Life After Breast Cancer: Fear, Healing, and Hope

What happens after breast cancer treatment ends? For many survivors, finishing treatment is a major milestone, but it does not always mean life immediately goes back to “normal.”

In this episode of Baptist HealthTalk, host Johanna Gomez, a breast cancer survivor,  speaks with breast cancer survivors Andrea de Armas and Nancy Antoine, both treated at Baptist Health Herbert Wertheim Cancer Institute, talk about diagnosis, treatment, survivorship and the emotional journey that continues long after active care ends.

They discuss:

• Being diagnosed with breast cancer at a young age
 • The importance of self advocacy and getting checked
 • The physical and emotional toll of chemotherapy
 • Fear of recurrence and scan anxiety
 • Fertility, hormone therapy and long term care
 • Body image, reconstruction and restorative tattooing
 • The importance of mental health and survivor community
 • How survivors can move from surviving to thriving

Breast cancer survivorship can bring new challenges, but it can also bring strength, purpose, community and hope.

For more health and wellness information, visit BaptistHealth.net/News.

Breast Cancer Survivor & Host:

Johanna Gomez
Award-Winning Host & Journalist

Guests:

Andrea de Armas
Breast Cancer Survivor 

Nancy Antoine
Breast Cancer Survivor

If you found this episode helpful, you may also like:

Young Women and Breast Cancer

Diagnosed with Breast Cancer: What's Next?

