Bras after Breast Cancer

Carol O'Kelly is a Certified Mastectomy Fitter and the General Manager of Tomorrow's Woman, which is a specialty post-surgical bra store, and The Perfect Fit, a bra boutique with a wide range of sizes. Both stores operate under Med Center Health in Bowling Green, Kentucky. In this episode, Carol shares about the physical changes that women may experience during and after breast cancer treatment, and how that affects their support needs. She talks us through prostheses and the products available to make every woman feel whole again.

She shares this resource: 

Tomorrow's Woman/The Perfect Fit at Med Center Health

https://medcenterhealth.org/location/tomorrows-woman-and-the-perfect-fit/  

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Transcript

[00:19] Greer: 
Hi, this is Greer, your host for Femammal, the podcast that holds space for women to explore what it means to live well in our bodies and celebrates moving through this world as female mammals. Carol O'Kelly is a certified mastectomy fitter and general manager of Tomorrow's Woman, which is a specialty post surgical bra store, and The Perfect Fit, a bra boutique with a wide range of sizes. Both stores operate under Med Center Health in Bowling Green, Kentucky. In this episode, Carol shares about the physical changes that women may experience during and after breast cancer treatment and how that affects their support needs. She talks us through prostheses and the products available to make every woman feel whole again. So, welcome. Carol. If you could start, I would love for you to tell us about your work and what drew you to serve women in this way.

[01:30] Carol: 
Sure. I am a certified mastectomy fitter as well as a trained retail bra fitter. What led me to doing this is, oddly enough, I had been working for an attorney which we did criminal and family law. So you can imagine, it was not quite an uplifting job. Everybody was in there, was not happy, not happy to be there. And I didn't feel like I was really doing any good. I would just kind of answer the phone and blah, blah. Well, then I was approached by a person that said, hey, I know someone who's looking for a fitter to do things with women who have had breast cancer and women who have problems finding bras. I'm like, well, that sounds kind of interesting. So I went and spoke with them, and they were just at the point, getting ready to be purchased by the hospital, which is who we work for now. And I interviewed and we discussed the different things, and I knew this would be great. I would be able to help women get educated about breast health, about the proper bras, what we can do. And you just have the training which was going to be provided was amazing, because I know, even from when I was younger, your mom hands you a bra, you put it on, and you're like, okay. And no one really kind of discusses, this is what's going to happen. This is how you're developing. You can change. And then I went through, while I was working here, a brief thing where I had to have a biopsy. Thankfully, I have been in this type of position, so I wasn't as apprehensive, but I was I was really kind of like, oh, gosh, what's going on? I'd always done my mammograms like I was supposed to. It turned out, thankfully, not to be cancer, so it wasn't anything major, but I did have to have a small lumpectomy. But that also helped me to be able to speak with these women and work with them. Now, granted, like I said, it wasn't cancer, so I didn't have the same thing, but to be able to empathize a little bit and to be able to help these women educate themselves and find out why it's important to just check your breast health. I'm amazed at how many women don't really know how to properly do a self examination. We have a little we call it a training tool. We use it a lot of health fairs, and it says, can you find the lumps? And it's just this breast prosthesis that has lumps in it. And they'll kind of pat it and they'll say, I don't feel anything. I'm like, well, you can't just pad it. You've got to kind of give a little pressure. You got to think about your breast tissue. It could be dense, it could be kind of thick. And they're always amazed. And so I think it's just a wonderful opportunity to be able to help women, all women, be educated on their breast health.

[04:07] Greer: 
That's so neat that you involve that education component. Do you do that during fittings or how does that education fit in?

[04:14] Carol: 
Typically we do it at a lot of health fairs or we'll do it sometimes at fittings, but by the time we get them, they've already usually had breast cancer. If they're not on the retail side, they've already went to see a surgeon. They've talked to a surgeon about it. Several of them have. Like, I found it myself, something wasn't right. But there are several that have their mammograms. Big thing. Mammograms are very important. They do find things. It can prevent cancer because sometimes they prevent the surgery altogether by having those as you need them every year, every exam. But we have used it a few times when women said, I didn't know what I was supposed to look for when I had cancer. And that's when we'll bring out that breast prosthesis with it. And we're like, can you find them, they're like, I didn't know what I was supposed to be looking for. That's probably true. Most of us don't. But it is a great training tool and we're going to try to possibly get in with some of the surgeons in town and just kind of see if maybe it's something that they might want to kind of borrow for a while and just see if it would help them with their education of their patients. So that's how we educate there. And of course, we always have informational packets, but I think the hands on, so to say, is a lot better.

