I knew that after active treatment had finished I was going to permanently alter my body. I was going to get a tattoo. I was going to control the alteration, and the pain. This seems to be a common occurrence for cancer survivors, I’d like to believe that because treatment is so traumatic, we are permanently marked anyways. This can be in the form of bespoke tattoos, or more commonly in breast cancer patients, mastectomy tattoos.

Because I had a nipple-sparing mastectomy I knew my options were limited there, as trauma to the nipples is a risky game after they’ve been left without their breast tissue friends. So I dug deep and tried to figure out what would bring out the fire in me, and would serve as a reminder for the rest of my life.

I already have one tattoo, one which means the world to me, because it’s about the world. It’s a rose compass on my back, I got it in 2014 after moving back to the U.S. I had spent 9 years in London building a life, and most of that life revolved around my biggest passion, traveling. I had racked up close to 30 countries and had no plans to stop. No set directions, endless possibilities. I still adore this tattoo (even if it was quite a popular choice at the time).

When I got my first tattoo I was so concerned about the world and its opinions. Would people judge me? My parents? My friends? They had to like it. In the end all of that went away, you can’t get a tattoo when you’re thinking about others, you have to do right by yourself. This tattoo was completely different, I had cancer to thank for that. I had no thoughts about the world, or its thoughts, I only had mine and my desires. This isn’t about them, it’s about me, and my body.

So then I had to consider “what” that control looked like. I love tattoos with dates on them, I know many in the cancer community get their remission dates or other significant ones. The roman numeral look is really cool too. But I have a multitude of cancer dates in my mind, and if I couldn’t choose just one, I’d end up with a sleeve… and I’m not there, yet.

That’s when +++ popped into my mind. My cancer is triple positive, made up of estrogen/progesterone/HER2. It’s a term I heard (and hear) often. Not only is it the symbolic representation of my cancer. It also breaks down the changes I’ve gone through: mind, body, soul. And the mental health practice I engaged to get through it: three things I’m grateful for every day. The meaning is profound for me. And I’m proud to have it.

Mind — I will never be the same, I am stronger

Body — I will never be the same, I will become stronger

Soul — I will never be the same, I am awake

Facing mortality is difficult, having a permanent reminder of the positivity and gratitude all around me, every single day, is something I look forward to. I don’t know the future, and if once again I may face this beast. But even if I do, I will need these reminders to get through it. Today and everyday, no matter what I face. +++, friends.

This post originally appeared on Rogue Boob. It is republished with permission.