[00:00:00] Adam Walker: From Susan G Komen, this is Real Pink, A podcast exploring real stories, struggles, and triumphs related to breast cancer. We’re taking the conversation from the doctor’s office to your living room.
[00:00:17] Today we’re joined by Karen Powell, a nurse practitioner who not only supports patients through breast reconstruction, but has also walked the journey herself. After being diagnosed with breast cancer, Karen gained a new perspective on early detection, the emotional weight of treatment decisions, and the power of having a strong support system.
[00:00:37] In this episode, she shares how informed choices and personal stories can empower others facing a diagnosis. So kinda give us the full spectrum of who you are, what you do, what do your days look like?
[00:00:51] Karen Powell: So my name is Karen Powell. I’m a nurse practitioner at Memorial Sloan Kettering. And I work in reconstruction and I help women through their recovery process of some reconstruction options.
[00:01:04] So I also work in women’s health when it comes to menopause and weight management.
[00:01:12] Adam Walker: So alright, so I have a lot of questions. So there’s a lot of different reconstruction options and I think it also, the options sort of vary by individual and by individual case. Right? And so, so like what is typically your advice
[00:01:27] to someone that’s newly diagnosed and they’re trying to approach their treatment options and understand all of the choices that are being thrown at them?
[00:01:35] Karen Powell: What I would tell women who are newly diagnosed with breast cancer is to weigh all the options and to have a really good support system.
[00:01:45] Bring somebody with you if you can, to your appointments. Write things down. You know, go home and go through the information and use Google sparingly. I would say, you know, trust your providers and what they’re telling you and use Google as a tool but not as a, not for your treatment plan. I find that women who have the extreme outcomes, that’s what gets filtered into Google and, you know, that can cause more anxiety than what’s necessary.
[00:02:19] Adam Walker: Yeah, go Google does tend to fly to the extremes quite a bit. So yeah we’ve been advised on this show many times not to refer to Dr. Google too often. Yeah. So I think that’s probably good advice. Now I understand do you have a personal connection also with cancer in this?
[00:02:35] Could you tell us a little bit more about that?
[00:02:38] Karen Powell: Yeah. So, it was last summer and I just accidentally happened to graze a lump. It was smaller than a pee in my right breast. And I immediately did a breast exam. And, you know, given my background, I could tell that it was irregular even though it was small.
[00:02:58] But it was mobile. So I got a mammogram. It was my first one because I wasn’t 40 years old yet. And they found this small nine millimeter lump that came back positive for breast cancer. And it was a very polarizing feeling to read my own path report with my name attached to it because it felt very clinical, the words I was reading, but at the same time it was a deeply visceral feeling.
[00:03:30] And, you know, going through the process on the other end of the exam room chair was eyeopening in so many ways. And it just made me more empathetic as a provider. I feel like I understand now that when women leave the exam room and they can go into, like, they go into their cars and they let out a cry or their home and they’re milling over every word, the clinician told them that…
[00:04:04] that means more to me than, you know, it humanizes the entire experience. And it the things I tell patients now, like, you know, make sure you leave your coffee cup on the counter because you’ll be able to walk up the stairs, but you won’t be able to, you know lift high in the cabinets. Like that’s a very real thing.
[00:04:23] And yeah, it’s more than a diagnosis, it’s recovery and it’s optimizing that outside of, you know, the hospital setting. I’m very aware of.
[00:04:33] Adam Walker: And so, so I’m curious, like how did your, you know, experience in this space affect sort of the choices that you made, like kind of going through this process?
[00:04:45] Karen Powell: Yeah, so it’s a very it was very disorienting because you know, I had
[00:04:54] stage one breast cancer, thankfully caught early. And I decided to do a double mastectomy. Mainly because from a cosmetic outcome I knew I would have a better result than doing a lumpectomy and radiation. I was given the choice and, you know, I’ve seen the complications of both and it is a very deeply personal decision.
[00:05:20] Some women don’t have the choice, so you know, if you’re in the later stages and a mastectomy’s preferred. One of the number one questions I would ask is, you know, where are the incisions going? And is it the implant going to be in the front of the muscle or behind the muscle? And are you a candidate for reconstruction using your own tissue?
[00:05:41] So yeah, there’s a number of things that you can do to really empower yourself as making the decision that may not be in your control.
