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CHAPTER 2

Swinging into Action

You may not believe me until you’re deep in the thick of it, but getting together a game plan for how you’re going to deal with your cancer experience goes a long way toward regaining a sense of control over your body and your emotions. Once you’ve picked yourself up off the floor after being whacked with that tidal wave of a diagnosis, you realize there is something very empowering and reassuring about taking action to manage your situation. This chapter addresses:

• The process and sources for Gathering Information, whether you become your own chief researcher, or you delegate to a family member, friend, or someone in your inner circle.

• Establishing Support and Coping Mechanisms to help you through your breast cancer experience.

• Recommendations on Building Your Health Care Team, including an overview of all the medical professionals and specialists involved, and how to get them most effectively working for you.

GATHERING INFORMATION: BECOMING AN INSTANT EXPERT

You Can Research Forever, but Faith in Your Doctor Is the End Goal.

Depending upon the specific circumstances around your diagnosis, how it unfolded, and when you received critical pieces of information, you may need to do research at several different times during the progression through your cancer experience. For example, I went through two phases. First, after receiving the results of my biopsy that showed malignant cells, and an initial consultation with my breast surgeon, who recommended a lumpectomy, I sought out a second opinion. I also did my own research on the pros and cons of lumpectomy versus mastectomy to feel comfortable with the lumpectomy recommendation of both doctors I had seen. (See Chapter 3, “Evaluating Your Options” for more on how that decision gets made by the medical community.) Then, once I received the pathology report that detailed the results of my lumpectomy surgery, with its implications for follow-up treatment, I sought out opinions from oncologists as to various chemotherapy options.

Each of you will have a slightly different experience as to when you need to gather information, for example, if you are having a mastectomy and have to consider immediate versus delayed reconstructive surgery. However, for simplicity’s sake, I will discuss the entire research and information-gathering process here in this section. It might turn out to be a few pages that you come back to time and time again.

The critical point to remember is that while you are the ultimate decision maker as to what does or does not happen to your body, in the end, you must have faith in and be comfortable with your doctors. You can do research until the cows come home, but your doctors have dedicated their lives to this topic, so you will never match their expertise, experience, and insight. All you can hope to do is gain a basic understanding to feel comfortable with their recommendations. If you aren’t comfortable, ask for explanations until you are. If you don’t receive satisfactory explanations in jargon-free, nontechnical English, maybe you should consider another doctor, one with whom you can develop a stronger rapport.

Time Doesn’t Stand Still, but It Will Pause for a Few Weeks.

This research phase may seem more ominous than attempting to read an entire semester’s syllabus two days before the final exam. You’re paralyzed as to where to even begin, and you’re sure that the cancer will grow exponentially inside you by the hour unless you have surgery tomorrow. Relax a bit. Most of the medical research suggests no variation in survival rates or treatment efficacy as long as you begin treatment within four to six weeks. So, take a couple of weeks to get all the information you need to feel comfortable with a decision, and then let it settle in for a week or so, as you’ll be living with this decision the rest of your life. By all means, don’t dally, but consider it nature’s reprieve, or time well spent, so you’re intellectually and emotionally ready when treatment begins.

Rationalize the Mortality Statistics : Consider It Healthy Denial.

No matter what stage your diagnosis, Stage I or Stage II, you will become terrified when you start to look at the mortality statistics associated with each. Overall, the statistical probability is that you will make it to the five-year survival mark, but you sure don’t want to be one of those statistics that doesn’t. Furthermore, you are not a statistic but a person. Statistics are necessary landmarks that doctors use to make treatment decisions among thousands of patients, and they may not be reflective of how your particular case unfolds.

Find your own coping mechanisms to convince yourself that you will fall into the survivor group. What I did was take comfort in my otherwise healthy lifestyle. I convinced myself that the minority of women in Stage I or Stage II who don’t make it to the five-year survival mark must be smokers, drinkers, overweight, already 98 years old, or had some other chronic condition that contributed to their poor prognosis. I also reminded myself that any study I read must be at least five years old to have had sufficient data to publish, and the medical world knows more every year about treating breast cancer—and a lot more than they did five years ago. In fact, according to annual statistics compiled by the National Cancer Institute and the Centers for Disease Control, 1996 was the first year in more than thirty years that the death rate from breast cancer actually declined, attributed to more widespread screening to identify cancer early on, and more effective systemic treatment at the early stages. So, the statistics five years from now—when they’re important to us—will look even better. Consider whatever rationalization you come up with your own form of healthy denial.

