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011: Drugs, Depression, and the Hidden Costs of Healing

Updated: Jun 22, 2021


Episode Summary:

Together, Tammey and Griff look back and dissect the real cost of pain in recovering from lifesaving surgeries. With vulnerability, openness, and humor - they speak through more than four years of experience, chronicling the hazards and setbacks of drug side effects, depression, self-image, relationship impacts, and the teamwork that brought them through it all in the face of the unknown. Please listen in as they illuminate their whole picture of recovery from a life-altering illness and the subsequent life-altering treatments.


Topics in this Episode:

  • Intro

  • A guide through hardship

  • Purposeful detachment

  • For you: I will fight!

  • The skills of suffering

  • Fear of the unknown vs. the power of Spiritual certainty

  • Afraid to hope?

  • The prize of privation

  • A vantage point of helplessness

  • Know thyself and thy partner!

  • A Thousand little things

  • Most wounds are hidden

  • Irrational Selfishness

  • Equally yoked

  • Requirements for success

  • Sign off

Contact Information and Social Links:

Resources:

A special thank you to our sponsor, Riverdance Soapworks. Handcrafted products we personally use. Visit www.riverdancesoapworks.com and let them know you heard about them from Tammey.


Transcript:

Intro

Tammey Grable-Woodford: Hello, and welcome back to Your Killer Life. We are so excited to be talking to you today, and we are going to be talking about drugs, and no, this is not the DARE mobile. This is not the this is, this is not a throwback to the ’80s or even ’90s, but we are going to be talking about drugs when it comes to all of the fun stuff associated with all the surgeries.


And, uh, gosh, before I get too far into this, I’m your host, Tammey Grable-Woodford.


Griff Woodford: Griff Woodford


Tammey Grable-Woodford: Also, host, and this is going to be an interesting topic. Um... Goodness. There are a lot of different drugs that get tossed at you. And I have had, for those of you that may have missed a previous episode, with breast cancer I had my biopsies, which were huge and they just gave me Tylenol for... and we’ll talk about why maybe we’ll talk about why that was just not nearly enough for 1.4 centimeters of tissue removal out of my breast with that stereotactic biopsy. Not a good night.


Um, then I had, so that was February of 2015. In March of 2015, I had my bilateral mastectomies. In June of 2015, I had my expanders placed, and we’re not going to go into that today, but we will do some episodes on reconstruction and expanders, cause that is a big deal and a big, painful deal.


Griff Woodford: It is.


Tammey Grable-Woodford: Whew... And then in December, uh, no, September of 2015, I had my first, um, was that when I had the first implants or was that December of 2015? It’s been so many; I want to say December 2015.


Griff Woodford: Ooo, I think it was


Tammey Grable-Woodford: And then we had those redone in April 2016. And then September 2016, I had my nipples reconstructed, and then just in April of 2019 had my, uh, implants done again because I was having some complications and went from under the muscle to over the muscle. And we’ll do an entirely different episode on that because that was, that’s a big deal. And there’s a lot of, uh,


Griff Woodford: Yeah, it was life-changing...


Tammey Grable-Woodford: Yeah, and a lot of stuff to talk about there, especially as we talk about pain, because as we walk through this process, we will talk about pain, but today, we’re going to talk pain mitigation and the double-edged sword of drugs.


Griff Woodford: Exactly


Tammey Grable-Woodford: So you want to kick it off, or you want me to?


Cornucopia of pharmacopoeia

Griff Woodford: Uh, well, I, I would start by, um, uh, stating to the, uh, the viewers and listeners that, uh, In terms of any longterm disease diagnosis and the mitigation of those diseases, you will be prescribed a pharmacopeia of different medications. And the reality is, is that it is your responsibility as a patient, and of course the caregiver to do your best to keep detailed logs, so you talked about medical journals before, on what you’re being prescribed, um, doses you’re being prescribed and the uh, ideal outcome of that. So that, you know, should you have to change physicians or something, something occurs within your care that, you know, what works for you, given your, your individual self, and then also what works in, uh, different stages or different terms of that disease or in our case surgeries, as they’re not all created equally.