[00:05:50] Adam Walker: Yeah. And so, obviously you found your lump early. You found it sort of by happenstance and I think thankfully found it, you know, early. What would you tell women about early detection about advocating for themselves, especially, you know, women that are under 40?
[00:06:10]
[00:06:10] Karen Powell: I would say that, you know, you’re never, you know, you’re never too young, you’re never too fit, and you’re never too healthy to get something that, you know, to get, to find a lump or to really get cancer. So really, it’s not to dismiss what you’re feeling and not to, You know, and just to be vigilant and I know, you know, women my age are busy building their families and their careers and have jam packed schedules, but really, you know they’re, this is not something to be dismissed.
[00:06:44] And if you feel like you’re not getting the right answer, then find somebody, find a clinician that you feel comfortable with. And that you can have a candid conversation with because you know, sure it can be hormonal, but it may not be, and you know, you have to trust your instincts.
[00:07:02] Adam Walker: Yeah. And so, so you’ve kind of gone through this, if you don’t mind me asking, like, what’s your current status
[00:07:08] Yeah.
[00:07:09] For your cancer?
[00:07:10] Karen Powell: So currently I am about six months out from my final stage of reconstruction and, I had an Oncotype test done, which was relatively low, so chemotherapy wasn’t recommended. But I am on Tamoxifen, which puts me in perimenopause super early. So, you know, I’m constantly conflicted with am I tired from having four kids or as this perimenopause, or is it this, that tamoxifen, and you know, it beats the alternative.
[00:07:41] And it was, yeah, scary as hell. Going through what I went through, but I would do it all again if I could because waiting and, you know, milling through some decisions would’ve meant getting diagnosed at early stage because it wasn’t going away.
[00:07:59] Adam Walker: Yeah. You have four kids. Wow. I didn’t realize that early.
[00:08:02] I mean I’ve got a bunch as well, and I understand the fatigue, the, that can cause. So yeah, that’s you’ve got a lot less gray hair than I would’ve expected, so that’s good. Well, so, so let’s talk a little bit about, you know, survivorship, right? I mean, like, talk about like, like getting back to your life, reclaiming kind of your life after breast cancer after a diagnosis.
[00:08:25] Like, what was that like, what was it like for your children? What was it like for yourself?
[00:08:30] Karen Powell: Yeah, so I mean, when you’re di diagnosed, it feels like everything just gets blown away. Like, because now you become super T, you’re you beco, you have tunnel vision. You become super focused on yourself while in some ways trying your best to show up.
[00:08:49] On the sidelines to show up at, you know, dance and sports and music practice as if you’re fully present and you’re not. And they’re giving yourself grace to accept that and accept things will come back. But they do come back in waves, so you’re not gonna reclaim your old life all at once. Some things will come back exactly as they were before.
[00:09:14] And other things will look completely different. And that’s because you are different. You are not the same person and you’re, you shouldn’t be expected to be and that’s okay. And there’s going to be pieces of your life from your old life that you mourn. But there’s also. There’s also positive things that come out of a life altering diagnosis, and that’s okay too.
[00:09:40] It’s just, you know it’s just a matter of giving yourself that grace to accept that things will change, but it doesn’t have to be all negative.
[00:09:51] Adam Walker: Yeah. Well do you have, I mean, I’m just curious like any examples of some of the positive things that have come out of this for you?
[00:09:58] Karen Powell: Yeah. So, you know, some of the things that I find very positive is I’m unapologetically, I can unapologetically say no to things I wanna say no to. I feel..
[00:10:12] Adam Walker: Oh, I love that. Yes. Yes.
[00:10:13] Karen Powell: I feel no, there is no love loss if I don’t wanna do something, I live my life for me and nobody else. Yes. Yes.
[00:10:21] That’s it.
[00:10:22] Adam Walker: I love that. I mean, that’s like, that’s a takeaway that everybody should have right there. Like, just say no to everything you don’t wanna do. It doesn’t matter who’s asking you. Just say, I love that. All right. Yeah. That’s great. Any any other positives for you?
[00:10:35] Karen Powell: Yeah I feel like, you know, you tend to, quite candidly, try to just get rid of the bullshit. I mean, there is you really have a clear view on what matters, and scrolling through social media becomes irrelevant. As, as opposed to, you know, being able to like tuck my children in before bed and spending maybe 20 minutes each with them.
