JBER Public Affairs
11/6/2015 - JOINT BASE ELMENDORF-RICHARDSON, Alaska -- It was November.
Breast Cancer Awareness Month had just wrapped up and Senior Master Sgt. Tracie Timmerman, the new 673d Force Support Squadron, Manpower and Personnel Flight superintendent, sat in the waiting area outside the radiology clinic, staring at all the pink ribbons and literature left out for the previous month's observance.
The display - and many others like it - was set up for October to raise awareness of breast cancer to encourage service members and their dependents to take their checks seriously in the hopes early detection would lead to more successful treatment.
Staring at the ribbons, Timmerman felt sick.
"I honestly can't go into the [hospital] and see all those pretty pink ribbons," Timmerman said. "It makes me sick. We put pink ribbons, and pink stuff everywhere. I get it, I have some of that myself, but when I look at it, and it's all over the place, I just want to make sure people really understand and are really aware how it affects people. Breast cancer isn't pretty. It's not."
Shortly before her permanent change of station to Joint Base Elmendorf-Richardson, Timmerman went to see the doctor at Robins Air Force Base, Georgia for the second mammogram of her life.
"I never had any thoughts of cancer, I just thought these checks were a pain," Timmerman said. "I did not do self checks. I didn't. I knew I was supposed to do it, but I didn't. I just never thought about it because cancer is just not in my family."
With normal mammogram results in hand, Timmerman went on with her PCS and arrived at JBER.
"I was good to go," Timmerman said. "Nothing was wrong."
An unwelcome surprise
But when she got to JBER, Timmerman said she began to experience unusual levels of exhaustion. She couldn't unpack her things as quickly as she usually would and she found it difficult to stay active.
"It was very difficult to explain how tired I was; I have never - in 20 years of military service - ever been late for work," Timmerman said. "I was very close to being late for work several times in 2014 over the summer because I couldn't physically get out of bed. I would get up and hunch over the bed, I had to hold on to the bed to get across the room and I felt just ... exhausted."
Cancer didn't cross her mind; after all, she had just gotten a normal mammogram a few months prior. Timmerman didn't know what was going on, but she did know she had a job to do.
"I let that go on all summer," Timmerman said. "I'm new here, I have a lot people that work for me, and I have a mission to do."
Timmerman continued to tough it out, even when a lump the size of a crabapple formed under her armpit.
"By the grace of God, my armpit swelled up," Timmerman said. "I could reach in and grab that lump and move it around; it hurt really bad. As I was feeling the lump in my armpit, I felt another one in my breast."
She panicked and went straight to the emergency room, but it was a Sunday, so there wasn't much they could do. She scheduled an appointment with family practice who referred her to radiology.
"I went to radiology, did the mammogram and you could see it on the screen. There was definitely a mass in my breast," Timmerman said as she began to cry. "The technician put the wand on there, and we went from having a normal conversation to her not talking to me at all."
Then she had the doctor come in.
"He couldn't tell me [for sure] because he had to do a biopsy, but he put his hand on my hand, looked at the screen and said 'this is not good,'" Timmerman said. "My husband was in the lobby, not yet aware I had four tumors, three under my arm and one in my left breast."
Ironically, Timmerman had been speaking to Senior Master Sgt. Michael Venning, 673d Contracting Squadron superintendent and his wife Laura, who was going through chemotherapy.
"Laura and I talked, so I could get her story and figure out what I really wanted to know. I wanted to validate what cancer was and try to say 'Oh I don't have it,'" Timmerman said. "I also wanted that friendship, that person to talk to, to help me through this process."
Laura told her there would be what survivors call a "find out" appointment, where the doctor would come in and tell her if she had cancer or not and, if she did, what her options were.
"Because of her help, I was able to prepare my mind so I knew what was going to happen when I walked in there. But nothing can prepare you for that," Timmerman said.
The doctor walked in and said, "Hi, I'm Dr. Woodham, let me go ahead and tell you right now - you have cancer."
"OK," Timmerman said. "Alright."
Then she lost it.
"At that point, you go through several different emotions: crying, screaming, hitting things. I wanted to turn the room upside down," Timmerman said.
"I'm eating right, I'm exercising, I take care of myself. How can I have cancer? I don't smoke, I don't do any of that stuff they say is a risk factor for cancer," she said - spitting the word cancer like a curse.
The doctor left her and her husband, Brad, a retired master sergeant for a while. Timmerman said the doctor had scheduled only the couple for that afternoon because he knew it'd be tough and wanted to be there for them.
