(Enjoy some videos of the boys. We’re in Montana for the week—it’s been so nice to escape L.A. for some time in nature.)
I spent the past month largely recovering from a (successful) double mastectomy—it was very intense, and I also had amazing care, from both my team at UCLA and also from my family and friends. I am healing well and my prognosis couldn’t be better—I’m very lucky that intervention was early and I am not fighting for my life. I recorded this episode of Pulling the Thread before my surgery—I did this for a number of reasons: to record the experience of navigating options, to highlight where the big fear pockets were for me, and also to work through a second diagnosis, that’s scary-sounding but also in hand. If you’ve faced something like this—or are fearful of facing something like this—I hope my thought process is helpful.
In last month’s solo episode of the podcast (“Taking Your Foot Off the Gas”), I talked a bit about needing a sabbatical—and this is why. I appreciate all of you so much—thank you for continuing to listen to Pulling the Thread while I take some time to take care of myself. I'm very grateful for your support.
EPISODE TRANSCRIPT:
ELISE:
So I am recording this at the end of May a couple of weeks before I am going to have surgery. So I had sort of intimated in last month's episode that I'm going through some stuff physically that is, I just want to be very bold and overt about this, not life threatening. I am going to be 100% fine and I am not scared. I'm not fighting for my life. I am very lucky. I am getting sort of a walk through the park compared to the rough initiations that many probably of you are on, friends of mine are on.
So I just want to be abundantly clear here that I'm not scared and I don't want anyone to be scared on my behalf. So I've had a spring. So I am contending with two things, one which is more slow rolling in which I don't know exactly what will happen because I'm still in the middle of the process and another one which needs more immediate attention. And I think I'll just today tell you the story because there are a couple PSAs involved and also yeah, I'm getting amazing care. And when you listen to this, I will be on the other side of most of it physically. And I wanted to do that in part because I don't really want feedback. There's so much and I have a lot to say about everything that comes at women in this process. So I didn't want feedback and I couldn't handle too much concern and care because if you listen to last month's episode, you know that accepting care is difficult for me and putting myself in the circle is difficult for me and it needs to be titrated runs.
I just didn't feel like I could handle too much energy coming my way. I just needed to be really quiet and still and give myself a moment to get through this and then talk about it. And like in any sort of memoir, it's better to write about these things and talk about these things on the other side. That said, I wanted to record this episode in the pre so that not only to have a record for myself, but if it's helpful to understand what I'm thinking about and how I am making decisions for anyone who finds themself in this journey, because it's a very common journey. So I'll just tell you my diagnoses. I have what my friend who's also going through this but in a more progressed way has, she called it the Disneyland of breast cancers, which made me laugh. But if you also have this diagnosis because it is the most common one, I hope you don't take offense to that.
It just feels easier than sort of what many others are up against. So I have non-life-threatening, non-invasive breast cancer. I have DCIS, which is ductal carcinoma in C2, which means that it is all along my ducts, but this will be confirmed or not confirmed through pathology. As far as we know, it hasn't breached the duct walls or eaten through to access the lymph, the blood, which would allow it to catch a ride to another part of my body. And it looks on MRI at least like my lymph nodes look good, which is sort of the main avenue out of the ductal system. But they will inject me with some sort of dye so they can determine which is the sentinel lymph node and that will be taken out as well and biopsied to make sure. So I don't know. And when this episode airs, I probably still won't know whether it's fully contained in the breast or not.
Okay. So that was one. The other diagnosis is that I have a brain aneurysm, which I have a very strong family history for. So that's my concurrent journey. Although at this point, I don't know exactly what will happen and I am in the middle of that process, but it is not an urgent, it's not about to rupture. And so I will be picking that up on the other side of this breast cancer journey. But let me back up. Let me just tell you because there are some PSAs in here. So I'm going to take you actually back to February of last year, January, February of last year and just the reality of being a doctor's kid, which is that I've never had a primary care physician. I've always been sort of figuring it out on the fly and I'm fortunate in that my father's a doctor.
So if I need a prescription, he can take care of it even though he really does not like to do that and is not inclined to do that anymore. And so has been on me to get a primary care physician. But for a long time I had a fantastic OBGYN who retired in 2024 and I was passed to a different doctor in her practice. And I saw this doctor in her Beverly Hills office, which was a totally normal doctor's office. And then last maybe late fall, 2024, beginning of 2025, I went to see this new doctor as part of the practice and they had relocated to this crazy fancy new palace. And I walked in and as longtime listeners will know, I live by this Krissa Schumacher quote, "Your vibration must be higher than what you create, otherwise you cannot manage it. " And I have seen so many people, particularly in the health and wellness space, get so far over their skis in terms of building these operations that then they need to stay in front of.