And, um, You know, it’s just some of the escapades that we had early on is, uh, you know, now, of course, I wasn’t there in, well, my current context, uh, for the original mastectomies. So that was something that you were doing more or less on your own, but, um, after that, once the expander started coming in, and then all of the subsequent surgeries I was, of course, part of that.


And just one example of that, of why keeping your own individual logs and being quite fastidious about it is because we, we knew early on the best possible combination of uh, pain... you know like narcotic pain relievers or benzodiazepine pain relievers, as well as, uh, high-test NSAIDs, so nonsteroidal, anti-inflammatory drugs.


Uh, so we had that really well dialed in with the minimal amount of side effects and really positive pain control. And then something as simple as a slight change in insurance provider. Well, OK. Now we can only get half of that equation. And the, as far as the, uh drug cocktail, if you will, trying to supplement that ended up being nearly a year of test fire and just, in some cases, crash and burn with something just as simple as, as a high strength NSAID, so being very conscious and cognizant and fastidious in your record, keeping, being able to not just say the dosage and the individual, or I should say, group of drugs, you’ll probably be prescribed, but also your personal effects of them.

So the potential of developing a low strength allergy or low-intensity allergy, even just due to a prolonged use of a specific drug, which that’s something that, uh, that we ended up having to deal with and, um, was very confusing for a while.


Tammey Grable-Woodford: Yeah, it was. So, goodness, so I think I want to back up a little bit. And just talk about sort of the the different, well, I want to talk about pain for starters, because if you’re listening to this and you’re a caregiver, it is, I think often misunderstood the amount of pain that comes with this process. And I think that two of the biggest misconceptions, and I’m going to say from the guy’s side, um, would be that you end up with Victoria’s Secret boobs at the end of this and that it’s like an augmentation. And if you do research on augmentation, no, it is nothing like augmentation. And not that that doesn’t have its own pain and, and whatever that comes with that. But this is nothing like that.


So one, that is not what that’s like.


And two, you know, I was not subtle when I said a few episodes ago, episode seven I think it was, that this is an amputation.


Griff Woodford: Yes


Sensations and confusion

Tammey Grable-Woodford: And with that comes a whole bunch of weirdness from ghost nipples, because your nerves are gone, and your body’s confused, to the pain of your nerves trying to regenerate, to just the pain of all the trauma that has happened.


And so I did say, and it’s true that like you’re numb to sensation. But... that’s the skin that’s that... and you actually described that really well. There was the, is it the, what’d you call the muscle sensation versus the, is it dumb, dumb nerves versus...


Griff Woodford: Oh, right. Um, external sensory nerves versus internal less sensory nerves. So smart nerves - dumb nerves.


Tammey Grable-Woodford: So those smart nerves, all severed and confused, don’t know what’s going on. The muscle nerves that, that provided like this weird burning tingling, like your foots asleep. And so, and then, of course, just random ghost pain. Of not having the breasts anymore and all of a sudden having, having that happen.


And so in all throughout this process, and like I said, we’ll talk about reconstruction later. There’s a whole bunch of stuff going on with your muscles, with your body, which, you know, you said in a previous episode, you know, you talked about how it’s a, even if it’s a sterile knife fight, it’s still a knife fight. Your body is...


Griff Woodford: Right


Tammey Grable-Woodford: Yeah. You know, you’ve been hit by a Mack truck. You’ve got some healing to do.


So there is a ton of pain that comes with it. So postoperatively and for me, because we’re so far away from Seattle, I always had an overnight, and not everybody has an overnight. And so as soon as I was out of recovery and into my room, then I had whatever was the, um, the, the postop drug of choice of my surgeon.


And. Initially, and I have an amazing surgeon, by the way. I, Oh my goodness.


Griff Woodford: Yes. She absolutely is.


