Nov. 3, 2022

Day 146: Covid Ruins Everything Again

Day 146: Covid Ruins Everything Again

After Natasha and friends travel to Mexico to celebrate the end of chemo, it’s her turn to catch COVID which delays her lumpectomy surgery for a week. Her nerves are shot from constant fear of the unknown.

After Natasha and friends travel to Mexico to celebrate the end of chemo, it’s her turn to catch COVID which delays her lumpectomy surgery for a week. Her nerves are shot from constant fear of the unknown. Because there’s nothing visible on her most recent mammogram, she worries they’ll find all kinds of horrors during surgery and with chemo behind her she’s scared the tumor will grow back.


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About Breast Cancer Stories

Breast Cancer Stories follows Natasha Curry, a palliative care nurse practitioner at San Francisco General Hospital, through her experience of going from being a nurse to a patient after being diagnosed with breast cancer.

Natasha was in Malawi on a Doctors Without Borders mission in 2021 when her husband of 25 years announced in a text message that he was leaving. She returned home, fell into bed for a few weeks, and eventually pulled herself together and went back to work. A few months later when she discovered an almond-sized lump in her armpit, she did everything she tells her patients not to do and dismissed it, or wrote it off as a “fat lump."

Months went by before Natasha finally got a mammogram, but radiology saw nothing in either breast. It was the armpit lump that caught their attention. Next step was an ultrasound, where the lump was clearly visible. One painful biopsy later, Natasha found out she had cancer; in one life-changing moment, the nurse became the patient.

This podcast is about what happens when you have breast cancer, told in real time.

Host and Executive Producer: Eva Sheie
Co-Host: Kristen Vengler
Editor and Audio Engineer: Daniel Croeser
Theme Music: Them Highs and Lows, Bird of Figment
Production Assistant: Mary Ellen Clarkson
Cover Art Designer: Shawn Hiatt

Breast Cancer Stories is a production of The Axis.



Kristen (00:03): I'm Kristin Vengler and our mission with this podcast is to help you and the people who love you through the shock of diagnosis and treatment.

Eva (00:11): I'm Eva Sheie, and the incredible woman whose story you're about to hear is a nurse practitioner in San Francisco who has dedicated her life to caring for patients more vulnerable than you can imagine.

Kristen (00:23): Her name is Natasha. This is a story about what happens when you have breast cancer, told in real time.

(00:34): So Natasha.

Natasha (00:36): Yes. Time has come.

Kristen (00:40): I'm already choking up.

(00:44): How are you, honey?

Natasha (00:46): I was just telling Eva, I've been packing my hospital bag, but I really don't know what should be in it because I'm only going to be there for a few hours. But they give this list and I think most of the information they give is for people getting a full mastectomy. So people expecting to stay overnight, which I'm not. They think I should just... It's an hour and a half surgery if everything goes to plan, and then somebody will pick me up. But it's a long day. They have to do a lot of things I don't really understand, mapping of the sentinel lymph node and then putting in another seed where the biopsy clip is, because the biopsy clip doesn't show up on whatever instrumentation they're using in surgery.

(01:30): So although my surgery is not till about two, I have to be there at seven in the morning for various bits and pieces of things. I'm not quite sure, it's hard to follow. So they think I should be done by 3:30 or 4:00, which is good. Yeah.

Kristen (01:49): So you should be recovered and home by seven?

Natasha (01:54): At the latest, yeah.

Kristen (01:55): At the latest, yeah. So 24 hours from now.

Natasha (01:59): Wow, that's so weird. I should be home. And it's so funny, the one thing I'm stressing about is a nurse telling me that I cannot sleep on my side or my tummy, I have to sleep on my back. And I'm a tummy sleeper, and I've been practicing with big pillows and various other things, but I'm sure I'll end up, I mean, there's no question I'm going to end up on my tummy at some point. And she's like, "Yeah, you could get a big bruise and it's really not good." And the one thing she did say that made me realize maybe it won't be that hard, she's like, "It's going to hurt if you lie on your tummy. So you may just lie over on your tummy for a second and then come back."

Kristen (02:39): Yeah.

Natasha (02:40): How long was your arm still just working at 90 degrees? Do you remember how long until you actually had full range of motion?

