Recurrence: Natasha’s Nonstop Obsession

Eva Sheie (00:07):
This is a story about what happens when you have breast cancer told in real time. 

Natasha (00:16):
So, hi. 

Kristen (00:19):
Hi. It's so good to see you. You too. It's been way too long. 

Natasha (00:24):
It has, it has. 

Kristen (00:26):
Way too lon. Life, right? 

Natasha (00:27):
Yeah, life bit me hard about a month ago, and I hit a really bad spell of depression and went to bed again, which is what I do had she called in sick to work for a week and was really future tripping on, and I think it has a lot to do with the patients that I take care of who are so desperate and so poor and so sick and so much going on in their lives. And my brain was giving me a thing of like, okay, you got through cancer alone and you were fine. What about when you have a stroke? Who's going to take care of you when you have a stroke? Who's going to take care of you when you've got dementia? Just like, and it really took me to a very dark place and other things were going on. I mean, just silly things I think most people can manage, but sometimes it just became overwhelming. The fridge broke. We'd had lots of windy weather. The back garden looked was just like ankle deep in leaves, and I just couldn't get my head around fixing any of this. So I just went into hibernation. 

Kristen (01:38):
It was overwhelming. 

Natasha (01:41):
Then friends were like, you know how most single women manage stuff? They ask for help. They're like most people have. It's not huge, but it's for San Francisco, it's a big-ish back garden. Most people have somebody who comes to clean the leaves up. You don't have a leaf blower. Hire somebody with a leaf blower. And slowly, slowly, I started pulling out, but I think it was a lot of revisiting what could have been with the cancer that, thank God, I mean, I got through it and I'm healthy, and the updates is I just had an MRI and everything is clear. 

Kristen (02:25):
Yes. 

Natasha (02:25):
Which is great. 

Kristen (02:28):
Well, it is. And the theory is, wow, it's clear. You're fine. Life should be great, just like before, and it's all good. 

Natasha (02:35):
Yeah. 

Kristen (02:35):
Bullshit. 

Natasha (02:36):
Yeah, and I think you and I also both know that there's a way that doing a breast MRI, it's a little bit of a false reassurance because yes, it can recur in the other breast. It can also recur in your brain, your liver on your lungs, and they're not looking there. They're just looking at your boobs. So I'm very happy. It hasn't recurred my boobs, but I'm still a little bit, could be somewhere else, and they're not checking. And I pushed my oncologist on that a little bit, and she's like, yeah, you're kind of right. It is a bit of a false reassurance. If it's metastasized to your brain, we won't know until you get lost in the street. 

Kristen (03:16):
I hear you. Because it's almost like we've done the work to be realistic, and sometimes that realism is haunting and just enough to know that, oh, this is great news ish. 

Natasha (03:36):
And I don't think she would mind me sharing this. My mom was just diagnosed with lung cancer about two months ago and helping her from a distance navigate the national health system that I should know better than I do, but I never worked as a nurse at home. I've only ever worked as a nurse in England. And just some of the decisions, she had a good response to the chemo, thank God, but now they want to do radiation and she has to decide whether to do brain radiation because this type of lung cancer comes to the brain and if it recurs, so she has to decide whether to do preventative brain radiation, which can lead to memory loss. As my mom said to me on the phone today, she's like, I've worked really hard to keep my brain healthy. I mean, she's 84, but she's an incredibly sprightly 84 year old. And so it's back to sort of grappling with those decisions where the oncologists don't weigh in, they're just like, it's up to you. It's your risk benefit analysis. She's really struggling with that. So I'm actually going home to England in 10 days to help her through some of these decisions. 

Kristen (04:54):
Oh, I'm so glad you are going. 

Natasha (04:55):
Yeah, me too. Me too. 

Kristen (04:57):
I'm so glad you're going. 

Natasha (04:57):
Yeah. 

Kristen (04:58):
You know, it's so hard because at 84, like she said, different situation, but we both talked about how rude it was that cancer hit us when we were healthy, and I was probably, the air quotes healthiest I'd been in a long time, had taken off weight, was active and all of that, and then rude cancer comes in. 

Natasha (05:20):
Yeah. I mean, I had just qualified as a yoga teacher. That was what I was going to do. I mean, I wasn't going to quit work, but I was going to bring in yoga as a pain modality, et cetera, et cetera. No. Then I suddenly weighed 98 pounds and could barely get out of bed. 

Kristen (05:36):
Right. 

