10 Days Left with the Girls: One Woman’s Countdown to a Double Mastectomy

Photo of Double Mastectomy patient post surgery

Diagnosed with breast cancer in early 2020, Christina Holzhauser recalls her personal journey preparing for a double mastectomy. 

Feb. 15: So You Have Breast Cancer

Three weeks ago, I had a mammogram. Then another. Then a biopsy. Then they called to say I have cancer, but the best kind. I’ve spent hours weighing my options. My biological mother had breast cancer when she was 32 and my biological grandma when she was 70. There didn’t seem to be much of a choice.

In 11 days, I’ll no longer have breasts.

Feb. 16: 10 Days Left with the Girls — The Hike

It’s called ductal carcinoma in situ. Some call it precancer. It’s considered stage 0, like, the very, very beginning. In situ means “in place.” (I learned that years ago while doing archaeology. If you find a cool artifact, you want it in situ so you can get the most information about it. Its integrity hasn’t been lost.) So, that means it hasn’t spread anywhere (most likely). That’s very good. It has a nuclear grade of 2 out of 3. That means it’s not the most aggressive, but it’s also not the least.

My options for treatment are a lumpectomy with radiation or a mastectomy. Why am I choosing a mastectomy when I could keep my boob? Because radiation treatment is a daily thing for up to six weeks. It can shrink your breast, burn it, or, in very rare cases, go into your lungs, heart or ribs. I’m not into all that. My cancer is only in one breast, so why get rid of both of them? Because I don’t want to spend the next half of my life worrying about that. Because at age 40 and with my family history, my chances of getting cancer again — possibly even worse the next time — is something like 40%.

After a few days of feeling really sad for myself, I decided to try to make this fun, or at least not awful. The most difficult question is this: What do you do with your breasts when you know they’ll be gone in 10 days?

So far I’ve:

  1. Run up and down the steps many times without a bra and without holding them. I want the sensation to be ingrained in my memory.
  2. Stood naked in the mirror and touched them a lot. Maybe for the first time, admiring their beauty.
  3. Had to explore my own gender identity.
  4. Worn real bras and not just sports bras.
  5. Been much more aware of their presence. Like, as in right now, I’m a person with boobs who is writing. This morning I was a person with boobs who brushed her teeth.

I promised them a farewell tour of some of their favorite things to do. I wanted to make their last days attached to my body fun for them, not all doom and gloom. So today we went on a hike. We took some photos of them with a nice landscape in the background and of one of them trying to take in their last (or maybe first) glimpse of sunlight. I tried to make boob imprints in the snow, but it was too old and hard. And, not surprisingly, it was very, very cold and uncomfortable.

Feb. 17: Nine Days Left — The Last Workout

It was only seven days ago that I met with my surgeon and decided the fate of my breasts. My surgeon is a woman, which makes me feel infinitely better about all of this. When they called with my diagnosis, I knew exactly what I was going to do. You see, when I met my biological mom 20 years ago and she told me about her history of breast cancer, I set my mind to survival. In an awful and very real sense, I’ve been preparing since then. I was worried that a man doctor might not understand my choices and would try to convince me to save them.

Did I mention what the girls did for the last time today? They went to the gym. Did I also mention that my surgeon just happens to go to my gym and take the same class I do? Well, she does. Today my boobs worked out in the same room as the woman who will cut them off in nine days.

Though I normally don’t look into the mirrors when lifting weights, I did today. I stared at my cleavage and saw how awkwardly my sports bra was fitting. Another thing I was very aware of was how I had to tug at the shoulder straps after lifting weights or rowing, you know, to hoist them back up. There were times I did this with a laugh and other times with tears in my eyes.

I like my workout class, except for one thing: the stupid heart rate monitor I have to wear around my sternum. Of course, I could buy one that goes on my arm, but they’re $100. No thanks. I usually just tuck the band under the bottom elastic of my sports bra so it feels more secure. I wonder: What will this strap look like on my chest when it’s the only thing there?

The next time I go to my gym class, I’ll have no breasts, an awkward chest strap with nowhere to be tucked and probably my surgeon on the treadmill next to me.

I wonder, though, this morning when we were running, rowing and lifting, did she look across the room and feel sorry for me? Could she tell from knowing me only a few hours that I’m struggling? That even though I know I’ve made the right choice, that I’m afraid of what happens when it’s all over? That the uncertainty of how long it takes me to really heal is what scares me the most?

Feb. 22: The Last Supper — Five Days Left

Besides rugby and working out, going to one of the local bars is what I do for self-care. I’ve pretty much been going there since 2002 (except a three-year hiatus when I was in Alaska for grad school … the first time). The drinks are strong, the food is bad for me, and I’ve given them most of my disposable income for upwards of 15 years. I am incredibly loyal to my bar — after all, it helped me through my 20s and 30s.

Last night, the girls had their last happy hour. I wasn’t sure how to capture a photo in a public space on a Friday night, but, with the help of many friends, we did it.

