Me & Angelina Jolie

My mom and I on my wedding day

I wish I could say that I too was once married to Brad Pitt, or that I’m an Academy Award-winning actress and filmmaker, credited with a long list of Hollywood blockbusters. I wish- secretly and vainly- that I too was frequently mentioned in People Magazine’s list of Most Beautiful People. And wouldn’t it be amazing if I could say I’m also a globally recognized humanitarian, advocating for refugees around the world? IF ONLY….

Truthfully, I don’t have much in common with Angelina Jolie.  Yep, we are both mothers to twins, but that certainly doesn’t warrant this essay.  What we do have in common is a lethal gene mutation, commonly referred to as BRCA, which took the lives of our mothers and grandmothers, and prompted us to take preventative measures to save our own lives. In a 2013 op-ed in the New York Times, Angelina wrote about the losses of her mother, grandmother, and aunt; finding out that she also carried the BRCA1 genetic mutation; and her decision to undergo preventative surgeries to dramatically reduce her risk of developing breast and ovarian cancers. I remember reading this op-ed, published 3 years after I had lost my own mother, with the knowledge that I would someday undergo the same procedures as Angelina had. This Hollywood celeb and I share something rather unfortunate in common.

In May 2002, while I was living in The Netherlands, my mom called me to share the news of being diagnosed with stage 3C ovarian cancer.  Despite our close relationship and regular phone calls while I was living abroad, she waited to disclose her diagnosis until she had seen a specialist at the Mayo Clinic for a full work-up.  Like many women who are diagnosed with this silent killer, Mom had been experiencing vague symptoms, like abdominal bloating and fatigue.  Her local gynecologist was the one who first identified a large mass growing on her left ovary and referred her to the Mayo Clinic for further testing.  The irony was that she only had one ovary, after undergoing a hysterectomy and removal of her right ovary twelve years prior to treat severe endometriosis.  The reproductive oncologist at the Mayo Clinic confirmed what her local gynecologist suspected: Mom had an advanced stage of ovarian cancer, which required immediate surgery followed by several rounds of chemotherapy.

Given the advanced stage of her cancer, the oncologists told my mom that she had a 25% chance to live another 5 years.  My warrior-of-a-mother defied the odds and lived for another 8 years, through more surgeries, reoccurrences, and chronic pain.  She fought- and I mean, FOUGHT- for every single day of those 8 years.  I remember the stretches of time when Mom was cancer-free, and able to enjoy her usual activities.  She had received an early medical retirement from her teaching career, so she spent her days making arts and crafts, baking, enjoying nature, and visiting with her many friends.  She made scrapbooks, cookbooks, and many handicrafts for my sister and me.  We managed to squeeze in some fantastic trips together when she was healthy, and I was often able to work remotely from my parents’ home in Michigan to spend time with her and support her through reoccurrences.  With checkups and blood tests every few months, she’d hold her breath and pray incessantly, awaiting to hear if the cancer had returned.  And it did, initially returning to her pelvic cavity and eventually spreading to her liver.

In April 2010, Mom asked me to fly home.  Through our regular calls, I could tell she was nearing the end, but nothing prepared me for how quickly she had deteriorated once the cancer had spread to her liver. I remember accompanying her to her last doctor’s appointment- she was in such pain that she laid on an air mattress in the back of the car while my dad and I drove her to the medical center.  Her doctor reviewed her treatment options, all of which she solemnly declined.  A lifelong Christian, my mom was ready for Heaven.  She wasn’t afraid of dying, and her only request was relief from the excruciating pain she was experiencing.  In-home palliative care was arranged, and my dad, my sister and I tried our best to keep her comfortable and savor every last moment with our beloved mother/wife.  My mom took her last breath 12 years ago to date (4/22/10).  She made her Heavenly ascent, reuniting with her Savior, as her family surrounded her.  Her blue eyes sprung open as we lovingly escorted her into Jesus’ arms, where she now soars free of any pain and suffering.

Since 2002, when my mom first shared the news of her diagnosis and learned she carried the BRCA1 gene mutation, I knew I would eventually choose to undergo preventative surgeries to reduce my own risk of ovarian and breast cancers.  At that time, I was a single 20-something year old professional living in Europe, and not ready to part with my breasts and reproductive organs.  I chose to undergo regular screenings for both breast and ovarian cancers for many years (2x a year of breast imaging, 2-3x a year of CA-125 blood test and transvaginal ultrasounds).  My anxiety peaked around every screening as I imagined my doctors discovering a growing tumor.  The fear of breast and ovarian cancers was always in the back of my mind, yet I didn’t feel ready to remove my lady parts until my family was complete.  My eldest son was born in 2012, and my husband and I spent several years trying to conceive again amidst multiple moves, job changes, and losing our home to natural disaster.  With the birth of our twin sons in late 2019, I finally felt that sense of completion and knew I was ready to begin planning the first of my preventative surgeries.

In January 2021, just three weeks after I had stopped breastfeeding my one-year-old twins, I underwent the elective removal of my ovaries, fallopian tubes, uterus, and cervix.  This procedure resulted in immediate menopause, without any hormone therapy.  I recovered from this procedure relatively quickly, noting that I bounced back faster than I did from my C-section a year prior.  Despite my concerns about the many symptoms associated with menopause, my symptoms have been quite mild.

