Bonnie Annis is a breast cancer survivor, diagnosed in 2014 with stage 2b invasive ductal carcinoma with metastasis to the lymph nodes. She is an avid photographer, freelance writer/blogger, wife, mother and grandmother.

Bonnie Annis

Bonnie Annis is a breast cancer survivor, diagnosed in 2014 with stage 2b invasive ductal carcinoma with metastasis to the lymph nodes. Catch up on 

The year is flying by and soon Summer will be here. In the South, that means scorching temperatures. Those warm days can cause challenges for those with lymphedema. In this article, read how Bonnie Annis prepares each year to beat the heat and reduce lymphatic swelling.

I live in the deep South and have for my entire life. When I was a child, Summers never bothered me. I ran around in sleeveless tops, shorts, and rarely wore shoes. I even grew up without air conditioning, which was a challenge, especially in the evenings when I was exhausted and longed for a comfortable sleep. An attic fan and open windows helped cool down our house some, but not enough.

As I grew older, I learned the best times to be outdoors during the Summer months. I’d rise early and get my work done. During the hottest parts of the day, I’d stay indoors in the wonderful air conditioning. As they day ended, and the temperatures lowered, I could venture outdoors to do some gardening or other outdoor chores.

When I was diagnosed with breast cancer, Summer had just begun. The stifling Georgia heat was just cranking up. I spent the first month after surgery either in a doctor’s well air-conditioned office, or at home resting in my own cool home. Nothing seemed to bother me until about a month after surgery.

About midday, I noticed some swelling. Reaching out to the doctor who’d performed my surgery, I explained my concerns. She asked me to come in for a post-surgical checkup and after examining me said I’d developed lymphedema. Although I’d heard of it before, I wasn’t quite sure what it meant. I asked questions and she gladly answered them before recommending I see a therapist certified in manual lymphatic drainage. She said when she’d removed lymph nodes from my arms after removing both my breasts, my lymphatic system had suffered.

I saw the therapist for 6 weeks. On each visit, she’d massage my arms for about an hour, working on one and then the other. She explained the massage would encourage excess fluid to flow upwards toward my heart if she started at my fingertips first. Then, it would travel through the “railway like” lymphatic system where it could be expelled. After the massages, she’d wrap my arms with compression bandages. I’d go home looking like a mummy, but admittedly, my arms felt better.

When my insurance coverage for these treatments expired, the doctor prescribed compression sleeves to help with the swelling. They were expensive, but insurance covered a good portion of the cost and allowed me to get 4 pairs a year. I found an online company that offered pretty patterns and bought the sleeves, but they were challenging to put on because they were so tight. I was told to put them on first thing in the morning and leave them on all day. They did keep the swelling down but as Summer progressed and temperatures soared, I found them uncomfortable to wear. Sweating was not something I enjoyed, and those tight Spandex sleeves made me sweat a lot! I looked for alternative ways of managing the swelling.

I started dry brushing in the shower. I bought a soft bristle body brush and would gently use it to push the fluid up toward my heart like the therapist had shown me. Then, I’d take a lukewarm shower. Hot showers could exacerbate the swelling, I had been told. Next, I’d use body lotion and beginning at the fingers, I’d gently move up my arm. Those things were great, but I had to do more if I was going to be outside.

While visiting the lymphatic massage therapist, I’d been warned about protecting my arms from injury. That included small wounds like bug bites, burns, or even sunburn. When I questioned the information, I was told wounds to my damaged limbs could cause cellulitis, a dangerous infection that can quickly escalate and sometimes require surgery. That scared me.

Now when Summer comes, and I plan to be outdoors, I wear thin long-sleeved shirts when I can. I’ve found several sporting goods stores that offer these type shirts with built in sun blockers. When it’s too hot to wear long sleeves, I spray myself with insect repellant. Normally I choose a product with DEET but lately I have opted for more natural sprays that don’t contain that chemical.

I also make sure to layer on sunscreen if I’ll be out for extended periods of time. I don’t want to risk a painful sunburn. And when I’m cooking at the grill, I wear long silicone mitts made especially for outdoor use. That way I’m sure my arms are protected from excessive heat.

Lymphedema isn’t something that can be cured. As a secondary complication from breast cancer surgery, the best thing I can do is manage it by protecting myself. When my arms begin to feel tight and uncomfortable, I’ll use my electric compression pump designed specifically for those who suffer from lymphedema and when I can’t do that, I’ll elevate my arms.

