We’re honored to share the inspiring journey of Nicole Holm, who joined Big Bend Hospice as our Chief Compliance Officer in April. Nicole’s experience with breast cancer has shaped her perspective on life and her commitment to helping others. Here, she reflects on her diagnosis and the lessons learned along the way.
Can you share your diagnosis story and how you first learned about your breast cancer?
I had a feeling that my annual mammogram would not be good in late fall of 2018. I had been on an every six-month mammogram schedule for years and had “graduated” to a yearly exam. I had my mammogram and follow-up appointment with my results on the same day. My doctor had always shown me the screen with the results, and on that day in early December, she hesitated and didn’t want me to see the screen. When she did turn it around, there was a giant, bright white, star-shaped tumor on the screen. While she assured me that we didn’t know what it was until after a biopsy, I knew it was breast cancer. The biopsy was scheduled for December 14th, and the official results came on December 17, 2018.
What emotions did you experience upon receiving your diagnosis?
At first, I felt confident that I would be just fine. I was actually more worried about how my family would handle the diagnosis. Then, some anger started creeping in, and as we learned about the aggressiveness of my triple-positive cancer and the manner in which it would be treated, the fear kicked in.
What were some of the first steps you took after your diagnosis?
When I got the phone call (at work!), I double-checked with the PA who called to confirm that she was telling me I had cancer, and then I politely hung up on her! Even though I knew it, that phone call made it real, and I needed to process that. I worked in a post-acute health care organization and was surrounded by nurses. They helped me formulate my questions, and I called back the next day with three pages of questions. The PA spent about an hour with me over the phone, helping me understand what would be coming next. There is a lot of waiting between receiving a diagnosis and the actual start of treatment. That was stressful, but I had a great support system that kept me going. As I set up my appointments, I made sure that my friend could come to each one. She quietly sat in the corner and took notes on everything the doctor was telling my husband and me. Neither of us could listen and absorb, so my friend’s notes became invaluable as we worked through the process.
Did you have regular screenings before your diagnosis? What prompted you to get screened?
My great-grandma, grandma, and mom (twice!) had breast cancer. I got a baseline mammogram right at 40 and had my first biopsy then. A few years later, I had another biopsy and was put on a schedule of every six-month mammograms and doctor appointments.
What do you think are the most important signs or symptoms to be aware of?
In the summer and early fall of 2018, I felt an unpleasant sensation (like the underwire from a bra when it pokes out of the material—ladies will know exactly what that feels like). I went out and bought new bras, but the feeling didn’t go away. I have always been consistent about self-exams but wasn’t feeling anything that felt different. If you feel like something is different in your gut, get it checked out.
What advice would you give to someone who might be hesitant to get screened?
Never wait! My mom and I had genetic testing and didn’t match on any markers. Breast cancer has so many different types and presentations. Always do a self-exam and don’t forget your armpits! Get a baseline mammogram when you can and be diligent.
Who has been your biggest source of support throughout your journey?
Without hesitation, my husband, Clayton! He has been right beside me for every hurdle and victory. The additional support from our family and friends was just as important, along with our faith.
Are there any specific resources or organizations that you found particularly helpful?
There are many different Facebook groups. They are a great place to hear from other women and realize you are not alone in what you are going through. The medical system where I had my treatment also had support groups. I also found a good therapist. There is no shame in admitting that overwhelming feelings and fears cannot always be dealt with by yourself.
How did you approach your employer about your diagnosis?
When I got off the phone with the PA, I went right to her office and told her. She was fantastically supportive. I told all the members of the team individually the next morning. I knew I would need their support and understanding.
Were there any challenges in setting boundaries at work, and how did you navigate them?
At first, I would get my chemo in the morning each week and then make it to work by 11:30 a.m. I thought I had to prove to everyone that I was okay, and that cancer wouldn’t slow me down. As chemo progressed and it became harder to bounce back, I realized that I really didn’t need to prove that I was okay and wasn’t affected. I had chemo for 18 months and radiation for five weeks during that time, along with multiple surgeries. I was tired! I needed to give myself permission to not be okay—my employer was well-prepared and supportive for me to not be okay.
What has been the most empowering part of your journey?
The realization that I am way stronger than I thought—not with needles, though! I still hate being poked for blood draws or IVs. And, I have great information to share and support others who are traveling a similar road. I have helped a few other women with things the professionals don’t always talk about. There is an entire side of chemo treatments that seem like taboo topics but are a reality for many.
How do you cope with the emotional ups and downs that come with cancer treatment?
Some days were better than others. The biggest thing for me was to always keep a sense of humor. Some of the things I went through were horrendous, but there was always something that could make me laugh. I had chemo every Thursday for twelve weeks starting in January 2019, and there was a snowstorm every one of those Thursdays. We only lived about four miles from the cancer center, so we never missed one. Sometimes, we would be almost the only people on the infusion floor, which meant we had great times with the nursing staff. Losing your hair makes it really easy to get ready in the morning (once you get over the fact that you are now bald). When you lose your appetite and the only thing that stays down is ice cream, your doctor will tell you that if that’s the only way to get calories in, then go for it! When I had down days, my friend and I had a code word. When I called her and said that word, she dropped everything and came to help me through whatever issue I couldn’t manage at that moment.
What message would you like to share with others who are currently facing a similar journey?
Always be your own advocate. While I recognize that doctors are way smarter than I am, they don’t know my body like I do. If you don’t understand something, continue to ask questions until you feel like you completely understand. Find that person or those persons who will hold onto you for dear life while you are battling to hold onto life.
How has your perspective on life changed since your diagnosis?
I realized that “me time” and time with those I love is far more important than anything else. Take the vacation you keep putting off. Take the lunch break to recharge during the day (it really does make the afternoon more productive). Set boundaries to protect your time away from work. Never take your health for granted!