Kristen (02:49): I'm still getting there, now. I've had three surgeries. Probably get a referral to some lymphedema PT, even though you won't have lymphedema, because they really do help. And I think she's right. If you think about, if you're sleeping on your stomach, you're going to have a big old hematoma sitting in there. Right? As far as your bag. Slippers, a shirt that opens to the front, I took a glasses case, water. Just while you're waiting. And make sure your phone is charged, you might want to take a charger.

Natasha (03:27): Oh, that's a good idea. Yeah.

Kristen (03:30): We talked to you about five days after your last chemo. It was kind of going well.

Natasha (03:34): Yeah.

Kristen (03:36): And how did it finish up? Did you finish on a feeling okay, after the last chemo?

Natasha (03:41): Yeah, I mean, it just sort of petered out. Cycle six, there was the usual low-lying nausea, but I was so happy that it was over that I think any side effects, I just downplayed. I thought I would bounce back quicker from it. And I was still really tired. I still am. And my taste buds still haven't really come back. But I'm definitely putting some weight on. I'm eating more. It's nice not to have that, now I'm more weeks out, not to have that constant nausea. And the heartburn. It's really, really nice, and just the days are more predictable. It's like, yeah, I'm going to be tired and I'm still not going out that much. I like to be in bed by 9:30 or 10:00.

(04:30): And then, I think what triggered some of the emotion about having the surgery came from their question of, who's going to pick you up? And I didn't have, because as we've talked, my husband took off. I have a lot of great friends, but there was nobody immediately that I could say, "Oh yes, my partner will be there to pick me up." And it made me really sad. Even though, again, I have a great crew of people and I have a backup for pickup. But it was just a reminder of, I've mostly gone through this on my own. And some concern about coming home, I know I want to come home after surgery. I don't want... A lot of people have offered come and stay at my place, and I just think I'm just going to want to be in my own bed.

Kristen (05:25): You are.

Natasha (05:27): But today I've been stuffing in the fridge with food and just things of, I have an 80 pound dog, that I'm going to need some help walking the dog.

Kristen (05:38): Absolutely.

Natasha (05:39): The garbage cans need collecting Monday, and I'm not going to be able to bring them in because I'm very right-hand dominant. And this is right-handed surgery. So asking people, can somebody come and bring the garbage in? And then just having worked in surgery, I was a first assist for a few years. It's not the sort of sacrosanct, super serious environment that most people anticipate. I don't know if you remember, there was about a year ago, this scandal, somebody put on YouTube or whatever, a bunch of people dancing for someone's birthday in the OR, or something like that. And people were horrified. "They're supposed to be doing surgery. Why are people...?" People dance in the OR, people tell stories.

(06:31): It's a Monday surgery. Everyone's going to be talking about what they did at the weekend, which is great in a way because the surgeons have done so many of these surgeries that it's like ironing a shirt. I can talk while I iron a shirt. But I'm also pretty aware that, I've met my surgeon and my plastic surgeon. But I'm at a teaching hospital and I doubt very, very much if either of them will be... They'll be in my surgery and they'll be overseeing it, but they're not going to be doing my surgery. That'll be most likely a resident. So that feels a little weird.

Kristen (07:09): Yeah, we talked about that. We talked about how you almost know too much.

Natasha (07:14): Right.

Kristen (07:15): And it being a teaching hospital. Did you ever get to talk to your surgeon about that concern or anything like that? Or was it just not an option?

Natasha (07:22): It's not really an option. I know that's what you get when you sign up for a teaching hospital. And I have every confidence in the fact that the surgeon will be overseeing it. And the plastic surgeon. (Dog barking) Is that my dog?

Kristen (07:39): I think so. Hi Pippa! Mine is much more high pitched and he's not here.

Natasha (07:46): And also another thing that has been making me really nervous is the unknown. If I read on the mammogram that I had a four centimeter mass and I knew where it was and I knew that they were going to take that out, it would feel very different. But now it's, everything I read is, "No residual mass. No this, no that." So A, I'm thrilled that that's the result. B, is that going to be the result when I come out of surgery? Are they going to find all kinds of horrors once they get in there and see? So I don't really understand why I'm having surgery. I don't know how much I can control.

