You Can Have Faith and a Panic Attack

Care Warning: In this blog I discuss my anxiety, panic related incidents, and death.

Yesterday was the first time I pulled into the Cancer Center since June 30th. I went for a quick injection at the lab for a medicine that’s used to manage my endometriosis during my treatment (called Lupron). It was almost like an out of body experience. I have spent so much time there since March, that it felt weird not being there for almost a month.

It’s honestly been nice to not have chemo these last four weeks. I feel more myself. I still wear out pretty quickly and often require rest late in the afternoon. I still can’t feel my toes or finger tips, the rest of my fingernails are starting to pull up, and to my dismay, my hair hasn’t started growing back (and probably won’t for another couple months).

The real truth, however, is that my anxiety has been at an all-time high and I’ve had a number of panic attacks in the last week. About two weeks ago, I was due for my Lupron shot, but insurance had to pre-authorize it and they weren’t responding. I was starting to have bad pain (from the endo) and stressing about what the next steps were. The last thing I want to do is finish cancer treatment and then have to deal with endometriosis that has gone untreated.

Then, about three days later, I got a letter in the mail from my insurance. It was a copy of something they sent to my oncologist, asking her for more information so that their third-party partner could review if my “chemotherapy was medically necessary”. That might have been what sent me over the edge.

So there I was, impending surgery, chemotherapy may not be “medically necessary,” and no answer on my Lupron. I was a ball of anxiety, standing in our bathroom trying to teach my six-year-old how to wash her own hair in our shower. She wasn’t listening and mostly screaming about the shampoo suds washing over her face – something she’s not used to in taking a bath. That’s when it hit. It always starts with shortness of breath and then the room starts to spin. I looked down at my Apple watch and quickly flipped to the heart rate monitor as I sat down on the edge of the tub. My heart rate quickly jumped from 78 to 210. Deep breaths, Jessica, deep breaths.

It happened again two days later standing at the kitchen counter in the morning as the kids were arguing about sitting too close to each other. I flipped to my heart monitor again and my pulse was 141, just standing there.

Then it happened again the next day. After doing some research on recurrence rates of triple-negative breast cancer and complications related to reconstruction surgery after radiation, it was back. I texted one of my best friends, Meghan, “I’m having a panic attack. I don’t want to die and for the first time, dying from cancer feels real.” as tears streamed down my face. She replied, “Stick your head in the freezer,” as I walked upstairs to take some medicine.

The truth is, as each of these moments were happening, I was trying to breathe deep while chanting my mantra, “Have Faith, Trust God, All Joy”. I’ve been doing my daily bible study and writing in my gratitude journal. I have medication I’m taking and I’m talking regularly to the 8 doctors on my care team.

Yet, I’m still afraid. My surgery is the last known thing on my treatment plan – after it – everything is a question mark. In fact, after my surgery, my treatment plan is blank. That gives me great anxiety, in addition to insurance, medication, and big decisions I have to make about my treatment, surgery and reconstruction – and all of it not knowing if its the right decision. There’s about six different possibilities after my surgery of what could come next and the lack of a clear plan gives my Type A-control freak self even more anxiety.

I don’t tell you all this for sympathy or for attention, honestly. I tell you this because this is the real truth of cancer. I know I have been strong through this journey – and many of you have shared with me how inspiring that is. I appreciate all of those messages so much, but I also want you to see that “superwoman” (as some of you have called me) is scared, tired, and feeling a little afraid. That’s the truth of it all.

I know fear is a liar. I still believe that God has my back and this journey I am on is for a reason, but there are moments when it is really really hard and really really scary. I know that I’m not in control and that I have to just take a deep breath and try to find peace and joy in the journey. But, as it turns out you can have faith and still have a panic attack.

Have Faith. Trust God. All Joy.

You’re My Favorite.

Authenticity is a popular topic. It seems that everyone has an opinion on it and practically everyone is searching for it. There was even a time in my life where I, myself, taught authenticity to young men and women on a daily basis.

What I love about the topic of authenticity is that it attempts to pull us away from the illusion of “perfect” and can teach us that we are enough, just as we are. I’m on board with that. I believe that society, social media, instagram filters, influencers, and the readily available feed of filtered, perfected comparisons has made so many of us feel perpetually inadequate. So we pump people with counterpoint messages of “be authentic,” and “you are enough just the way you are!”