Exactly one year later, on January 5, 2022, I underwent a preventative double mastectomy with reconstruction using my tummy tissue (referred to as DIEP-FLAP). This was a NINE-hour surgery, with two surgeons, three nights in the hospital, and a six-week recovery. This was the most complex of my surgeries because, after one surgeon performed the bi-lateral mastectomy, then a second surgeon transplanted my abdominal tissue to my chest and reconnected tiny veins and arteries to supply blood to the transplanted tissue.  This surgery was certainly the most challenging of recoveries due to having a hip-to-hip incision, a relocated belly button, and two newly constructed breasts.  A month after my surgery, I finally felt ready to look at my new chest in the mirror, and I was surprised at how natural my reconstructed breasts looked.  I jokingly say that my newly constructed boobs are made from Christmas cookies because I ate with no restraint in the month prior to my DIEP-FLAP, knowing every ounce of belly fat would be excised and used to reconstruct my breasts. Might as well indulge!

8 weeks after DIEP Flap surgery

Today, as I sit before my laptop on the 12th anniversary of my mom’s passing, I am recovering from my second surgery to complete my breast reconstruction.  In early April 2022, I underwent a “Revision” surgery to tweak the reconstructed breasts by lifting, removing scar tissue, and filling in gaps using fat grafting.  My favorite part about this surgery is the liposuction of hip and thigh fat, which is then grafted to the breasts.  My body needs another few weeks to fully recover, but I am back to most of my normal activities and grateful to have the most difficult surgeries behind me.  I’m truly in awe of the surgical teams, techniques, and technologies which made all of these surgeries possible, as well as my body’s miraculous recovery and healing. (Edited to add that I underwent a third surgery in October 2022 to graft more fat to my upper chest.) 

2 weeks after my Revision surgery

Similar to Angelina, witnessing what my mom endured as she battled ovarian cancer made my decision to undergo these surgeries a “no-brainer.”  Naturally, I had a lot of emotions going into my surgeries: grief, fear, bitterness, and more.  Each procedure triggered memories of my mom, all she endured to extend her life as long as possible, and how much I longed for her presence.  I won’t deny that I shed many tears as I prepared for each surgery by saying “thank you and goodbye” to these body parts which had served me so well. For the first time in my life, I truly appreciated my body and wished that I had treated my body with greater love and kindness sooner.

While honoring these intense feelings, I continued to stay laser-focused on my motivation:  my three beautiful young sons.  I’d do anything for my children, even if it means removing my body parts that made their lives possible.  My lady parts had fulfilled their purpose by growing and nourishing these tiny humans, and, once I stopped breastfeeding my twins, I felt at peace with my decision to proceed with these preventative surgeries.  Now that these surgeries are in my rearview mirror, I take comfort in knowing that my risk of breast cancer has been reduced from over 80% to less than 5%, and my risk of ovarian cancer has been reduced from over 50% to less than 5%.  I can go forward in life with dramatically reduced cancer risk, greater peace of mind, a very perky set of new boobies, and- BONUS- a flatter tummy.

While this blog post hardly compares to Angelina’s op-ed in the New York Times, I do hope that my openness will benefit other women with strong family histories of breast and/or ovarian cancers, those who are BRCA1/2 positive, or those recently diagnosed with breast cancer and weighing their options.  I come from a long line of strong, courageous women who made choices that both gave me life and helped me to extend my life.  I hope their legacies live through me, and that our stories will inspire other women to make empowered decisions about their health.  May we all live longer, healthier lives in honor of the many women who journeyed before us.  (Link to One Year Later post: One Year Later – Christina Zini)


Notes of Gratitude:

I would like to express my deep gratitude to the many people who have supported me through eleven years of medical interventions and surgeries, starting with fertility treatments in 2011 and ending with my most recent surgery to complete my reconstruction in 2022!  This past decade+ has been incredibly challenging and emotional, bringing out both the best and worst in me.  I’m thankful for the family and friends who stuck by my side, believed in my dreams, and encouraged me to stay the course.

My husband, Thierry, has been a very supportive partner, and has carried more than his fair share of household and parenting duties. Acts of service are his love language! My oldest son, Ollie, has been very understanding and so helpful with his little brothers as I’ve recovered from my surgeries. My Xandi and Benji are too young to understand what their mama has been through, but I am grateful for the healing power of their kisses and cuddles!

To my extended family for their love, prayers, encouragement, gift cards for meals, and get-well surprises, especially my aunt Bobbi who took care of my kids for 2.5 weeks after my DIEP-FLAP surgery.  And to Angela for being an inspiration and great support- ILY2TM&B!

To my doctors and surgeons, including Dr. Michael Hold, Dr. Katherine McKnight, Dr. Liz Lee, and Dr. Warren Ellsworth, as well as the wonderful health care professionals at both Memorial Hermann-Memorial City and Houston Methodist-West hospitals.  God + Science for the WIN!

To Dr. Rajka, who is both one of my dearest friends and my favorite Functional Medicine doctor!

To my therapist, Leslee, thanks for listening and supporting since 2016- I feel so blessed to have found you when I moved to Houston!!

To my dear friend, Jenna, a big thanks for sharing your own journey with me and always lending a helping hand- you are truly amazing!

To my new friend, Christie, thanks for being such a great resource of information and advice on DIEP-FLAP- you are a total rockstar!

To my Amsterdam girlfriends, you went above and beyond with gifts for the entire family, groceries, meal delivery gift cards, Zoom calls, and more- I am so thankful for our 20 years of friendship and sisterhood!

To my many friends and neighbors, thank you for the meals, groceries, running errands, helping out with my kids, and your compassion-  I hope I can someday repay your acts of kindness!

To my Mom, I am so grateful that you brought me into this world and raised me to be the woman I am today.  You taught me so much about friendship, motherhood, and Jesus.  Because of your love, my heart is open, tender, and generous.  Because of your courage, I was able to have these preventative surgeries and share our story.  Thank you for fighting so hard to stay alive so we could spend as much time together as possible.  I am so proud to be your daughter.  I miss you so much, and I look forward to the day that we reunite in Heaven.  I love you to the moon and back!