Kristen (08:32): That's okay. Dogs are part of it.

Natasha (08:35): She's very much part of it. Yeah.

Kristen (08:37): It's just part of life. It's just part of life.

Natasha (08:40): Yeah. Just the unknown of, I don't know what I'll wake up to. Whereas I feel like if there was a mass, a very identifiable mass and I woke up and they said, "We got it and we got clean margins," I'd be like, yay. But I'm not quite sure what they're fishing around for.

Kristen (09:00): And I think we talked about that was part of your rationale for, well maybe I don't even need surgery. There's nothing there anymore. We got it all. And I probably made the crude analogy of the lunch meat that you're not sure if it's expired or not, and you don't know if it's bad or what's really in there until you open it. And so as a kind of the veteran breast cancer girl over here, because I'm a year ahead of you, maybe, I felt very protective when we talked of you. And just wanted you to have the peace of mind that they looked and they saw and you kicked this. And it's done. As opposed to looking at the MRI to know that, because you haven't opened it and seen it. And so we reframed it, didn't we?

Natasha (09:52): We did. I'm actually just having a rather large biopsy, which is so much... Yeah,

Kristen (09:58): It's a fancy biopsy.

Natasha (10:00): It's a fancy biopsy, and I'll get a nice nap at the same time.

Kristen (10:03): Right, exactly. And you get a lot of attention afterward and you don't have to do anything. And going back a little bit to what you were talking about with taking out the trash and all of that. You are very similar to me and you're not one to ask for help. You're extremely self-sufficient. You didn't have a husband who doted and spoiled and took care of every nook and cranny anyhow.

Natasha (10:29): Right. I've been wondering, and there's two people vying for picking me up tomorrow, whether I actually just want to come upstairs, go to bed and say "Thank you." I don't know that I really want somebody to stay. And the hospital's been pretty clear. It's like, no, "we would really like somebody." And it's like, but I don't want fussing over. Because I think anesthesia kind of makes me a little emotional. I have no issue crying in front of everybody. I just don't want to drag it out. I mean, it's so funny. On one hand I'm saying, "Moo, there's nobody to take care of me." And on the other hand it's like, actually I really don't want somebody there. It's odd.

Kristen (11:12): Well you want somebody to do the things that a caretaker would do, and then leave you the fuck alone.

Natasha (11:17): Exactly. Exactly. Don't sit on the edge of my bed and ask me how I'm doing every 10 minutes, because I'll kill you.

Kristen (11:24): Right. And it's okay. It's really okay for you to say, "I know I'm not going to want to talk to anybody. I'm probably going to be very aloof, also emotional. So can you just do me a favor and check in with me every once in a while, get me some water, make sure I've taken my meds and that I'm still alive. But don't even tell me you're doing those things."

Natasha (11:47): Yeah.

Kristen (11:48): I totally get it. I am going to sound like a mom on this or the nurse, that I think it is important for somebody to be there that first 24 hours, afterward. Just, I'm sure everything's going to be fine, but just somebody to stay the night with you. Just to-

Natasha (12:04): I think that's... Yeah. And my hope, and what I've been told is because the lumpectomy is such a smaller, surgery that I should be up and walking by the next day. And they're like, "Yeah, we want you to be walking as much as you can." And as far as pain meds, they're just relying on Tylenol and Ibuprofen. There's no nothing stronger. Initially I was like, "That's not fair. Where's my Vicodin?" But I was like, Wait a minute, if that's really all that I need, then actually, that's good. I don't need the constipation from the... And I get super itchy from Vicodin and Norco. It's weird.

Kristen (12:43): Something that helped me that you might consider is Robaxin, to help with the muscles that were just a little pissed off. And also it might help you to sleep a little bit better on your back or your side. That's just if they happen to give it to you. And that's a great sign that you're relying on over the counter painkillers.

Natasha (13:02): Right. Exactly.

Kristen (13:02): That's amazing.

Natasha (13:03): Yeah. I mean it goes back to your reframing of this just being a bigger biopsy.

Kristin (13:08): The fancy biopsy.

Natasha (13:10): So far, one of the most painful things I've had was the port placement. And the next day it was all kind of, everything felt better, so.