Breast Cancer Survivorship: 10-Years Later

Transcript

0:00

You know when I woke up today, I took my immunotherapy, I took my hormone blocking therapy, and I took my vitamin E for hot flush and I said, thank you to the women who are part of these studies that I get to take these medications for. And I'm going back to when you said cure, when I signed the paper for the immunotherapy and it said intent cure, I cried because and not something more out of emotion, nothing super exaggerated. No one saw me, but I said, cure. Okay, this is this is the topic. This is what we're talking about. Welcome to Baptist Health Talk, a podcast on all things healthcare, powered by Baptist Health South Florida, your trusted source for healthcare prevention and wellness. Hi everyone, I'm your host, Joanna Gomez. Welcome back to a new episode of Baptist Health Talk, where we answer your most searched questions on trending health topics. Today we're talking about breast cancer survivorship and what life can look like after treatment. For many patients, finishing treatment is a major milestone, but it doesn't always mean life immediately goes back to normal. Survivorship can come with physical side effects, emotional changes, follow-up appointments, new priorities, and a different outlook on life. We are joined by Andrea de Admas and Nancy Antoine, both breast cancer survivors treated at Baptist Health Herbert Wertheim Cancer Institute. Andrea is a PA who was diagnosed at just 26 years old one day before beginning her physician assistant graduate program. Nancy is now several years post-remission and uses her experience to help other women navigate healing after breast cancer through her work and 3D nipple tattooing. Ladies, it is a pleasure to be in your presence today. Thank you. I just want to start off at the bat and thank you for just sharing your stories with us because it is difficult. Uh, and I want to just press rewind for a second and start with both of you can answer this. Take me back to that moment that you found out and you were diagnosed with breast cancer. Um, so for me, it was like we were talking about earlier in the shower. I have a little lump. I get a breast ultrasound. I actually wasn't even at uh the Baptist institution. They gave me a biopsy about a month out. I was starting PA school. I said, I can't wait for that. Uh, thankfully, in communication, there was an open availability at MCI at the time. I got an ultrasound biopsy mammogram. Four days later, Monday morning, 3 p.m. A call I was gut-wrenching all day waiting for. And there was a call, unfortunately, positive for breast cancer. And at that moment, obviously, my life, I just felt like everything was like silent. And in from one second to the next, they said, you know, if you're available, uh, Dr. Lopez is available now at the clinic. We can start talking and go from there. And I said yes, got in my car. The rest was history. 26 years old, though. I'm gonna go ahead and emphasize on that because very, very young. Any family history at all? So, no, at all. Um, actually, through genetic testing at uh Baptist, we were able to find out I do have genetic predisposition from a Bowel B2 mutation. So it puts you at about 40 to 60 percent risk in your lifetime. Um, it's actually through my dad's side, and my dad has three sisters. Wow. So this information obviously takes a toll on the whole family. Again, scary, yeah, but also um empowering, you know? I have a younger sister, I have younger cousins. Now we're able to do screenings, do what we need to do, and be in a different position. But definitely, yeah, 26 with scary genetic predisposition gives me some kind of comfort and understanding this process. But yeah, and here you are. And I'm so happy to hear that and to see you here. And it is absolutely crazy when you think about like, you know exactly where you were. You can remember that feeling. I I know as well because I it takes me back to my moment also when I got that phone call and it was 2:30 in the afternoon. And it just takes you back. And it doesn't matter how many years it has been since, it's still you still get that icky feeling in your body. Nancy, what was that like for you? Oh, for me, it was a complete shock because I always say cancer, breast cancer is never yours, it's always someone else's until it happened to you. Um we never really want to go through life in having to experience something such as um cancer. So for me, November 2021, I was already getting my mammograms six months prior. I had a mammogram that was unremarkable. And I felt a lump in my axila, which is right here. Yeah. And my OBGYN said, okay, let's just book a mammogram and ultrasound for you. So when they booked the mammogram and the ultrasound, and I was told that I needed a biopsy. But it's funny, they did the mammogram first, and then they told me that I could go home and return in six months because the mammogram didn't show anything. But I insisted and I told the lady, please tell the radiologist that I'm not leaving because I do have a lump and I do want the ultrasound done, just as was the um ordered by my physician. So they let me have the ultrasound, and that's when they made the decision for the biopsy. Fast forward to me getting a biopsy, and I went in for my appointment. No one had called. Oh. So I was told in person it was COVID. Yeah. And um there you, there, there I am now, almost what, four and a half years later? Yeah. Yep. Oh my gosh. You you were an advocate for yourself, and so both of you were. Yeah, I was gonna tell you, I'm so glad you were an advocate as well. The same thing to me, the first tech I saw at an outpatient center was like, so you're here for breast ultrasound. Of course, everyone. And you're 26, you're young. Every time they got out, I'm like, I'm gonna be the next one. And it wasn't until I'm like, yeah, I'm here for a lump. I like, I'm not, like, I don't know what else to say, right? And it's not until she finishes with the left side, goes over my right side, and then goes over my right side and keeps going. And I'm like, wow, that doesn't seem right. And she went quiet. And I said, you