boston Marathon. My training was tapering down and I was still tired. That same week I found a bump under my armpit. I made an appointment with my doctor. She ordered a complete blood panel. It came back ok. She ordered a mammogram and an ultrasound. I had to beat a specific time at the Napa Valley Marathon to qualify for the Boston Marathon. I put my heart and soul into it. It was one of the most important things in my life. I trained hard, ate well, slept well, and avoided unhealthy things. I didn’t smoke. I didn’t do drugs… That weekend I ran the Napa Valley Marathon and qualified. I was on cloud 9! I was indestructible. Discipline, Determination and Drive as my father would say! My life was running like clockwork. But… I made my appointments with my doctor. After a complete blood panel, followed by a mammogram, an ultrasound and a scan my world turned upside down. I remember walking into a hospital in Orange County for my appointments. Never worried. Never scared. I ate well. I didn’t smoke. I didn’t do drugs. I was a marathon runner. I was too healthy to be sick…. My scans were completed and I was waiting for the radiologist to tell me, “All clear. Have a nice day. ” … But instead, he came out and told me I needed to come back for a biopsy… Now I was scared! What was wrong? Cancer still had not crossed my mind. The following Monday, I went in for the biopsy and that Wednesday I would find out the results. Wednesday, March 23, 2011 was an unusual day…. It was pouring rain in sunny Southern California. It never rains here. My mom and I were called back into an exam room; we waited and waited and waited. I paced the hallway…. I found a nurse and asked her if she had the results from the biopsy. She came into the room and crushed me. “Kandace, I’m sorry. You have stage II breast cancer.” I said, “That’s not possible. I am only thirty years old. I just ran the best marathon of my life.” Mom and I immediately went into crisis solving mode. A family friend had been diagnosed six months earlier, so mom knew what oncologist and surgeon to ask for….I met my surgeon that evening and my oncologist two days later. My path of life was forever changed! I had no idea what was going to happen to me, but I knew in my soul that I was going to live: determination, discipline and drive. In the months to follow, I underwent a lumpectomy removing seventeen lymph nodes, seven of which were cancerous, had twelve rounds of chemotherapy, a blood transfusion, capillary leakage in my lungs, eight months of prednisone, thirty-eight rounds of radiation, ongoing physical therapy for my arm, four years of hormone therapy, and all of the complications that came along the way. I was knocked down over and over again, but I always stood up, brushed myself off and kept fighting. Failure was not an option. As the months of treatment were further and further behind me, I became stronger – physically, mentally, and emotionally. I had a great support system; in fact, I still do. I began working full time again, traveling and living life again. I was strong. I was going to live. I had a new reality! I was a young breast cancer survivor! I continued seeing my oncologist and having my yearly scans, which were always clear. Always something to celebrate! I reached my five-year cancer free anniversary and boy did we celebrate! I had a party with family, friends, and clients to rejoice such a big milestone. Six months following my five-year anniversary I felt normal in my new reality: working, running, and of course traveling. Friends would often tease me and say, “Kan, your suitcase is always packed. Where are you off to now?” I’d laugh and excitedly tell them about my next destination. September 2016 I suffered from edema in my left arm due to the lumpectomy in 2011. I had, and still have, a lymphedema treatment on my arm three times per week to keep the swelling down and to keep the scar tissue to a minimum. It is not my favorite treatment because it hurts when the chiropractor breaks up all the scar tissue. It was my normal 2pm time slot… At one of these regular appointments in September 2016, however, we found a bump in my chest…. I was not concerned given the PET scan six months earlier… Needless to say, it needed to be addressed. I called my oncologist and we set up an appointment to have the bump biopsied…. The results came back negative for cancer, but given my health history we did another scan. I remember sitting on my parent’s deck with my dad having a conversation about my current situation. I said, “Dad, I can handle whatever this is, I just don’t want to look like a cancer patient again”. He said, “I know Kan, I know.” I will never forget the day I met my mom and