[05:33] Greer: 
You're making me think of CPR trainings where you train with a dummy. So why not, when teenagers are taking their health classes, why not do breast exams with the prosthesis you're describing? That would be such a value-add.

[05:48] Carol: 
Absolutely. Because particularly in high school and even college, they have the mindset, nothing's ever going to happen to me. I don't have to do this. And it would be good just to kind of have this little health fair within those things or even go to end those classes, which is something, thank you, I might check out, see if I can go in and kind of help educate them. We do have, I would say, it's like a hanger thing that you can put in your shower or somewhere close that goes over the elements of doing this self exam and what you should find or what you could find. That's pretty cool, too.

[06:25] Greer: 
Oh, that's such a great resource. And you mentioned that you are a Certified Mastectomy Fitter. What goes into that certification process?

[06:34] Carol: 
Well, you have to have at least 150 to 200 hours of training by a certified Mastectomy Fitter. So I was fortunate enough when I came into Tomorrow's Woman, there were two Certified Mastectomy Fitters already, so I was able to be able to train under both of them. And then you need to take a course through either American Breast Care or Amoena. Both offer them, and they're called the First Fittings and Beyond. And they kind of go over the different types of cancers, the different things you may see, and how to fit a woman, how to talk to them, what you should and shouldn't say, maybe the setup of mastectomy fitting room. So you have this whole course that you need to take, and it's a whole day. You take that one, and then if you pass that and then you have to take an exam by a certification facility. You could do ABC, which is American Board of Orthotics and Prosthetics. Or BOC, which is Board of Certification for Orthotics and Prosthetics. And then you take an exam. Actually, you submit to want to take the exam, and then they'll either accept or deny dependent upon your documentation. And then you take that exam, and a couple of weeks later, you get to be certified and you have to be recertified every year. And we also have to do a certain amount of CEUs, which is continuing education. They're based on different categories. For instance, you have to have so many on scientific, which means what is new in the breast care area? Is there anything new in prosthesis? What's going on? New surgically? We have ones that just in the fitting process. What's new items? What can we do? So there are any type of CEU or it could be as far as billing insurance. Is there anything new? Insurance? Are they covering something they didn't before? Those are all items we have to do every year as well. I can't remember how many there is. We have to obtain within a certain three or four year period. But they're pretty good anyway. We take them anyway because they're helpful.

[08:42] Greer: 
I'm listening to you with a huge smile on my face because I love that women are getting your support and that it's a support that is so thoughtful and well informed. I just think it's so wonderful. There's so much in our healthcare system that doesn't go well or we don't get the follow up we need. But this sounds like a really well-developed area and it's so refreshing to hear about.

[09:05] Carol: 
Thank you. I do think it's just so important, and I do agree with you, there's a lot of women's health that is kind of just, I would say shoved under the rug, but not intentionally. It's just not discussed like you think it should. Everybody talks about a heart attack or I can't even think of cancers, but the breast area and the women's health area tend to be left out or they don't quite know where to go to follow up. So I love that they allow us to have all this training, and where we work is very open. They're like, do what you can. We've got a great facility we work in. We try to make it non-clinical for these ladies. And what I mean by that is, by the time they come to us, they're kind of over going to a physician office all the time. We are actually located in a women's pavilion, so it is all about women's health, but it's just less clinical. Like, we don't wear scrubs, we don't wear anything like that. We just have conversations with them, try to put them at ease. And they always like they're like, okay, I like this because I don't feel like I'm going to the doctor's office. That's good, because they're tired of it by time they see me. 

[10:19] Greer: 
Sure. And I had not really thought a whole lot before about how a woman's breast support needs might change after experiencing various treatments for breast cancer. Could you talk a little bit about that?