It went like this: One very tall and broad friend held up a black blanket to block the view of the large table behind us. Two friends warned the nearby tables of what was about to happen. It wasn’t revealed to me if they were invited to look or instructed to avert their gaze. Two friends stood by the door to stop any patrons from entering and getting an eyeful. Two friends joined me in a perfect photo.

Feb. 25: No Boobs ≠ Boy — 15 Hours Until Surgery

I’ve never really cared about my boobs. There are very few occasions I remember trying to show them off, and I’ve never tried to hide them. They aren’t big enough to cause problems like back pain or the dreaded male gaze. They aren’t small enough for anyone to have commented on their smallness. Usually one heavy duty sports bra is enough for rugby, and regular bras off the rack seem to fit just fine. I’ve never yearned for more or less of them. I’ve been pleased with them this whole time and never really knew. Don’t it always seem to go that you don’t know what you’ve got ‘til it’s gone.

As a cis-woman who’s only been sexually involved with other cis-women, my adult life has been full of breasts of all colors, shapes and sizes. It would be incorrect to say that I don’t sexualize them, because, you know, I’m queer, but I’ve never stared at them on strangers or cared about their size or shape on my partners. In comparison to the way cis-men seem to lose their minds over them, I am not like that at all. They are demystified when you have your own to touch and look at whenever you want.

During my consultation with Dr. Emily Albright, I asked if she could save my nipples and maybe give me a male chest. She said that she knows a great plastic surgeon who’s done FTM (female-to-male) transitions. But that would take some time, and I’d have to talk to that surgeon first to see if I was a good candidate and all that. Then, my brain was like … stop. I tried to imagine taking off my shirt to see a male chest in my mirror on my body. And it seemed really, really wrong. I halted that conversation with her and was like, no, not really, sorry. Just cut them off and leave the scars.

Of course, boobs do not a woman make. I am not a woman because I have them. I am a woman because I am a woman.

Tomorrow is the big day. See you on the other side.

Feb. 28: Into the Void — Two Days Without

It was a long day at the hospital for everyone except me since I got to sleep through most of it. The WHOLE surgery team was made of women, so that made me feel super awesome right until the moment they knocked me out.

Am I in pain? Kind of. My chest feels tight and my muscles sore, but it just feels like the soreness after working out super hard. I’ve felt worse after rugby games, honestly. The most annoying pain is caused by the drains on both sides of my chest. I’m hoping those can come out relatively soon. After that, well, I can pretty much do whatever I want.

But what about my mental health? I feel great, actually. But there are moments of strangeness. Last night I was holding a mug. And breasted people, you know how you bring your arms in and hold mugs to your breast? (Or maybe you don’t know because I didn’t realize until last night.) Well, I did that, but my arms never touched my chest. So, I used my hand to reach for where a breast should be, to test my emotions. When my hand got to where it should have felt something, and I kept moving it closer to my body, well, it just felt like my hand fell into a black hole. I don’t quite know how to describe it. There’s a void or negative space where my breasts once were. It’s like my hand fell through time.

I get to wear this cute, pink bra thing. It keeps pressure on my new wounds and holds my drains so they don’t get tugged on. The next big step will be taking off the bra and bandages to really have a look inside. I’m not ready for that yet, but the time will come. And rest assured, you’re going to hear about it whether you want to or not.

March 2: The Healing — Four Days Without

I’m bored. But I don’t have enough energy to actually do anything. Two days ago, I left the house with my partner. I walked a few blocks downtown and then came home to sit some more. I feel lazy, but I think this is what I’m supposed to do.

I took off the pink bra thing yesterday. It was pretty hard to look at. I have two very long scars with crusty blood and steri-strips covering the length of them. I’m not so sure how confident I am about this new body. I’ll be fine, though. The most awful part right now are the drains. They’re moving gross fluid away from my wounds and are held into my skin with just one stitch. They are sore. They itch. They are annoying. I’m hoping they’ll get taken out tomorrow. After that, I’ll probably feel a lot better.

There’s really no sensation in my chest. There are areas around my armpits where it feels like I was numb, but it’s starting to wake up. My understanding is that I could feel like that for the rest of my life.

Since I last wrote, I’ve cried. There are a lot of reasons why. You can guess most of them, I’m sure. I don’t regret my decision, but hey, it’s been just a few days, so I’m giving myself some time to deal. It’s a lot to see my body change so drastically. To contemplate what it means to live without breasts for the rest of my life. They were literally just here and now they’re gone. And now I just have to sit around waiting to feel better.

March 4: Down the Drains — One Week Without

Today was a stellar day. For real.

My surgery was last Wednesday, and today, Wednesday, I was able to get my drains removed. Technically, I was supposed to only have one taken out, but Dr. Albright came to my appointment to tell me the pathology results of my lymph node (all clear!), and I showed her what a good patient I’d been keeping track of the output of my drains. So she told the nurse she could remove both. I can’t remember being that happy in recent memory.