And my heart sank when I walked into this practice because I was like, "How are they possibly going to afford this overhead? This is crazy." And it felt like a factory. I spent a couple minutes with this doctor who I'd never seen before. She prescribed my mammogram. I didn't need a pelvic exam and set me on my way. And then I followed up with her team to be like, "I really need an ultrasound. I have dense breasts, et cetera." And that was it. And I went and did my mammogram ultrasound. It was right around the time of the fires. And simultaneous with this, after my appointment, I got an email from the practice saying that they were going concierge. And so to stay in the practice, I would need to pay hundreds of dollars a year just to get this four minute conversation and a mammogram prescription.
And if you want to text your doctor and all this other stuff, you can pay $1,000 a month or whatever. It's nuts. So anyway, I was like, "This is the end of my road with this particular physician. Yes, dad, I know I need a primary care physician and so does my husband." And so I asked around and everyone would say, "Oh, referral only or my primary care physician has gone concierge or whatnot." And then I was talking to, I ran into Cara Natterson, who's a pediatrician here in LA, who does a lot of great programs for kids around going through puberty and whatnot. If you have ever encountered her in the wild and her husband, Paul, who I think is a cardiothoracic surgeon, maybe. I'm probably getting that wrong, but we were at a party together and I was like, "Oh, do you guys have a good primary care physician for me?”
And Paul was like, "Just go to UCLA." He was like, "There's this practice, I think they're required by UCLA, but you should be able to just find a great young UCLA doc." I was like, "Yeah, no, you're right." And then this part, which fills me with shame, but I was like, "I'll do this. I'll do this. It's not time for my mammogram. I'll deal." And then my husband, I have a migraine disorder and my oldest has a migraine disorder, a really bad one. And I get this from my father. And so my husband got this terrible migraine where he was vomiting. And I was like, "Is this a thunderclop headache? Is he having an aneurysm? Oh my God." I flew into action. My father was like, "No, he's not having an aneurysm. He's having a migraine." But I was like, "I got to find a primary care physician because Rob needs to be seen." So that was my ultimate motivation.
And yes, it's embarrassing to admit. So I went on UCLA's website and I found, I was like, "I'm going to find a young primary care physician who's building their practice and has plenty of time and isn't about to retire." And that's what I did. And I went in to see this wonderful doctor, Dr. Melamed, if anyone needs a physician. I love her. She's great. And she did my full physical. And as part of it, she did my family history and I told her, "Oh yeah, my mom had an aneurysm that almost killed her when I was in high school. And she has fibromuscular dysplasia, which was discovered with her aneurysm where she has these carotid arteries or stenosis in her carotid arteries. She had bilateral stents put into her carotid arteries." I think it was the first time that surgery was ever done at Stanford.
But FMD, which can also affect the renal system, really only shows up in women. And when it's the renal system, it's an irregularly high blood pressure and otherwise healthy people, but it's not really diagnosed and it's not really that widely studied obviously. And the treatment is to take an aspirin a day and to be conscious of the fact you're at a heightened risk for stroke. And my mom needed an actual physical intervention to make sure that her carotid arteries stayed open and she didn't have a stroke. So anyway, so that, and then my aunt also had an aneurysm that ruptured in her 20s that was a really big deal. She had to go from Iowa to the Mayo Clinic. My mom had to fly to Arizona to Barrow to have hers repaired by the best neurosurgeon in the world at the time because it was behind her eye.
It was very complicated and scary. And I had an MRA at that time in my early 20s and theoretically was told that I should get an MRA every 10 years, but obviously I hadn't done it because guys, I haven't had a primary care physician. So Dr. Melamed was like, "You are going to get an MRA." And she gave me my mammogram prescription and did my labs and sent me on my way. And I got in to get an MRA earlier than I got in to get my mammogram. So this is late March or mid-March, I can't remember, but I did my MRA and guess what? I have an aneurysm. It's very small. It's behind. And the radiologist though that it was located, it's called the cavernous ICA. And I was like, "Wow, I am so lucky." I got on open evidence. My dad flipped it to a couple of radiologists and neurosurgeons in Missoula where I'm from.
