Felicia Mitchell, retired from college teaching, is a poet and writer who makes her home in southwestern Virginia. She is a survivor of stage 2b HER2-positive breast cancer diagnosed in 2010. Website: 

Felicia Mitchell

Felicia Mitchell is a survivor of stage 2b HER2-positive breast cancer diagnosed in 2010. Catch up on all 

A message I recently received from my personal health portal rubbed me the wrong way. I do not know if it came from a robot with a name or a human with a robot-like personality, but I wrote back that I, a breast cancer survivor, was never delinquent in scheduling annual mammograms.

The message began, “Hi Felicia, Breast cancer screenings save lives! If you're due for a mammogram, you can schedule it quickly and easily right through MyChart. If you've already had your mammogram this year, please let us know or upload a copy to MyChart so we can keep your record up to date.”

It continued: “This message was sent as part of a routine outreach to help keep you on track with preventive care. If you have any questions or concerns, feel free to reply to this message — we’re here to help! Thank you for taking care of your health.”

“Thank you for taking care of your health” can be a good reminder. It can also sound passive-aggressive, as in, “You are not taking care of your health and need to try harder.” How much harder can I try? My annual mammogram is scheduled (the order transparent in MyChart). I received a mammogram (MyChart showing results) in December.

Feedback can educate bots and/or humans, so write back when inspired. I wrote, “You can see in [health provider] and MyChart that I had a mammogram. I am a cancer survivor and would not miss one. Please fix your system. Thanks!” The response was short but sweet: “This has been fixed.” Good!

If I were sending an automated message regarding the value of mammograms, though, this is what I would say: “Breast cancer screenings can save lives! We hope you have scheduled or completed your annual mammogram. This message is being shared as part of a routine outreach. If you have any questions or concerns, feel free to reply to this message — we’re here to help! Thank you for taking care of your health.”

Notice how I delete “to help keep you on track with preventive care.” Imagine somebody just diagnosed with breast cancer receiving the breezy message from a bot/human that does not know the recipient’s current situation. Plus, a mammogram can be preventive but can also be diagnostic, initiating an arduous cancer journey. Additionally, “save” and “can save” have two very different meanings. Mammograms do save lives, but not always.

Despite that clumsy message, MyChart is a handy resource. I also recommend following advice from Breastcancer.org: “Keep copies of all your test results. As you receive each new test result, it’s a good idea to get into the habit of saving your own copy. Develop a system that works for you for saving a complete set of all your test results and medical records in one place, whether that’s a digital folder or a file on a shelf. Having your own complete set of records can make managing your care easier, including getting second opinions and applying for a clinical trial.”

A personal medical portal, or patient portal, can be a useful tool. Remember, though, that you, the consumer, can always provide feedback if it needs some tweaking. What would you like a mammogram reminder to look like?

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Articles

The message from a personal health portal about mammogram scheduling was perceived as passive-aggressive by a breast cancer survivor. The recipient, who had already scheduled and completed her mammogram, responded to correct the system. The article emphasizes the importance of feedback to improve automated messages and suggests a more sensitive approach to communication. It highlights the dual role of mammograms in both prevention and diagnosis. Additionally, it underscores the value of maintaining personal medical records and encourages feedback to enhance patient portals.

I reflect on how a generic mammogram reminder overlooked my experience as a breast cancer survivor and how thoughtful messaging could make a difference.

How Mammogram Reminders Can Be More Thoughtful Following Breast Cancer

Felicia Mitchell is a survivor of stage 2b HER2-positive breast cancer diagnosed in 2010. Catch up on all of 

I am not sure if it is because I added a scoop of caffeinated coffee to my two decaffeinated scoops or if I am trying to distract myself. Likely it is a combination of both. Plus, it is spring. Spring cleaning happens. As a breast cancer survivor facing a series of tests to explore an unexpected change in my body, I have never cleaned as much as I have these past few weeks.

Scanxiety, while something survivors experience, is not what has preoccupied me most. In fact, after one of the scans, I let go of some anxiety about whatever will unfold, ordinary or not, with the process of exploring what is up with this medical glitch. Bring the scans on! They will give me clarity of mind and let me (or doctors) fix anything that needs to be fixed, if something needs to be fixed, or just let what is happening go for the time being.

Life after cancer truly is a joy. To be realistic, though, it comes with some challenges to be mindful of side effects of treatment, potential side effects of treatment, potential metastases, new developments, etc. While I have gotten pretty good about taking some of the emotions of surviving cancer in stride, I am a mere mortal. As much as I try to be positive, I have my moments.

With the current situation, before I jumped into spring cleaning with the energy of a person bound and determined to leave no corner cluttered, I did what we tend to do these days. I turned to Internet searches, including exchanges with artificial intelligence, as if I could find a clue there before my scans let me know the truth. I fell deep into the “what if” water. It could be this? It could be that? It could be anything, good or bad or in between.