Don’t get me wrong, those messages are so important. There’s a point however when messages about authenticity can become toxic, too. There was a point in my life, where I was regularly talking about authenticity – and in particular – being the “best version of yourself”. I often struggled to describe what it meant to truly be the best version of you and differentiate that from the attempt to achieve perfection.

In fact, I couldn’t really tell the difference between the two in myself, let alone describe it to others.

The best version of me often looked like someone who was trying to look perfect, dress perfect, be a perfect leader, say the perfect things, achieve the perfect outcomes – and what I thought was the best version of me, was really a perfection attempt in disguise. To be honest, I struggled a lot with the concept, with teaching it, and with defining what the best version of me really was.

It’s taken me years to figure that out – and to figure out what I really believe about authenticity. What I believe is that the “best version” of ourselves is often defined by others and their expectations of us. That’s not authenticity. Authenticity cannot be defined by anyone but you. We need to stop holding on to how others define us and start defining ourselves.

Our lives are more meaningful and we as people are more powerful when we seek to live authentically – as our favorite version of ourselves.

The favorite version is defined by you and only you. It allows you to decide what authenticity truly is. It also allows for us to give ourselves some grace. It lets us be messy, broken, and imperfect. It allows us to be fully make-uped or fresh-skinned, Nike shorts or dresses. It lets us to be our own definition of authentic – and for it to be the version we like the most in ourselves.

I feel lucky to be on a path of discovery to the favorite version of myself during my cancer journey. It’s helped me see pieces of myself that were hiding and discover new things about myself that I never knew. I feel more myself than I’ve ever felt in my entire life – and it’s because I’ve discovered the version of me that I like the best.

The favorite version of me is joyful and practices gratitude on a daily basis. I reflect on scripture and work daily to strengthen my relationship with Christ. I love wearing make-up and secretly love drawing on my eyebrows, but I am not afraid to walk out the door fresh-faced anymore. I secretly love being bald because it saves a solid 30 minutes of time on a daily basis. The favorite version of me loves being a mom, a business owner, a boss, and a crazy dog lady. I love the me that is honest, transparent, and open. The person that shares my experiences, stories, and journey in hopes that it helps others. More than anything, I love the me that fights for others – those in crisis, starting new careers, stepping boldly into new opportunities, facing bias or discrimination, or kiddos that need someone to be their voice. Most of all, my favorite version of me isn’t afraid to make mistakes, face disappointment, or screw things up.

That’s my favorite version of me.

I hope you’ll join me in defining yours.

XOXO

Mammograms, Protocols, and Radiation: Oh My!

Listen to the Blog instead of READ!

May 3rd was my last dose of Adriamycin (the “red devil”) chemotherapy and marked the alleged halfway point of my chemo treatments. At that point, my surgeon ordered more imagining to check in on how the chemotherapy was impacting my two cancer spots – the tumor and the calcifications. So, on May 10th, I went in for more imaging with an appointment immediately following with my surgeon, Dr. Nate.

As I walked back into the breast imaging center, I was teleported back to the day I found out I had cancer. What was supposed to be a routine diagnostic mammogram to confirm a cyst, turned into an almost 5-hour experience ending with the words, “this is going to come back as cancer.” That was almost four months ago now, but walking into the office still put a chill down my spine.

Per usual, I was escorted back to an imaging room and handed a sexy 1985 mauve crop-top front-opening breast exam gown to change into. My technician quickly got a couple of images on the mammogram machine. Thankfully, there are titanium markers left in my breast that make it easier for them to see the exact spots where the cancer biopsies were taken – so the mammograms and ultrasounds are much quicker. We then walked down to the ultrasound room and waited for the radiologist to come in and take a look at the tumor (the tumor can’t be seen on a mammogram machine because its so close to my chest wall). She did some measuring, took some more pictures, and confirmed that she still doesn’t see any lymph-node inclusion. She said, “I’ll type up the report and send it to Dr. Nate right now.”

I got dressed and headed down the hall to Dr. Nate’s office. Dr. Nate’s nurse Laurie greeted me after I checked in. She is probably one of my favorite care providers. She is like a bright ray of sunshine. She is kind, compassionate, and laughs at my jokes. She hands me a new breast exam gown – a longer, newer, maroon number – and I make a joke about how much nicer their gowns are. She chuckles and leaves the room so that I can change. I lay back on the table, close my eyes, breathe, and chant, “Trust God. Have Faith. All Joy.”