Drugs and recovery

Tammey Grable-Woodford: Absolutely fantastic. But the first, so... to the... back to the drugs, the first part of that, the first few surgeries, when I came out, it was morphine. And morphine, I would have a morphine pump, and so every seven minutes or something, or eight minutes, I would hit the button, and then I would have relief, and we found that my body processed it so fast.


Griff Woodford: Yes. So with morphine, in particular, there is, well, I would say more rapidly metabolized than something like a Dilaudid or even a benzodiazepine based pain reliever. So the it’s very commonly prescribed or at least has been, but again, because of it’s long, I would say long-term ineffectiveness. Because it can be very effective in the in the short term, but having a long las... long-lasting, excuse me, um, intravenous, uh, narcotic, it’s really not great for, again, that, that long-term pain relief.


So, you know, with, with your example of that is effectively maxing out your, your, the the the timeout feature on your morphine pump and was still not effective. Then when we made that, I shouldn’t say we, when, uh, you know, the attending doctor realized that was a problem, changing that prescription to, um, actually the same milligram dose of Dilaudid. Uh, that was a big, a huge difference.


Tammey Grable-Woodford: Yeah, I just slept. Which was nice.


Griff Woodford: Right. Right. Which I mean, thinking about in terms of recovery, you know, the more that you can sleep and sleep peacefully, the faster the physiological recovery is going to going to occur.


Life defined by “side effects”

Tammey Grable-Woodford: Right. And I know with me, you know, the morphine there’s with all of these, to your point, knowing the side effects is really important because it’s not just the pain meds, they were also the NSAIDs, and there were also muscle relaxers. And so it was, you know, this is why we called it the, uh, the Elvis Presley repair kit, because it was just this, you know this bag off of whatever. And um... trying to find that combination that really worked. But I think one of them, the more important things I wanted to talk about today was the mental health when it comes to the side effects of all of this.


Griff Woodford: Yeah, absolutely. And I would say from, well, with certainty as a caregiver. So understanding that any patient that you are inconsistent, and severe at times, physical pain, you know, we as caregivers, we, we under, we certainly understand that factor. It’s something we can see, something we can dialogue, and something that we have um, at least a somewhat known path of how to, how to fix. You know, if you have a pain attack, OK, well, then you get another one of X and another one of X, and that should bring you back to a manageable level.


Now, the, what I personally had the most difficulty with and the observed experience of other caregivers who really didn’t know where to begin, in terms of that as the psychological side effects and the emotional side effects of long-term high tests, narcotics, benzodiazepines, um, cyclobenzaprine, there... it is, um, I don’t know if confusing is the right word, but really not going into with a full conceptual understanding of what, um, what can happen when on those long-term dosages and relatively high dosages?


Um, not surprisingly about every aside from the the NSAIDs, um, every muscle relaxer, every tranquilizer, every narcotic, every synthetic narcotic that was prescribed... one of the main side effects is depression.


On all of them, at one point, we had four different medications on board that we were dosing daily, that one of their main side effects was depression. So. Oddly that happened. And to a degree that frankly was frightening. And as a caregiver, I couldn’t figure out where it was coming from, you know.

And it was also, I don’t know if interesting... well... additionally confusing... because the trend was, at least in my mind, is that those significant and dark places of depression would usually come after some sort of incremental gain, whether it’s surgical or in the healing process, there would be in my mind as a caregiver, there’d be something to be kind of happy about, you know?


We’ve, we’ve passed a milestone, you know. We’ve, um, you know, are getting closer to a milestone. Where in reality, it was within a relatively small amount of time of those, those instances was this very dark and frightening depression that would just seemingly come out of nowhere.


You know, again, uh, I think, well, I know that for, in the beginning, neither of us were really understanding where it was coming from. And that was, that was frightening, you know, particularly just not knowing where to even begin.


So going deeper into research and trying to understand is, is this a chemical response? Is this a physiological response? And, and finding out that well, 80% of the medications that you’re currently on all have within the top three bulleted side effects of depression.

So the, um, again, it’s not just the physical side effects, the central nervous system depressant type thing that needs to be addressed and known, also the psychological and emotional effects.


