Managing breast cancer as a single parent: Amber Tisi

Even under the best circumstances, single parenthood means juggling schedules, finances, energy, and emotions. In September 2018, Amber Tisi, of Minot, North Dakota, was going through a tough time as a single parent. She was raising three young children, working full-time, and contending with legal and personal conflicts related to separation and divorce.

Then she found a lump in her breast and was diagnosed with stage II breast cancer. The news left Amber, who was 38, feeling in “a big whirlwind, a blur,” she recalls. “I was thinking, ‘Did that really happen?’ The divorce was causing me so much stress, I was worried about it more than my health.”

She had also just signed a lease on a new apartment. Amber and the children moved in over a weekend and she had a bilateral mastectomy the next day. There would be more challenges ahead. Amber talked with LBBC contributor Robin Warshaw about being a single parent with breast cancer.

Robin: Were you alone when you learned your diagnosis?

Amber: I had a friend with me. They had lined up a team: a nurse navigator, oncologist, and surgeon. I’m a mammography technologist so I knew that side, but I never knew what all was entailed after having a biopsy done.

Robin: Your twin girls were 7 years old and your son was 3. What were your biggest concerns?

Amber: At that point, my ex-husband was only seeing the kids on Sundays, so I wasn’t getting much help. I had to figure out time for all the doctors’ appointments, my work, and the kids’ schedules. Going through a divorce, I had a lot of money going to lawyers. Financially, it was very worrisome.

It was hard to talk to the kids and make them understand what was happening. Their first thought was that I was gonna die. Kids think that everyone dies if they get cancer.

I told my kids that I was having surgery, my body will look a little different, and that I would be okay, that they had nothing to worry about. When they saw me for the first time, they were kinda scared to be close to me because of the drains and bandages.

Robin: How did you handle your post-surgery healing with no other adult at home?

Amber: My ex only took the kids for 2 days. I got them back my second day out of surgery. I remember that first day of picking them up from school, just reaching over to buckle my son in his car seat. They took lymph nodes out of my left side and that reaching around was very difficult to do.

My parents helped when they could. They were working during all of this and helped out with pick-up and drop-off at school and daycare.

Robin: You planned to have reconstruction with a plastic surgeon in Bismarck, North Dakota, about 100 miles away. What happened?

Amber: Initially, when I got my pathology back, it recommended no radiation or chemo. I had to wait 6 months to start reconstruction. About 3 months after my mastectomy, the doctors called and said, “To be on the safe side, we think you should have radiation.”

I was about to start radiation in March 2019 when my daughter got diagnosed with thyroid cancer. It was the day I signed the divorce paperwork, a day I had been waiting a very long time for. To get that news was devastating.

We went down to Fargo, North Dakota, about 4 1/2 hours away, for surgery to take out her thyroid. By then, my ex was taking the kids every other weekend and every Wednesday. He was gonna have the other two kids Wednesday and we were supposed to get back on Thursday. Because my daughter wasn’t medically ready to be discharged, I messaged my ex to see if he would take the other kids for Thursday since we weren’t gonna be back. He said no because it wasn’t his scheduled time. My parents took the other two kids for me.

I started my radiation after her surgery, in between going back and forth to Fargo where my daughter also had radioactive iodine treatment. We both finished our last treatments in the same week in May. That was exciting to be done with all of that. My daughter is doing great now.

Robin: Did you finally have reconstruction?

Amber: The plastic surgeon said radiation would make my skin hard, making it more complicated for reconstruction. She told me that I needed to go to the Mayo Clinic in Rochester, Minnesota, which is about 10 hours from me.

I was a week out from getting my expanders put in when I got a call from Mayo that the surgery had been cancelled due to COVID. That was a huge let-down. I finally went down in May. I had to go 2 days early to get tested for COVID, so that meant 2 extra nights of paying a hotel. I’ll have to do that again in October.

When I go down for fills it’s one overnight trip. It literally takes 5 minutes in the doctor’s office — all that driving for a 5-minute appointment! I asked plastic surgeons in the area here just to do my fills but no one would take me on.

I have had five trips there so far and go back soon for the second fill. My last trip will be in October, so seven trips total. I try to schedule them over my ex’s time to have the kids so I don’t have to get too much help from my parents.

Robin: What happened with school for the kids during the pandemic?

Amber: Fortunately, because I’m in the medical field, the schools opened a program during the day for essential personnel’s kids. I still have stress about what the school year is gonna bring. My 5-year-old is starting kindergarten and my twins are going into fourth grade. They start with in-school learning 5 days a week in late August. I don’t know what will happen if we have to go back to remote learning.

Robin: How have you handled the financial impact of treatment?

Amber: I have to make my health insurance deductibles every year. It gets to be expensive.

I’ve had to take out a few loans for my medical bills. It ends up being about $6,000 out-of-pocket every year.

Because I chose to have a bilateral mastectomy and insurance doesn’t cover the side that doesn’t have cancer, there was an extra $4,000 charge. I’m still paying that off in monthly payments.

Robin: How have you been doing emotionally?

Amber: I started to get really down at the 1-year anniversary mark of my diagnosis. I wasn’t anywhere close to being done. I still had a long road ahead of me. It didn’t seem like there was any end in sight.

I went to some counseling then, about three times. I was bringing the kids for counseling, too. I have so many doctors’ appointments all the time, it’s constant. After Christmas, for a couple months we didn’t do anything, and then COVID hit. It’s been busy and I need to get back to doing counseling but it’s hard to find time to do that.

Robin: Do you have friends or others you can talk with?

Amber: There’s a private Facebook group for young women with breast cancer that started in Bismarck. A girl I met on that decided to start one in Minot. We were doing Zoom meetings for a while. In the summertime, we’ve been doing it at one of the ladies’ houses, outside on the deck. One time a month, we get together and talk.

It’s totally different going through breast cancer under 40 versus a woman in her 70s or 80s. The group is nice to have, so that’s a big help.

Visit our page on parenting with breast cancer for information and resources.

 

This article was supported by the Grant or Cooperative Agreement Number 1 U58 DP005403, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.