Natasha (05:37):
Like, thank you, cancer, that was rude. 

Kristen (05:39):
It's so rude, right? 

Natasha (05:40):
It's rude. 

Kristen (05:40):
This is so rude. But the thing is that we work all our lives. Your mom is working on her memory. We work all our lives to be able to ski, to run, to walk, to do those things in our sixties, in our seventies, in our eighties, and we take good care of ourselves. And then it's just all of a sudden at the drop of, I take a shower, touch the wrong thing. Exactly. Find the wrong thing at the wrong time or right time, however you want to think of it. I know. Yes, I'm grateful and fine. However, with your mom's memory at 84 going through radiation and that mask thing and the trauma of it. 

Natasha (06:23):
No, she doesn't know any of that. I have not shared that with her. 

Kristen (06:27):
Oh, yeah. You're a good daughter. 

Natasha (06:28):
Yeah. Yeah. 

Kristen (06:31):
So with your mom, how are you feeling? I mean, that's a really big responsibility.  

Natasha (06:37):
Yeah. I mean, actually it feels like I'm more worried about her than I was about myself and the serendipity with which she was diagnosed, and then maybe people out there in the podcast world who've had a similar thing. For the two of us, we had a lump or something was pretty obvious that we knew wasn't right. 

(06:58)
For my mom, she had been to see her primary care provider, and she at 84 found out that she had slightly high blood pressure, and she was really upset that she was going to have to take blood pressure meds, and she was just leaving the doctor's room and then was like, oh, by the way, I've lost a fair bit of weight in the last couple of months. And the doc was like, well, how much? And she's like seven or eight pounds. And my mom's, she's pretty little, and the primary care doc was any shortness of breath, anything? Nope. Just this weight loss. And she did her job. She sent her for a chest, which showed up, something which led to a CT scan, which led to an MRI, but it was just like six or seven pound weight loss, no other symptoms. And it's a little iffy of which stage she is, but it's a stage. 

(07:51)
It's not early stage. It's like a three-ish. So they're talking this wonderful phrase of palliative chemotherapy. So she's acknowledged the fact that it's not going away, but that she may be able to live with it. 

Kristen (08:06):
To manage it? 

Natasha (08:07):
To manage it. Yeah. It's a little, but no, I feel more worried for her than I did for myself. When we talked about doing this recording tonight, I had to kind of remind myself that I actually went through chemo, and I often will refer it to it when colleagues or other people, I am very open about it at work, not with patients unless it's relevant, but with other staff members. And I'll always say, I went through the whole circus and the circus. I'm like, yeah, I had chemo surgery, radiation. There was nothing really. And then hormonal suppression, it's like there wasn't much left they could throw at me. But I'm also very aware that this is breast cancer awareness month.

Kristen (08:53):
Right.

Natasha (08:53):
Which is, it's interesting around the hospital, there's lots of posters of one in eight women. But what I find really interesting is that we have some information about male breast cancer, and I have a number of male patients right now with breast cancer, and I think that adds a whole different level of complexity. I don't know if there are any men listening to this. I hope if there are any women who know men struggling with breast cancer, it's a whole different diagnosis for men to grapple with. They don't really want to wear pink ribbons and do Avon walks with a bunch of other women. I mean, one of the patients has told me it's like there's a real stigma and a real shame. And I have one patient who hasn't told his family that he's got breast cancer. 

Kristen (09:43):
Well, I can imagine for a man, it can feel like breast cancer. Do I have too much estrogen? Is there something unmanly about me that I got breast cancer? And I don't feel that way, but I can imagine we don't have male parts. You know what I mean?

Natasha (10:03):
Right, right. Actually, that's a really good point. No, we don't. 

Kristen (10:06):
And all men have, they have nipples, they have breast tissue. They just don't have the hormones or the makeup to have the breasts that we have. Right. And so there's no equivalent for a woman to be able to imagine. 

Natasha (10:22):
That's a really good point. 

Kristen (10:23):
Right. Because I don't have a prostate. 

Natasha (10:26):
Right. 

Kristen (10:28):
So tell me 10 days you're going to see your mom. 

Natasha (10:31):
Yes. Yeah, A week and a half.  

Kristen (10:33):
And how long are you going to be out there? 

Natasha (10:35):
Just two weeks. 

Kristen (10:36):
Okay. 