And with that is knowing how to combat those side effects. What are some things that you can put in place, whether it’s through activity, through well, any process that’s going to help mitigate those, well, almost certain side effects.


Tammey Grable-Woodford: And I have been accused my whole life and being perpetually optimistic. Ben sunshine and Pollyanna.


Griff Woodford: Right.


Tammey Grable-Woodford: Yeah. So, so for me to be in these dark places was uncharted territory, and it was so dark.


Griff Woodford: Yes.


Tammey Grable-Woodford: And typically, you know, your pharmacist is your friend. And, but this is where it gets a little bit different because you come out of surgery, and you’re not the one talking to the pharmacist.


Usually, your caregiver or someone has gone and picked up the drugs for you.


Griff Woodford: Right.


Tammey Grable-Woodford: And so you’re home, and yes, you have the package insert to read. And I’m sure that I read them. And I’m sure that I don’t remember reading them...


Griff Woodford: Of which you have no recollection.


Tammey Grable-Woodford: Exactly. So let’s just be real there. So this is one of those things that I kind of learned as I went along, that I needed to do a little more research with. And for me personally, the muscle relaxer was probably the hardest on my system, mentally. And it’s not just mentally, I mean, when you’re looking at the side effects, almost all of these also the other side effect is constipation.


So you know what wel... wel...welcome to real talk about breast cancer because that is also so a challenge that is not a fun one. And you want to talk about being incredibly vulnerable in, in a vulnerable space and having to... you had said on a previous episode. There’s no more secrets after, after something like this.


Griff Woodford: Right


Tammey Grable-Woodford: How true that is...


Griff Woodford: Indeed


Do your homework and make sure the pharmacist does theirs

Tammey Grable-Woodford: But your pharmacist is your friend. I do want to say that it’s still... as amazing as my doctors have been, there still was not a lot of conversation around the side effects of the pharmaceuticals outside of the things that would be sort of urgent or emergent.


Griff Woodford: The immediate risks to health, you know physiological health. Again like a central nervous system depressant, rapid heartbeat, you know, um, temporary blindness... dying. What have you. Um, but I mean, in all seriousness, that is one thing that. Uh, I mean, in both cases, we’re were glossed over, you know, and that was my job for months of having direct and accurate conversations with a pharmacist at the window while you are in surgery, recovering.


Um, I need to know exactly what to look for. I need to know everything I need to know about it. And whereas it was... I won’t say glossed over, but the, uh, the impact was certainly understated with every pharmacist that I spoke to or any pharmacist aid that I spoke to. It wasn’t through actually living through it and trying really urgently to figure out what exactly was going wrong.


That, you know, you... well, I was just able to even find the information and then make those correlations.


Tammey Grable-Woodford: Yeah, it was, you know, a oh goodness. It’s just so interesting that whole process. I mean, we’ve joked about things that I have said to you. I have no recollection of... like, apparently, I have a preference for non-pink Barbies. That’s that is, that is something...


Griff Woodford: Yeah, you uh...


Tammey Grable-Woodford: I made that very clear.


Griff Woodford: Yep, completely asleep. Absolutely unconscious and a full conversation about how you will not stand for me to buy you the pink Barbie. You wanted the blue one.


Tammey Grable-Woodford: Is there a blue one? I don’t even know! (both laughing)


Griff Woodford: And you are asleep. You you are genuinely asleep. You’re unconscious. And we were having this conversation


Tammey Grable-Woodford: Full conversation? Lovely. Thank you for not recording any of that.


Griff Woodford: You are welcome.


Psychological and physical health

Tammey Grable-Woodford: Yes. So, but I think that you know, I really, I do want to get back to the depression, because this is a tough one. You know, it typically. Postoperatively. You’re really only on these things for a couple of weeks. It was during the expansion phase that I was on them for an extended period of time.