The second stage was to spend less time on Internet searches and more time feeling upbeat and positive. I said to myself, “Well, you have been given an extra 15 years. Imagine that! You have lived a good life.” While contemplating a worst-case scenario, which probably happens to people who have never had cancer too, I began to feel serene, as if I was getting the emotional reaction over with before knowing I needed to have one.

The third stage was to feel at peace with whatever might come, even if that meant a return to the cancer center that I had just graduated from. Knowing the cancer center from front to back, I knew I could manage anything else I would ever have to manage, if I had to. This would not be, as they say, my first rodeo. I would be an old hand at whatever came. If it came. And would it? Most probably not. Still, when we are waiting for scans to unfold and share the appropriate information, our minds can go anywhere, even there (and by “there,” I mean “the end”).

Fortunately, between scans, I have moved to my favorite stage, the one in which I clean obsessively. One day I sawed up a large branch that smashed a dog pen. The next day I figured out how to dismantle the pen, bolt by bolt, pole by pole, to cart it to the recycling bin (all by myself) the same afternoon. I looked around the house. What next? The sunroom came first. Now my study is neater than ever. I am also a little embarrassed to admit I organized a few family heirlooms to pass down.

Meanwhile, I wait for the next scan, the one that will assure me that all is well, or not, whatever comes. Knowing I am in good company with other survivors who understand makes it all easier.

For more news on cancer updates, research and education,

don’t forget to subscribe to CURE®’s newsletters here.

Facing the uncertainty of potential cancer recurrence, a breast cancer survivor navigates the emotional landscape of "scanxiety" with a mix of proactive distraction and acceptance. While initially consumed by internet searches and "what if" scenarios, she transitions to a more positive outlook, appreciating the life she has lived. Embracing peace with whatever outcome may arise, she channels her energy into spring cleaning, finding solace in the process. The support of fellow survivors provides comfort as she awaits clarity from upcoming medical scans.

Survivors facing new medical concerns may fear the unknown, but perseverance is possible as they navigate unexpected challenges in their new normal.

Surviving Scans While Surviving Breast Cancer

An image that comes to mind when I think of my brother, John Henry, in his last days with Hodgkin’s lymphoma, is of him in his baseball cap; his hair was mostly gone, and his face and lips were swollen. There is no photograph, but the mind records what it records. This image has competed with childhood memories and photos taken before cancer ravaged his body. Now, since seeing a Polaroid taken not quite five months before he passed away, I have a new image residing in my head.

I wish I could say that this is a photo of him celebrating his last Christmas with us on a day that was one of the best holidays my parents orchestrated for their four children. I wish it were a photograph of him with classmates when he went camping on the South Carolina coast for the first and last time, loving his field trip with a biology class while recognizing he was not on this earth for long. I wish I could say it was taken by a friend one night when he went out to the movies for the last time. But there are no photos of these occasions.

John Henry lived a long time ago, before cell phones could easily document every move for a photo app or Facebook. Whereas I documented my cancer journey with photographs pre- and post-mastectomy, photographs of hair lost and hair found, and even photographs of pink socks on feet peeking out of a warm blanket given to me in the chemo infusion chair, John Henry did not document his journey, though we had cameras in the house. (We had tape recorders! Why did I not sit down and record him speaking some of his old-soul wisdom?)

Even when his face was swollen almost past recognition, John Henry went to class at the University of South Carolina. That biology class was his one last thread attaching him to the normalcy he sought when he was given a terminal diagnosis at 19 years old while serving in the Navy. I understand his lack of vanity, his zest for life. I still wonder about who was in that class and what lessons they all learned about resilience and hope from my brother. Did at least one of the students go on to medical school and study how to treat (or cure) cancer?

But before John Henry lost his hair, before his disease almost completely ravaged his body, he was what we would recognize as a handsome young man. His hair was jet black, like our father’s before he was bald. He had bushy eyebrows — a family feature. He came into his prime as a young adult in the 1970s, growing his hair out before it fell out because he had always wanted to. It never got a chance to get long, but it got shaggy. And he wore a mustache and beard.

The Polaroid another brother recently shared with me is a candid shot of John Henry with the ambience of a painting by Lucien Freud. He is reclining against our yellow hand-me-down couch, a red throw of patchwork plaids behind his back where he spent so much time, resting there. The curtains are drawn on the picture window, the outside world obscured. Wearing a blue checked flannel shirt and jeans, clothes that are by now a little loose on him, John Henry sits, sunglasses on his lap as if he just came in from outside.