About 5 minutes later Dr. Nate walks in. I love him. He is warm and personable and you can tell how much he cares about his patients. He begins pulling up my images from before treatment and from today. He says, “We don’t expect to see any changes in the calcifications. They don’t really change with chemo. We’re really looking to see if we have changes in the size of the tumor. Anything other than growth is good.”

Then he said something incredible. “Your tumor has shrunk about 30%. We will stay the course on your chemotherapy treatment. I’ll order more imaging for the end of chemo and we’ve got your surgery scheduled for August.”

I was on cloud nine.

Then Dr. Nate said something I wasn’t expecting. “I do want you to meet with Dr. Graybill, the Radiation Oncologist, just to confirm that she doesn’t think you’ll need radiation after surgery. Some protocols are changing.”

A week later, I was headed to see Dr. Graybill, with a sick sense in my stomach that radiation was in my future. I was hopeful that I wouldn’t have to have it. My tumor wasn’t big enough or advanced enough to immediately qualify me for radiation at diagnosis, so it really wasn’t a part of the conversation…until now.

I was escorted into a meeting room, adjacent to an exam room. Dr. Graybill and her NP entered, asked some questions and then had me put on another sweet breast exam gown for a quick exam. We then went back into the meeting room where Dr. Graybill said:

“I recommend 6 weeks of radiation post-operation.”

My heart just sank.

Dr. Graybill then proceeded, the research on breast cancer is ever evolving and changing constantly. They once believed that radiation was really only for women with large tumors or who did lumpectomies without chemotherapy. Now they are realizing that the patients that actually need the radiation the most are the younger ones, with the most aggressive breast cancer (triple negative) to ensure that there is absolutely no recurrence of the cancer again. In the last 2 months the recommendations have started to change that women under 40 with triple negative breast cancers should have radiation post-op.

I trust my doctors. They are all trained and certified my M.D. Anderson Cancer Hospital in Houston. I know they are working with the most cutting-edge information and the best protocols available when it comes to treating cancer. The fact that Dr. Nate knew the protocol changed and referred me to radiation gives me so much confidence in my care.

Dr. Graybill recommends that my radiation be 5 days a week for 6-weeks, 15 minutes a day, post-mastectomy.

Obviously this was not the news that I wanted, but I looked at the doctor and said, “Well, I’d rather not get cancer again. If this gives me the best chance at being cancer free, I want that chance.”

Trust God. Have Faith. All Joy.

Dr. Graybill said, “You have the absolute right attitude about it.”

As I got back into my car to head home, I was upset. I went home and had ice cream for dinner – no shame. I called every girlfriend I could to complain and sulk. Then I reminded myself that I am being walked through is journey for a reason. I have to Trust God. Have Faith, and find the Joy in this journey.

The radiation does push my reconstruction out a bit – and as it turns out – that might be right around Christmas. So hey, new boobs for Christmas? #alljoy.

XOXO

PS. Another blog coming this week about my new chemo drug, side-effects, and a project that I may be helping with in the Indiana legislature.

What My Cancer Diagnosis Taught Me About Leadership

There’s no manual for how to have cancer and run a business – much less any significant health or life issue. I’ve had my fair share of them. Prior to my cancer diagnosis, I was running at lightening speed in 18 different directions. I was leading a business I had recently acquired, running a side business speaking to college students, while also building a third business in my extremely limited free time. I was doing too much and delegating too little. My to-do list was never ending and I was a bottleneck for a number of things my staff and business partners were trying to do. I wasn’t asking for help. I wasn’t being transparent about how overwhelmed I felt. The levee was about to break.

And then I got cancer.

But instead of the levee breaking, the rain stopped and the flood waters receded.

Here’s what I mean. When I was diagnosed with cancer, I was honest about it. My staff, my team, and my business partners were some of the first people to know about it. I was honest about the road ahead. I put every doctor appointment (and what it was) on my calendar. I was honest about how I was feeling. I communicated with them when I needed their help when I had to crawl back in bed because the exhaustion (and nausea) was too much. I shared openly in meetings about my treatments, my reactions to it, and how I was feeling. I know they’re grateful for how open I’ve been.