Summer seems to aggravate my symptoms. During cooler months, I don’t notice the lymphedema as much, but it’s still there. I guess it’s a small price to pay for surviving breast cancer and I’m willing to do whatever necessary to keep myself well and comfortable.

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Managing lymphedema during the hot Southern summers poses significant challenges, especially for those who have undergone breast cancer surgery. Effective strategies include early morning activities, staying indoors during peak heat, and using air conditioning. Manual lymphatic drainage therapy and compression sleeves help manage swelling, though they can be uncomfortable in the heat. Additional measures include dry brushing, using insect repellent, wearing protective clothing, and applying sunscreen to prevent injuries and infections. While lymphedema is incurable, these strategies help manage symptoms and maintain comfort.

Summer heat can worsen my lymphedema, but I’ve learned simple ways to stay cool, reduce swelling and protect my arms — here’s what helps me most.

Lymphedema Makes Summer Preparations Challenging After Breast Cancer

Bonnie Annis is a breast cancer survivor, diagnosed in 2014 with stage 2b invasive ductal carcinoma with metastasis to the lymph nodes. Catch up on all of 

When my husband retired and we lost his health insurance, I wasn’t worried. I knew we’d qualify for Medicare. I assumed, like many others, that in my old age, the government-provided health care would take care of most of my needs. I wasn’t naïve in thinking I’d get the same quality coverage I’d received through my husband’s insurance company, but assumed it’d be close. Boy, was I mistaken.

When it came time to buy new breast prostheses and mastectomy bras, I went to our local shop. I’d become friends with the owner after my first visit and the subsequent visits. Every two years, under my husband’s policy, I was entitled to new breast prostheses. Since I’d had a double mastectomy, I was thankful. Silicone prostheses don’t last forever, even if you take good care of them. Mine had gotten old and wrinkly from constant wear and were ready to be replaced by the end of each two-year period. And the bras, with constant use, wore out quickly. I was thankful I qualified for four new mastectomy bras every year under his plan. Since this was the first time visiting the shop without company insurance coverage, I wasn’t sure about my Medicare coverage or benefits.

I talked with the shop owner, and she asked for my Medicare card. She was going to call and verify coverage. While she was calling, she told me to look around the shop and see if I saw anything I liked. I explained I didn’t really need to do that since I’d been coming so long. I’d found, through years of trial and error, my favorite breast prostheses and bras. Smiling, I said, “I’ll just reorder the ones I’ve purchased in the past. That way it will be easier for both of us.” She pulled my folder from a file cabinet and verified the products I wanted, then went in the back to call Medicare. When she came out, I could tell by the look on her face the news wasn’t good.

Leaning over the counter, she told me in a soft voice that the coverage wasn’t great. Medicare was only going to pay fifty percent of the costs, and the remainder, over $500, would be out of pocket. Taken aback, I inhaled and said, “I can’t really afford that. We’re living on a fixed income – solely on Social Security.” She was kind and understanding. Closing my folder, she said, “Let me know if things change.”

When I got out to the car, I talked to my husband. Explaining the information I’d received, he was as disappointed in our coverage as I was. We didn’t understand why Medicare didn’t cover the products at 80% like our old insurance coverage. Wasn’t government care supposed to be better?

When I got home, I looked up some information on the internet and found some unexpected information. I knew, from past research, that the Women’s Health and Cancer Rights Act of 1998 provided protection for patients who’d chosen to have breast reconstruction surgery. It was also supposed to allow for treatments related to complications from mastectomy, like lymphedema, an unexpected side effect I suffered after having lymph nodes removed. The act supposedly had provisions for prostheses and bras, but according to information listed on the American Cancer Society’s website, the law didn’t include Medicare or Medicaid coverage.

Finding that information was frustrating. It felt like I was being punished for two things: for being an older adult under government health care coverage and for being a breast cancer survivor.

I guess 50% coverage is better than nothing, but when each silicone breast prosthesis costs between $400 and $600 and I needed two of them, that was a lot to come up with out of pocket. On top of that, each mastectomy bra was between $50 and $75 dollars! When you’re living on a fixed income, how can you justify spending that much money to look normal? I could buy several months’ worth of groceries for the same price.