three of her closest girlfriends at the imaging center. We were telling funny stories - giggling and laughing. I was called back to have my scan. Half way through, the power went off. I had two options: come back another day or drive across town in rush hour traffic. The five of us hopped in the car. Finally, the scan was completed. I called my doctor and he said he would call as soon as he had the results. One can imagine my level of anxiety. My doctor called…. I answered the phone praying for good news. “Hi Kandace, It’s doctor A”. I’m sorry. I have bad news. Your cancer is back and you have tumors all throughout your body. The good news is that the cancer is the same cancer you had before, therefore it is treatable. I’ll have my nurse call you in the morning to get you in to go over all the details.”… I said, “Ok, thank you.” I hung up the phone, staring into nothing… I began having a conversation with Lulu, my golden retriever. “Lulu,” I said, “I can have my meltdown now and we will still have to retake the exam, or I can keep myself together, take the exam and then have my meltdown.” I took Lulu’s advice. I finished the exam and passed! Later, I threw myself on the floor next to Lulu and had my meltdown. “How could this be happening – to me - yet again?” …Why is this happening again? Moving forward with my new diagnosis, I was able to secure second opinion. I scheduled an appointment with Dr. James Waisman at the City of Hope. I had an instant connection with him and knew he would be my guide to remission. Dr. Waisman made me feel safe. He was direct and thorough when talking with me. I knew City of Hope was the right place for me. I would be on ten months of oral chemotherapy and shots to create remission. Since my cancer was estrogen positive I made the decision to have my ovaries removed. This was the best decision for my body! Exercise and nutrition absolutely play a vital role in keeping the mind and body healthy, But I felt my body needed extra support. I enjoy running on the beach. Strength training is a must for me; it keeps my bones strong and reduces stress. Yoga is great for the mind. I currently take daily supplements based on my blood work and receive weekly IV’s of vitamins and minerals. Being diagnosed with cancer two times as a young female is hard to imagine, and even harder to imagine that it would spread throughout my entire body after I had won the first round. I was thirty years old the first round and thirty-five years old the second round. I often wonder why me, but I always go back to the recognition that cancer is an indiscriminate serial killer without a conscience or morality. I am a positive person and believe the glass is half full. I continue my healthy lifestyle habits: training for half marathons, strength training, frequent infrared saunas and a clean diet, within moderation of course. My life is about balance and purpose: I travel the world because it makes me happy; I spend time with family and friends because I love them; and, I enjoy my career because I help people. I know in my heart that cancer would not have been put on my plate, not once but twice, if I wasn’t strong enough mentally, emotionally, and physically to handle it. Maybe I was meant to have this journey to help others who were going to be walking in my shoes. Maybe I was meant to have this journey to learn to love myself with compassion and grace. Maybe I was meant to have this journey because it was just the cards I was dealt. Maybe there is no reason. Maybe the decision I made to fight, whatever the obstacle or hardship, was the reason in itself. I can’t say that what I did was for others, but I truly hope in my heart that people that are in the fight can see my journey that I stumbled through as a beacon in the dark. Thank you all for being here! A big special thank you from the bottom of my heart to Dr. Waisman, his nurses and the City of Hope team. I am in remission once again and back living a meaningful and joyful life, running half marathons and traveling to new and far off destinations. If not for the discipline, determination and drive City of Hope has to treat and cure cancer, I may not be standing before you today, sharing the hope and healing I received at City of Hope.​ ​Every club member is unique and so is the connection they have with their doctor. Life in the club is theirs to manage (handle) ?... But I choose to be positive and hopeful…I believe in HOPE…because HOPE springs eternal…I use to have “Long Term” goals…now I have “SHORT” term goals! I use to think I am and was a “Survivor” of cancer…but now I believe and think I am and will be “CONQUERER” of cancer. ​I believe in the triumph of HOPE… over past experience!