know, obviously we're here for a reason, you know. And I feel bad. I'm sure she learned from that experience to never like belittle somebody. And I didn't don't think she meant to, but definitely shocking. And the same thing happened. She went three times, said, Give me one second. I need the radiologist to come in and cold read it. The radiologist comes in and says, Well, you need a biopsy. And again, no context. I'm not really understanding. I'm like, well, fibroadenomas and cis can still get biopsies. It wasn't until somebody really had to say, like, no, it's this needs to be done. And it was on a piece of paper that I read it, birods five, high suspicion. Yeah, like nothing alarming. And when I read that, leaving the centers, when I said, No, I'm not waiting one month. I'm gonna figure something out. Yeah, you always have to be in your own advocate. So I'm with you. But but in all fairness, you you were so young. You are young. Right, right, right. You were so young at that moment when you were diagnosed that I mean anyone would look at that and say, You're 26 in a way. It's probably nothing for you to worry about because I was 10 years older than what you were when I was diagnosed. And the entire time it was like, you're fine, you're going to be okay. And then the emotional side, right? That comes right after. It's like, so now you've been diagnosed and your whole world just kind of like for me, it was like black and white. Everything just kind of like stopped. And I was like, what is going on? What happened with you, your family, your village, both of you? Um, the same thing, you know, I still lived with my parents at the time. So I feel like I carried a lot of emotional baggage for my family because I'm the first person who ever really has had a cancer in my family, actually. So, you know, being the child, uh being the grandchild of somebody, being the sibling, I don't know, maybe it's in my personality too, but I just it's the fight or flight that I'm sure we all have felt within all the emotions. And just you kind of carry the weight for everyone to be the village for you, to know that when you're having the moments that you need them, they're always there, but never to feel that when you need them, it's because you're down. It's just because you need that extra support. So I definitely feel like we can all appreciate that needing to be that crutch for everyone and they follow our lead. So yeah, I I definitely wouldn't be here today without my village and my faith. Can you say the same? Absolutely. I mean, for me, there's the medical support system. Of course, but there's also the family, the friends, the village, as you said. That's just as important because the village helps you endure the emotional side of things. Yeah. Because going through treatment will take uh a beating, you'll take a beating, your body will take a beating, but then the mind is just as important towards actually healing, towards the very end of that entire journey. And when you have a support system, and for me, my support system was everywhere. And it's funny because I went through cancer during COVID. Yeah, so it looked different already from than what I went through. And completely because other than the first session of chemo, no one was allowed to sit with me during chemo. So my family, whether my husband or anyone, had to drop me off downstairs at the door. They could not even enter the building. But it was always interesting to my husband to say, You going to chemo, you look so happy. And I feel so bad dropping you off and not being able to go with you. I'm like, it's not that I'm happy. I just felt that I was in good hands. Oh. The staff, the nurses, the infusion unit, the doctors at Baptist. It was for me, it was as if I was going home. Yeah. After all six months of chemo, um, the first half of that time every week, once a week. Once a week. So it becomes a second home, you know. And the nurses, you know, they always towards the very end, when things got really tough for me physically with the chemo, especially with Adrian Mison. With Adrian Mecin, the Red Devil. The Red Devil. I took two sessions and I'm I'm not coming back. And it took them one day. They they they put me in the center and they formed a circle around me. And they talked me through it and they said, You are coming back. We're waiting for you. You are coming back. And it did everything that I needed for me to come back that one more time and then one last time. Well, I actually didn't want to go back after that first one. So you're a way better person is stronger than I am, because I was walking in there kicking and screaming every Tuesday. Not nothing to do with the staff, just had to do with the reality of me not wanting this to be my reality, the physical toll that it takes, your hair, your skin, how you feel every day nauseous, what you taste in your mouth. I'm not sure if you guys felt all the side effects that came with treatment. Yeah, Dr. Carcass, she said to me, she said, You are one of the worst cases I've had when it comes to nausea. Because the thing about nausea is like you're not vomiting, but then you have this horrible feeling like inside of you, and it's just not going away. And they would try everything and nothing worked. And I'm I'm like, God, just I just want to vomit. I just want to throw up. Please let me throw up. Nothing would happen. I never threw up, but I had constant nausea for months. And the mental load while you're going through treatment, because you're physically changing, but then somehow you have to stay strong. How did you stay strong? So everyone thinks I'm crazy for saying it, but being in school was the biggest blessing. Um, I'm a very focused individual in the sense of if I were if I were gonna be home, I would go to treatment and be home, treatment and be home. I didn't want to take a leave from school. So the idea that I said, okay, well, at least after this, you know, I guess I was thinking about the after. Yeah. So I agree. The in between, I don't even want to think about the infusion, don't want to think about the dehydration, fatigue, nausea that comes after