Considering all that, I decided I’d make my old, wrinkly boobs last a little longer. At least they’d be hidden in my dingy, gray mastectomy bra from last year. And when they were no longer usable, I’d opt for another choice. I found several cheaper options online. Of course, those are not high-quality silicone prostheses with cooling gel backs, like my old ones, but they’d work in a pinch. They were made of molded foam and were able to be inserted into a mastectomy-type camisole that’d work just about as well as an expensive mastectomy bra. For one-fourth of the price of the silicone boobs and nice, pocketed mastectomy bras, I could look normal. And, if I felt I couldn’t fork out $100 a pop for a set of those, I could always resort to stuffing an old bra with polyester fiberfill.

Sometimes, I wish I’d gone the reconstruction route. At least that would have been a “once and done” kind of thing. But after seeing some of the results from that type of surgery and the abnormal appearance of the built-in breasts, I figured I’d be better off faking my femininity.

If you’re an older woman, like me, and need breast prostheses or mastectomy bras, you might want to check your Medicare coverage before heading to a shop for your purchases. Since I have a Medicare Advantage plan, my coverage may be a little different than those with standard Medicare parts A and B. I’m not sure. If you’re blessed to have company insurance, you may want to check that coverage, too. And if you haven’t read through the WHCRA, you may want to do it. Medical professionals don’t always know the ins and outs of the law. Remember, you must be your own advocate when it comes to health-related issues and especially those relating to breast cancer.

Navigating Medicare coverage for breast prostheses and mastectomy bras can be challenging, especially for those accustomed to private insurance benefits. Medicare often covers only 50% of these costs, leaving patients with significant out-of-pocket expenses. The Women's Health and Cancer Rights Act of 1998 does not extend to Medicare or Medicaid, complicating access to necessary post-mastectomy products. Patients must be proactive in understanding their coverage and exploring alternative options to manage costs. Advocacy and awareness of legal protections are crucial for breast cancer survivors relying on government healthcare.

Eleven years post diagnosis and issues related to breast cancer still frustrate me. 

Unexpected Challenges 11 Years After Breast Cancer

We were barely through with the first week of the New Year when the weather began to get ugly. Listening to weather reports, we were shocked to find we were in for the first snowfall of the year. In the South, we don’t get snow often, so when weathermen say, “Get ready!” we do.

We bought a load of firewood, gathered oil lamps and oil, made sure we had some charcoal on hand in case our power went out and we needed a cooking source. Over the years, we’ve weathered several ice storms and even a blizzard or two. Though those aren’t regular occurrences in our area, they do come, and when they do, people act crazy. They run to the store for bread and milk. They gas up their cars, just in case, and like us, many of them hunker down until the nasty, cold weather passes. But when it only snows here, it’s beautiful! Looking out the window at our yard covered in white is so peaceful and serene.

We weren’t expecting much snow, only a dusting, but instead we were surprised to get about 5 inches! Grabbing my coat, hat, gloves and cell phone, I practically shoved my husband outside to get a photo, but just as I was about to open the door, I realized my hair was a disheveled mess. I’d taken a shower the night before but had bed head, and that wouldn’t make for a good photo. Rushing into my closet, I pulled down a pink box. Inside it was a beautiful, natural hair wig I’d purchased right after learning of my cancer diagnosis. From talking with other breast cancer survivors, I knew, with my stage and grade of cancer, I’d probably be going through chemotherapy and more than likely would lose my hair. I could hardly imagine what I’d look like without hair but knew it wouldn’t be pretty. So, I bought the wig. But I never used it.

After my initial diagnosis, I did a ton of research on treatment options – both traditional and non-traditional. I didn’t want to subject my body to more trauma than was necessary, so I spent a lot of time deciding what I was willing to do. After I’d made my decision, I shared it with my oncologist. He wasn’t very pleased with my decision, but that didn’t matter to me. I had to do what I thought best; after all, it was my body.

I shook out the wig and affixed it to the top of my head as best I could. Since I’d never worn it before, I wasn’t quite sure how to make it stay in place but kept it semi-straight by plopping a knitted cap on top of it. My husband had already gone outside and was waiting for me. We’d planned a photo in front of our new house, and the backdrop of the winter scene was perfect. Placing my cell phone into the selfie stick, I took several shots, and then we were so cold, we ran back inside.

As I got ready to remove my winter attire, my husband said, “Is that a wig?” I laughed and replied in the affirmative. He asked where I got it and when, so I told him. He nodded and told me it looked nice.

I went into the bathroom to remove the wig and brush my real hair. Gently, I placed the wig back in its box for safekeeping, and as I did, I was overcome with emotion. I was grateful I’d never needed the wig while undergoing treatment but knew several friends who’d opted for chemo and had either chosen to go bald or use head wraps. A couple of them had quite a collection of wigs and would wear them often, but some of them looked so fake I didn’t know how they did it.