Read, Educate Yourself, and Ask So Many Questions That You Drive Your Doctor Nuts.

The single most influential determinant of getting the best care and treatment is you. Educate yourself. Read everything you can handle, at whatever stage you can handle it. (See pages 39–44 for some helpful reference books and association materials.) You’ll know when you are emotionally ready to read the harsher, more clinical material. Some may be too scary too early on. Put yourself on a somewhat level playing field. Write a list of questions to ask your doctors. You’re paying a lot of money for their expertise, so educate yourself enough to hold an intelligent discussion. Tap all the knowledge you can and utilize it well. Then, together the two of you can decide what’s best for your otherwise healthy body, your disease state, and your emotional state.

Find a Collaborator If You Need Some Heavy Lifting.

If you find that you just can’t focus on or absorb any reading material right now, or you just don’t want to do it, enlist the help of someone from your inner circle to sort through research for you and bring you only the information relevant to your decisions. Some women find this an excellent way to involve their spouses in the process. If the man in your life fits the stereotype of being more comfortable solving problems than dealing with emotions, research is perfect for him. It will make him feel that he is helping to solve the problem in a rational, practical way. Alternatively, some women turn to family members or friends who are medical professionals, and most likely have access to resources and can grasp medically technical language. Or if you know someone who is a survivor, she may be able to jump in and even provide research shortcuts as she already knows where to look.

There’s Much More to a “Second Opinion” Than Just an Opinion.

If you don’t get the information you seek or satisfactory responses in consulting with an oncologist as to how to treat your disease, get a second opinion (and sometimes even a third, as a tiebreaker if there is a discrepancy between your first two). A thorough, comprehensive second opinion will most likely include the following:

• A review of your complete medical history, even beyond breast cancer (to determine if there are any considerations that might affect treatment decisions).

• A full physical exam.

• A review of the “slides” of your tumor, or microscope slides containing slices of the cancerous tissue removed, which are evaluated by a pathologist.

• A review of any X rays or imaging studies, such as mammograms or sonograms, by a breast radiologist.

• A detailed proposal for a treatment plan.

. . . But a Thorough Opinion Results from Providing a Thorough Medical Portfolio.

To aid your doctor in giving you the most comprehensive, detailed opinion possible, you must be well prepared. Make sure you bring all relevant medical reports, including:

• All pathology reports and slides (pre- and postsurgery).

• All radiographic materials, such as mammograms, X rays, CAT scans, etc.

• All lab reports from routine tests, including blood tests.

• Any reports from other medical conditions that you think might affect your treatment (if in doubt, bring it).

If possible, get as much information as you can to the doctor ahead of time in order for him or her to review before your appointment. Offer to fax copies of written reports a couple of days ahead. But never send original films or slides. Keep those in your sight at all times. Pick them up from the originating institution and carry them with you to any other consultation.

Be Aggressive.... Isn’t That What Sports Coaches Always Tell You?

If you’ve ever competed in any sports in your life, your coach has always told you to “get out there, be aggressive, just do it.” (Yes, Nike has made many millions off those last three words.)

And now you have your health care team most likely telling you to “Be Aggressive.” Why? Why would they want you to undergo unnecessary trauma if there’s a chance you were cured with surgery? Fast-forward five years. Don’t you want to be able to look back at your treatment protocol and say to yourself, “We did everything possible at that time to make sure that my cancer would never ever come back”? You’ll live every successive day of your life in comfort. And even if you should face a recurrence, you’ll have the comfort of knowing that you did whatever you could to prevent it. You’ll never have to live with the guilt of “I should have . . .” or “I wish the doctors had told me to do . . .” So, since everyone involved wants you to have a long, full life, the treatment recommended to you may seem aggressive, but will optimize your survival chances.

Beware of Information Overload. Know When to Stop Reading.

At different points in your journey through this experience, you will hit your “information overload” threshold. Your mind will start spinning, you’ll experience confusion rather than clarity on decisions, and you’ll start terrifying yourself by thinking that every negative aspect of this disease definitely applies to you. You might even start to blank out and not be able to absorb any more. It’s your brain’s protective way of signaling to you that enough is enough.

Overload Relief: Find a Mental Parachute for Quick Bailouts.