"She gets excellents on her physical training tests, she's healthier than I am! This doesn't make sense." Timmerman's husband said when the doctor came back in to give them their options.
Cancer doesn't make sense, Timmerman said. It just happens.
Because each cancer is different, each person is treated differently. Timmerman was told she had a couple of options. She could go ahead and have a mastectomy to remove the cancerous breast, or they could start with chemotherapy.
Timmerman said she and her husband prayed many times, looking for guidance and support.
"I don't care about my breast, I want to live," Timmerman said.
Through this process, they decided she was going to have a double mastectomy and remove both breasts, rather than just one.
"I honestly don't know why, but we decided a double mastectomy was the right course of action," she said. "I signed the paperwork, I signed my breasts away Nov. 17, 2014. Later on down the road, we found out it was the best course of action."
For the following week, Timmerman hid her cancer from her children, Madison and Tyler, then 11 and 8. She said she didn't want to disturb their schooling, and wanted to protect them even as she squared off against a nightmare.
She protected her family as best she could from the terrible news, but later, her family would be the ones protecting her as she fought through her recovery.
"My motivation to thrive is my family. I have been married to a wonderful man for 24 years and I live for my beautiful kids," Timmerman said. "I knew I had to push through everything so they could see I was going to be around for many years."
Before her surgery, she tried to protect her children by hiding an ugly truth until it was absolutely necessary. When her recovery was fully underway, her children and their father protected her by giving her something to fight for.
"I took a lot of showers where I would just sit in the bottom of the shower and cry so my kids wouldn't hear me," Timmerman said. "I went to bed early, I cut myself away from my children so they wouldn't see me cry."
On the Saturday before her surgery, which she describes as the worst day of her life, Timmerman explained to her kids she had breast cancer.
"They thought I was going to die," Timmerman choked the words out, visibly more concerned for her children than her own mortality. "It was awful."
To encourage her kids, she introduced them to Laura, so they could see what their mommy would look like after she began treatment in full.
"That way my children could see another mommy who didn't have hair - which is what their mommy was going to look like very soon - and was battling cancer as well," Timmerman said. "They could see their kids were fine, and the house was fully functional and everybody was OK."
After her kids said "Mommy is just going to wear a hat. Miss Laura is OK, so mommy is going to be OK too." Timmerman could finally face her surgery, knowing her kids would be alright.
Surgery
On Nov. 26, she was rolled out of surgery and into nearly 12 months of recovery.
"I came out and I was bound up really tight. There were lots and lots of dressings and drains - all kinds of drains and tubes hanging out of my body - I was really weak and sick from the anesthesia," Timmerman said. "It was really difficult for my kids to see me like that, they trusted I wasn't going to die, but when they saw me like that they thought I really was going to die. I looked like death."
Timmerman said she didn't want to look. She didn't want to see what her body looked like.
"When the doctor took the dressings off, of course I looked. I dealt with it a little bit better than I thought I would. When I looked down and saw what my body looked like now," Timmerman said. "There were a lot of stitches, a lot of cuts - it was a mess.
"I thought, OK, it is what it is."
Recovery from the surgery took six weeks, during which she had drains attached to her body, suspended in bags she kept in a vest that had pockets all around.
To determine the best kind of treatment, the medical group sent her breast tissue to get a pathology report.
"They take - this was difficult to look at - they take your breast, your body part, cut it up and put it in all kinds of little specimens, send the tumors off to path[ology], and they look at it all," Timmerman said. "They test it for all different types of things to see what caused the cancer, what kind of cancer it is."
Following her pathology report, Timmerman met with her doctor again. He explained the condition of her tumors and what kind of treatment they would need to proceed with.
He explained her tumors weren't metastatic. This was good news - it meant the tumors were taken out as whole masses, they hadn't broken up and begun relocating as a series of small masses.
"It was stage 2. There are four stages, four is the worst," her doctor told her. "But you're triple negative."
Triple negative. Timmerman thought that sounded like more good news.
"No. Horrible. Worst cancer because it's aggressive," Timmerman said. "That means I was negative for estrogen, progesterone and [human epidermal growth factor receptor 2]."
Most chemotherapies target one of those three receptors, so treating triple-negative cancer is more difficult than other types, requiring combinations of chemotherapies.
Chemotherapy
When she finished her treatment, there would be no pills Timmerman could take to help her remission be successful, as there are for many kinds of cancer.
Her options were simple: surgery, chemotherapy and radiation.