Putting the wig box up on the shelf in my closet, I noticed my prostheses. I kept them in their storage boxes when I wasn’t using them. Another wave of emotion hit. I couldn’t help but remember when I’d first gone for a fitting for breast forms. I was utterly embarrassed and even a little ashamed. When I got home from that first appointment, I cried and cried. First, I was angry that breast cancer had entered my body and then, I mourned the loss of my breasts. They were part of me and though they’d never been large, I liked them. To me, they were my femininity.

It took a few minutes to collect myself and that’s when I realized how far I’d come since those first days, weeks, and months after diagnosis. I’d gone through a range of emotions and had finally come to a place of acceptance. Facing reality has taken a long time and if I’m honest, there are still some difficult days for me.

Breast cancer is not only a physical journey but an emotional one. My first thoughts, after hearing I had cancer, were those of fear and trepidation. I had no idea how things would go as I began treatment. I felt so unsure of my future. The next emotion was frustration as I did my best to make myself look normal. Without breasts, I often felt like a fake and a failure. I was so hard on myself thinking I should be stronger than I was. It was difficult to process all the ways cancer was changing my life, but over time, I think I’ve gotten to the point of being able to say I’ve finally made peace with the situation.

That wig will stay in my closet until I choose to bring it out again. It’s a beautiful one – a silvery gray shoulder-length bob with bangs. It definitely is thicker than my thin hair and does make me look a few years younger than I actually do.

It might be nice to use the wig for special occasions. I should have worn it for my youngest daughter’s wedding last year, but I’d forgotten all about it. I’m sure I would have looked 100% better in the professional photos if I’d had it on, but the pictures turned out nice anyway.

Coping with emotions before, during, and after breast cancer is challenging. People deal with emotional turmoil in different ways. What I learned is that I had to take one emotion at a time and work through it. As I did, I realized many things about myself – that I was resilient, strong, determined, and eventually optimistic about my future.

Wearing the wig outside for the snow photo this morning was fun! None of the neighbors were out, so they didn’t know I was wearing a wig under my hat. What I should have done is grab both the wig and the hat and thrown them into the air at the same time with an expression of glee on my face (just like Mary Tyler Moore used to do at the beginning of her television show –although she only threw a hat, not a wig.) And after tossing those into the air, I should have plopped down in the snow and made a snow angel. I haven’t done that since I was a kid, but I was afraid I’d managed to get down there I might not have been able to get back up. I’m a whole lot older now, and my bones and joints don’t always want to do what I tell them to do.

A diagnosis of breast cancer is traumatic, challenging, frightening, and often unexpected. There’s no real way to prepare for a possible “what if,” so I’d like to give one piece of advice as an 11-year survivor – give yourself grace. That’s the only way I’ve managed to get through each day. And it’s important to do things your way. If you want to buy a wig, do it! If you don’t, don’t. It’s okay. It really is okay.

Breast cancer is a multifaceted journey, encompassing both physical and emotional challenges. The narrative highlights the personal experience of a breast cancer survivor who navigated treatment decisions, emotional turmoil, and self-acceptance. The survivor chose a non-traditional treatment path, valuing personal autonomy over medical advice. The story underscores the importance of self-compassion and individual choice in coping with cancer's impact. The symbolic use of a wig reflects the survivor's journey towards acceptance and resilience, emphasizing the significance of personal agency and grace in overcoming adversity.

Cancer memories often sneak up on me when I least expect them to. 

Snow, A Wig, and Memories After My Breast Cancer Diagnosis

I don't know when my love of art began, but I would have to say more than likely it was when I was in elementary school. When I opened my first box of Crayola crayons and saw the myriads of colors, I was astounded. They were so pretty! Immediately, I took a piece of paper and began to draw. As I worked, I felt peaceful watching the colors glide across the paper. Not only was I being productive, but I was learning the power of creativity to express myself.

As I grew older, I began to dabble in other mediums — acrylic paints, oil paints, mixed media, assemblage, and other artistic materials. Though I've never had a formal class, I've taught myself various techniques by watching others, watching YouTube videos, and experimenting on my own. As I watched, I learned what I liked and disliked. What I found surprised me. Of course, realistic art impressed me, but abstract art did, too. I loved that each piece of art conveyed a message. I wanted mine to do that, too.