And during expansion, they place a, and I’ll go into deeper depths of this, another episode, but in a nutshell shell, they placed this very, very hard implant underneath your pectoral muscle. And every couple of weeks, they add saline to it, and they expand it. And as they do that, they’re stretching your pec muscle.


And as they stretch your pec muscle, that impacts your neck muscles, your shoulder muscles.


Griff Woodford: Everything.


Tammey Grable-Woodford: Oh, my gosh, there’s so much pain. And then I also had a lot of pain after I had fat transfers.


Griff Woodford: Yes. That was, aside from the actual mastectomies that was, uh, easily the most violent procedure that you went through.


Tammey Grable-Woodford: Oh yeah, definitely.


Griff Woodford: The amount of edema and retained fluid, just the swelling, um, that all settled around your pelvis.


Tammey Grable-Woodford: It just pooled...


Griff Woodford: And that’s where it stayed, was um, frankly shocking.


Tammey Grable-Woodford: Yeah.


Griff Woodford: Uh, that was one of the things physiologically. I was not prepared for. I’d never seen that before.


Tammey Grable-Woodford: Yeah. So we will definitely have some episodes on that. Cause those were some eye-opening moments, but typically it is just for a couple of weeks postoperatively that you have those pills. I don’t like taking them. So you were really more of an advocate. I’m like, just give me a, not Tylenol because Tylenol, Oh my goodness.


You know, just give me a, an Advil, give me an Aleve. Give me an Excedrin. Give me a... I don’t really want to take these things. But you were very much an advocate for it. And I mentioned on a previous episode that I would have so much pain that I was adapting to and just pushing through because I didn’t want to take these at work because I was still trying to work.


I was driving myself to work. Right? So all of this stuff, like you just kind of suffer through the pain as painful as it is. And. Those three months of expanders were absolutely the worst because I was on pain meds because it was so painful, and I was on muscle relaxers because my muscles were fighting the expansion, causing even more pain.


Griff Woodford: At all times.


Tammey Grable-Woodford: Right. And that double dose really threw me into the darkest of the darknesses. I think.


Griff Woodford: Yeah, certainly, I would attest to that, um, uh, to, to me, not just as a caregiver, but just as a partner, those were the most difficult times for me as far as actually questioning whether or not this is going to even work as it was so, not just the darkness, I understand darkness. I get that. But not being able to see any correlation to what was happening, like in, in, in my view of the world and what I’m experiencing with you having no idea where this is coming from and not having any clue of what to do.


You know, your... you’ve always been, at least since I’ve known you, always very optimistic and very logical and rational, and the side effects of that combination of drugs for that period of time completely took that away. Yeah, it was the exact opposite on not a daily basis, but with enough frequency to where, again, just not having any clue where this is going and not, and why it’s even happening.


Tammey Grable-Woodford: I think that it would actually be worse that it isn’t daily because then you’re just getting hit with it by surprise as a caregiver. And so you’re used to, you know, one and we are still getting to know each other also. So remember that.


Griff Woodford: There is that too. (both laughing)


Tammey Grable-Woodford: You know, as we go through this process, we had been friends. So we knew each other, you know, from, from that aspect.


And then, you know, kind of jumping into being a little bit more and being supportive and and figuring all of that stuff out and stepping into the caregiver role. But, to have someone that there’s no way I could have been a consistent me. I, you know, just all of, all of the mental trauma of loss and fear and frustration and the lack of confidence. I mean, just everything being annihilated is stepping out of my career, you know, just that whole loss of hope and all of the heaviness around that will take even the most optimistic person to a, an area of how many silver linings can I look for in this, this cloud of crap. Right?


And then add to that this... the drugs, and then add to that... you’re going through the reconstruction process, and, and you, you are not being reconstructed into anything that you looked like before, and especially at that point.


Griff Woodford: Right.


Tammey Grable-Woodford: So there’s depression around that. And so it just seemed like there was so much pain.


And then I would think from your side, just the, like you said, you know, with the expanders were placed, this should be a good thing. And then in my head, a) I’ve got, you know the the drugs that are playing and then I’ve also got the, but I still look like crap, and I don’t see how this is ever going to look like how I looked before.