"Very few people diagnosed with breast cancer have triple negative," Timmerman said. "It's a very aggressive cancer which explains why it quickly went from me having a [normal] mammogram in March of 2014 to having four cancerous tumors in November."
She also found out her and her husband's instincts were right. By asking the doctor to take both her breasts, she greatly increased her chances for survival. There were some suspicious masses in her other breast the doctors believed had a high chance of becoming cancerous.
"They can't guarantee that cancer won't come back. It can still come back on the scars, it can still come back in the lymph nodes, it can come into my thyroid, anywhere," Timmerman said. "They decided the type of chemotherapy I needed was this thing survivors call the 'Red Devil.'"
When she showed up for her first session of chemotherapy, Timmerman said the red devil - doxorubicin, also known as Adriamycin - looked innocent enough, but after her first treatment, she learned why they called it that.
"I was drained. I was nauseous, laying flat out in the bed with cold cloths on my head and a bucket next to me; it was not pretty," Timmerman said. "It's not a beautiful disease."
Because the type of chemotherapy she was getting was so strong, Timmerman went once every other week, if her white blood cell count was high enough. The first two weeks, she said she lived in fear of waking up one day and finding all her hair on her pillow.
"I went to the bathroom, and my hair started falling out in the sink, it was just coming out in clumps, fistfuls," Timmerman said. "My head started hurting because my hair follicles were dying. I couldn't even touch my head."
After Brad shaved her head, she started to lose her eyebrows, eyelashes, everything.
"Now I have no breasts and no hair, so I really don't feel or look like a woman, at all," Timmerman said. "But I am a woman, I just didn't feel it. It was much harder than I thought."
Throughout the process, Timmerman said the support from her family and squadron was critical, but found she didn't want people to cheer her up with silver linings and pink ribbons. She just wanted them to understand what breast cancer really is.
"People want to put a positive spin and say, 'well at least you don't have to shave your legs,'" Timmerman said. "Painting your eyebrows on, trying to figure out how to have eyelashes when you don't have them, presenting yourself like a woman after being a woman for 43 years, it's very difficult, very hard.
"There's nothing positive about that. Cancer sucks."
Timmerman graduated from chemotherapy the last workday before Memorial Day, she and Brad decided to take the whole family to Homer to celebrate before she went into the next stage of her recovery - radiation.
Radiation
"I would go in every single day, lay on a table in a mold of my body from the hips all the way up to my head," Timmerman said. "They did a couple of tattoos so they could make sure the beams lined up on my body correctly every time so my heart wasn't getting radiation."
So every day for 48 days, in the hopes of a healthier future, Timmerman went downtown and got the worst sunburn of her life.
"There was a lot of medication, lots of creams and stuff like that to put on my skin. They gave me bandages because it is hard to wear clothes and my skin was actually falling off my body," Timmerman said. "I'm not trying to paint a super-ugly picture, but it's very ugly."
Timmerman will always have the scars from her surgery.
She will always have a scar where they installed a port into her chest so chemotherapy could be administered to her regularly without wearing out the skin on her arm, and she will always have a beer bottle-shaped scar on above her sternum where the radiation left its permanent mark.
But she's a survivor; she has a team of doctors she can trust looking out for her and a support group of other people who are fighting breast cancer she can rely on.
"I've joined a support group, that was very difficult. It took my husband to push me to get out to that support group, but that
support has been a godsend to me," Timmerman said. "If I'm frustrated or upset about the fact that I don't look like a woman, I can say that to them and they understand it. They get it."
Though there is no such group on base, case managers assigned to the hospital often refer JBER patients to groups outside.
"This is an awesome med group," Timmerman said. "If you're ill, this is the place to be ill."
Now that her treatment is over, Timmerman has a team of doctors who are keeping a close eye on her for relapse, and will do so for the next five years.
"I check myself constantly - too much probably," Timmerman said. "I make a list of things I want my doctor to look at, and when I ask him, he just says 'OK, let's do it.' I've had nothing but wonderful treatment here. There have been little hiccups here and there, but with cancer, that's expected."
Even with the best medical teams in the world, there's nothing pretty about breast cancer. That's why it's so important to take self-checks seriously. Timmerman didn't.
"Mine was aggressive and it spread into my lymph nodes. If I had caught it earlier, it wouldn't have spread into my lymph nodes," Timmerman said. "I possibly could have avoided radiation.
"The earlier you find this stuff, the earlier the stages, the better off you'll be. That message needs to be portrayed."
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