When I was diagnosed with cancer, I found art to be wonderful therapy. Picking up a brush and wielding it against a canvas, I could express myself freely. Some days I painted realistically, and other days I painted abstractly. My mood dictated the technique for the day. Friends and family members soon became recipients of my art. Often, they would exclaim they had received a clear vision of how I was feeling from my work. Happy days were normally filled with brilliant colors, while sad days were dark and moody.

I entered several art contests in our community and won prizes for my work. One of my paintings was even selected to be used in a cancer magazine, and I was so proud. I wanted my work to speak to the lives of other women going through breast cancer.

Though I still paint, I find myself writing more than ever. It has been a very cathartic release since my diagnosis. I've had the honor of writing for several publications focusing on cancer in women. As I've written, I've tried to give a very clear picture of my breast cancer journey. I haven't wanted to sugarcoat anything, but I haven't wanted to scare anyone to death either.

Over the years, I've found many cancer publications choose to paint a breast cancer journey in a very positive light. While I understand they want to give patients with cancer hope, I also feel it's important to share the negative aspects of the disease. Real life isn’t always easy, and it should never be portrayed as such, especially regarding health issues.

Artists use both positive and negative spaces in their paintings. These different values can help draw the eye to a specific point in a work of art. Without the negatives, the positives don't shine. I feel it's the same when survivors paint their experiences with breast cancer.

If I were using art to explain where I am on my cancer journey today, you’d see a canvas filled with muted tones. There would be no dark spaces and no bright-colored spaces. Instead, there would be soft, gentle tones blended abstractly. The reason I feel this way is because I’ve finally come to a point of acceptance along my breast cancer journey.

In March, I will be returning to the cancer treatment center for an annual checkup. No longer do I go to my appointment with fear and dread. I am expecting the visit to be routine, thus the muted tones. In the past, if I were to paint a piece of art to portray the beginning of my journey, it would be splattered with dark blobs overshadowing bright colors. The dark would overpower the light, but not so now.

As a breast cancer survivor, I don’t think I can give an accurate representation of my life if I don't let others see what I’m feeling. The only way they can do that is to stand before my canvas, study it, and come to their own interpretation.

Beauty is in the eye of the beholder and though there have been many dark, depressing days along my cancer path, there have been glorious days as well.

I have a canvas on my easel right now and have been working on it for days. Though it’s been cold and dreary outside, I’m not feeling that way on the inside. As I lift my brush to the canvas, wet paint slides easily. I feel powerful as I carefully place each stroke. No longer do I work on a painting for hours at a time and finish it; instead, I work in quick increments and then step away to reassess. I think that's the same thing we have to do with our lives, especially after having been diagnosed with cancer. It’s important to experience, feel, understand, and accept our lives much in the same way an art connoisseur would do.

Cancer is not a clear black-and-white picture. In the beginning, it's often a muddled mess, but as days go by, and feelings change and grow, a clearer picture often presents itself.

The muted tones of my life and my canvas have melded together over the years. I've watched gentle, soft greens push into heavenly shades of blue. I've watched rosy pinks wade into majestic purples. It’s been interesting to see my work evolve, just as my outlook toward breast cancer has over the years. No longer does it possess the power it once had over me. Now I wield the brush and paint what I want others to see.

I read somewhere that our purpose is to leave the world a better place than when we found it. For me, leaving a true and accurate picture of my life as a survivor is one of the best ways to do that. More importantly, I want my life’s work to convey a very specific message — that fear loses power in the face of someone who’s known courage. Cancer forced me to be courageous. I never expected that to happen, but perhaps that’s part of the masterpiece breast cancer created in me.

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Art has been a therapeutic outlet for a breast cancer survivor, allowing her to express emotions and experiences through various mediums. Initially captivated by colors in childhood, she explored different artistic techniques, finding solace in painting during her cancer journey. Her work, reflecting her emotional state, has been recognized in contests and publications. Writing has also become a cathartic release, offering an honest portrayal of her cancer experience. Acceptance has brought a sense of peace, with her art now embodying muted tones, symbolizing her journey's evolution and newfound courage.

As a breast cancer survivor, I feel it is incumbent upon me to give an accurate picture of cancer to others, particularly newly diagnosed patients. 

Bonnie Annis

Lymphedema Makes Summer Preparations Challenging After Breast Cancer

Unexpected Challenges 11 Years After Breast Cancer

Snow, A Wig, and Memories After My Breast Cancer Diagnosis

Painting an Accurate Portrait of Breast Cancer Survivorship

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