But I was like, "It's behind my eye. It's facing my ocular cavity. So if it's not in the dura, so if it ruptures, it's not going to kill me. It will just fill my eye socket with blood and it will need to be repaired, but it might temporarily affect my vision or it might get big enough to affect my ocular nerve. But this is really not going to be a big deal." And this is one of those things in the context of my recent conversation with Alexandra Siferlin about sort of the diagnosis creep. I'm like, "This might be better if I didn't even know about it because I have a feeling that they're going to just say the treatment is worse than the disease and this is something we'll just monitor and watch." And my dad was like, "Let's ask around and I want to look at all of these neurosurgeons in this really big UCLA practice and let's just find the right one and I want you to be with the right neurosurgeon." So we went through and I picked the guy.
I'm seeing his name's Dr. Colby. But I felt shame. I was like, "I'm embarrassed to be taking this guy's time. I mean, this is so messed up guys, but you're getting some real insight into how I operate." I'm like, "This guy's just going to be like, you don't really need this appointment and there's nothing to do here and let's just follow it and blah, blah, blah, blah, blah." So that appointment was scheduled for late April, his first availability. And then I went and did my MRA and there was no ultrasound put in. So I was like, "Oh, I'm definitely going to get called back because I have dense breasts. I don't have the densest breasts that require an MRI." I'm sure all of you listening know this, but just to say it again, if you have heterogeneously dense breasts, which is what I have, which is I think half the population, it's very difficult.
And I think actually AI is very helpful here, but we have so much dense fibrous tissue that can conceal tumors and masses. And so you need an ultrasound in order to really see what's going on. And if you have super dense breasts, which is definitely more rare, but it's good to know if you have this, then you might need an MRI in order to really actually see what's what in there. And I think from what I understand, denser breasts are more likely to develop breast cancer anyway. If you have more sort of fatty tissue, it's safer for you. So anyway, so I went in to get my mammogram and I was like, "I'm definitely going to get called back." And sure enough, I got called back and I was like, "This is nothing." And then I went in and it's not good when one of the techs who's been a tech for a while is like, "I've never taken images like this.”
So it was two techs and they were trying to figure out where this was in my breast. And the radiologist was like, after I'd done 40 images, I was in there forever. I was like, "We need to do a biopsy and it's complicated because it's very close to your skin. And so it might not be successful, but we need to do it. " And I was like, "Do we really? " And she was like, "Yes, it doesn't look that suspicious, but we really need to do it. " So I was like, "Okay, no problem." So I did my biopsy, which was so uncomfortable. None of these machines are designed for women and I thought it couldn't get worse than a mammogram, but this is a machine where you lie on what looks like a massage table, but it actually has bars jutting up into your ribcage.
It's so uncomfortable. And they put you into a mammogram vice and then they do the biopsy in order to really make it perfect. It is so uncomfortable just saying it. And a woman or engineer needs to redesign these machines because it's cruel. So I did my biopsy. I went on spring break and I was like, "This is nothing. There's just no way I have cancer. I don't have a family history of cancer at all. Although in the course of this, I realized that my dad's an only child and who knows on his side. I think I do have family history of cancer. And that's my Ashkenazi Jewish side where there's much higher rates of BRCA. But I just was like, there's just no way. I am just going to keep dodging bullets. I fall off a horse and break my neck and I'm miraculously fine.
And then I have an aneurysm, but it's miraculously well placed. And oh my God, I'm just fine. I'm great guys. Anyway, I was in Omaha mid-April a few days after this biopsy. And it just so happened that I was with my mom who was in town because I was interviewing this Holocaust historian, Devorah Dwark, at the University of Nebraska and that my friend Michael had put together. And all of her sisters came, saved one over from Des Moines. And then her sister lives in Omaha who used to run this trauma ward. And we'd spent the day actually with her friend who had just gone through what I was diagnosed with. But yeah, so my mom and my aunt were there, which was a happy coincidence. And I got a call right before I went on stage to interview this historian. And my poor primary care physician was like, "I'm sorry.
I'm really not used to calling someone within weeks to say you have a brain aneurysm and you have breast cancer, but there we are. " She did do a great job of disclaimering it. Noninvasive. It's intermediate grade. So it's showing activity. There's necrosis. It's moving and shaking, but non-invasive as far as they can tell. And then I had to go on stage, but in a way it was better. I wanted obviously to call Rob right away. I wanted to call my dad. I wanted to tell my mom and my brother, but I was like, "I'm going to hold this, get through this. " I actually enjoyed it. It was a fascinating conversation and it was good for me to be with myself for an hour and then to be with my mom and my aunt. And my aunt had gone with her friend to every single appointment.