[10:31] Carol: 
Yeah, well, women's breast changes throughout their life. I mean, it's a constant change, whether it's the band size or the cup size or type of bra. They need women as they get older, they lose elasticity in the breast, so they generally need a bra that's supportive through the band. But they don't need an underwire, they don't need anything heavy. For women who have had mastectomies for the first two years, we refit them about every six months. If we can get them in here, it takes a good year for their chest wall to settle. As they're healing, some experience a lot of change where they feel like, particularly if they've had a single, like where they've just had a right or a left, they'll feel like it's changing a lot. And their right or left natural breast will feel like their shoulders are sloping or it's heavier. And that's just because their chest wall is kind of settling and we need to get them in a different bra or a different prosthesis to help balance and symmetry. The other thing that can change for them is some experience swelling through lymphedema, which I don't know if you know what that is at all. It's where lymph nodes have been removed, so your lymphatic system which pushes the fluid through your body, that part of it has been removed. So it can retain fluid. Not always, but so then we have to get them in a more compression type bra, and that may not come on right away after surgery. That may be a year or two down the road. So those are things we do. Now, women who have had a reconstruction or an augmentation, a lot of times they're told you don't need to wear a bra. I would say any breast tissue needs to be supported. Whether it's something simple as a comfortable sports type bra or leisure bra, that's fine. You don't need a heavy duty underwire for those kind of things. But they do need to support them because that breast implant can shift and can start to slope as well because it is stretched in your skin. So those are things that they need to look in and we discuss with them. The difference between, as people would say, a retail bra or a mastectomy bra is the mastectomy bra has pockets in it in the cup, and that's what holds prosthesis. So most of our bras are non wire. They typically cannot wear an underwire bra until they're at least a year past surgery due to the fluctuation of their chest wall and their body changes. So when we get them in here for their first fitting, which is typically six weeks after they have had surgery or their surgeon releases them, that's when we decide. Do they need a full prosthesis or a shaper, which is for partials, or what they need bra wise, what size, what style, what fits them best? Some women have a port where they have to have chemo through, and that also has an impact on the type of bra. We have to make sure that that's accessible, that they're not going to get the bra strap caught on it. So there's a lot of those things we go over in their appointments when they come in.

[13:32] Greer: 
Wow, I'm learning so much. So very basic question. So if a woman has a mastectomy, is she using a prosthesis, only if she hasn't had an implant. Like prosthesis is the word for kind of the external shape rather than getting an implant internally?

[13:51] Carol: 
Typically, yes. The only time they would have a prosthesis when they have had an implant is if for some reason they've had reconstruction and there's something gone wrong with the surgery or they had it right away and then their chest wall settled, or they had to have radiation and it caused the side with the implant to shrink. Then they may need a shaper or something to balance them out. But typically they don't usually have to have it's only if they've had the full removal or enough of a partial removal that it is obvious, particularly to them that their breasts are not symmetrical. They're not the same size.

[14:30] Greer: 
Okay, wow, that's so interesting. Could you say a little bit more about the prostheses, like how long they last, how often you replace them, what that looks like.

[14:41] Carol: 
Yeah. The prosthesis we use are by a company called American Breast Care. They will feel like real breast tissue. We always tell them they'll pass the hug test. If someone hugs you, they're going to have no idea you're wearing a prosthesis. They're very pliable, soft. Some of them come with a diamond shape on the back that allows for airflow because they can get a little hot. There's different shapes and profiles because as we know, women are not all, not all breast tissue is the same shape. We're all not out there like the old playtex bras, which is probably before your time. But they have, some have a sidebar, which we call it, which helps them if they've had a lot of lymph nodes removed or their breast tissue was more removed on the side. We also have, like I said, partials that are very thin, that just cover mostly maybe the apex of the breast, which was smaller. So that helps balance them. So we have a lot of options for them. Bras are typically non latex. They're very soft. I think we have about 20 styles of mastectomy bras, and they range from like AAA cup to we go up to, I think, a G in the US. For these ladies. If they're a bilateral, we try to fit them as close as to what they feel like they looked like prior to surgery. So they'll wear a prosthetic in each side and typically those are exactly their two mimicking prosthesis. And they'll be able to say, well, this one looks more like it, or this one's more comfortable. So at that point they get to decide what size they want. And a lot of them want to go smaller. That's always what I hear. A few of them will want to go bigger. And there's only so much weight your body can hold even if you are putting them. If you're a very thin little person, you don't want to put a lot of weight on your chest wall. So we size them in that and the profiles, what fits their body type. If they're very petite, they're going to need something that's not as wide in the profile. If they're maybe a stockier built person, they might want something wider that kind of makes them feel like their body's filled out more. And that's what we do in our fitting process.