I’ve always valued transparency and honesty as a leader. That’s not a new trait for me. They have been among the core tenants of how I lead, for much of my career. I believe that honesty, vulnerability, and transparency fosters trust and limits the false narratives that are sometimes created in the absence of information. It allows people to trust you as a leader, trust that their experience working for you is real, and believe they know where they stand at every moment. It took my cancer diagnosis to remind me how important these things are in leadership and to the people I was leading.

Being vulnerable, sharing personal stuff (and frankly business stuff) openly and honestly with people often seems counter to how we should lead. However, I know it’s one of the most important things we can do to create an environment of trust among the people who work for us and with us.

But here was my unexpected lesson: It taught me to trust, too.

What happened in response to my honesty about my cancer, was that my staff and my partners showed up for me. I didn’t have a choice to let go of some of the work I was holding on to. I didn’t have the physical capacity to work at the pace I was. It taught me that I can delegate, I don’t have to do everything myself, and that I have a lot of really talented, really capable people surrounding me. It allowed me to let go of all the work I was holding onto “in the weeds” and focus on the big picture stuff that really mattered.

Suddenly, my to-do list was shorter and the things that I hadn’t finished, were suddenly getting done. We were moving forward faster, yet I was moving slower. It was like a slap on the back of my head; Why hadn’t I done this sooner?

I know this is often the case for small business owners, entrepreneurs, and even lots of leaders. The transition out of the “doing” and into the “leading” is a hard one. Trusting people to get the work done can be difficult – and sometimes it feels easier, better, and quicker to just do it yourself. We become micromanagers, our staff gets frustrated because we “won’t let them do anything themselves” or we become the bottleneck slowing performance, productivity, and outcomes down.

The lesson I learned was to trust the talents of the people I had put on my team – that’s why I hired them (or work with them) isn’t it? To let go of the need to control and I know they have my back. Turns out I needed to get cancer to learn that lesson.

Regardless of my cancer diagnosis, these lessons were important for me to be reminded of and learn. I’m grateful for that. I recognize that being honest and transparent is hard – and trusting others is even harder. I know attempting to lead with trust and transparency will look different for every leader. I also know, how important and powerful it can be. I’ve seen the results across my leadership experiences time and time again. I encourage you to give it a try.

“Plastics”

Warning: I talk openly and honestly about my consultation for reconstruction post-mastectomy (read: boob job). I find the process and information fascinating and want to share it with you all, however, conversations about my boobs might make you uncomfortable. You’ve been warned.

After the meeting with my breast surgeon (the one doing the mastectomy), I was left with a checklist of tests and appointments that I needed to accomplish before treatment could start. I was determined to get it all accomplished as quickly as possible, so when the scheduler called and said, “plastics can get you in with the doctor at 4:30 today, if you can make that work.” I jumped at the appointment.

When I arrived at the “Plastics” Group office for my appointment, it was 4 p.m. on a Friday afternoon. The waiting room was empty and you could tell they added me to the end of the schedule, as the week was winding down. As I sat, waiting to be called back, the receptionist would banter and talk with each patient as they left – some of them bald, all of them with boobs. As they filed out, I wondered where they were in their reconstruction journey. Were they just starting like me?

I was jolted back alert from my introspection when the nurse called my name and I was escorted down a long hallway to an exam room. She handed me a gown and asked me to “strip from the waist up with the gown open in the front”. At this point, I had become all-too-familiar with these instructions and this gown – a short-sleeve number that is a delightful color of 1985 mauve and hits just above your hips like you’re a 25 year-old instagram influencer in a trendy crop-top. In the last week, I had slid a gown on like this, no less than 5 times.

As I sat on the exam table waiting for the doctor, I closed my eyes, began to breathe deeply, and chant a mantra I had be using to manage my anxiety since my diagnosis, “Have faith. Trust God. All joy.” Over and over again, “Have faith. Trust God. All joy.” I was jolted back alert, when the doctor entered with a nurse and introduced himself. The doctor, a shorter, older gentleman, reminded me of an older Rick Moranis from Honey I Shrunk the Kids. He carried an old-school digital camera, in a leather case with him, like a dad at Disney World with the kids for the first time. He asked me a bunch of questions about my health history and then instructed me to open the gown, put my arms down, and let the gown fall down to my wrists.

I was officially uncomfortable.

I tend to make jokes when I’m uncomfortable and strongly considered making a comment like, “Doctor we just met,” but decided against it.