the food adversities. I was, I didn't believe it until when I was on tax. So it's almost like night and day with my aversions to food. But all of those things you don't really think about until after. And maybe that was my saving grace of thinking about everything that was coming right after. Like, oh, after this, I have to go there. And oh, I'm gonna do this. And oh, next week I have to worry about this exam and all of that. It was kind of like helping you not focus on what you had to deal with. A hundred percent. So I think that's where my mind, but I agree, the mind was everything. I mentally prepared myself. The same thing with faith. I tell everyone, I'm like, I never questioned once why me, why this, why that. I thought to just be pretty practical. Like, unfortunately, we're humans, life happens. Yeah. Um, it's kind of what we do about it. So I totally agree. So the mentality of the chemo brain exists. I never had I haven't had children, so I don't know what the brain fog people say that happens also postpartum or when you're pregnant, but I was so nervous to lose myself because everything else looked different. And when my mind was still me, I don't know if any of you can appreciate it. I was like, okay, okay, the little pieces of me, I'll pick her back up because the base is still there. Whatever, whatever's still there is still there and it'll come back. But yeah, the physical takes the biggest toe, I think, as well, um, that anyone can think of. Because the mental, somehow you're still yourself somewhere in there. It's there. Or you want to at least tell yourself that you are still in there. Okay, so I I remember after I was done with treatment, I was like, can someone please take this port off of me? Deport me off of this island because now I'm gonna go back to normal. And then I was like, Okay, it's not back to normal. I still have all these other things that I need to do, and now I have to go into surgery. Uh, how was your journey after the back to normal that wasn't back to normal? Well, for me, it was tough. It was survivorship to me is tougher than treatment. Oh, why? A hundred percent. Going through treatment for I guess it's my personality, right? When my doctor explained the whole picture to me, I went immediately into battleground. The goal is to save my life, fight, whatever I had to do. But also important was I remember clear as day when the doctor told me to sign the paper that I am being treated for cure. That in itself, I think it carried me through a whole lot of it because then I said, okay, now we're going to battle and we're gonna win this thing. And then whatever happens after the fact, I never even thought about it. So you think like maybe you just weren't ready for the survivorship? Exactly, because there was so much during treatment that because triple negative breast cancer, the treatment I had, it's it's it's it's very um, it's very toxic. Taxing on your body, taxing on your mind. Yes, and it's it's a long process, right? Because we had it, we had everything. You had triple negative six months of chemotherapy, I had double mastectomy, I had uh radiation. For the mastectomy, my first mastectomy, they canceled the second breast because I chose to have the other breast removed. But I agreed to just get the one breast with cancer removed, but I kept on insisting after that she scheduled me a first time cancel, a second time cancel the third time because my body took such a beating from cancer, it would probably not be able to res withstand the double chances of an infection. So the doctor said, let's just remove the breast with cancer. So when nine months later I went into surgery to remove the second one prophylactically, she I never forgot my surgeon came into my room, she said everything went well. I even removed two left nodes, so nothing. I'll see you in a week. Went to see her post op in a week, pathology came back. Already I was DCIS in the left breast at my own insistence. No, yes. So having gone through all of that, I'm gonna just pause for a second because I know there's somebody watching right now and saying, What is DC? Explain. No, you're perfect. It's just so people can understand because this is why we're having this confirm conversation to educate. Yes. All of us are learning about our journeys. So it's the equivalent to stage zero. So it's ductal carcinoma in site too. So your um, the mass or the tumor is still within the duct. It has not left the breast, it has not you know extended to other parts. Whereas for my right breast that was positive, it was already in my lymph nodes. I had eight positive lymph nodes. So it was very in the cancer was very involved on the right side. Yeah. So it was kind of a stage zero, but it's just to show you that although I I mean, thank God I insisted on having the other breast. Yeah. Like what are the odds the first time and the second time around? So to me, thank God I did that. But then nothing truly prepared me for survivorship because you get to a point where there's life before and there's life after. There's not a continuation of life. There's not a let I'm going to pick up where I left off. No, because it's almost as if you've gained a new identity, you've gained a new life. And now it's up to you to decide how am I going to go with this life. But nonetheless, you still have this voice in the back of your head that walks the journey with you till the very end. And sometimes you forget, but sometimes it reminds you that it's still there. It's like having, I was, it's like having a fire alarm on your ceiling, and then the battery goes low and you get that beep, beep, there's no fire, but the battery's reminding you, and you have to change the every couple of months. Like that, beep, beep. Yeah. So to me, it was really hard because with that also came other medical conditions from treatment that now you're still having several doctors' appointments, several tests, you're under surveillance surveillance for recurrence. So, especially triple negative breast cancer has a very high, high rate of recurrence. Yeah. Within the first five years, at some point we used to be up to 50%. Now