You know you’ve just reached your limit. You just can’t think about, talk about, or deal with your cancer for one more minute. Find an emotional escape mechanism, a mental parachute that lets you bail out at a moment’s notice. One caveat: What might have worked for you in the past might not be appropriate for this time in your life. Under normal circumstances, I am an avid athlete and outdoors person, which I very much utilize as my escape from everyday life. However, in the midst of my surgery and treatment period, I found that I couldn’t be as adventurous as I normally might (plus I couldn’t be too far from a hospital). So, my escape became reading—everything from inspirational outdoor adventures, such as expeditions up Mt. Everest, to books about art and architecture. Everything except breast cancer. Find what works for you, what makes you feel good and inspires you, be it reading a juicy novel, yoga or meditation, music, jigsaw puzzles, knitting . . . anything you can pick up at a moment’s notice. When you have to come back to reality, you’ll find yourself mentally refreshed and recharged.

Warning: You May Not Die of Breast Cancer, but the Reference Books Might Crush You.

I admit to stealing this line from the infamous television character Murphy Brown (remember her?), who exclaimed it while standing in her office buried by reams of computer printouts and books on cancer when she was initially diagnosed with breast cancer. It’s true. At some point, sooner or later, you will have done all the research you need to determine what’s best for you. You’ll know when you reach that point, as you’ll be both mentally and physically exhausted. And regardless of the lists of pros and cons you’ve made for various alternatives, you’ll know in your gut what you want to do, even though it may seem terrifying. Don’t let that instinct be crushed by all those reference materials.

Take a Deep Breath and Plunge In. The Sooner You Get Going, the Sooner It’ll Be Over.

When you’ve exhausted your tolerance for information gathering and come to that conclusion about what’s best for you, you have to just get going with treatment. Just like stepping off a high dive into a swimming pool, you never know exactly how you’re going to land and how cold the water will be, but eventually you’ll surface. The important thing is to just get going. Remember, you should start treatment within four to six weeks of surgery. This is enough time to gather the information you need to feel like you’re in control of your decision, to recover a bit from surgery, and to “strike while the iron is hot” (so said one of my doctors) to get the most impact from treatment. Take the time you need to feel comfortable, but don’t delay. Just plunge in, and before you know it, it will be over.

A Special Note on Alternative or Complementary Medicine: Save It for Later?

You may be wondering about if and/or how to incorporate alternative or complementary medicine into your treatment regimen. This is a very personal decision—to be made in conjunction with your doctor—based on your belief systems, religious persuasion, faith in the traditional medical community, and a host of other factors. I used a blend of both at different times. I relied solely on traditional Western medicine to get me through the immediate crisis—making sure that cancer was gone from my body, through surgery, chemotherapy, and radiation. I made this decision partly based on my own beliefs and partly at the recommendation of my health-care team, who were concerned about the potential for herbal remedies to interfere with the effectiveness of my treatment. However, I have decided to pursue some alternative therapies in my postcancer program—including nutritional changes, herbal programs, consistency of exercise, etc.—for both physical and emotional reasons. Not only do I try to keep my body as healthy as possible, but by taking active steps to enhance my overall health, I feel that I have at least some semblance of control over my body and my life again. Should I ever get a recurrence, I won’t look back and blame myself for not doing everything in my power to prevent it. (See Chapter 9, “Alternative Medicine,” for a discussion of basic alternatives.)

Instant Expertise: Useful References and Organizations

Since any other cancer book that you open will most likely contain extensive appendices listing information sources and suggested reading, I’ll be brief here. Here are just a few of the most accessible, informative sources I’ve found:

Books/Publications

• Dr. Susan Love’s Breast Book, by Susan M. Love, M.D.

This everything-you-wanted-to-know-about-breasts-and-cancer-but-were-afraid-of-and-afraid-to-ask 600-page tome is the “bible” of clinical breast cancer books. Although she is somewhat controversial politically, and it comes through in her writing, Dr. Love’s easy-to-understand language, and non–jargon-laden descriptions of complex medical issues is a must-read before you meet with surgeons and oncologists to discuss treatment alternatives. At times it may terrify you, but you’ll be glad you got through it to know what questions to ask your doctors, and to be able to understand their responses to make informed decisions. It also contains appendices with extensive listings of additional resources, references, suggested reading, and listings of both national cancer centers and regional support organizations. Then, return to this book for some hope and a smile.