Kristen (13:19): That's a quick question that I had for you is, so you still have the infusions for the HER2 positive, right? The HER2 positive. And so you are still keeping the port in. I mean, you could take it out right now and have the infusion in your arm if you really wanted to. Or is it better to just have the port? I'm just curious.

Natasha (13:39): I mean, I could take it out just, now that I'm just doing the two hormone blockers. It makes the day so much faster. I mean, it goes back to the same. And I'm used to it. It doesn't hurt anymore. I did learn that it's possible to play with a port and you can flip it.

Kristen (13:56): That's what I remember Dr. Fritz saying.

Natasha (13:59): That's right. I was listening to that again. And I was like, ooh. So it is fun to play with and I'm trying desperately not to flip it.

Kristen (14:07): That's so funny. Mine was so tight in there that I didn't. But no, so I figured you were keeping it in.

Natasha (14:13): And I'll have an infusion two days after surgery and I checked with my oncologist. I'm like, "Is this okay to come in two days after surgery?" And she's like, "Absolutely." So everything I'm hearing is setting me up for a pretty straightforward recovery. I have this thing in my mind, and I worked with a surgeon a bunch of years ago in GYN oncology, and he used to refer to surgery as being rude. It's like it's so rude to just cut into people. And it was his sort of cute way of explaining the intimacy that you have with your patients. But I still think now it's like, it is rude. They're going to put me to sleep, they're going to have a knife and then they're going to cut me?

Kristen (14:53): Okay, Dexter.

Natasha (14:54): It's rude.

Kristen (14:56): I know, I know, it is. Yeah. Wow. I wanted to go back for a second and take you back to just after your chemo finished. Cause you had a little adventure in another country.

Natasha (15:11): Oh, that's right.

Kristen (15:11): And they came back with another little adventure, little passenger.

Natasha (15:14): Yes, I did. So with a couple of girlfriends to celebrate the end of my chemo, we decided to go to Mexico City. There was a friend living there. There were three of us. It's a great city. I mean, the weather wasn't amazing, but it was just such a walkable city. There's all these parks that hook up with each other, so you can just sort of walk through park for ages. Really good street food. We were walking in a park one night and suddenly there's this tango performance in a raised band shell. I mean it was all very magical. And then we decided one night we absolutely had to go to the Mexican wrestling event, the Lucha Libre, it was called.

Kristen (16:00): Lucha Libre. Was it with the masks?

Natasha (16:01): With the masks. The whole thing. And so it's indoors, there's a bunch of people screaming and yelling. And it seemed like a very cult thing. Everybody seemed to know the fighters and they had these nicknames they were calling them. And I can remember in that thinking, this feels like a real COVID event. And I kept pulling my mask up, but it would come down and nobody else was wearing a mask. And no, on the plane, on the way home, I was freezing, freezing cold. And I got home and I got the sweats. And lo and behold, I had the COVID. Oh. And so did one other person I was traveling with. And my fever got really quite high. I was up to 103 at one point.

(16:50): And so I know what they tell you from the infusion center is anything over 100.4. So I called the hospital and got the triage nurse. And at one point they wanted to admit me overnight for observation. And I was like, what are you going to do? Really, let's not waste a bed for somebody who really needs it. And I also know I hate sleeping in hospitals. I hate getting woken up to have my vital signs taken. I just needed some really good nights' sleep. But they started me on the Paxlovid, the antiviral, because I was high risk. And I had a couple of days of feeling pretty crummy, and then turned it around pretty quickly. But it pushed my surgery out a week. I should be done by now. But they wanted me 21 days clear. So I've been very careful this weekend, I was like, "do not..." Yeah.

Kristen (17:41): Did you have to have a COVID test yesterday?

Natasha (17:44): No, because they know it could test positive, because I'm still recovering.

Kristen (17:48): Got it.

Natasha (17:49): Yeah. So even, actually my first infusion without chemo, so my first just hormone blocker infusion, they had me in a private room. Everybody had the hazmat suits on, even though I tested negative, they still... So I think they're being very careful, which is great. And I have friends tonight who are like, "Come out with us. Let's celebrate your night before surgery." I'm like, "A, I don't think we should celebrate the night before surgery. I'm not sure. Going out on a bender is a great idea."