with the new protocols, things have gotten better. The numbers of for recurrence have gotten better. So I'm truly relying on that. June 22nd will be my fourth year. So we're almost like I see the light at the end of the tunnel for you. You will get there. You will get there. I you were nodding the entire time, Nancy. Was talking. You're like, mm-hmm. Yep, yep, I agree. Yeah. Survivorship, same thing. So much harder. I was so on the battlegrounds with you. The same thing. I go, I'm going to school. I'm doing whatever my doctors tell me. This timeline is super long. I don't want to think about it. I'm going to think about the active treatment and go from there. It wasn't until after, so I did chemotherapy as well, six months. So that's the tough side about being young. They also hit you with the kitchen sink because they want you to live a long time. Um, so I was with you guys with radiation, double mastectomy, everything. And it wasn't until I think after my like my last radiation day, I'm in my bedroom. And I just when I forgot Saturday, 10 a.m. sobbing out of nowhere. My sister and mom come into my room. I think we were gonna go out or something, and they're like, what's wrong? I go, I have no idea. And it's everything hits you at once, right? I just, you don't know what, like, I know what's gonna come the next day. I'm gonna go to school, I'm gonna do this, I'm gonna be with my family, my friends, but all of the emotional baggage, all of the risk of recurrence, all of the treatment that follows. I know it's triple negative. There's not protocol for like longer-term therapy, all of my hormone therapy, just everything, right? Hit me at once. And that was the hardest part. I was really, really lucky to have sought out mental health services at Baptist. I saw I was with the health psychologist. She graduated me like two weeks ago. She was like, Yeah, she was like, You, you, you don't need me. She goes, You have come full circle and I'm happy for you. And I'm like, you know what? Thank you. I needed that, you know? And that that I agree with survivorship. And the same thing with recurrence and all of that. I I find ways to navigate my mind and my thoughts and my future, thinking about family and things like that. But I try to ground myself in the today. I think that's what Kencha's really, really taught me. I almost can't think too far in the future and not in any negative way. It's only because I need to be grateful for what's going on right now and just be present, also. Like live your day-to-day. Yeah. Yeah. Um, I'm I was smiling when you said that because I remember when I graduated from my therapist, she's like, I think you're good. You're ready to go out to the world now and be a big girl. I'm like, okay. Yeah, I did this. I can do this. We can all do this. 100%. But you did say something about navigating through everything. They really were helpful with you with your journey, navigating through school and accommodating. That must have been something really special for you. It was on so many levels. Like now I take it with me to my day-to-day and realize like care is so individualized for whatever reason. Like we may have done the same protocol, but the concept of, you know, double mastectomy takes time for recovery. I wanted to stay in school. So the option for lumbectomy, at least, because my my breast oncologist was like, at least take the tumor out. My um surgeon was on board. She knows somebody who had done it previously, another surgeon in her practice. So she's like, if you're down for two surgeries, I'm fine with that as well. I was like, no problems. Like, I'm here to do what I need to do. So that's kind of where my individualized care came into play. I had a lumbectomy, yeah, uh, port placement. So yeah, I had port placement, no, sorry, lumpectomy, pet scan, port placement. Port placement went to chemote right after. Went from South Miami Hospital to chemo because I said, with school, I need to be on this schedule so that my exams don't land on my chemo day. It was a lot of planning. I went to the T and it worked out to the best, but the same thing between school and MCI, they were every Friday, first appointment, 6 30, or what was it, 7 a.m.? Yeah. It had its the same, it was just so amazing, right? And the same thing, the environment. I I can't think of a better place to be nurses, staff, everyone getting you going. They knew you had school, they knew you had this. Anything bumps that happened during chemo, whatever, you can't. Yeah. But anything else, oh, they were on top of it, making sure blood work was okay. This was okay. Because of your age, did you ever stop for a second to think about having kids? You're smiling. I think you already know where I'm going with this fertility. Was that a conversation for you? Or were you like, I'm just not there right now? So both, right? Um, sitting there where it's like I have hormone receptor positive breast cancer, 99% progesterone, estrogen, thinking of pumping my body with estrogen already freaked me out for egg retrieval. I spoke to fratitoli nurse practitioner. She told me, you know, your risk, I mean, your ability to have kids in the future at your age, think looking in the long term, is still very, very high. You know, I don't, I don't want to tell you that if you don't harvest eggs now, you'll never have children, but you know, it's your decision. So I lived on anxiety, did not have a partner at the time, did not have any ideas of wanting children at the time. I was 26. I hadn't even started my career. So I just opted to hope for the best of preserving fertility in the future, um, which is something I mean, my oncologist actually spoke about in my last appointment. And it looks bright, right? But 100% so very much that is like a looming other like light and fear and anxiety and kind of conversation I always have with myself and in therapy. And I've learned to talk myself down and just understand that whatever's in my plan, whatever's in my path, whatever my family will look like in the future, because I know that will happen. Yeah. Um, I accept and I I can move forward. You just you mentioned