And so she knew a lot and had pamphlets and brochures on her phone. And I spoke to another older woman who had gone through it, two older women, and they were both like, "It's very cut and dry. It is a lumpectomy and then it's radiation and then it's tamoxifen." And I was like, "Okay, great. Then that's what I'm getting. And I am so sure that I know exactly what's going to happen." So whereas with the neurosurgeon, my dad was like, "We need to be really specific here with this cancer." He was like, "This is very cut and dry. This is the basics of basics. So I think you can feel confident with sort of the team that they assigned to you. And as long as you have a good rapport and you feel like they're answering all of your questions and you feel trust." And I was like, "Okay, I'm down with that.”
And at UCLA, they have on the west side at least, you can go. It's sort of an all - in-one breast cancer center. So you see your surgeon, your medical oncologist and your radiation oncologist in one appointment and they're all talking. So that's fantastic. And it just so happened that I had my neurosurgeon on the Monday and then I had my oncology appointments on the Tuesday. What I will say is when you go into patient land, which I have been in, it is like a full-time job. It is beyond the distraction of it. It is so many appointments and it takes over your entire life. And I was like, "I'm going to give this one to the universe." And I got some great signs. So first of all, the oncologist's phone number has my Peter number in it, 825. So I was like, "Okay, that feels great." And then on the way to the neurosurgeon appointment, this delivery van, when we were driving down out of the canyon from our house with Rob, this delivery van sort of pulled out in front of us and we stopped to let them pull out and pull down.
And it's this business that's in West Hollywood. I don't know what they were doing near us. So Peter is my late brother-in-law and my brother always called him Pete. And then my brother's new partner or newer partner is John. And this delivery van said, "John and Pete's fine wines and spirits." And I just had to laugh. I was like, "Okay, Peter, I know you've got me. " And then that night before my oncology appointment, I had this dream. I never dream about Peter and I never really remember my dreams. But in this dream, this Italian restaurant in Astoria, Queens had been written up in either the New Yorker or the New York Times and I was like, "I've got to go to that restaurant." So this is not my typical behavior, friends. So I was like, "I'll never be able to get a reservation." And I called and before I could say anything or introduce myself, they said, "Hi Elise, of course we have a table for you.
We have room for you. " And I was like, "How do you know my name?" And they said, "Peter told us." And I was like, "How do you know Peter?" And they were like, "Of course we know Peter. That's a given. He's a very, very important person." He was still dead, but they knew Peter. And they were like, "Just come in. We've got you. " And so that to me felt like the universe having my back. And so it turns out I went with the team that they assembled based on availability. And the surgeon who I love, Jennifer Baker, she hasn't done her surgery yet, but I have really enjoyed being her patient and I'm sure she will do a fantastic job. And if I'm running this on the other side, it means she did a great job. But she grew up in Des Moines like my mom and her mom lives in Montana and her mom grew up in Montana and her grandfather was a single town physician.
And I just felt an immediate kismet. I love her. And then the medical oncologist is the person... I have a friend who is an oncologist physician at UCLA who runs a lab and focuses on blood cancers. And I asked him, I was like, "Who do you know who's good in the medical oncology space for breast cancer?" And he was like, "I would love to be with Dr. McAndrews." And I was like, "That's my doctor." And then my surgeon picked my plastic surgeon, Ginger Slack.
Anyway, so I went into this appointment though, fully certain. I'd spoken to these three older women who'd all had the same treatment and that's what Claude was telling me it was so cut and dry. And I went in and she was like, "Do you know sort of what's going to happen?" And I was like, "I'm going to have a lumpectomy, radiation and tamoxifen." And she was like, "Not exactly." And then she examined me and I'm tall, I'm five 10 and I am well endowed or I'm proportionally endowed. And so she looked at me and she was like, "Okay, if you really want a lumpectomy, we can pursue this, but I have six centimeters of calcination. So it's like a constellation, a splatter paint of this DCIS that all has to be removed." And so she was like, "It's a big expanse along the lower side of my left breast." And so she was like, "We could do it.
We can try and do a lumpectomy. It will need to be bilateral reconstruction because this isn't just taking out a small thing. This is taking out a lot, a big expanse. And then I would need you to promise me that if I can't clear the margins, and I don't really know exactly if there's going to be more, that if I can't clear the margins and the pathology comes back and the margins aren't clear." And she's like, "This also rides on what we see in the MRI that I need you to go for and your genetic testing that I need you to do. If we don't get clear margins, I need you to tell me now that we can go to full mastectomy." So it'd be a two week delay. They'd start the surgery and then finish it. So I was like, "Okay." And I just went on with the appointment and she was like, "And I need you to understand recurrence rates because these are compounding." I think it's 0.5 to 1% chance of recurrence every year, but it compounds.