[00:11:02] And for kids it’s over an hour of putting them to bed. But talking to them like that that real connection and that real conversation becomes very apparent because when that’s threatened, there are things in life that all of a sudden don’t seem important anymore. And that’s, and there’s freedom in that.
[00:11:24] Adam Walker: I mean, it gives a lot of perspective, right? You know, a lot of I mean, it sounds like you’ve really got a, you’ve honed in on what’s important and you’re focused on that and not any of the other stuff. I like that. I like you said, it gets rid of the bullshit, like that’s. Yeah that’s a great outcome. Now,
[00:11:41] so I’m curious too, and you kind of, I guess going back to your diagnosis do you have a family history of breast cancer? Like, was this already sort of, I mean, it was on your radar because of your profession, but like was it on your personal radar already?
[00:11:52] Karen Powell: Yeah, so that’s an interesting that kind of ties everything together.
[00:11:57] So I had no. I wasn’t considered high risk because I had no first degree relative with breast cancer. So my mother, all of my aunts and my sister never had any sort of breast cancer. I was genetically BRCA negative, so I had no family history in that sense, but both my grandmothers had breast cancer and one of my grandmothers was 32 and my other grandmother was 60.
[00:12:26] And what makes this so interesting is they were two very strong women with two very different outcomes. So my grandmother, who was 32, had felt a lump, ended up getting a mastectomy, went through chemo and radiation, and lived to be 88. And my other grandmother felt a lump as well and did nothing. And I think it was an education gap.
[00:12:48] I think there was a learning barrier. I think there was fear in losing her breast and she ended up passing away with metastatic disease at 64, so four years after originally found the lump. She was gone and that, that was the footings I think that led me into my career. I think in some ways I was very comfortable around
[00:13:12] Women in such a vulnerable time in their life that it just felt like a natural calling. Yeah, so my grandmother, who was 32 who ended up having breast cancer, you know, she basically watched me quite a bit when I was growing up. So I saw the survivorship end of things firsthand from when I was little.
[00:13:36] And you know I knew that’s where my soul belonged and that’s where, you know, I could dedicate my life to. So yes, in some ways, yes, I did have a family background and you know it, which led me into my career so inadvertently. So my grandmothers saved my life.
[00:13:58] Adam Walker: Wow. Wow, that’s amazing. And are now impacting through you so many other women that you’re having such impact on as well.
[00:14:07] Karen Powell: Absolutely. And hopefully for generations to come.
[00:14:10] Adam Walker: Yeah. Yeah. That is absolutely goal. Well you know, I, I guess last couple of questions here and I think I get a sense for why, but I’ll ask so we know like why are you here, why are you sharing your story? Why is it important to get this information out into the world, to you?
[00:14:28] Karen Powell: So you know, when I went through my my MRI and my mammography, I was sitting in the exam room with women who were decades old, older than me. I was, you know, who, you know and I’m looking around thinking to myself like a little anger, like, why am I here? I should be treating you. I shouldn’t be on this end of the exam room table.
[00:14:51] But, and then I just had this thought with. How many women in my position would’ve dismissed the lump because it was so small. And that is who I’m speaking to, is the women who it, you know, you think it couldn’t happen to or it shouldn’t happen to because it’s decades before our time, and that is who I think about every day when I come to work and, you know, in that exam room.
[00:15:18] So that’s why I feel like my story is so important.
[00:15:21] Adam Walker: It is. It is important because it’s, I think it’s easy to pretend that you didn’t. Yeah. You I didn’t feel that. Right. It’s easy to pretend and also very dangerous to do that. And we don’t want people to do that. So Karen you’re amazing.
[00:15:37] Your story’s amazing. The work that you do is amazing. Do you have any final thoughts you’d like to share with our audience?
[00:15:43] Karen Powell: Yeah, I just wanna say thank you for having me and putting my out there and, you know, feel your boobs and trust yourself.
[00:15:53] Adam Walker: That’s right. That’s right. Trust yourself. Well, Karen, thank you so much for joining us on Real Pink Today, so we so appreciate having you on the show.
[00:16:00] Karen Powell: Thank you, Adam. I appreciate it.
[00:16:07] Adam Walker: Thanks for listening to Real Pink, a weekly podcast by Susan G Komen. For more episodes, visit real pink.Komen.org. And for more on breast cancer, visit Komen.org. Make sure to check out at Susan G Komen on social media. I’m your host, Adam. You can find me on Twitter at AJ Walker or on my blog adam j walker.com.