Natasha (10:37):
Yeah. And it's interesting. They haven't seen me since my diagnosis. I went home, it was two Christmases ago before all of it, but when I knew something was wrong, because I had blown off a couple of mammogram appointments, and I can remember saying to my mom, feel this under my arm. Is it just me or is there something there? And she's like, there's something there. And she's like, do not blow off the next mammogram. And I didn't. 

Kristen (11:04):
Yeah. Well, I'm so glad you're going to be there for her, and I'm so sorry that you're having to make all these decisions. So please keep me posted and I will do Give your mom a hug for me. I know she doesn't know me from Adam. 

Natasha (11:19):
So I had an interesting conversation with my oncologist when I saw her a couple of weeks ago. I wasn't sure when the cancer-free date begins. I know with being her two positive, the riskiest time for me is the first three years. And so I was like, does it start from diagnosis? Does it start from when I finished the hormone suppressants when? And she didn't have a great answer, which I thought was really interesting. She's like, nobody's ever asked me this before. I'm like, well, I'm a numbers person. I will celebrate when I've got through three years. And so she gave me my post-surgical date as my cancer. Is that what they gave you? 

Kristen (12:07):
Nobody gave me anything. They kind of asked me back. I said, so what's my cancer free date? And they said, well, when was the cancer out of your body? And I was like, okay. And so I can see how yours is a little different because yours was gone. Gone. It was gone. There was nothing there. And so I count mine as 6 22 21 was the date that I had my mastectomy. And so I count that as my cancer-free date. And so I guess when they went in for you and they found nothing there?

Natasha (12:39):
I guess, but I'm also a little tempted to make it after radiation, just because then I know that everything had been zapped. But then I'm like, but I didn't finish my hormone suppressant until March of this year. So it's kind of confusing. 

Kristen (12:56):
But how are you feeling? 

Natasha (12:59):
I'm the only symptom I have, and I don't know if it's, I'm also a couple of years older than I was when I got my diagnosis. 

Kristen (13:08):
Sure. 

Natasha (13:11):
I'm still tired. I can't do the going to bed at midnight thing anymore. But that also might be like, it's kind of become a habit to go to bed at 9:30. It doesn't feel pathological or weird. I don't have any issues with it. And partly living alone, it's like once I've eaten dinner, I'm not entirely sure what to do for the rest of the evening. So it's nice to snuggle up with the pets, listen to a podcast and fall asleep. So I don't have an issue with that really. 

Kristen (13:39):
Am I remembering there's a big birthday coming up? 

Natasha (13:41):
There is. I know. 

Kristen (13:44):
It's November, right? 

Natasha (13:45):
Yeah. November 12th I turned 60. 

Kristen (13:49):
How is that happening? 

Natasha (13:51):
It beats me. I think my mom's making stuff up. That's why I'm going home. I want to see my birth certificate. 

Kristen (13:58):
Are you going to be there for your birthday? 

Natasha (14:00):
No, I'll be back for that.

Kristen (14:00):
You'll be back, okay. 

Natasha (14:02):
Yeah. But I'll be there for her 85th, which is nice. 

Kristen (14:05):
Wow. Yeah. That's really nice.

Natasha (14:07):
No, it feels very weird. And I think part of the depression that I just went through was also sixties, older. I'm not going to say old, but it's older, and it's like I can pretend it's not true, but things start breaking down. And I think what I've really been talking with my therapist about and with other people is I don't have a will, which is dumb. I don't have an advanced directive. I don't have anything. So if I'm worried about who's going to take care of me after a stroke, which I haven't had a stroke, there's no indication that I'm about to, but this is my fear, put some stuff down on paper. So I have some very smart friends who will be my executor of my will and all of this. So it's like maybe 60 is about time to start putting some things down on paper. 

Kristen (15:00):
Well, turning sixtie's a whole different ballgame than turning 50. 

Natasha (15:04):
Yes. Yes, it is. 

Kristen (15:06):
I went to a friend's 60th birthday party this summer, and then a couple weeks later was my 40th high school reunion. And what was really interesting is there was a friend of mine who was there, and I was like, oh, Zach, I haven't seen you since. What's it been? I don't think we were old enough to drink last time I saw you. And now we're talking about memory care for your mom. What the hell? And a, where's the time go? So cliche, but it's a different ball game. You and I are probably some of the only people who can have this conversation about, wow, between 50 and 60, I went through fucking ca.ncer 

Natasha (15:45):
Yeah.

Kristen (15:46):
And I'm coming out on the other side bitches. 