So by the time you're 20 or 30 years out, your recurrence rate is actually very high. It's like 30% or 40%. I can't remember exactly what it climbs to. But she was like, "I just need you to... " She was great. She was like, "I just need you to see this. " And I was like, "Got it, got it, got it. " But in my mind, I'm like, "Give me the basic thing. Give me the most straightforward, low maintenance thing." And I just, I don't know. I hadn't contemplated that there would be any alternative. And then I met with the radiation oncologist who was like, "Okay, then if you want a lumpectomy, this will be four weeks of radiation every day." And took me through the whole process. And then I met with the oncologist who was like, "I am going to tell you a lot of things and you're going to remember almost nothing, which is true.
So I will be back. We'll have this conversation again after we get the pathology, but you are not a candidate for tamoxifen because of your aneurysm and it does have increased stroke risk. And what I would probably need to put you on if you do need drugs would be Lupron, which will put you into early menopause." So I was like, "Oh my God." Every appointment you're like, "Oh, I'm going to lose that and I'm going to lose that. " And granted, I'm maybe five years away, but I'm like, "I'm not there yet." But yeah, he was like, "And just so you understand, it's not to kill... We will get all of the cancer out of the breast. This is in the case that it's eaten through the duct wall. It's gone through a limp. It's in your system. This is sort of the army that goes out and finds those stray cancer cells to ensure that they don't take root anywhere else because breast cancer doesn't kill you, but it's when it's breast cancer elsewhere that it starts to really be a problem.
So your cancer is named for where it starts. Oh, and what he also said, he's like at six centimeters, when it gets into eight centimeters, nine centimeters, there's just no way we can do all the pathology. It would take us a year to do all the pathology for that much. And so at that point, I sort of say that you kind of have to have drugs because we can't say for sure that there's no invasiveness and you're going to be on the line and we'll have to contend with that on the other side I did the pathology report, but I just want to mention it, that at six centimeters it's a lot. And so spoke to my surgeon again and I was like, what? So this is fast that this has for me to have this all in a year because this wasn't on my mammogram last year.
And she pulled up my mammogram. After I found my primary care physician, she requested all my records. So I sent out a record request to get my colonoscopy and everything that I, all my mammograms and from the last six years. And she pulled it up and she was like, "It was on your mammogram." So friends, because now I have my mammogram and I can read it, I had an abnormal mammogram in 2025 and nobody called me, not the radiation center and not my doctor. No messages, no through clarinet, no emails, no phone calls, no missed calls, no voicemails. In the process of going concierge, apparently they didn't call me. And I have been really, I spent a week being very angry and feeling like, well, this is malpractice and it is malpractice. And I learned a lot about malpractice, which is I'd always assumed that doctors were plagued by ambulance chasers and that this was a massive issue because I think that's how it's been sold to us.
And what I've learned is that this is not so. It's actually incredibly difficult to pursue malpractice outside of very clear taking off the wrong leg, like dismemberment and death. And that in California, but I know that this is true in other states as well, including I think Montana, and I spoke to a lovely attorney who gave me the whole landscape, but starting maybe like 30 or 40 years ago, California had these very draconian laws that were put into place out of concern that doctors would leave the state if they couldn't access malpractice insurance if it became too expensive. And so they instituted these laws that cap what you can pursue in terms for essentially pain and suffering. And they also capped what a lawyer could take as a contingency. So a lot of these cases theoretically work on contingency where if you win the case, your lawyer takes a portion of it.
So California put in laws to severely inhibit that and limit how much you can earn, how much you can win. And now they're working to try to rescind the laws because I think they realize patients really lose, this isn't serving and that insurance rates are as sky high as ever. But yeah, the way that it works is there's a very tight timeline. It's one year. Then you have to prove malpractice, which I could do. And then you have to prove sort of damages and that's where it gets dicier. And his point was, so I would have to prove that my care is dramatically different than what it would have been a year ago when maybe I would have gotten away with a simple lumpectomy. And his point was that doctors get to decide whether to go to trial or not, not the insurance company. And if it's more than $30,000, it shows up on their record and so they are very motivated to go to trial.
So he was outlining how he's had the most insane cut and dry cases where healthy, young, 20 something women have lost the ability to have children because the diseased ovary was left in and the healthy ovary was taken out. And that was taken to trial where his traumatized witness had to testify and then she got a nominal amount of money as compensation for the loss of the ability to have children. This is one small example, but so it's just not worth it. But there are things that you can do. But it was also, I've just been operating under the belief that doctors are really scared of malpractice and so are really, really, really buttoned up. And to learn that that's not true, this is not to say I think most doctors, vast majority of doctors really care about their patients, have amazing front offices and are totally buttoned up.