[16:53] Greer: 
Wow, there's so much that goes into it. Do you see some women who haven't made a decision yet about whether they're going to go back and get implants? They didn't do it initially, but they're thinking that might still be a good option for them. And how do you work with those women specifically?

[17:09] Carol: 
Yes, we do have a lot of women who just aren't ready to pull that trigger and say, I'm going to get implants. It's really a personal choice. They'll ask us, well, what do you think I should do? And I'm like, well, it's a personal choice. It's not just a physical choice. It's also a mental choice. Which will you feel more comfortable? Do you feel like that's something that you want that would make your life easier or better? And we always ask them that's something you need to discuss with your surgeon, your plastic surgeon, because not all people are eligible for it. It could be due to the type of surgery they couldn't have it or some other medical history, but we're there to help them. We can do it several different ways. If they're pretty sure they're going to do it within the first year, we can give them a prosthesis that will help them along as the augmentation the reconstruction goes along. Now, typically nowadays, they do a lot of it right away, like they'll have their mastectomy and then the plastic surgeons right behind it to do the augmentation, the implants. So the skin is already stretched. They can already put it in, and that's what they like to do. Or they do a trans flap, which is also where they take tissue and body fat from other part of the body and use that to construct the breast. So they do a lot more of that than they used to. Back when I first started, it was usually a small window. And they would do it. They would put expanders in, so those expanders would have to be stretching out the skin as a process, over eight weeks to maybe six months. Somewhere around there, they would put those in there, and we would have a breast prosthesis that you could add stuffing, whatever you put the stuffing in, and it would grow with your reconstruction. So if you were just like particularly if you're just a right or left, so you would have that to even you out until the full reconstruction was completed. They don't do it that way as much, but we do have that ability to help them with that.

[19:12] Greer: 
Okay, wow. And if someone gets a Lumpectomy, do their support needs change at all? Or is that always so minor that it's negligible? They don't need something different.

[19:25] Carol: 
A lumpectomy, which actually we call a partial mastectomy. It depends because a lumpectomy typically is any lump area or any area removed from any part of the body. A partial mastectomy means it was part of the breast removed. It will depend on how much breast tissue was taken. Some women, there's not a size difference, really. I mean, unless you get a microscope and there may be one 8th of an inch or something, it's not enough difference for them to want to wear a prosthesis. Now, there are some that their partial mastectomy is pretty extreme. You can tell they may be two or three sizes smaller on that size. And that's when we add either a shaper or a full prosthetic, depending on which works best for them. There are many types of prosthetics, like I said before, there are some that you can just do the apex, which is, people would say, the most projection of your breast that just cover the apex because maybe their mastectomy or partial mastectomy was right in that area. And that's where they seem to not be able to fill out a bra. So we will just get that type of prosthesis. Or maybe it was over to the side or underneath the breast tissue and there are prosthesis just to kind of fill that area. Or a lot of the ladies call it a divet underneath that breast tissue, over to the side just to even them out. So as they're wearing a bra, they feel like they are, as they would say, normal that they look like they did before.

[20:56] Greer: 
Okay, that's really helpful to understand. And I was able to interview a breast cancer survivor who did get implants, and she told the story of getting 3D tattoos to restore her appearance of nipples. And I thought that was so neat. If someone is not going the tattoo route, are there other options to kind of recreate that nipple appearance?

[21:22] Carol: 
There are. There are actually nipple prosthesis and they are covered by insurance. They can have just the nipple that they would put on their breasts because sometimes when they have reconstruction, if they don't, they can't or they aren't able to save the nipple area, then they would have the reconstruction, but they have no nipples. 

Greer: 
So you could do a nipple prosthesis and that is covered by insurance? 

Carol: 
Yeah, it comes in the various sizes are pretty much there's a couple of sizes and various shades to match their skin tone.

[21:49] Greer: 
And does it stick on with some kind of adhesive? How does that work?