The drain removal was … strange. If you’ve ever had them, you know. If you haven’t, well, it’s like a snake being pulled from under your flesh. It hurts, but in a small worm-being-pulled-from-your-skin kind of way. Now I have two largish holes in my skin leaking some pinkish fluid, but it’s nothing that won’t heal in a few days.

In other, very exciting news, I’m wearing a T-shirt and hoodie instead of an oversized button-up men’s shirt. I feel like myself. Or very close to myself. For my appointment today, I wore a dress shirt that I sometimes wear to work. It was the first time I’d worn regular clothes. It is a button-up, but a men’s, and one that actually fits me. I looked fabulous in it. No boobs made it fit perfectly. There was no boob-button gap. And, like my partner has been telling me, I look like I lost weight. (I did; they weighed three pounds.) I look really fit. But really, I just don’t have boobs. You can’t really tell I don’t have boobs, though. I just look like a person in a shirt. And my shoulders look great. Like, wide, fit and awesome. Even the nurse commented on it.

I have the brain space now to start thinking about other things: taking care of my partner, the kids, planning for grad school, planning our summer vacation. Did I mention we bought a house — or, that I got accepted into grad school, bought a house and found out I had cancer all in the span of like, nine days? That was crazy. I’m still not able to let those things come into my brain yet, but I know there’s space for them. Every minute, I’m clearing a path. And that means everything right now.

May 5: Scar Twins/Twin Scars — 2½ Months Without

It’s like I lost my breasts and the world changed. I had cancer, and then the world suffered from a pandemic.

Because of all the world news happening, I forget I even had cancer or that I used to have boobs. I wonder, if I would’ve known I’d have all this time at home, if I would’ve just gotten some reconstructed breasts. Probably not. But all this time has made me think. It’s also forced me to slow down and heal in ways I probably wouldn’t have if rugby were still going on.

In an effort to tell my body to go f*** itself, I’ve started running. Not the kind I usually do, which involves a ball and an objective, just the kind where you go out and force yourself to keep your legs pumping into nothingness. It’s awfully boring. But I hear it’s good for me. Maybe you’re wondering, you know, what’s it like to run without boobs? It’s great! I only have to wear a shirt — no special bra. I feel sleeker. I feel more athletic, even though my times and distance don’t really prove that.

I did have an appointment the other day with a medical oncologist. My surgeon sent me there to make sure I couldn’t benefit from an estrogen blocker (since my cancer was estrogen positive), but he told me the risks outweigh the benefits, especially considering that I shouldn’t have any breast tissue left. We discussed my next appointment with genetics. There, they can tell me if I have a serious mutation, like one of the BRCA things. Like, maybe the one that causes ovarian and uterine cancer, too. The oncologist said the dreaded words I’ve heard all year long “at your age …”

Getting cancer at my age, he says, probably means there’s something else going on with me — something that genetics will find. And if I have that gene, he says, I should just go ahead and have a total hysterectomy. Or I can have transvaginal ultrasounds every three months until I die. No, thank you. I’d rather have another major surgery.

A uterus does not a woman make.

When I finally showed our 10-year-old son my scars, his face lit up, “Mom, I love it!” He lifted his shirt to reveal the vertical scar that runs down the middle of his stomach from his feeding tube surgeries. “Now we’re scar twins!” Of course I cried.

July 26: Five Months Without

What a difference five months can make. A pandemic is escalating in our country along with justified social unrest. My boobs mean nothing these days. February feels like a lifetime ago. That was a time before masks and homeschooling. Before time collapsed in on itself.

Physically, I feel great. I’ve kept up with running, and I went back to the gym as soon as it could safely open. I had saved a few sports bras to wear to the gym under my tank top because, you know, old habits. But I never wore them. I still go to the gym with just a tank top. I wonder if anyone notices. Sometimes the scars peek out just under my armpits. Sometimes, if we’re doing pushups or planks, there’s just a straight shot down my chest for anyone looking from the right angle.

I still have one sports bra left in my drawer. I always forget it’s there, so when I’m digging through for other things, I find it and hold it for a moment. Now, it seems so naïve that I thought I’d ever wear one again. Now, it seems unreal that I ever had breasts at all. That I ever had to cross my arms over my chest to try to conceal how cold I was. That I ever had to worry about putting a tank top under my dress shirts so, if that one button popped, I wouldn’t be causing a scene. That I ever had to turn my back to take off my shirt. That I ever shifted while sleeping on my stomach to get them in the right position. That anyone ever accidentally touched one and we both had to apologize profusely. That my partner ever squished one while we were cuddling. That I ever accidentally wore the “bad” bra to rugby practice. That I ever fussed over a slipping shoulder strap during an important interview …

That bra is now a symbol. A souvenir. An artifact.

So, I fold it up and put it back where it belongs.

 

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