October 22, is my birthday. Strangely, the first thought I had when I opened my eyes that morning was that this birthday, my 37th, is the first birthday that I have earned and not just stumbled upon. What I mean is, this is the first birthday that I could have feasibly missed had I not caught my cancer early, had I waited for symptoms rather than attend my annual mammogram, and had I not taken every measure to ensure my cancer’s demise. I could have been looking at a far different outcome than the one I had. I could have missed this birthday.
October "pinkwashing" (when a company uses that recognizable pink ribbon symbol or signature shade to market a product or service without meaningfully supporting breast cancer research or awareness) can often be triggering and generally unhelpful for many Breast Cancer survivors. I understand the good intentions surrounding Breast Cancer Awareness Month; however, it is a month-long reminder of the worst time of my life. Since recovery, I have desperately been trying to ensure that my identifier to myself and others is not ‘the girl with cancer’, but that is difficult when reminders that you are/were, in fact, the girl with cancer are all around.
It is exceptionally difficult to avoid medical PTSD triggers when the trigger is your own body. When I get in the shower or ready for work, I am triggered by the sight of the myriad of scars on my chest or the strange and unfamiliar shape of my torso left behind by fat grafting to recreate breasts. When I get a hot flash, I am reminded with a jolt that I did, in fact, have cancer. This frequently brings tears because my personality and sense of self have been fissured. I do not feel at one with my body. I am no longer at war with her, but she is a trigger.
So, let’s talk about that pink ribbon and ‘Breast Cancer Awareness Month’. What does the pink ribbon mean anyway? We know that it is for Breast Cancer Awareness, but what, exactly, are we meant to be aware of? Aware that it exists? Aware that a lot of women have had it? Aware that cancer is awful? Aware that you should donate money? The pink ribbon leaves much to be desired by a large swath of Breast Cancer Survivors. I want to take a moment with you, Dear Reader, to tell you what I think you should really be aware of during October, and throughout the rest of the year.
First, I will attempt to summarize my experience:
On June 15, 2021, I was 35 years old. I was newly married, I had a good job, 2 perfect puppies, and a house that my husband and I had finally made a home. I had been tested for the BRCA gene in 2014 and had been found to be negative for BRCA 1 and 2. I had a family history on both sides of breast cancer; most specifically my mom was diagnosed when she was 37, but she and every other woman in my family had the BRCA gene. I did not. When I tested negative, I allowed cancer to seep into the back of my consciousness.
I had been getting annual mammograms starting at 27 years old; 10 years prior to when my closest family member was diagnosed. However, in June of 2021, I was about 4 months late for my mammogram. I had gotten busy with life and work, and it did not seem like a priority; especially having tested negative for the BRCA gene. I was reminded to make my mammograms a priority when a friend’s mother was diagnosed. I made my appointment, strutted into the imaging center feeling fearless, and walked out with an appointment for a biopsy the next day.
Cue the panic.
I believe that this part is important to note. I had a fantastic gynecologist that encouraged mammograms and ultrasounds. She specifically called in both for me each year, despite not testing positive for the BRCA gene. She knew my family history and insisted that I get checked. However, many doctors that I had been to in the past had told me that testing prior to 40 years old was unnecessary and they would fight me in my yearly requests for a mammogram. If you currently have a doctor that is pushing back on scheduling mammograms, or doesn’t believe that you need one, run. There are thousands that you can choose from and the world is brighter when you have a doctor that is willing to code things correctly with your insurance company to give you peace of mind.
Also, some women get confused by the ‘ultrasound’ portion of my scans so I will explain. While a mammogram is incredibly helpful, it is not the full story. Most often, when women have dense breast tissue, doctors will request an ultrasound as well since dense breast tissue can sometimes miss a mass or misread the results. The ultrasound is what saved my life. The mammogram missed my lump completely as the lump was directly on my chest wall and not in the bouncy part of my breast. The ultrasound tech saw something, moved on, but then kept coming back to the same spot and decided to mark it as needing further review by the doctor.
I was terrified for the biopsy. I was told that they are incredibly ‘uncomfortable’…as doctors like to say. “You will feel pressure/discomfort” is something I became deeply annoyed with as time went on. I wish they would just say that this is going to hurt like a S.O.B. I will impart here that the biopsy is not as bad as you often hear. It is painful. I will not lie. However, it wasn’t the worst I have experienced by a long shot. It did, however, suck.
My biopsy was on a Thursday, and I had to wait until that next Tuesday to get the results. I was diagnosed over the phone on that Tuesday while reviewing cases in my boss’ office on June 15, 2021. I answered the phone thinking that it would be a quick, routine call to let me know that my biopsy results were back, and everything was clear. I was sure that it was a small mass that might need to be removed eventually, but of course it wasn’t cancer. I was 35 years old, for god’s sake! I was negative for the BRCA gene! This was not something that I had to worry about.