• MAMM: Women, Cancer and Community

349 West 12th Street

New York, NY 10014

Phone: 888-901-MAMM (for subscription information)

Web site: www.mamm.com

Directly from their Web site: “MAMM is the women’s magazine dedicated to providing the necessary tools to live healthier and happier lives with a cancer diagnosis. MAMM is for anyone whose life has been impacted by breast or reproductive cancers, including partners, family members and coworkers. Each issue provides the latest treatment updates (including emerging findings about alternative and complementary therapies), inspiring profiles of women who are survivors, and insightful coverage of controversies, politics and culture as viewed through the unique prism of cancer diagnosis.” An annual subscription to this bimonthly magazine is less than $15, and well worth the helpful advice and inspiration it provides. Consider it as ongoing chapters of a book like this one, with new advice and helpful hints every other month!

Organizations

• National Alliance of Breast Cancer Organizations (NABCO)

9 East 37th Street, 10th floor

New York, NY 10016

Phone: 212-889-0606, 800-719-9154

Web site: www.nabco.org

A network of over 375 organizations, NABCO is the leading nonprofit central resource for breast cancer. It’s a wealth of information and resources to guide you through your decision-making and treatment phases, but has also been my best source of staying informed since. While the mass media may tend to hype studies as “the next cure,” NABCO’s publications offer practical discussion and analysis of breakthroughs and new developments in the treatment of the disease. They offer the answer to, “What do the results of this study really mean?” and “What are the experts’ attitudes toward practical, rather than purely scientific, applications?” Your health is worth the nominal annual subscription fee, which entitles you to an extensive resource list, newsletter, and special conference news highlights of breast cancer medical forums and conferences.

• National Cancer Institute (NCI)

Bethesda, MD 20892

Phone: 800-4-CANCER (Cancer Information Service)

Web site(s): www.cancernet.gov or www.nlm.nih.gov (for the U.S. National Library of Medicine’s MEDLINE and other online services)

As one of eight government agencies that comprise the National Institutes of Health, NCI is funded through the U.S. Department of Health & Human Services. Their nationwide Cancer Information Service (CIS) is a free public service education network that has trained staff to answer your questions, send you relevant written materials, or refer you to resources in your local area, including medical facilities, home care assistance programs, and support groups and services (both emotional and financial). Information is also available via their CancerFax^® computerized service, by calling 301-402-5874 and following instructions. Or you can access their Web site, which can also be your gateway to Internet breast cancer information, as they provide a directory of “Useful Links.”

Regardless of how you contact NCI, you’ll have access to their database, Physician Data Query (PDQ), the most detailed, timely data relevant to your specific cancer available anywhere. Just provide the details of your specific cancer—cell types, stage, tumor size, etc.—and they’ll send the latest on treatment protocols, side effects, prognosis, relevant clinical trials, and research programs. There are two versions—one for doctors, one for consumers. Neither is uplifting reading, but discussing them with your doctor will reassure you that you are on the leading edge of treatment.

• American Cancer Society (ACS)

National Office

1599 Clifton Road, NE

Atlanta, GA 30329-4251

Phone: 1-800-ACS-2345, 1-800-395-LOOK (for Look Good,

Feel Better® Program only)

Web site: www.cancer.org

With chapters in most major cities, the volunteer-based ACS is one of the most widely known cancer organizations. Since ACS deals with all types and stages of cancer, its services are extensive, but some of the written publications can be a bit generic (better to stick with books specific to breast cancer or publications provided by your doctors). However, ACS efforts specifically for breast cancer include:

Reach to Recovery. This is a one-to-one visitation program for women who have just been through surgery. An ACS-TRAINED survivor offers assistance with the physical and emotional issues that the newly diagnosed woman must address. It’s like having a new friend who really does understand exactly where you’re coming from.

Look Good, Feel Better. Cosponsored by the National Cosmetology Association and the Cosmetic, Toiletry and Fragrance Association, the premise of this program is that women can benefit from the psychological “lift” of looking their best. This one-time, two-hour session teaches you how to “mask” the ugly side effects of chemo and radiation (e.g., hair loss, skin changes). Not only will you be given a wig if you need one, and good tips for wig care, but you’ll go home with a big box of cosmetics from leading companies like Estée Lauder, Chanel, Lancôme, and others!

TLC Catalog. This seasonal catalog offers essential products for women coping with effects of the disease, including hats, scarves, hairpieces, and bathing suits and prostheses for women with mastectomies. Call 1-800-850-9445 to order.