fear, Nancy. You mentioned the fire alarm. And I actually love that because I always say there's like a little noise in the back of my head every now and then that's like, hello, I'm coming back. And I'm like, shh, don't talk. I'm like, just stay back there. Uh do you you have that noise and you have that noise? Is it is it on a lot? And most importantly, what do you tell other women that are listening to this right now that are going, okay, I I don't, it's not gonna happen to me. What I tell other women is to live in the present, understand the possibilities, understand your chances, but at the same time, mental health. But it roots back to fear. Mental health is very important because look, getting the mental health you need to teach you how to move forward, to teach you how to live through these moments of fear, these moments of uncertainty is also very important. And you uh you can't deny them, but they will come. We're all human. Fear is part of our emotions, but at the same time, is really how much of it do you let take over your mind because it can paralyze you. Yeah. It can paralyze you, and also the fear of not knowing if it could happen to you. A lot of women just don't want to get checked, they don't want to know because they have that fear. Well, what I say to them let's say you were to get checked, yeah, and you were to be found positive for breast cancer, I usually tell them, I guarantee you it's an easier battle than the one you would have to face if you were to never get checked and be found positive at a much later stage. Very true. I agree with you. I say this. That's what I say. Like my first daughter's um godmother, she was afraid of getting a mammogram. Like she's scared, cry, pain, and everything. I said, that's fine. You get a Valium, you talk to your physician, whatever they can prescribe to you, you will get that medication prescribed to you. The morning of you'll take it, and I will walk through these doors with you, and we're going to have a mammogram. You're good, you're good human. You really are. Uh, let's talk about hormone therapy because that also is something that fears me as a woman in in her 40s, uh, in perimenopause. A lot of women are in menopause, they've had cancer, and I know for myself, I can only speak and say, as a cancer survivor, I'm like, well, should I have put this in my body? Do you guys think of these things as well? Do you have that fear? No, 50-50. I'm with you. I'm like the same thing. Think of all the side effects. And then I try to bring myself back to, you know, these studies, the general population benefited in what like degree. And I said, I'm gonna be in the normal. I'm gonna be in that general. Like, that's what I kind of remind myself. I had a conversation the other day with a younger patient for a different condition and her fear of side effects and cancer, et cetera. And I said, Let me let me give you some context. You know what? I woke up today, I took my immunotherapy, I took my hormone blocking therapy, and I took my vitamin E for hot flash, and I said, Thank you to the women who are part of these studies that I get to take these medications for. And I'm going back to when you said cure, when I signed the paper for the immunotherapy and it said intent cure, I cried because and not something more out of emotion, nothing super exaggerated. No one saw me, but I said, cure. Okay, this is this is the topic. This is what we're what we're talking about. All of this is for and we're intentional. We're for prevention. And even if we find something, the intention is cure the low risk of recurrence. If there are recurrence, we know where stage four is now. It's just all of these things that I try to exactly remind myself, you know, be grateful for the the age that we live in in medicine. And just if we do that, we can always push forward. What has surprised you both about life after treatment? For me is not knowing how to move forward. I even I I feel like we're not prepared for the after treatment stinging of life. And um, in the back of my head, I thought everything was on hold. And that wasn't true. How do you wish it would look like? Um that I wouldn't have to have this fear. One of the things that constantly remind you of what you've been through is the ongoing medical care. Because treatment comes at a cost. Yeah. You know, so there are side effects and there are secondary conditions that you gain from treatment. But at the end of the day, right, people will tell you, Well, you didn't die from cancer. Oh, I hate it when I hear that. Exactly. So, you know, there's the chemo, for example. Then now you go from osteopenia, now osteoporosis, where your bones get really brittle. And now I have to look into what am I going to do? Do I take an injection for three years every six months? Or do I start lifting weight and strengthen my bones and do other, you know what I mean, other kinds of remedies and drinks and protein and all of that to try to, you know, do I take this path or do I take the injection path? The injection comes with its own um risks. Then there's the um red devil chemo, the the, you know, the impact on your cardiac um um condition, yeah, on your heart. Now I'm seeing a cardiologist. Like there are so many other things. Keytruda, for example. I mean, I consider it's funny, now I consider myself one of the lucky ones. It it destroyed my thyroids. Right. So, but I'm on thyroid medication for the rest of my life. Yeah. You know, it's all of these other things that you weren't truly prepared for. You were not prepared for. So for me, that's really what makes it hard because you're not picking up where you left off. It's a new life, it's a new beginning, it's a different life. But that life also, it's not a life where you're handed a treatment protocol. It's a life where you choose. You have actually, you have to choose how to move forward. Yeah. Do I move forward knowing all of these things, dealing with all of this, and still staying in the presence, staying positive and living in community? Or do I move forward in fear? Do I s or do I stay paralyzed in fear? So now we have to choose. When you're