[21:54] Carol: 
Yes, there's like an adhesive that it sticks on with and then there's like the scrub to make sure you take it off so it won't fall off. It won't end up on the wrong side of your bra. So yes, it is an adhesive type. There are also adhesive prosthetics that you can use an adhesive and stick them to your chest wall, but unfortunately insurance does not cover those. Well, Medicare and Medicaid do not cover those. Sometimes the standard commercial insurance will cover those, but I don't know why they don't do those. But they don't. Recently, I believe Medicare has approved what they call it's the prosthesis, where it is a specialized where they go in from ABC, say my rep would come in and she would actually do a custom prosthesis so that prosthesis would be shaped exactly to that woman's chest wall. And then so when she puts it on, it fits right onto her chest wall. Every curve, every move, everything in there is fit. Now those are just now where they're working really well, but they're not completely approved by all insurance. That's something we're hoping to get done. The only downfall of those is if you happen to be a person that gains weight or loses weight in your breast easily, or your chest wall, then that will change quite a bit. And you may be constantly having to get them redone, because if you gain ten pounds in that area, it probably won't fit anymore.

[23:21] Greer: 
That makes sense. And with these adhesive products, are you taking them on and off on a daily basis and cleaning your skin and all that?

[23:29] Carol: 
Yes. And they're special cleansers for the prosthesis themselves and for your skin, and special lotions that you can use to keep your skin from getting irritated. But they're all made with non irritating lotions and adhesives. But yeah, there are specific things that they would do to require to keep their chest wall from getting infected or irritated. That's why a lot of women don't do those.

[23:55] Greer: 
Yeah, it sounds like kind of a lot of maintenance.

[23:58] Carol: 
It is. But some women might want to do those if they want to wear like, maybe a low cut strapless dress or something to that effect. And we have had those circumstances where they're like, look, I've got to be in this wedding, and it's cut down to here and it's a halter top. Sure. So they need their options.

[24:16] Greer: 
Yeah. It's neat how much you take into consideration if someone is initially in their recovery phase from breast cancer. First, where can people go to buy bras after breast cancer? How do they find a store like yours in their area?

[24:35] Carol: 
They can google mastectomy supplies. They fall under durable medical equipment, which sounds horrible, but we are under a durable medical umbrella. But fortunately, the medical center, which we work for, realized that it was beneficial to have our own boutique type setting for these ladies, which is fantastic. So that doesn't make them feel like they're going where someone would go get a walker or a brace, a pharmacy. Some pharmacies carry them and do them have certified fitters. There are different types of mastectomy and bra boutiques. You sometimes find a mix. I know. I think Nashville has a couple of them, which we are close to Nashville. I think there's some in the state of Kentucky and Lexington, Louisville, Paducah. So there's usually a mastectomy boutique somewhere, or a pharmacy or somewhere that can help them. Now, if you go to a pharmacy, a lot of times they don't have quite the availability of product because that's not their specialty. So you can also contact any of like, Amoena or American Breast Care or Essentially Women, any of those type of groups will able to lead a woman to a mastectomy shop or somewhere they can get help in their area, so it doesn't matter where they live.

[25:56] Greer: 
That's really helpful. And you mentioned that as your recovery progresses, you might continue to change even a year down the line or more. So how often do you recommend that women come back and see you? Is it when they just begin to notice changes? Or do you kind of go ahead and put someone on the calendar? Go ahead and come back in six months. How does that work?

[26:21] Carol: 
Well, when they're first after their first fitting, we usually bring them in every six months, like I said, and then we refit them. Prosthesis insurance companies usually allow one every two years or two every two years, depending if you're bilateral or right or left. But if you have an extreme change, then it's your surgeon or your doctor. Give me your general practitioner. Maybe they've lost 25 pounds and it just doesn't fit anymore. Then we get the documentation for that and we change that. That usually happens a little later than when they're first. Medicare ladies are able to get bras three every six months and a prosthesis every two years. Some of the commercials, it's how many a year? Like some Blue Cross, Blue Shield allow four bras a year and a prosthesis every two years. Typically, it's every two years because they're pretty durable. I mean, as long as you take care of them. We instruct them when they come in, how to care for their prosthesis, how to make sure that they don't leave it hanging in a bra so it doesn't get warped. They come in a little case, and we always say when you go to bed, you put it to bed. They make sure they keep it clean and they're warrantied for two years. So if something happens to them, the manufacturers will replace them.

[27:39] Greer: 
That's good to hear. And you've been alluding to different insurance arrangements. Are we at the point where all types of insurance are obligated to cover at least some forms of mastectomy bras and prostheses, even if it's not everything?