By Liz Brown Where’s the Scoreboard? Is there anything better than a 10 year old parks and recreation baseball game? As I hobbled to my favorite lucky spot behind home plate equipped with a cooler full of water, Gatorades, and snacks for my favorite players, the excitement was in the air! Two teams on a field of dreams, as they say, playing their best baseball - a fight to the end. Unfortunately, maybe more so for the hard core parents than the kids, there will be a loser in this fight. But there will also be a winner!. One of the teams' players will jump for joy at the end of the game celebrating all the way home and the other will go home wondering what they did wrong. Oh wait, a close second to a battle on the baseball field are the sounds of Friday night lights on a small town high school football field. High school football players work tirelessly through the summer to prepare for their battles on the field. The cheerleaders show their support as the stands erupt after a long touchdown pass or a pop of a tackle heard from the top of the stands. The ups and downs of the game keep the fans watching every play intently. The band plays and the fight continues. Four quarters goes by in a flash (well, for us die hards) and again, there will be a winner and a loser of this full on fight to the finish. The loser will go to the locker room with a probable lashing from coaches as to what should have happened on the field to prevent the fumble or how missing that one tackle gave up the winning touchdown while cheers echo from the locker room as the winning team celebrates. I come from a long line of sports fanatics. My grandmother (who we affectionately called Meremere) would have one game on the tv in her family room,one on her small black and white tv in the kitchen, and one playing on the radio in the kitchen. My dad has never missed a golf tournament or a college football game. I have watched my three boys play countless games from elementary age to high school and my youngest, well, his ipad constantly beeps with updates from every MLB game while Sportscenter is a morning staple. We are used to winners and losers. We understand fighting to win a game. We understand, in losses, that game film is a must in evaluating what was done right in the game and how to evaluate what was done wrong. Cancer is not a game. There are no winners or losers. When I hear that I am fighting cancer, I can’t help but think to look for a scoreboard to see how much time is remaining in the game and thankfully, there is no scoreboard. I immediately shift my thinking to how can there be a winner and a loser in a disease? Often, we hear “she lost her battle with breast cancer”. Lost? What? I hear lost and immediately think, well, who won? What could have been done differently? What did we do wrong? Let’s look at this from a mathematical standpoint. The old adage of “keep fighting, you’ve got this” leads us to the conditional statement that “if we fight hard enough, then we will win this battle against cancer”. From geometry class, you recall (were you listening that day?), that the contrapositive of a conditional statement is always true if and only if the conditional statement is true...sorry had to get my math lesson in for the day-shout out to my math department in Manteo! In following that logic, the following statement would be true, “if we do NOT win the battle against cancer, then we did not fight hard enough”. Hmmmm, is that really what we believe….absolutely not. No matter what the age and no matter what the stage of any cancer patient, you can be assured they are doing everything they possibly can to do for what is best for their body, their family, and themselves. And furthermore, while I’m on a roll, why is cancer the only disease we “beat” or “fight” or “lose to”? I have asthma and no one says I am fighting it; no one says those words in conjunction to diabetes, epilepsy, heart disease, etc. nor should they. There is an implication of weakness or something that could have been done better when we use the word “lost”. We should never use such negative associations with someone who has died of cancer. In fact I read once where it was written in an obituary that she “won her battle with cancer as she joined the Lord in heaven.” So much better and much more accurate! In the beginning, I mentioned that I hobbled to my seat for the baseball game. A few weeks later, I found out that I had a compression fracture in my back at T9 - I guess that explains the hobble. The doctors could not figure out how I had fractured my vertebrae. I was otherwise a healthy and active 46 year old just running around juggling teaching and crazily chasing three boys with my husband. They could not figure it out until my regularly scheduled mammogram came back looking suspicious. And, as they say, the “you know what” hit the fan. In less than a week, I had a bone scan, a biopsy on my breast, kyphoplasty, a biopsy on my T9 vertebra, and multiple other