Natasha (15:49):
Yeah. And I don't know if we've talked since I went on my trip to Saudi. Did we?  

Kristen (15:53):
No. You were just about to go. The pictures were so amazing. Tell me. Yeah, 

Natasha (15:58):
I had an amazing time for so many different reasons. But what was interesting, so I went with a group because kind of one of the only ways to go and traveling solo. I didn't want to be on my own for the two weeks. And there were eight of us on the trip, seven women and one guy. 

Kristen (16:17):
Good for him. 

Natasha (16:17):
And he was with one of the other women, and I was probably 20 years younger than everybody else on the trip. And it was such a joy to be with a group of late 70, early year, 80 year old women, most of whom had had cancer. 

(16:39)
There was some colon cancer, there was some breast cancer, I think a couple of colon cancers. The guy had prostate cancer on the trip. And I think we talked, I can remember saying before I went like, oh, I'm not sure if I'm going to bring it up. Everyone was like, we've all had cancer. And a couple of them used ski poles to walk, but they were all so positive and energetic. And one of the women was like, do you mind if I ask how old you are? And I said, no, of course. I don't care. And she's like, really enjoy your sixties. She's like, your sixties are amazing. She's like, you will find that you don't give a shit about so many things. I love it. I was like, this sounds great. This sounds amazing. And she's like, what I see is a lot of my girlfriends were sick in their fifties. If you get to your sixties, your knees are going to go and your hips are going to go and you won't remember where your keys are. And she's like, but you are going to have such a great time. And I was like, that is so reassuring. 

Kristen (17:46):
Ah, I love that.

Natasha (17:47):
Yeah, me too. Me too. 

Kristen (17:49):
That's so fantastic. 

Natasha (17:50):
And they were all retired, and one of them had a much younger lover from Trinidad, and they was showing me these pictures of this hot guy. I was like, this is great. I love it. And the one thing they're like, keep off the dating apps. They're like, once you turn 60, they all look like granddads. 

Kristen (18:14):
It's probably true. 

Natasha (18:16):
Yeah. Yeah. 

Kristen (18:17):
Well, I love that about your trip. 

Natasha (18:20):
Yeah, 

Kristen (18:20):
That's invigorating. And you know what? I think that the traveling is probably what keeps them young.

Natasha (18:24):
Absolutely. I mean, these women had traveled. They weren't just doing two weeks in Saudi. They had done two weeks in Oman beforehand. They were going somewhere else afterwards. Afterwards they're just like, yeah. It's like we rent our house out and we just travel and we have physical limitations. But the oldest lady on the trip who walked with a couple of ski poles the whole time, she was up and down rock faces, and she would fall and pick herself up again. She didn't give a shit. And I was like, I tore my ACL 10 years ago, and I still feel like a baby sometimes. She was such a great group of people, and it's kind of self-selected because it was an expensive trip. And so they're probably super wealthy entitled women, but I don't often hang out with 80 year olds. And it was amazing. That was great.

Kristen (19:15):
I love that. I love that. That makes me want to go do that now. 

Natasha (19:20):
And their lack of concern about their own cancers, they're just like, ah, all of our friends have had breast cancer or colon cancer or rectal cancer or some of those. It was just kind of amazing. 

Kristen (19:31):
Wow. 

Natasha (19:33):
And I know statistically one in three women will have cancer of some kind in our life time, but it was just, yeah, it really put it into perspective for me. Yeah. No, it was great. I highly recommend a trip with a bunch of retired eighty year old women. 

Kristen (19:51):
Let's do it. Let me know next time, and I'll go.

Natasha (19:53):
No, I'll do, I will do. 

Kristen (19:55):
That would be so much fun. So Antonio? <laugh>

Natasha (19:58):
Hm-hmmm. <laugh> 

Kristen (20:02):
You told me when I asked you about your bathroom and you're like, well, I'm dating my contractor. I'm like, oh, who's your hot contractor? 

Natasha (20:10):
So he's still around. It's still as nebulous as it ever was. My bathroom isn't finished. He says he's coming tomorrow. We're supposed to go out tomorrow night. We'll see if that happens. But for right now, the last two years, I've sort of had to reinvent myself from so many different angles. And I feel like I'm just coming out figuring out who I am as a single woman. I mean single, but dating woman. 