[27:54] Carol: 
Yes. Typically, almost every company I've maybe run into one, which is a particularly odd one, but only one that did not allow for prosthesis and bras. Probably the least amount of bras they're allowed is two a year. The most is, I think, six a year. And then all of them are usually allowed a prosthesis every two years. I have not run into any company other than that, just one. And there's only one person that I know that has it that does not allow for that. So it's very good. The insurance companies are working through this and it's always subject to your deductible and copay and all that good stuff. But they do pay quite a bit on them. So it's a great opportunity for those ladies to utilize their insurance. And some people don't know that.

[28:42] Greer: 
Yeah, it's really helpful for you to be sharing this message because it wouldn't have occurred to me that a bra would be something covered by health insurance. But it makes complete sense the way you talk about everything that goes into it. It just might not occur to someone.

[28:56] Carol: 
Right. Because the bra is to hold the prosthesis. They need a bra and bras are holding those prosthesis. So they need to be changed, they need to be taken care of. And the insurance has realized that as they call it, the 'housing,' the bra has to be there and it has to be in great condition and not stretched out in order for them to be able to support those prosthesis because they'll feel weighted, like an actual breast feels weighted.

[29:23] Greer: 
I was wondering, recovering from breast cancer and going through the whole experience of diagnosis and treatment can be a really tender time for women. And maybe coming out on the other side of surgery or other forms of treatment, women might be feeling very self conscious about their bodies or having a hard time coming to terms with all of the changes. Do you have any advice for women who are struggling with some of these self conscious feelings and are having a hard time coming in because of it?

[29:54] Carol: 
I know that they feel very self conscious, but this is here to be a place of healing, most mastectomy places are there to help. They are there to make you feel better, make you feel confident. Our goal is to have them feel confident when they look in the mirror for them to realize that regardless of the surgery, they are a wonderful, beautiful person and that most of the time they're more self conscious. People are just wanting to see their smile. They just want to see them happy. So we try to bring them in here and there are some women that come in right after and they're totally fine with it. They come in six, seven months later, they're still fine with it. And then we have women that maybe had breast surgery ten years ago and they're still unhappy with it. I would suggest outside of what we do, support groups, there are a lot of breast cancer survivor support groups and those are very important. Even if you're a person that thinks, oh, I don't need a support group, I don't need that. But they are. They're just other women who have been through what you're going through and they're just that sisterhood, that someone to connect with you and say, oh yeah, I went through this too, and I went through that a lot of times. They don't even talk about breast cancer. After a while they just become this support group of women that support each other.

[31:11] Greer: 
That's such a great message to hear. And I understand your shop, you really have two stores paired together. Do you want to talk a little bit about that arrangement and how that works well for you?

[31:24] Carol: 
Sure. We have The Tomorrow's Woman, which is our mastectomy side, and then we have another one called The Perfect Fit. The Perfect Fit, we specialize in women who have a hard time finding bras to fit them because they are large busted. Now we do some your typical range C, D, whatever, but we have clear up to an O cup. A lot of these women experience back pain, neck pain, shoulder pain, because they're trying to fit themselves into the mass bras that are out there. And there's nothing wrong with the bras that are out there. They're just not made for those ladies. So we fit ladies who have a hard time finding a bra that allows their breasts to be supported and covered and they feel comfortable. And then a lot of times we have doctors, we actually have one surgeon who does a lot of mastectomies. He will send women to us that have not had any breast surgery and say, you need to go get a good bra to support your back. So that's the Perfect Fit side. We come in, we fit you, we size you, get you in a great fitting bra, whether it's underwire, non wire, whatever your case should be that you need, and we help you feel more confident. A lot of these ladies are like, wow, this feels so much better. Or I hated underwires, but I didn't know why. Well, because the underwire was not meant for their size, and it would be uncomfortable. It would poke in the wrong place or pull in the wrong place. And then in order for them to get a cup size large enough for them, they would get a huge band size, so there was no support for underneath their breasts. So the band and cup combination is very important in order for you to be properly fitted. And that way you well say, okay, this is comfortable. I don't want to rip this off the minute I get home. Although most of us do. It just helps them if they fit better in their clothes. I always put it this way when women say, well, I don't want to do a bra fitting. Our bras are expensive. I just want to get a cheap one. When you build a house, the most important thing is not the furniture or the curtains. It's the foundation. So if you have a great bra on, you are supporting your body with a great foundation. Therefore, if you buy A-$5 T shirt, it's going to look fantastic. But if you have a terrible supporting bra, you could spend $50 on a T shirt, and it's not going to look as good as that $5 over that supported bra.