• The Breast Cancer Fund

282 Second Avenue, 2nd floor

San Francisco, CA 94105

Phone: 415-543-2979 or 800-487-0492

Web site: www.breastcancerfund.org

The Breast Cancer Fund (BCF) was founded in 1992 to raise awareness and fund cutting-edge projects in research, education, patient support, and advocacy. Its mission is to eliminate deaths from breast cancer in our lifetime, and make sure that women living with breast cancer receive the best available care and support. Emphasizing quality of life for women living with breast cancer, they focus on such issues as early detection programs, the value of exercise during treatment, psycho-social programs for patients and families, integration of complementary techniques with traditional medical treatments, and research in areas such as investigating less toxic treatments or the potential impact of the environment on the development of breast cancer.

One of their more visible programs to raise hope, awareness, and funding is “Climb Against the Odds,” in which a group of breast cancer survivors climb some of the world’s highest mountain peaks (which have included Mt. McKinley and Mt. Aconcagua to date). The motivational message is that you can make it through breast cancer just as you can make it to the top of a mountain—one step at a time.

• SHARE

1501 Broadway, 17th floor

New York, NY 10036

Phone: 212-719-0364 or 212-382-2111 (for hotline)

Web site: www.sharecancersupport.org

This New York–based volunteer organization is a unique, nonprofit self-help support organization for women with breast or ovarian cancer and their families and friends. SHARE’s services include information hotlines, peer-led support groups, public education, advocacy, and wellness programs. Visible on a national basis, SHARE’s work enables women to make informed decisions about their medical care and treatment, and contributes to a broader awareness regarding research, prevention, and early detection. With its extensive and broad membership, SHARE’s programs run the gamut, including special programs for young women, parenting after breast cancer, alternative medicine and nutrition, meditation and visualization, and information on leading-edge medical breakthroughs. Even if you don’t live in New York, it’s a very helpful network to tap into.

• National Coalition for Cancer Survivorship

1010 Wayne Avenue, 5th floor

Silver Spring, MD 20910

Phone: 888-YES-NCCS or 888-650-9127 (toll-free direct

line)

Web site: www.canceradvocacy.org

Founded by and for cancer survivors, NCCS is a national grassroots network. Its mission is to lead and strengthen the cancer survivorship movement, to empower cancer survivors, and to advocate for policy issues that affect survivors’ quality of life. NCCS serves as a clearinghouse for information on services and materials on survivorship. A sampling of the useful publications available from NCCS (some for a nominal fee, others free) include: “Working It Out: Your Employment Rights as a Cancer Survivor,” or “What Cancer Survivors Need to Know About Health Insurance.” Their Web site also contains a useful section called “CanSearch: Online Guide to Cancer Research.” In addition to general oncology-related Web sites, it suggests several breast cancer–specific sites.

• Y-ME Breast Cancer Support Program, Inc.

212 West Van Buren, 4th floor

Chicago, IL 60607

Phone: 800-221-2141

Web site: www.y-me.org

Y-Me provides information and education programs for patients, as well as a telephone hotline staffed by trained survivors who can share concerns and exchange information. Y-Me also maintains a wig and prosthesis bank.

• CancerCare

1180 Avenue of the Americas, 2nd floor

New York, NY 10036

Phone: 212-221-3300 or 800-813-HOPE (4673)

Web site: www.cancercare.org

CancerCare’s offices are located primarily in the Northeast United States, but they offer a wide range of services to cancer patients and their families nationwide via a toll-free hotline, teleconferences, and their Web site. Among the free services CancerCare offers are: individual counseling and support groups, information and education, and access to financial resources and assistance. While CancerCare offers guidance for all cancers, they have special programs unique to different types of cancer. For example, their Web site contains numerous prerecorded teleconferences on breast cancer topics ranging from “Sexuality and Breast Cancer” to “All You Wanted to Know about Tamoxifen.”

Web Sites Can Be Helpful . . . But Three Caveats About the Internet

Yes, the Internet can be a fabulous source of information, but it can also be dangerous. Its helpfulness is the wealth of the most up-to-date information, free of charge, that can be searched for on very specific topics (e.g., surgery, hormone treatment) directly from the medical community. Aside from the Web sites associated with the organizations mentioned above, I won’t even attempt to offer recommendations on helpful Web sites, as new sites emerge daily. However, don’t feel compelled to go “surfing” immediately. And remember that chatting with total strangers is not the same as reviewing medical articles on Medscape.