(18:19): But it feels, I don't know if you had this, it feels a little weird and a little vulnerable not getting chemo anymore. Not that I would ever want more chemo. And I don't take the hormone blockers as treatment as seriously as maybe I should. But I was like, what if everything's growing now I'm not on chemo? And what if it's all changed? And one of the nurses was like, "Wait till you're done completely and we send you off and we say, see you in three months." She's like, people freak out.

Kristen (18:52): Oh yeah. Big time. Well, not that radiation is a blessing, but I think part of it too is the control. So you still maybe have radiation, is that right?

Natasha (19:03): I'm assuming so.

Kristen (19:04): Okay. So you'll find out more after the surgery, after they look and see what's going on.

Natasha (19:10): And I also haven't seen my oncologist for a while. I don't think I saw her before I did the hormone blocker. And so it's like, I can read the reports and the MRIs and the ultrasounds and everything that says everything's good. But for some reason she's become this sort of big figure in my life. It's like I want to hear it from her. And they're doing at UCSF a lot more phone visits, which for me as a patient, it doesn't really work. I mean, I can understand why it works for them, but it's like I want your hands in my armpit telling me again that there's no lump there.

Kristen (19:49): Agree.

Natasha (19:50): Because she was the very first one, and it's all kind of magical thinking. But she's the one who wrote for the chemo and the chemo worked. So I don't want to lose her off my team. And I'm sure the surgery will work just fine. And the radiation, oncology, the radiation will work just fine, but it feels like she got the magic sauce.

Kristen (20:12): Oh, completely. Isn't it weird? You can't explain this. You can't explain the feelings that you have because the last thing you want to do is go to more appointments. But those appointments have also become what... It's information, because you want information about what's happening inside you.

Natasha (20:30): And I think for me, which is a horrible confession I'm about to make, is that I'm kind of an overachiever. And so I want her to tell me that I'm doing a good job. It's really pathetic, but it's-

Kristen (20:41): No, I love it. Your body did a good job for you. Of course. No, of course.

Natasha (20:46): Yeah.

Kristen (20:47): So you're reporting tomorrow at seven. And what are you still doing this evening?

Natasha (20:53): I have to do my special hebe cleanse shower, with the-

Kristen (20:58): Special stuff.

Natasha (20:59): With the special stuff that came. And I'm trying to push eating late because I can't eat after midnight. And then I'm not sure, probably an early night and listen to a podcast and I don't really know. I've been journaling a little bit, but I don't feel like I want-

Kristen (21:19): You don't feel journally?

Natasha (21:19): No, I don't feel journally. I'll probably feel journally tomorrow.

Kristen (21:25): Go back to the very beginning and you said, what is one thing that you would tell me? And it's to treat yourself like a princess. And so that's all you have to do tonight. And get a bag ready so that you can get up. Do your cleanse again, brush your teeth, all of that, and dress as easily as you can.

Natasha (21:48): Yeah, I've been looking at that. Yeah. It was funny. I bought some of the front closing bras and I bought a white one and a gray one and decided I didn't like them, as if it really matters. So I ordered a pink one and now I feel happy. It's like it's exactly the same brand. And I don't know if it's the breast cancer pink that I wanted, or it's like I want something girlier, -like

Kristen (22:19): I'm noticing... Because you don't seem like you're kind of the pink girly thing all the time. And we talked about your pedicure with your shiny pink toes. And now your pink bra.

Natasha (22:31): I know, I know.

Kristen (22:32): I love it. It's something that makes you feel a little bit different than what you normally did.

Natasha (22:37): Yeah, and it was interesting. When I was on Friday getting the mammogram and the ultrasound, there were a group of women in gowns sitting in the gown area and most people are playing on their phones and it just seems so sad. So I started up a conversation about some of the artwork on the wall and people joined in and people's phones went away. And we actually started having a conversation, and we were all at a completely different stage. One woman had come back from a unusual biopsy and was having some more work done. And then this very quiet woman in the corner, she's like, "I've got breast cancer." I'm like, "Me too." And it was just kind of great, as if we are talking about like, "Oh, I've been to that bar as well."