[33:46] Greer: 
Thanks for that perspective. It sounds very complementary. And it's really helpful to hear about the health dividends that are paid by investing in the right kind of support for what you need.

[33:58] Carol: 
Yes, it is. And bras don't have to be expensive, and they don't have to be uncomfortable. It's just we need to make sure that we are supporting our breasts, that we are paying attention to our breasts, caring for them. Breast health is very important. It helps, like I said, back problems, neck problems, shoulder problems. A lot of that can be affected because of how your breast is supported, even if you're not very busty, if you're just a smaller but if you happen to have problems with your shoulders. We have ladies have trouble with their posture and a lot of times they need a great bra in order for their posture to be better. I mean, there's just so many things that go into the importance of breast health that I think is just kind of glazed over. We think of bras as this sexy, wonderful thing we wear, and they can be and they can be comfortable, but they also are something that's very important for everyday wear.

[34:52] Greer: 
Yeah, absolutely. And thinking back to the survivors you get to serve, what do you get to bear witness to as you accompany women in your work?

[35:02] Carol: 
Some of the I would say I don't even know that makes you feel good. The warm fuzzies, I guess, is when they come in and they're very uncomfortable and then they'll say, you've made this so comfortable. I feel like myself again. This has been such a good experience. I feel like I'm me again. I just feel like people won't be staring at me or they'll come back in and say, my grandkids hugged me and they can't even tell. They have no idea. Or they'll say, I bought a new dress because I just felt so much better about myself. Or they'll be like, I just don't feel like I'm incomplete anymore. Or we have ladies that come in and have hey, I've went to some support groups. They are fantastic. And we get a lot of information on support groups from some of our ladies that come. It's amazing to see them go through the change of where they thought something was wrong with them and they've learned to separate the fact that they had cancer. It was a disease. There's nothing wrong with them. It's no different than if someone else had to have part of a leg amputated or an arm because it got cancer or something in it. People go through changes in their body and this is just a change for them. And it does take them a while. And they need to learn self acceptance, learn that you allow yourself time to heal and allow yourself time to come to terms with it. And just to see them light up. When you see them, you come in here, even if the first time they're not too happy or the second or third, they come in and then they finally are like, hey, can I get a bra that looks pretty? Or hey, can I get something that does this? I need a sports bra, or to see them just getting back into life and that is amazing to me.

[36:45] Greer: 
That's so good to hear. I have one last question. It's the question I always like to end these interviews with. I'm wondering, do you have any advice for how we can listen well to our bodies.

[36:58] Carol: 
I would say the biggest advice I would have is to get familiar with your body. I think that's been kind of a taboo subject for many years, meaning women don't really do self exams, not just on their breasts, just in general, looking over their body, understanding what's going on with their body. And if you feel like something's wrong, go see someone in that area, whether it's breast or any part of your body. We work above OBGYN. If something's not right, just go get it checked out. I mean, it's better to do it ahead of time and to find out what's going on with your body, but listen to your body, become in tune with your body so that you know, this isn't right, this doesn't feel right. And even if you shrug it off, oh, I think it'll just be this. I'll take a couple of Tylenol. It'll be fine. Just still keeping aware. My daughter has severe cramps with her menstruation, and she says, what should I do? I'm like, you need to go to a gynecologist. You need to make sure that there's nothing going on. So I took Mydol and it kind of helped. I'm like, well, I'm sure it does, but sometimes that just masks a problem. But I really think that women need to listen to their bodies and not be afraid to stand up and say, hey, something's going on. I know my body and this needs something checked.

[38:18] Greer: 
That's great advice. I really appreciate you coming on today, Carol. I learned so much from you. Thank you so much for your time.

[38:27] Carol: 
Thank you very much. And I appreciate you putting out these podcasts. It's fantastic. So I wish you the very best.

[38:34] Greer: 
Oh, thank you. If today's episode resonated with you, I'd love to hear from you. You can email me at femammalpodcast@gmail.com. That's femammalpodcast@gmail.com. You can also follow this podcast on Facebook. Just search for Femammal Podcast and you will find a community of people who are interested in living well in our bodies. And of course, I'd love for you to rate this podcast and leave a review wherever you download your podcasts. Until next time, be well.