(20:41)
And I've done some big things that I chose and bought a new fridge, which to some people, that sounds like a kind of a silly thing, but I was in a marriage where I wasn't allowed to have my own opinion for 25 years. So it's like I'm making some changes in the house, and I asked for help with somebody to help me with the garden, and I'm going to do some painting. And it's just, I don't know if this is right to say it feels like a female thing, but I feel like a lot of us get controlled by the men in our lives. And now I have no one controlling me. And it's been a little terrifying where it's like, I could really do anything I want, but I don't know what I want. Because somebody for 25 years told me what I wanted. I actually asked for a good friend's help with buying a new fridge. I just couldn't get my head around it. It's like there's a bazillion fridges, and I was scared. I would screw it up, and someone was like, you can't screw up buying a fridge. They keep things cold. 

Kristen (21:43):
<laugh> It's got one job. 

Natasha (21:47):
You can spend $300 on a fridge, or you can spend 6,000 on a fridge. I'm like, how do I know which one I want? I'm like, honestly, it doesn't really matter. 

Kristen (21:55):
Just what do you want your fridge to do? The more you want it to do, the more it's going to cost. Right?  

Natasha (22:02):
Yeah. You know and then the one I ordered when they delivered the interior light didn't work. And initially I was like, that's it. I've got a broken fridge. And people are like, no, you just send it back. 

Kristen (22:14):
I know. Well, it's an uphill climb to be single after so long. In general, it's an uphill climb to get normal after. It's an uphill climb to get your head around who you are after cancer, and both your body, your mind, your spirit, your soul, all of those things. And you're having to figure that all out at the same time, and proud of you. It's a lot. 

Natasha (22:45):
Well, some days I do okay, and some days I don't. And that's the way it goes. Right? 

Kristen (22:51):
Yeah. And so you don't have any more treatments at all?

Natasha (22:54):
No, I'm just getting what I love about the way my oncology team at UCSF is managing it. They wanted to just do mammograms. And I said to them, look, even when we knew when I had the tumor and exactly where it was, it didn't show up in a mammogram. So I'm not happy just getting mammograms. So we're alternating. MRI mammogram, which I really like. I like that a lot. Yeah. Yeah. 

Kristen (23:21):
That's great. 

Natasha (23:22):
And they gave me the spiel last time I saw them of like, look, if you had to have breast cancer, which you didn't have to have it having a two positive stage two, you couldn't have asked for anything better. I'm like, I probably could have done, but I hear what you're coming from. <laugh>

Kristen (23:43):
Like, maybe like a stage zero with a couple little, 

Natasha (23:45):
Right. It's like my mom had DCIS. It's not even a stage. There's a movement in medicine to have that not even counted as cancer. So maybe I'd have liked that one? 

Kristen (23:55):
If I could choose. I didn't get to mark the box. 

Natasha (23:57):
Right. 

Kristen (23:58):
Okay. 

Natasha (23:59):
Right. 

Kristen (24:00):
Yeah. Well, so you have those every six months, is that right? 

Natasha (24:05):
No, I think it's every three months for the first two years because of the HER two. 

Kristen (24:10):
Okay. That's great. 

Natasha (24:12):
Well, and I'm still so stunned that the chemo just zapped it all. Yeah, me too. And the phrase they use is My oncologist says it melted it away. 

Kristen (24:23):
I love it. Yeah, I love it. 

Natasha (24:26):
And I'm kind of curious, did I pee it out? Did I poop it out? Where did it actually go? And I don't know what the answer is. I should ask a colleague. I should ask a colleague, oncologist cause I don't know what 

Kristen (24:38):
You should ask. I'm curious about that. 

Natasha (24:41):
Yeah, because did it just kill itself or I don't know. 

Kristen (24:45):
Did the poison pick it up and take it? 

Natasha (24:47):
I don't know. I mean, I know our pee is highly scary after chemo. You're supposed to flush the toilet twice and all of this. But are we shedding dead cancer cells? 

Kristen (24:59):
I don't know. The chemo didn't work for me, so I don't know. But I want to know the answer to that question. 

Natasha (25:06):
Yeah, I'll find out. 

Kristen (25:07):
Where does a tumor go when it goes away? Right. 

Natasha (25:10):
Yeah, me too. And I hope there are people out there in podcast world googling this right now. 

Kristen (25:17):
I hope so too. I hope. Come on. I want to know. 

Natasha (25:19):
Yeah. 

Kristen (25:20):
Wow. 

Eva Sheie (25:24):
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Eva Sheie (26:27):
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