Kristen (23:22): "I saw that movie."

Natasha (23:23): And her journey, again, is so different. She's come for a second opinion to UCSF. She's got a great surgeon and she's a stage two something. She's going to surgery first, before chemo. And she was asking me why. I'm like, "I think I'm not the person to tell you." I can have some theories, but... And I don't know, I never went for a second opinion. And I wonder about the added level of anxiety that can come from a second opinion. It's like, do you then need a third opinion? Because there's many ways of approaching this, but it was just very interesting to be able to talk about something so openly in a waiting room, when it used to be so much more taboo. I mean, that's been one of my things from the beginning. It's like friends want to talk in euphemisms. And I've always been like, "No, I'm getting treatment for breast cancer." I don't feel ashamed of having it or anything. And as I get further away from the tearful days of January, it's like I feel more of a badass having this.

Kristen (24:32): Oh, 2000 percent.

Natasha (24:34): Yeah. Yeah.

Kristen (24:36): And it's weird because, I don't know if you and I have talked about this or not, but I have with some other women who I've talked to with breast cancer. It's like, I don't want to say coolest club, but it's kind of a badass club that you never wanted to be a part of. But now that you are, you realize the kind of people that you're meeting in it. And when you were saying that about people on their phones, and everybody's in the room and everybody has a level of anxiety and fear, and they probably want that alleviated in some way, but they don't know how to do it with strangers. And so by you talking about the artwork, it actually allowed all of you... And you saying you have breast cancer, it allowed everybody to just go, "Oh." They kind of vomit a little bit about their vulnerability and their feelings, and give some relief. And so I'm glad that you had that conversation.

Natasha (25:35): It was an interesting reminder. I was reading the Susan Love Breast Care book that I think everybody buys when they get diagnosed. And one of the things that I think I knew intellectually, but it's never really been spelled out to me is women don't generally die from the tumor in their breasts. That's not what kills us. It's when it goes to the brain, bones and liver. It's like that's why. If they can kill any cells outside, then our chances of this not coming back, it's so much higher. So it's remarkable the number of modalities that they give for this disease. Chemo, surgery, radiation, hormone blockers. It's like, they're not messing around.

Kristen (26:21): No, and the thing is that I feel like the smallest piece in all of the treatment, it's the most important, but is the removal of the tumor. Because all of these other things are to limit recurrence and to limit where any micro cells might have gone. And so it's like, just taking the tumor out seems like it's the smallest piece.

Natasha (26:47): Right, yeah. No, and it's interesting. My mom had DCIS maybe 10 years ago, and she had a lumpectomy. And they didn't get clean margins, and so they actually had to go back in and get more tissue, which is kind of horrifying. I don't want them to do that to me. But my mom, who's a bit of a drama queen, plays it down completely. She's like, "Oh yeah, they had to go in again because they weren't happy with the clean margins." I'm like, okay. Two surgeries in the same place through the same scar tissue. It's like, God.

Kristen (27:23): Well just tomorrow, just say, "Hey, be sure and get clean margins."

Natasha (27:26): Yes. Have the resident do the surgery, and then I'd like you to come and take a look and make sure the margins are clean.

Kristen (27:32): Yeah. Check his work.

Natasha (27:33): Yep.

Kristen (27:35): Well, I'm glad that you're at this point.

Natasha (27:37): Me too.

Kristen (27:38): I know that there's some unknowns going into surgery and all of that. But again, we'll talk about it being a fancy biopsy and you know I'm here.

Natasha (27:47): Thank you.

Kristen (27:47): For whatever you need, and I'll be checking on you too.

Natasha (27:51): Thank you so much.

Eva (27:56): Thank you for listening to Breast Cancer Stories. To continue telling this story and helping others, we need your help. All podcasts require resources, and we have a team of people who produce it, there's costs involved, and it takes time.

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Eva (28:59): Thanks for listening to breast cancer stories. If you're facing a breast cancer diagnosis and you want to tell your story on the podcast, send an email to I'm Eva Sheie Your host and executive producer. Production support for the show comes from Mary Ellen Clarkson, and our engineer is Daniel Croeser. Breast Cancer Stories is a production of The Axis, the