“Megan, honey, you have breast cancer. You have what is called invasive ductal carcinoma and…” I instinctively threw the phone to speaker knowing that my paralegal would swoop in and take notes while I essentially blacked out. I don’t remember a single word the doctor said after that. I quickly called it a day at the office, went home to take the appropriate amount of Xanax, and called my gynecologist. She and I put together a dream team including my oncologist, my oncology surgeon, and my plastic surgeon. (Here’s lookin’ at you, Dr. Mardones, Dr. Griffith, and Dr. Lo!)
Thus began the year-long slog of doctor’s offices, medications, scans, pokes, IVs, surgeries, procedures, physical therapy, and curse words. I had a double mastectomy, reconstruction of my breasts, and a total hysterectomy removing my ovaries, uterus, and cervix. Thrown in the mix was a month-and-a-half-long stint in a hyperbaric oxygen chamber due to necrotizing tissue around my sad looking pseudo-rebuilt breasts, and a month of shots and hormones to freeze my eggs before they took out my ovaries, cervix, and uterus, throwing me directly into full blown menopause for which I cannot take hormone replacement therapy.
A year of the above will inevitably leave one feeling broken, battered, frazzled, and with crushing medical PTSD.
For a year I have been trying to shake this recurring vision…or scene almost…of me being bare and bleeding chested, arms outstretched and tied down, intubated with my eyes taped shut, and beeping all around me. I am hovering over my body like an ‘out-of-body’ experience, or like those who have just died but have not yet passed, and one of the surgeons is just starting to lean back off my body. While my oncology surgeon is now done, my plastic surgeon is now leaning forward and taking over to place my expanders as ground zero of reconstruction, but my attention is drawn to only two places. First, to the gaping red indents in my chest where my breasts once were. Second, I am drawn to the nurse who is holding the tray with the lumps of fat that were my breasts. The lumps of fat that were my nerves, my nipples, my milk ducts, my sexual pleasure, my femininity, my joy, and my confidence. I watch that nurse walk with the tray to the other side of the room, fold the lumps of fat that define so much of me into the appropriate containers to be sent to the lab for testing, fiddled with unceremoniously until they determine that I did, in fact, have cancer, and then dropped into the hazmat bin for pickup and incineration later that day. I feel rage.
The level of panic on the day of my double mastectomy, but also on the weeks leading up to it, are like nothing I have ever experienced. For many women, they cannot feel their nipples and they get very little sensation from their breasts, so losing them is not the great severing of body and mind that it was for me. The panic was debilitating. So much so that even thinking back on the panic now, almost 16 months later, brings up similar dreadful episodes. A wrenching in the gut. A twisting of the jaw. A clenching of the fists. A tightening of the torso. A fire and burning in the face.
I don’t remember waking up the morning of the mastectomy, but it was a 12 o’clock surgery so I got to sleep in a bit. My first memory of the day was waking up and hearing my sister-in-law downstairs as she was going to watch the dogs for us that day. I awkwardly walked downstairs to force some small talk with her as if I wasn’t scared shitless. I wanted to present to her and the world around me that I was handling this gracefully. I was not.
I had extensions added days before my surgery, along with Viking-esque braids weaved into my hair as a feeble but pronounced act of defiance against the coming change. My husband, mom, and I drove in relative silence to the hospital while I strangled my husband’s hand the whole way. I know that we waited quite some time to be called back to the pre-op room and, as it was during COVID, only my husband was allowed back with me. It was at this point that I started to lose my mind.
The pre-op room is where they have you change, start signing forms, talk to your surgeons, and start getting hooked up to IVs. I was discussing the surgery with the nurse and I could not stop shaking or crying. I wanted to run out of the room. I wanted to get everyone off me. I viscerally wanted to scream and push people aside and tell everyone that I didn’t belong there. Maybe other women can do this, but not me. I am NOT the girl with cancer! No one was going to take my breasts. Are you kidding me!?!?!? My BREASTS!?!?!? Take a foot instead! Or a finger. Not all of those are necessary. Alas…people kept coming in and out of the room as if they do this every day (of course they do this every day) while my husband and I sat there wide eyed and terrified. He tried so hard to keep it together for me and I know that he was crumbling inside while he watched me fall apart outwardly. I know that at some point I received two pillows shaped like hearts. I thought they were cute at the time, but I didn’t realize how handy they would be in the upcoming months. Apparently, they were made by some other ladies that had gone through this before. Precious. I didn’t have time for it. Still shaking.
I met with the anesthesiologist and begged him to put me out. I realized at that point that I couldn’t get out of this, but I couldn’t handle the waiting. My feelings had overwhelmed me and the waiting was too much. I was sure that I was going to pass out or throw up or start sobbing to the point where I would upset other patients. I needed to be put out of my misery. He advised that he couldn’t give me anything until I had signed all the paperwork. Rational…but rude.