The doc then proceeded to pull out a measuring tape, like one a seamstress would use, and measure my breasts – nipple to bottom, nipple to top, side to side, top to bottom, size of the nipple – each time shouting measurements back to the nurse as she feverishly wrote them down. Then, he asked me to close the gown, stand up, and stand up against the blank white wall at the back of the exam room. As I stood up against the wall, he said, “okay now open the gown and let it fall back to your wrists again,” as he pulled out the digital camera and proceeded to snap photos of me from variety of angles.

I am certain that I have never been more uncomfortable in my life.

Until it got worse.

The doctor then instructed me to pull my pants down to my bikini line as he took another set of photos from a variety of angles. I was not ready for this. As all of this is occurring, the nurse is just standing there jotting down everything the doctor is saying as I’m dying a slow, painful death of mortification on the inside.

After he was done, he asked me to cover back up and take a seat in a chair next to the exam table. The doctor pulled up a stool and sat down as the nurse closed up my file and left the room. The doctor then began to describe the two recommended options for reconstruction:

One: Using your own tissue. As he described it, they essentially make an “old-school c-section” incision across your abdomen and remove tissue from your belly to replace the tissue that was removed at mastectomy. The benefit is that it is your own tissue and not something like silicone in your body. It is a more difficult surgery with a more difficult recovery. The downside is that the breasts would age like normal breast tissue would over time. The doctor then said to me, “You’re not a candidate for this though, as you do not have enough fat on your belly.”

I looked at him as said, “That’s the nicest thing anyone has every said to me. Could you write that down?” He chuckled as I thought to myself, “I could kiss him right now, but I’m topless and that feels inappropriate.” [jokes].

Two: Implants. The second option, is more familiar – a silicone or saline implant. These implants would be placed at a date after the mastectomy, over the muscle. They used to do under the muscle to help hold the weight of the implant, but they looked less natural because they move with a woman’s arm movements. Now they place them over the muscle, just under the skin, with the help of cadaver skin (read: sanitized skin from dead people) to hold the implant in.

This option would include a “delayed-immediate reconstruction” during the mastectomy. Since I am not scheduled to have radiation, they can place a “balloon-like” tissue expander in after they remove my breast tissue. Then starting at two-weeks post-op, they begin inflating the expander incrementally until it is at the correct size. This allows me to avoid the painful re-stretching of skin that can occur when they don’t insert the expander at mastectomy. After my tissue is allowed to heal and my treatment is complete, they will go in and replace the expander with a silicone or saline implant.

After we discussed my reconstruction options, we then discussed topics that no one dreams of talking about with strangers – much less your closest friends – like the shape, size, color, and proportion of my nipples to my overall breast and if I would like to keep my nipples or have them removed. This is something I’ve never thought about and felt wholly unprepared to make a decision on. After being largely uncomfortable with the discussion of my nipples and the pressure to make a decision, the doctor shared, “most women are happier with their reconstruction when they have their nipples removed”. Okay done. Remove them. We then discussed nipple tattoos as an option post-recovery to replace my absent nipples. I don’t have strong feelings either way, but if you’re feeling brave, Google image search “post-mastectomy nipple tattoos”, you’ll be amazed (NSFW).

Then we talked about my breast size. In my discomfort, I said, “well my husband would like them to be bigger,” to which he chuckled. As it turns out, however, you really can’t go bigger and you really can’t go smaller (except maybe a 1/2 size). Okay cool. As they are. Fine.

As the conversation went on, it became clear to me why he took the pictures and measurements, and I slowly felt at ease. It was clear he was a professional and his ultimate goal was to make something that is pretty traumatic for most women, as easy as possible. That his ultimate goal was to get you as close to “original” as possible.

As I left, I felt a sense of calm about the reconstruction process; still totally mortified, but calm with a sense of humor about the whole thing. I know the mastectomy and reconstruction is a long road and its absolutely no cake walk, but I have a sense of what the process will be like and I honestly appreciate the level of choice and control I have in the matter. I get to order up the boobs I want, nipples and all. If that’s the positive of getting breast cancer, I’ll take it.

As I got into my car, I chuckled to myself about the whole thing, and smiled as I remembered my mantra: “All JOY.” (and then promptly group called my girlfriends to tell them all about what. just. happened.)

All joy.

XOXO