scans. I went from teaching high school math one day to hearing the news of being diagnosed with metastatic breast cancer to my bones the next. Meta-who? My mom and I practiced saying the word and spelling the word. I didn’t even know how to pronounce metastatic much less understand what in the world it all meant. I was definitely in shock and to be quite honest, none of it registered until I asked my primary doctor, “Would I be teaching this year?” She quietly replied, “no” and then I understood that this was something big and unwanted. I started my 4 week regiment of the “red devil” chemo and 12 weeks of Taxol chemo within a week of diagnosis. I followed up with a lumpectomy and 20 rounds of radiation on my breast where the tumor had emerged. I started on Kisqali among all sorts of other medications but my liver was too sensitive to the Kisqali and I have had to since change to Verzenio. I am a year and a half into my story (not a journey to me because a journey is supposed to be fun). Metastatic disease is a roller coaster with oncology appointments every month, at the minimum, and scans every three months to make sure the cancer has not spread further. Every medication has its own side effects which is really fun in itself. I don’t want to ever look back and think about how I could have or should have done things differently. I will never lose because it is not a fight, it is simply a new lifestyle…..okay fine, some days I have to be stronger (look out Darana, my other soap box word) than others but I know that no matter what I win! I always win! I have a long road ahead and my new “job” is to take care of myself and my family, steer clear of stress, and go to as many ball games as I can so I can enjoy looking at a real scoreboard and smile no matter if we are on the winning side or the losing side. Now, if you’ll excuse me, I need to go pack my cooler! Liz Brown Manteo, NC I’m hoping to share my story and resources to help you or someone you love calm the waves in your crazy cancer storm. *****Blog/website: www.mbcoutlier .com *****Instagram: mbcoutlier

By Kathleen Friel, Ph.D., March Is Cerebral Palsy Awareness Month I have the interesting opportunity to live with two types of medical issues – cerebral palsy (CP) and metastatic breast cancer (MBC). CP is usually a condition that a baby is born with or acquires during the first two years of postnatal life. CP is most often called by a stroke or brain bleed – yes, babies and kids can have strokes, even in utero. Sometimes, CP is caused by malformation of the brain or a genetic issue. The bottom line is that the brain damage resulting in CP causes movement challenges. Sometimes, people with CP also have challenges in sensation, vision, hearing, speech, and/or thinking. I was diagnosed with CP around 1.5 years of age. The diagnosing neurologist told my parents I had no rehabilitative potential, and that the best life for me (and them) would be if they put me in an institution and focused on my soon-to-be-born brother. Thankfully, they found a new doctor for me, pronto. The wonderful doctor who guided my family through my first years of life was funny (he never wore socks, something that my four-year-old self found hilarious) and encouraged my parents to treat me like they’d treat any other kid. Sure, I had plenty of surgeries to make my legs walk better, speech therapy that enabled me to order pizza during college, and physical therapy that enabled me to stroll the mall with my friends in junior high. When I was prescribed occupational therapy in first grade, I figured it must be time for me to begin job training. Little did I know, OT is a discipline that focuses on improving finer motor skills like typing, cutting up food, and fastening buttons. I now run a clinical research lab at the Burke Neurological Institute in White Plains, NY. Soon after I got my PhD in neurophysiology, my dad tried to track down that neurologist who had given me such a grave prognosis. No luck. I would have loved to see his face when he learned that I indeed spend most of my time in an institution… running a research program! Greater Awareness is Sorely Needed My multi-faceted relationship with cerebral palsy (CP) gives me a rather unique perspective on CP awareness. The mission of my lab at BNI is to develop novel therapies for people with CP that are rooted in a deep understanding of the neurobiology of CP. Through our research, I’ve gotten to know hundreds of children and their families as they navigate life with CP. For those who have only ever met me over Zoom, now you know, it’s not my audio connection that garbles my speech, it’s CP! These perspectives all converge to one theme: greater awareness is sorely needed. Approximately 3 in 1,000 people have CP, which translates to approximately 800,000 people in the United States, and over 18 million people worldwide – approximately 50-50% split between children and adults. To put these numbers in perspective, 800,000 people is