My surgeons then came in to talk to me. My oncology surgeon and my plastic surgeon; both whom I love and trust entirely, but it felt as though I was loving and trusting my executioner. This must have been how Anne Boleyn felt while waiting for her special executioner from France who had the renowned capability of beheading with one fell swoop. No suffering. No multiple hacks. Just there…then gone. I knew they would do incredible work, but I couldn’t imagine ever wanting to see someone less.
By the time the anesthesiologist was finally able to put me out I had been actively resisting the primal urge to get out of the bed and run away for about an hour. I could not believe that I was in this position and that this was the last time I would ever feel by breasts. They would be gone after this. I would be different after this. What happened to me that day feels as though it happened without my consent. Of course, I had a choice, but is ‘do this or die’ really a choice? I was wheeled back sobbing and hugging my chest.
Since that day, and all the surgeries afterward, I felt lost, hurt, angry, traumatized, voiceless, and confused; going through the motions of the life I once led but tripping all over myself in the process. I have found myself unsuccessfully fighting every day for some semblance of control over my life or for some outward acknowledgment of my ongoing pain.
Very few people discuss the long-lasting physical and mental side effects of cancer that linger for months and years after treatment. I was thrown into menopause at 36 years old on a Thursday in November of 2021 due to a full hysterectomy. I am unable to do any hormone replacement therapy because my cancer was estrogen and progesterone positive…meaning that my cancer uses estrogen and progesterone as fuel to grow. I have about one hot flash per hour and, dear god, the night sweats! There are many other side effects that are not meant for polite company so, Dear Reader, I will spare you the details.
The aftermath of a cancer diagnosis is incomprehensible. Brutal, really. Every day is a challenge to give myself grace, relate to others, find compassion for other people’s problems, and convince myself that this ‘new’ me is valid and valuable. I am not dead, but I am changed. I mourn every day for myself, the self that I was, and I have the feeling that I will continue to mourn for a very long time. I don't know how this will all pan out and what parts of me will be restored and which parts of me will never go back to normal, but I can tell you that it has been, without a doubt, the most challenging year of my life. However, the only reason that I am able to write this article is because I caught it early.
Within 6 months of diagnosis, I lost my breasts, my reproductive organs, my ability to have children, the ability to breastfeed said children, and the freedom that comes with never having to wonder if it will come back. I have been 'cancer ghosted' by some that I never imagined would do so, and I slowly watched the entire trajectory of my life shift.
However, I have also come to realize my ability to take a beating and come back from it mildly calloused, but stronger. I recognize my resilience and capacity to make light of horrifying situations and laugh in the face of fear. I am also acutely aware of the necessity of friendship, family, and those that have gone through shared experiences. It took a while, but in retrospect, I finally realize that I am a beast.
Now, Dear Reader, how can you be suitably ‘aware’ during Breast Cancer Awareness month?
First, find yourself a job that values you as a person and who is willing to hold your position if you get sick. A better way of saying this is, do not work for a company or firm who would replace you if you were not consistently producing and making money for it. I was lucky enough to work for a firm that held my position for me while I took 8 months to tackle surgery after surgery. I cannot imagine what it would have been like to have to focus on my clients, being in domestic relations law, with their own sets of life-altering issues while focusing on my own healing. Truly, I don’t think it would have been possible. Being provided the opportunity to focus on myself rather than my career for a bit made such a significant difference in my mindset and self-preservation.
Second, get ALL the insurance. I happened to have an awesome insurance plan through Anthem BCBS. I was also incredibly lucky to have solid short-term and long-term disability insurance policy through my firm. However, if I can impart any wisdom here, it would be to sign up for every bit of insurance that you can. If your firm does not offer the benefits that you would need were you to get cancer, petition them to begin providing said insurance. I might also suggest asking your firm to provide fertility insurance. If you do not get adequate health insurance, I suggest saving up for a good bankruptcy attorney because the final amount spent by myself and my insurance company was over 1.2 million dollars.
Next, get a doctor that champions your desire to get regular testing. Doctors will tell you that you don’t need to get a mammogram and ultrasound yet and all the reasons why. I believe this overwhelming and pervasive lack of preventative care primarily stems from the insurance system in this country, but that little reservoir of anger can be opened on a different day in a different article. I’ll tell you something, though…you do not want to wait until you have symptoms of breast cancer to find out that you have breast cancer. At that point, you have a serious problem on your hands. Also, it is not your doctor’s body. It is YOUR body. You are the one that needs to live in it. Do not be lulled into a false sense of security by other people’s standards of practice. If you have breasts, you can get breast cancer. I know that is a bummer, and many apologies for that, but it is true.