Consider one woman who stayed awake all through the night she was diagnosed, gathering material on treatment options to discuss with her doctor. By morning she had terrified herself, convinced that any treatment would leave her with permanent, debilitating side effects that she refused to endure. She exclaimed to me, “Did you know that there’s something called ‘chemo-brain’ where you lose your memory?” I calmly replied, “That sounds suspicious. Did it ever occur to you that the woman you were ‘chatting’ with on-line may have been eighty-eight years old and a victim of Alzheimer’s?” “No,” she replied. “Maybe I am being silly.” With that said, I give you three caveats about chatting on-line:

• Caveat 1: You never know who’s on the other end. When you go on-line to talk to people about cancer, or any subject, you have no idea who is at the other end, and what their physical, mental or emotional state may be. People enter the world of cancer with very different health histories which may have nothing to do with the cancer challenge at hand.

• Caveat 2: Every person and case is different. When you start discussing cancer therapies with other women, there is an immediate tendency to compare yourselves, to go running to your doctors sure that they are missing something because all other women have been told to do something that you haven’t. Resist the temptation. Every single case of cancer is different and you have no idea why one doctor recommended what he or she did. This is true when you’ve actually met, but even more so on the Internet, when you’ve never even seen the woman!

• Caveat 3: The focus may be more on problems than answers. Most people who take the time and effort to sign on are generally seeking solutions to their own problems rather than altruistically offering advice about how to sail through challenging times. Approach Web sites and chatrooms a bit irreverently, and keep your focus on finding answers, not unearthing new worries.

Nope, You Didn’t Choose It, Sister, but You’ve Just Been Initiated into a Special Sorority.

It’s never too late to gather helpful information, even when you’re well into the treatment phase. Regardless of any ambivalence you might have about not wanting to be around other people who are “sick”—no, not me, you think—get to know other women going through this. They’re the only other people in the world who really understand exactly what you are going through. Plus, they’re a great source of information. When you go for your first chemotherapy treatment, you might be afraid to talk with other women there. Don’t be. They are all seasoned “pros” and they are just waiting to give you helpful pieces of advice, comfort, and encouragement. Go ahead. Talk to them. It will make them feel better to know they’re helping you, and you might walk away with some helpful hints.

ESTABLISHING SUPPORT AND COPING MECHANISMS

Brace Yourself for the Emotional Roller Coaster . . .

In the ups and downs of an individual’s emotional life, any significant changes—sometimes even good ones—may cause an increase in stress, worry, or anxiety which can throw you onto an emotional roller coaster. Particularly during breast cancer, it is very common for women to seek out help—from a variety of sources—at any or all phases: (a) at the shock of diagnosis, (b) during the seemingly endless routine of treatment, and (c) upon the completion of treatment, facing the uncertainty of returning to “normal” life.

To be perfectly candid, I found the most emotionally difficult time to be after it was all over. I had put my head down and plodded my way through, simply focusing on my day-by-day physical changes and needs. But then it was over. Doctors were no longer monitoring me weekly. I had done everything medically possible to prevent the cancer from recurring. And my phone no longer rang several times a day with friends and family calling to find out how I felt and what they could do for me. All that was left to do was go back to my life and wait . . . and hopefully live a full life until I’m an old woman of 90.

. . . And Beware of Triggering Events.

While the whole experience of breast cancer is probably a significant enough change for all of us to ride the emotional roller coaster, there are moments of particular vulnerability, or “triggering events” that can set off feelings of panic, worry, and undue anxiety. They can happen at obvious times, such as birthday or anniversary celebrations (anything that marks the passing of time and realization that we’re all mortal) or upon entering a treatment facility or hospital to go for chemotherapy (which brings back memories of past visits). Or they can happen at very unexpected moments, perhaps even something as seemingly innocuous as scheduling an appointment. So, brace yourself for them, call on your coping mechanisms, and ride them out, knowing they are normal and should subside.

Don’t Be Bashful about Asking for Professional Help.

If you find yourself in any type of elevated emotional state for more than a few weeks at a time, or reeling from emotions that prevent you from functioning, then it’s time to seek individual counseling. Prolonged feelings of being overwhelmed, helpless, out of control, angry, depressed, or paralyzed about making a decision deserve the attention of a trained professional. Find someone who specializes in the issues associated with cancer, and better yet, breast cancer. Many women—especially those who are independent, self-sufficient, and used to a great sense of control and mastery over their lives—find that this small task of asking for extra help is excruciatingly difficult. Why? By nature, women are not programmed to ask for help, but are raised to be the nurturers, the caretakers. So when we need help ourselves, we enter unfamiliar territory, uncertain about where to turn and what to do. If you feel a sense of hopelessness, loss, and inability to make a decision, do not hesitate to call any of your doctors and ask for help.

Find a Role Model like Gracie the Taxi Driver.