in treatment, you don't really choose much because the choices, science has laid out all the options. But you're not really all there while you're going to treatment. We just go ahead and acknowledge that you're not really thinking straight. Yeah. There's a lot going on. Yeah. So that's why I say, like, what surpr what has surprised you the most now, now that you're done? Right. Dunnish. No, yeah. I I would say like we can say Dunnish, but the same kind of concept, there's no going back. It's almost you don't recall who you were before all of it. And it's not negative and it's definitely a new normal. So it, but it's choosing what you do with your life every single day. And it's choosing what you want to do. And of course, at any age, um, ongoing treatment, ongoing specialist, ongoing all of those things. Some days are better than others. Some days I'm annoyed of it, but I'm gonna stick through the plan because I want to be here for the longer to like run of the future, right? Yeah. But yeah, some days I'm annoyed, some days I'm mad. The I still get skin anxiety for something so simple like a bone density. I got my bone density done a couple weeks ago. I'm like, oh, improvement. Okay, cool. But the same concept, you know, like it's never not gonna still be there always with the small simple things that we get done. Please tell me that I am not the only one that when I walk into the cancer center, there is a smell that takes me back. And it's like, I swear it's like PTSD sometimes. I tell my husband all the time, I'm like, I just walking in takes me back because of the smell. Something's so small. And he's like, but it's been years. I'm like, I don't know why, but there's something about the smell. And I even asked my oncologist, and she was like, Yeah, it's true. Some patients, like the smell of it all, just kind of takes you back. And and it really is. You know, your cells have memory, yeah, especially when it comes to trauma. So I'm not going to crazy. They remember trauma. You remember trauma. You do remember trauma. That trauma. And then so even after it years after when I go back, I'm like, oh, there's that smell again. I can, and I just feel the anxiety that you feel every time you walk into a scan. Well, every time I feel all of us walk in to get a scan, it just like you said, ourselves have, you know, memories and they and they know. But thank God we're on the other side, right? Let's be grateful for that. Of course. We've got body image sometimes issues as well. Reconstruction surgery, that was probably the best reaction, Nancy, when you took that big deep breath there. But you are helping so many women. Yes. Um, for me, through the work that I do, yeah, the areola restorative tattooing, body image is at the forefront of the service. Yeah. And one of the things that I um make sure to implement in within my my space when I have a patient in the room is to be present with what they're feeling, with any gesture, grimacing, anything. I watch for their reactions. I watch for are they okay, are they calm? Are they nervous? And I if I see the tears, you know, welling up, and then I would put my tattoo machine down and I would stop and I give them the time to go through the emotion to process it. And it's intentional for me to provide a space that is trauma-informed because I know that for them there is so much more for a woman to lose their breasts. And many women have their femininity lodged into the idea of their breast, right? Self-worth, self-confidence, sexuality, especially when there's a partner or um a spouse involved. So there is a lot of emotional baggage that comes with that. And oftentimes it's the last step of the journey. So there's that too. It's kind of a celebration of the good and the bad. So you know, studies have been made, have been done where the women who've had the areola tattooing have said about over 80% of them, it has restored their femininity. It has restored the way they feel about their body, it has restored their sexual life. It's also healing the psych, the psychosocial component of what they do, the way they dress, the confidence they portray when they walk into a room. Their children will tell you, oh, my mom has changed. Things that we we didn't do before, now she does them. Clothing that she never wore before, now she wears them. Even going to the pool, now mom joins, she joins us in the pool. She hasn't done that in so many years. There are so many layers to it. And it's all part of the mental health that comes after treatment because treatment carries the physical uh emotions. And I think the survivorship and also the restorative tattooing and all of these services, they help heal the emotional component of everything else that cancer left behind. Yeah, I think that's probably one of the biggest things that I have a gripe with because I feel that there's not enough emphasis on it matters what you look like, your confidence. Absolutely. Um, and we're no one can judge anyone for whatever they have to do to get to that place where they are happy with themselves because it really starts with yourself looking yourself at the mirror. A hundred percent you like it, right? And you're happy, and you're gonna walk out there, you know, with your shoulders back a little bit and your head up, and you're gonna feel good about yourself. Absolutely. Because you like you like what you see. Identity. Yeah, it likes your identity. Yeah, I I agree. I mean, I mine was nipple sparing, so I didn't know the difference at the time. And then when it came to reconstruction is when I realized, I'm like, oh my goodness, like something so what anyone else would say, like, oh, but who cares whether they're there or not? Are you yeah, it's life changing, and I can see where it's confidence and everything. So what you do is amazing. Yeah. I'm so glad you're able to offer that kind of support in a way that, again, many people will never understand. But to those women, you're changing their life and their future trajectory, and like you said, the way they think about themselves, they go about their family dynamics, their personal dynamics. So at the end of