equivalent to the population of Seattle, and 18 million individuals is equivalent to the population of the state of New York. The Demand for Cerebral Palsy Research Recently, research has demonstrated molecular and cellular consequences of CP. People with CP typically expend 3-5x the energy of their nondisabled peers to perform activities of daily living. Muscles and bones in people with CP have less of an organized structure than in nondisabled peers – interestingly, some of these structural differences occur before a baby shows motor symptoms of CP. This raises the possibility that muscle and bone cellular disorganization contributes to the development of motor symptoms, rather than emerge as a consequence of aberrant movement. Much research is necessary. The work in my lab is focused on improving movement in school-aged children, to help kids gain more skillful movement ability, which then poises them to improve their confidence, quality of life, and independence. More work is needed to define early biomarkers of CP: despite most brain injuries occurring before or near the time of birth, kids are often not diagnosed until or after their first birthday. If we can diagnose early, we may find ways to intervene and prevent emergent impairments. We also need therapies to help adults with CP age well – many adults with CP develop age-related conditions like osteoporosis decades before nondisabled peers. Adults with CP 3x more likely to get MBC than people without CP, as I’ve learned in 2018, “ Unstoppable: How Dr. Kathleen Friel has made incredible accomplishments despite cerebral palsy and metastatic breast cancer ” ! Although CP is not a progressive neurological disorder, adults with CP experience greater pain, fatigue, and loss of mobility earlier in life than adults without CP. Going Beyond the Science Greater awareness about CP must go beyond the science. What’s it like to live with CP? I’m only one person, and my experiences do not generalize to all people with CP. Here’s a bit of my perspective. People often assume I have a cognitive impairment because of how I speak. It’s exhausting to deal with misperceptions. 2020 was a great year for avoiding unsuspecting strangers! By far, the most difficult aspect of my CP is my speech. Zoom chat is amazing, and trying to be understood while I’m wearing a mask is frustrating. Most importantly, people with CP – and other disabilities – want to be known as people. We have rich social lives, hobbies, favorite sports teams, and so much to offer. We’re more than the way we move or talk. Did you know…? People with CP and other disabilities spearheaded landmark legislation that protects the rights of people with disabilities, including the Rehabilitation Act and the Americans with Disabilities Act. The movie Crip Camp shares their story (available on Netflix!). In one part of the movie, people with disabilities held a sit-in in Sacramento to fight for accessibility in the 1970s. At one point, the disgruntled police shut off the phone system, so people could not call their supporters outside. Shortly after, some deaf participants went to the windows of the building and used sign language to communicate with the people outside. The police couldn’t stop them, and eventually conceded! The MBC Connection I was diagnosed with MBC in 2018, with a lesion in my spine. I think that the joint pain and mouth sores caused by my treatment exacerbate my CP impairments. Some days, speaking clearly and moving freely are quite difficult. I’ve needed more accommodations, and my fatigue (already a “CP issue”) can be frustrating. I have a wonderful oncology care team, but sometimes nurses, radiology staff, and others can make annoying assumptions about my cognitive capacity. Even answering, “Who is with you and how did you get here?” with, “Nobody, and I drove my damn self,” can be that “one more thing” that zaps my last nerve. I usually don’t say damn, but maybe I should! We all know how deflating it can be to go to our appointments, wait forever, get poked and prodded, literally eat/infuse poison in hopes it will only kill the cancer calls, and listen to that bossy little “Breathe in, hold your breath………. breathe out,” CT scanner voice. After that, if someone insists on taking me out to my caregiver, I want to throw a punch. But there is always hope. In December, a radiologist really pissed me off. A kind nurse asked me what was wrong, and I started crying. I pulled up my “Unstoppable” article, linked above, on my phone and gave it to her. Then she started crying! She asked permission to share it with the radiology department. I went for my next CT, and everyone was all smiles and pats on the back. I saw the same nurse, and she gave me a big hug. Many people with breast cancer have other health issues. I’m grateful for the opportunity to share my “CP + MBC” story during CP Awareness Month. We all have a complex identity, and the greatest gift we can give each other is compassion and kindness.