And every experience that I've had at UCLA has been, they have hammered me on every single phone message, MyChart, it's email, et cetera. They're not letting anything fall through the cracks. And this stuff obviously happens. So I have notified the office so that someone doesn't die. They're lucky and that I have slow moving DCIS and I filed a complaint. You can file a complaint with the state board, either with the medical board or the osteopathy board, depending on whether you have an MD or a DO. And so I've done that and that is sort of clearing my conscience in terms of an unacceptable standard of care. So anyway, here I am with six centimeters and I left my doctor's office after that first appointment and I realized, I think I just missed the whole memo. I think my doctor was trying to talk to me between the lines and honoring what I wanted and I just missed it, which is that I am not doing what she thinks is the most health protective thing.
And then I started talking to younger women who are women 40s. She told me the youngest woman in her office that week had been 22. It's just a different calculus for younger women where we have many, many years where recurrence can happen versus being 70 and maybe it comes back in 20 years, but you might not even be alive versus being 40 and chasing this for the rest of your life and feeling haunted by the prospect of a recurrence. And so I started speaking to younger women who have been through this and only one woman that I had spoken to had stopped at a lumpectomy or managed to. Everyone I'd either chosen a double mastectomy out of the gate because of invasiveness or risk or ended up there based on not clear margins or recurrence. And I was like, "Okay, I think this is the message.
I need to just go all the way. I need to do the most to do the least." And that was shocking to me. I just went in thinking it was going to be one thing and then finding out was another. And then I think I skipped over my neurosurgery appointment, but on Monday when I went to see this neurosurgeon who I felt like I was wasting his time and that he was going to tell me, "Don't worry, get screened. I'll see you down the road. This isn't going to be a problem." But he told me that actually the radiologist had misread it and it is in my dura, which means if it were to rupture, it would be potentially catastrophic and that it's not about to rupture. It's very small, but I can't just forget it. And so he had me do an angiogram, which I did last week up through my...
It's where they went up through my femoral artery because I have terrible arteries and they put an iodine in your brain and they take x-rays so that he could get a much clearer shot of exactly what this thing looks like and what's happening in terms of the potential for FMD. And I have that appointment, the follow-up appointment later this week. But my hunch is that he will tell me after this breast cancer journey, once I'm no longer on whatever I need to be on, blood thinners, et cetera, that when it's safe that he will probably go in and drop a coil. It's amazing the technology that they have where they can laparoscopically put in a stent or coil and repair these aneurysms in various ways. And you get to just move on with your life. You're still studied, but that particular aneurysm would no longer be a threat.
So that's what's happening with that. I'm just living with it. And yeah, after I left my doctor's office, my oncologist's office, I was like, okay, I think I need... And I spoke to several more women about their calculation and it was great. I spoke to a friend of mine who had been through this. She lives far away from me, but she's one of my oldest friends. And when she went through this, it's like I knew she was going through breast cancer, but she just didn't want to talk about it and she didn't want flowers. And we were talking about it now. And I was like, "Is that why you were so weird?" And she was like, "Yeah, because it's not that big of a deal. It's not pancreatic cancer. It's not glioblastoma. It's not stage two. It's fine." And I felt very anxious about people's concern.
And I was like, "I totally understand." And as someone who writes about my life, I feel awkward. As a private public person, it's like, I don't want to be sort of harvesting attention here, but I feel like I share about my life. I don't know. It's a mind fuck. So I've been in that mind fuck. Am I going to write about this? Am I going to tell people? When do I tell people? And now I'm sort of at the point where I feel like I am, as mentioned, going to take a sabbatical to recover and heal and then to work on my book. And so I have one more episode coming from you next week and then we're going to do sort of greatest hits. And I hope you'll hang through and listen because it helps me. But I also, you might have missed these episodes or they're just bangers that are absolutely worth a re-listen.
And then I'll be back. My intent is to start recording new episodes again at the end of this month and early next month. And then I'll be back in August with fresh episodes and I will be back not on Subset because I'm moving off of Substack so we'll be in a new space, but that I'll be back in your inboxes most likely in August, if not September. And I've got some group energy healings and some other workshops planned as well. But I'm getting off track here.