the day, whether you're a wife, whether you're a mother, whether whatever you are, you're still yourself. Yeah. You know, and you're allowed to do, like you said, whatever you want to feel like yourself and you're able to grow and evolve. I don't care how old you are, if you had breast cancer at 20 or at 60, um, you know, you need to do what you need to do to be able to pick yourself up every day and get up and say, I this is who I am. Yeah. So as we close out this conversation, I want to know your thoughts on thriving, not just surviving. Oh, that's right. Well, I think the thriving comes from what we just said. It's kind of these little things that give us so I called it, oh, what did I used to call it? Um, well, whatever. I'll go back to just the concept of just these little things that may seem so minuscal to others, but important to us, you know? So th thriving, I never understood when I was in treatment and early survivorship. That concept, I'm like, okay, I mean, sure. Maybe my version of thriving is definitely being able to go back to the new normal and figure out who you are, what you want to do with your life. Do activities and things that you used to be so fearful of a year back and say, there's no way I'm gonna be able to do this again. It's okay. And you do it. You travel, you experience things. You, I don't know, just these little things that you don't realize that you have fears of doing because you don't think you're gonna be able to experience it or your experience is a modified version of it. But it's really just your new version of it or the way that you do it, right? So that's that's how I like to categorize thriving. Well, for me, thriving, um, it's really rooted in in everything that I've gone through and my hopes for um, I want to lend my voice where changes can take place on the medical aspect of things. I want there to be a little bit more emphasis on the mental health aspect for it to start early on, not just after treatment, and you find yourself um um what's the word? Like encompass or com there, just a lot of it. And then now you're like you're overwhelmed, and then that's when they try to bring in the mental health aspect of things to help you by the exactly. So to me, my hope for you know our society is that on the medical aspect, they they they they can implement that early on. The second part is to the survivors, especially people that are new into this, I tell them it's important to be in community. Because sometimes I find people who tell me, well, I don't want to hear anything about cancer, I don't want to hear to me, that is a form of not of not coping well. And being in community, you get to choose how much you want to be in community. You get to choose what community looks like to you. But what it does, it when you're walking around, you've had this whole experience. There's this burden on your shoulder. When you walk into a room where there's a community of survivors, thrivers, or pre-vivors like you, there's not much that that needs to be said. You feel understood. You feel like, oh, I can relate. I'm not the only one. There's something else going through this. I'm not crazy. I'm not crazy, yeah. Exactly. Or there's a solution. Yeah, there's a person that I can call, if ever. Because no matter how much your mom loves you, your sisters, brothers, your husband, any your children love you, they will never be able to understand that's the content. And that goes even like I have one of my closest friends, she's a physician. And when I was diagnosed by um the psychologist with major depressive disorder, she was like, No, that's not true. She's a physician herself. Why? Because, like my psychologist said, I'm high functioning. So everybody thinks, oh, she's doing so well. You're doing fabulous, yeah. Right? Right. So, but if I am in a community of people who've gone through the same or similar situations, they understand what that means. They understand their signals that they can pick up right away. And that not much explanation needs to be given. To me, that community is important. So, in thriving, you need to adopt a new family, not just the family you had before, not just the friends you have before. You need to adopt a new family within the community of survivors. Preach. Yeah. I love everything. You know, I want to piggyback one more thing since this is informative more than anything. And I think you did you said it so well. Well, all of us have said it really well, is don't ever think that when it's over, it's over, right? The concept of community, leaning on anyone, even if it's one person, it's so important because unfortunately, it's never not over and not for the negative. It's just, it's a new little stamp for us that we carry with us. And it's not like a burden, but we have to, we have to accept that it's there. And I think that's the hardest part when you try to ignore. So I just want to, for anyone out there, just know you don't have to, you don't have to say, okay, next chapter to close, and I'm never looking back, except for what your life has become now. And you're gonna grow. You're gonna meet amazing people, and they're gonna motivate you to live the life you deserve to live. You ladies are fabulous. Thank you so much for sharing your journey, your stories with us. And and I'm gonna continue praying for both of you. We'll keep you in our prayers and our thoughts. You both are wonderful. This conversation has truly been powerful. Remember, viewers, be sure to hit that subscribe button on our channel here to keep up with the latest health and wellness information and tips from our experts. You can also find Baptist Health Talk on Apple Podcasts, Spotify, or wherever you listen to podcasts. So you can listen anytime, anywhere. Be healthy. Thanks so much for watching. Ladies, can I get a high five for surviving? There we go. I love it. Find additional valuable health and wellness information on our resource blog at baptisthealth.net slash news. And be sure to interact with us on our social media channels for live and upcoming events. Baptist Health Talk is brought to you by Baptist Health, the warmer side of care.