By Abigail Johnston I love the holidays. The family togetherness, the food, the exchanges of gifts, the celebration of what God has given us and the sacrifice of His Son, it’s all magical to me. Of course having my birthday in the mix, on the Winter Solstice, is also something to look forward to every year, but don’t get me started on the whole Santa thing. I literally start planning for the following Christmas in January each year when it comes to gifts and I’m always on the lookout for the perfect gift for the people on my list, which grows and grows every year much to my husband’s chagrin. That the end of the year culminates in getting to see people happy about what I’ve selected, that’s the highlight for me. Since 2017, when I was diagnosed with Stage IV Metastatic Breast Cancer (MBC), I’ve started to see holidays differently. I vividly recall the first celebrations following my diagnosis when I struggled with both wanting to go overboard in making memories and also wanting to simply withdraw from everything. The thought that this holiday, this birthday, this celebration, this time, this will be the last time, is always in the back of my mind. I still find myself staring at the people I love, during holidays or otherwise, trying to memorize their faces, fixing the memories in my brain so … what? So that I will remember after I die? My logical brain asserts itself and is pretty scornful of this fanciful notion that my efforts mean anything. Does me fixing this point in time in my memory mean anything now? I’ll be the one leaving a chair empty at the table at a time in the not so distant future. What does it matter whether there is a celebration this year or next when any one of them will be my last? Sometimes I think my logical brain is a bit bitchy or maybe just angry. No, I don’t have multiple personalities, but it helps me to cast these ambivalent feelings as actual characters with different points of view to better make sense of the whole. This living with two contradictory ideas/feelings at once is confusing. I’m alive, yet dying, happy, yet intensely sad, in excruciating pain, yet content, horribly nauseous, yet hungry for the mouth watering food, smiling, yet yearning for my bed. I have to carry all of these contradictory urges all at once. It can be exhausting. I ruminate over what my kids will remember and then frantically take pictures to preserve what I think is important. I secret away notes and letters and keepsakes, knowing logically that my boys likely won’t fully grasp their significance. I talk to all the people who I think need to know something about what I want after I’m gone, knowing full well I’m the one who cares about these things, not others. How do you reconcile wanting to celebrate and be present with the very real fear that you will be erased, replaced, become irrelevant in the lives of those you care about the most? This anticipatory grief amongst the very real festivities of the holidays is mind boggling/numbing/blowing. There are people in my life who have pulled back from me or created conflicts to separate themselves from me because of this, I think. Everyone deals with anticipatory grief in different ways. Courage requires one response, safety another. What you choose reveals something. What I choose reveals something. What results becomes a legacy of intimacy created by opportunities taken or separation because of opportunities missed. How many more opportunities can there be? And that’s all before we add COVID-19 into the mix. I talk to others living with MBC who are contemplating risking exposure and likely death from COVID-19 in light of the fact that due to our truncated life expectancy, this holiday season may well be our last. How do you weigh all the risks/benefits when attempting to make decisions amongst so many unknowns? Absent a crystal ball (and I need one of those), I think we have to make the best decisions with what we have to work with, right now. I think we have to focus on the knowns to make decisions, not make ourselves crazy with attempting to contemplate the unknowns. I think we have to be able to take responsibility for the things we can influence and just pitch the rest. Not an easy task. So not an easy task. I have discovered that to feel settled about my plans and my decisions, I do have to shrink my level of care for those around me to the ones who matter the most. Those who I have genuine connections to; those who are focused on making memories with me. That means I have to let go of many of the defaults of years past, not an easy thing. That means I have to be more picky and more intentional and more settled (i.e., not running around with a million projects) to be able to have the emotional capacity to focus on what matters most. These decisions are fraught with so many pitfalls and worries and feelings, present and past. It is a struggle and causes often sleepless nights in the lead up to the holidays; however, I know that when I put in some work to think this through rather than going with the flow, the holidays contain the people and elements that matter most to me in the end.