So then this last few weeks has just been waiting. Oh and then I spoke to a friend who has really been through the ringer. She had a recurrence. Once you have radiated your skin too is what I learned. It can make reconstruction very difficult down the line. So that was also part of my calculus. And I spoke to a friend who was like, "I have seen and met every single oncologist in LA and if I could go with anyone." And I didn't choose her because she looked too young, but it would be ginger slack. And I was like, "That is my doctor. So that's my plastic surgeon." And I saw her to cement the plan and get on her schedule. And again, I went in, I was like, and this I think is really important if you're going through this journey is you want to make sure obviously you want to love and trust your doctors because ultimately, and you want them to be able to answer all your questions and then you need to take a leap of faith.
There's a certain point where you're like, "I bow down to your expertise and your knowledge." And the way I've been thinking about it is that I wanted to be with a plastic surgeon who can do the full menu because there's lots of novel ways of treating this, but who also understands, let's just call them dietary restrictions. But I didn't want to be denied an intervention because my plastic surgeon didn't know how to do it or didn't feel comfortable.
But I recognized, and I've only kind of learned this now, let's be real, but that ultimately I needed to defer to her expertise. And so I went into my appointment with her and I was like, "I know exactly what I want. " And partly because everyone will tell you these are the important and everyone will tell you about sort of their bad experiences. The reality is we're all so different physically and otherwise and that is a big factor in terms of determining what is the right way to rebuild or reconstruct. And so I went in and I was like, "I'm obviously keeping my nipples. I want sensation. I want deep flap transfers. I'll explain what that means. And if not those, then I want direct to implant. I'll explain what that means. I don't want expanders. I definitely don't want expanders under my chest wall and so on and so forth.
And I can cut to the chase and tell you I'm not getting anything that I want. So the deep flap transfers, and this is where it's important to have a surgeon if you're a candidate for this and it's something that you would want who can do it. Mine, I think she's the only female or at the time that I read this on her site, she was the only female microsurgeon at UCLA. This is what I mean by being able to offer the full menu. But they can do this reconstruction now where they essentially take your flesh from different parts of your body and they give you... So you get a tummy tuck or they take it from your inner thighs or your butt and they rebuild, they reconstruct your breasts using your own tissue. And then the microsurgery comes online because she goes in and she reconnects blood vessels and nerves.
And then you end up with reconstructed breasts made from you that age like other tissue and you don't have an implant that needs to be sort of maintained and there are complications with implants. And so long as there's no necrosis or skin death or tissue death, it's an amazing option. And for some people it's like, oh, tummy tuck. Okay, great. So anyway, I was like, that's what I want. And I didn't really, again, I've just gone into this sort of, this is what I want. And they're like, no, you can't have that. So I don't have enough to do that, which feels obvious when I'm like, all right, I can't have a tummy tuck. I am a normal BMI. I'm not skinny, but I'm sort of totally normal. And she was like, I can get an A cup out of you, but it wouldn't be enough.
You would still need an implant. If I did that, it would look more like a typical boob job where there's your own tissue on top of an implant. So it would be softer and that might be worth it to you. But yeah, you'd have a second surgery site. And so that was a no for me. I didn't want to do that. And then because of my size and the amount of skin that they have to remove because I have a lot of DCIS, I am not a candidate for direct to implant because they need to take my pocket down significantly. They're cutting off a lot of skin on the underside of my breast to get the cancer out. And then they like to put in an expander that's much smaller to give your body a chance to heal and to give the skin a chance to heal from the shock.
And then they slowly expand you using saline over three months until you're at sort of the size that feels right for you at which point at minimum three months, but sometimes longer they will go. Then they go in and they put in an implant and she will likely do a little bit of liposuction on me to add some fat graft, like graft in some fat to the top so it's a little bit of a softer because with a normal boob job, you're working with someone's natural tissue and with a mastectomy, it's all going away. So yeah, it's harsh. It's harsh. So anyway, so that would happen in three plus months. And so that's why I can't go straight to an implant. And then I don't get to keep my nipples, which was hard to hear, but I think important to state because I feel like if you go through this journey, everyone's like, "You have to keep them." And I totally understand why.
But her point was like, "If we save your nipples, they will end up in the wrong place and you will hate them and you will be very unhappy." She told me I would look like one of those bodybuilders because again, they're taking out all the skin underneath and I have a naturally sloped boop, 34D boob, and I'm going to what she calls a gravity defying implant. And so it's just not in the right place. And so that's another important calculation. And so at three months after that, they will reconstruct. They do it using skin and then tattoos. And she told me, and I'm just choosing to trust her. I left without looking at photos because I'm just going into this and deep surrender. But she was like, sometimes I look and I'm like, "Did I make that or is that natural?" She's like, "They're really amazing." So I was like, "Okay, I'm just going to take your word for it.