Get yourself checked! Always advocate for yourself, even if your doctor is hesitant because of your age, gene status, or family history. The key is to catch this early. I have made too many 'cancer buddies' over the past year who will not make it to next Christmas because they caught it too late believing that they are too young or not a cancer risk. Get. Them. Checked. You are not too young. You are not exempt. You do not need to have a family history. You do not need to have the BRCA gene. You don’t need to have symptoms, and you certainly don’t need to beg a doctor. Get them checked. Now and each year afterward until your boobs touch the ground. I don’t want to be the one to break it to you, Dear Reader, but if you are old enough to be perusing an article from the Colorado Women’s Bar Association, you are old enough for a mammogram and ultrasound. What used to be perky and playful has now become a liability.
Find your group. Women seem to have the inherent ability to cultivate community, and I know that I am not alone when I say that one of the first things that I did when I was scared, lonely, and confused was to reach out to others in my position via Facebook groups. We tend to seek camaraderie through speaking with individuals. Being a part of Facebook groups or support groups with other women was incredibly helpful for me. There is an unspoken language in ‘cancer land’. Hard learned acronyms. There is a dark humor that makes ‘cancer muggles’ (shoutout to @thecancerpatient for that one) deeply uncomfortable and makes those going through it belly laugh.
An interesting item of note is that I have found no support groups for younger women going through breast cancer. I attended a few support groups throughout my ‘cancer journey’ (I hate that term) but I was always the youngest of the group despite knowing full well that there were too many young women throughout the Denver/Colorado community fighting the same battle I am fighting. I would like to change this. I have been deliberating for some time now about starting an AYA (“Adolescent and Young Adult”) support group. I will speak more on this later.
Very few people in my life seems to understand the daily struggle after being a cancer patient, and I don’t expect them to. How could they if they have not experienced it firsthand? For example, my husband was the primary source of support during my surgeries and recoveries. However, no matter how much he tries, he will never know what it feels like to have your breasts taken, your future motherhood vanishing in an instant with one unfortunate yet necessary decision, and your femininity seemingly scattered to the wind.
My support system is just so happy that I am still alive and will likely not be dying any time soon that they miss the rage, fear, and incredible solitude of knowing that I will never be the same. I will never have feeling in my breasts again, my body is covered in scars, I entered menopause at 36 years old, and I am trying so hard to relearn how it feels to be feminine.
Finally, realize that it is perfectly reasonable to sit with those in your life battling cancer or other chronic diseases in quiet solidarity. Words do not always need to be spoken. There is no fixing this. Those going through cancer will always live with the constant fear of it coming back and metastasizing. They will often not have the words to describe their loss of self and control. The feeling is inexplicable unless you have been through the same thing. This is why I am starting a low key, come as you are, let’s drink about it, wholly irreverent type of support group for young women that have been diagnosed with breast cancer or who have undergone a mastectomy as a preventative measure. There are too many things that the internet, books, and doctors do not tell you. I believe it was Madeline Albright who said “there is a special place in hell for women who do not help other women”. I have no intention of letting down that saucy little firecracker.
So, Dear Reader, please take this article as my call to action to care for yourselves, to reevaluate your priorities, to look out for those around you, and to seek out a community of women that will add value to your already invaluable lives. Also, please reach out to me if you or someone you know would be or should be interested in a support group for young women diagnosed with breast cancer.
I am still pretty salty about the cancer experience, and I do not know what good will come from my cancer, if any. Whatever remains after all that is said and done that is 'positive', though, will be because I made it so. I am being recreated, re-formed, and reimagined. I cannot wait to see the final result.
Gift ideas for those getting a mastectomy/cancer treatments:
Sleep Again Pillows: These were created by our own Rachel Baumel, after she went through her own cancer diagnosis and double mastectomy. These specific pillows were bought for me by the partners at my firm and they were a game changer. It is impossible to get comfortable or fall asleep after a mastectomy without proper support. I highly recommend buying these for yourself or someone you love who is facing a mastectomy.
Look Up on Amazon:
Mastectomy Seatbelt Pillow
Mastectomy Recovery Shirt/Robe
Front Closure Sports Bras
Extra Set of Sheets
Food Delivery gift cards
Anise candy (for nausea)
Megan Courtney is a native of Michigan and graduated from Michigan State College of Law. She has lived and practiced in Colorado since 2010. Megan has a background in finance, bankruptcy (Ch. 7 & 13), and business law, however, she has focused singularly on domestic relations law since 2019 and is currently an associate attorney with Gebhardt, Emerson, Moodie & Bonanno, LLC. When she isn't working, Megan loves snowboarding, hiking with her dogs, journaling, and reading.
You can contact Megan by email at firstname.lastname@example.org