And his hands. You can see both hands well, including the right hand that fed me my bottle years before, held tools for tinkering on his car, and later held our mother’s hand as he died. Strapped to his left wrist is a watch he bought when he joined the Navy, a diver’s watch my son refurbished and wears on special occasions. You can see his neck, which is a little swollen. You see his pallor. Most of all, though, you see those hazel eyes staring out at you above a patrician nose, just looking at you across the decades from a deep mortal space.

John Henry is not smiling, but he is not frowning, and these hazel eyes do everything to illustrate the notion that eyes are the window to the soul. I know I can see right into John Henry’s soul with this Polaroid, everything I never learned about what cancer meant to him revealed in this moment in time on a Polaroid on which our father wrote on the back, “John H., Dec. 11, 1975.”

The narrative reflects on the poignant memories of John Henry, a young man who battled Hodgkin’s lymphoma. Despite the lack of photographic documentation, vivid mental images capture his journey, resilience, and the impact of his illness. A recently discovered Polaroid offers a glimpse into his life, revealing his essence and the profound effect of cancer on his existence. The story underscores the importance of preserving memories and the enduring influence of those who face terminal illness with courage and dignity.

Years after losing my brother to Hodgkin’s lymphoma, I learned something about how he felt facing a terminal diagnosis by studying an old Polaroid. 

A Picture is Worth Ten Thousand Words When it Comes to Cancer

My relationship with lymphedema has been more complicated than my relationship with the mastectomy. While I am less stressed about managing lymphedema than I was when first diagnosed during cancer treatment, it has made me more self-conscious than having only one breast.

I should not complain. My lymphedema, despite the occasional lapse as with some overuse last summer and a bad weather moment the other day, is well managed. I have even over the years learned to let myself be seen in sleeveless shirts now and then, especially when I need to take off an overshirt on a hot summer day’s hike (but then I put it back on to avoid too much sun). I am who I am.

The other day, however, I experienced some self-pity when I had to scrape ice and snow from the car in 11-degree weather to get to a doctor’s appointment. My poor right hand grew numb immediately, despite gloves, so I got in the car and held it until it warmed up so I could get back out and finish scraping with only my left hand. Sitting in the car after that, I burst into tears.

Later in the day, feeling vulnerable, I decided to spend an hour in an antique barn I sometimes wander through to clear my head. Not a big shopper, I may buy gifts such as a children’s book published in 1945 or a tiny painted vase or a trinket to adorn a knitting project. Some days I just meander, lost in thought in this museum of the past.

Checking the jewelry cabinet for a pin that might complement a knitted cap, I found myself coveting a bracelet I had looked at many times and passed over. I am at an age when I do not need more jewelry and in fact donated the bulk of superfluous pieces to a charity thrift store. I do not need bracelets either because, if I want to wear one for a special occasion, I have a few that belonged to my mother.

This bracelet I had looked at many times was a scarab bracelet, something I wanted when I was a young woman but could not afford. Staring at it in mental recovery from the morning’s minor ordeal, I asked the clerk if I could try it on. I tried it on. Even though it cost $30, I could have spent it on something practical or a gift for somebody else, I bought it to give to myself for my 69th birthday. Of course, I Googled it too to see if $30 was reasonable; it was more than reasonable.

As soon as I got home, though, I realized that the bracelet would easily fall off my left hand, the hand that I always use for bracelets. No worries, I thought, going through a mental list of people I could give the bracelet to. Or I could donate it to a charity white elephant sale. Then I had a thought. The bracelet was so pretty. What if I tried it on my right and bigger wrist?

It fit like a glove on my lymphedema limb, though loose enough not to impede any lymph flow. So now, wearing it, I bask in the glow of something pretty to remind me of a silver lining I never wanted. When the beautiful scarab stones rest on my hand, I see them and not a hand that is impaired. I see a hand I have treated like a nagging reminder of cancer being honored with something beautiful. I begin to understand why some cancer survivors want tattoos.

My scarab bracelet goes with everything: jeans, leggings, whatever I put on, because it goes best with lymphedema. Best $30 for retail therapy I ever spent.

The narrative explores the emotional journey of living with lymphedema post-mastectomy, highlighting the complexities of self-image and acceptance. Despite managing the condition well, moments of vulnerability persist, as illustrated by a challenging winter day. A visit to an antique store leads to the purchase of a scarab bracelet, symbolizing self-compassion and acceptance. The bracelet, fitting perfectly on the affected limb, transforms a reminder of cancer into a source of beauty and empowerment, illustrating the therapeutic power of self-gifting and the importance of finding silver linings.

Buying a pretty bracelet was healing because it let me look at my lymphedema in a new light. 

Felicia Mitchell

How Mammogram Reminders Can Be More Thoughtful Following Breast Cancer

Surviving Scans While Surviving Breast Cancer

A Picture is Worth Ten Thousand Words When it Comes to Cancer

Treating Lymphedema with a Simple Trinket

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