"So yeah, so three procedures. Again, exactly what I said I did not want. And I'm just hoping that I'm going to be doing what I can to encourage my body to accept all of this without protest and getting, I think with their permission, lymphatic massage going and a little bit of body work. And I'm definitely doing energy work throughout this whole thing. And then really instead of trying to force my way through it, just allowing and letting myself heal. And I spoke to a physician who went through this process three months ago and this morning and it was really helpful because she was like, "Listen, I relate so hard and you're going to feel like you hit a wall and it's a really big procedure and really do what you can to give yourself time to heal." And if you go back and listen to last month's solo episode, which is all about this and the anxiety that kicks up for me around being someone who's compensated for what I produce, this is going to be my work is working through that and hopefully being surprised about how supportive everyone is even when I'm not cranking out.
I just don't think that's why people are supporting me. It's not because I'm so productive. And yet I've sort of painted myself into that corner in terms of that being a belief for me. So that needs to shake loose in part because it's funny when I'm like, "I'm looking forward to this because I'm so tired and I need a break." It's a bit like during COVID when it became less deadly, I was like, "Oh, I wouldn't mind getting COVID so I can just lie in bed." I'm like, "That's not good." I know I'm not alone in thinking that, being like, "Oh, I hope that flu that's going around at school, I hope that takes me down because I'm so white." That's not healthy. So guys, that is my big health update. In July, I'm going to come back on and assuming I'm up for it and give you guys an update.
I'm sure I'll have learned a lot. And I have a lot of feelings. I mean, I haven't gone there in this episode because it really gets my pulse racing, but I stayed off Instagram fortunately until recently. And now I'm in the breast cancer stream of mastectomy content and breast cancer content. And let me tell you, I am mad. I am so mad about what I'm seeing, including from some actual doctors about the role of lifestyle and women just picking themselves apart for not eating perfectly and da, da, da. Let me tell you, all of the people who I know who are sick, and I count myself in this, and the people, a friend of mine who died from glioblastoma last year, a friend of mine, Jesse Creel, who has stage four lung cancer and is the first person through this MD Anderson trial for this vaccine for lung cancer, but she's also getting all these experiential treatments and these clinical trials.
And it's working. It's amazing. You can follow her on Instagram. There are some amazing things despite the massive cuts to science that we're experiencing, but there's some amazing treatments coming down the pike incredibly targeted. And I will say to go through something that's so cut and dry and then to also have it be so tailored and specific is a testament to where we are where it's not just, oh, let's just hope something works. But also a reminder when you're being supportive, everyone's different. Everyone's going to have a different course of treatment and need different things. So that instinct to tell people what to do, I understand that it's strong, but might not apply. Anyway, and my dad's a pulmonologist by the way. So this whole idea of non-smokers, healthy non-smokers getting stage four lung cancer is not new to me. Obviously he saw a lot of people who had emphysema and COPD and smoked packs of cigarettes a day, but this is often just totally random.
Nobody I've spoken to who's going through this has the genetics for cancer. All of our genetic tests are negative. And I'm a poster child. I don't know if you guys know this, but for the modern wellness movement, I have not used quote unquote toxic deodorant since college. I do all the things right. And so I will not be blaming myself or shaming myself or accepting blame or shame for my diet, exercise and so on and so forth. This is an environmental catastrophe. And of course you can do all these things. They're good for you and they're good for the environment. This is an environmental catastrophe. I have so much more to say about this in terms of where we need to be training our attention rather than sort of in this My Body is a Temple, incredibly neurotic and anxious, fear-inducing, drama triangle, hellscape that is our modern world and Instagram.
But the best thing you can do is to get screened and stay on top of these things. I'm not saying that eating well and limiting your exposure to toxic chemicals isn't obviously the right thing to do. And it doesn't matter in the light of the fact that it's raining glyphosate on us and there are microplastics everywhere and that clean energy stipends are being cut and we need all of it. We all know this. Our world is being poisoned. We are a reflection. The micro is a reflection of the macro. And all of our atention needs to be on cleaning up our oceans, preserving the Amazon, pushing for regulations against these toxic chemicals that are polluting the ground and polluting the water, data centers that are polluting the water. That's where our attention needs to be, not on is this strawberry pesticide free and judging ourselves if it's not.
That's not it guys. So anyway, I have a lot more to say about that. I didn't mean to go on a mini TED Talk rant. All right. I hope everyone's hanging in there and I will see you on the flip side.
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