Keeping the end-state in focus

Griff Woodford: Mmhmm. Yeah. And, you know, I, I certainly can understand the, um, the feeling of like disfigurement. And we talked about that specifically about that before it was the the term that you used, you know, I certainly in that moment understood that, um, And, and, you know, and, um, future context as well, which we had a lot of conversations about that.


And mainly like when we were in the middle of it is that honey, we’re not done. We’re not done. This is something that you and I have to be very patient. And as to this is not where it stops, but. Each additional step forward requires a lot of time in between. Right. You know, I know that we all want it to happen right now.


That would be certainly the most, most pleasant, but that’s not how this is going to work. You went through a catastrophically large surgery that has altered so many things. And I think that, well, I don’t think, we will be talking about the, um, the differences between subpectoral and extra pectoral implants, which uh... a little bit of a spoiler alert, I, as, as someone who has been in the medical profession before, I, I genuinely don’t understand how that is still a practice, how you can...


Tammey Grable-Woodford: There are, no there are, there are uses for it. Yeah, there are because you have to keep in mind like I didn’t have radiation damage. I didn’t have... my inframammary fold on one side was damaged from the mastectomies, and that was originally why because we didn’t know if my, my skin would hold and they...


Griff Woodford: Oh yeah, yeah, I remember...


Tammey Grable-Woodford: Yeah. So there’s a lot of, there are, there are times for it, but I will also say that back when I had mine done it also, wasn’t done very often.


And so. That was also a reason. So, but oh my goodness. That is, that’s going to be, that’s going to be an eye-opener for anybody on the caregiving side.


The full cost of pain

Griff Woodford: Yeah. That’s a very in-depth conversation and dialogue about, um, the, uh, unrepentant difficulties that that particular procedure presents. And of course, there’s many, many others that are associated with long-term disease. And it really in the same categories, they’re not done very often when they are done, they’re relatively special cases.


So the, um, the experience may be unique to this context, but there is a lot of applicability or application for the side effects and not just the physical, of course, the constant and consistent high level of physical pain, but also the subsequent um, issues and side effects that come up from just dealing with that pain.


Um, and also not just the, uh, the pharmacological aspect, but the psychological aspect of just being in pain all the time. No, there’s only so much medication you can take before you endanger yourself. And so having to stay in that ground at 24 hours a day to where nothing feels good, there is no complete relief for months at a time.


It’s it is just absolutely draining. And again, as a caretaker, who is... who has seen the ravages of long-term disease before, before you and I even met. And then, of course, being romantically involved with you as I am, I am with you. I am here. It’s, it’s, it’s a lot more personal than just a simple caretaker role.


And seeing that, seeing the the... the collateral damage from that, it was certainly easier for me to understand where a lot of the, uh, the depression came from the some of the darkness. But again, with the. The gravity of that. And the inconsistency of that as well was very, very difficult for for me to even just conceptualize.


And again, I’m, there’s, there’s nothing about that. That was your fault, or there is... the same thing with anyone going through that they are not to blame period. That is not how this is. This is not how that goes. And the reason that we’re even bringing it up is, is for both parties to understand that there are significant hurdles that you have to attack as a unit, not as individuals. I mean, of course, there’s individual responsibility, but this has to be approached as a team in both people have to be on their game as much as they possibly can be, or it is, it will rapidly spiral out of control.


Tammey Grable-Woodford: And I will be very Frank. This is a very vulnerable episode for me because I don’t remember so much of it, and the reality of it is that, um, frankly, it was a shift in my, these drugs caused a shift in my natural personality. And so for Griff to say, “You're not always rational," which by the way, is, is much nicer than you're being irrational. Side note. (both laughing)


You're not always rational or, or having the ability to use your words to reframe conversation. It is more work on the side of the caregiver, and it is fatiguing. And so here's the other thing, there's a certain amount of grace the first time someone's going through it. And then you get to the second surgery, and then you get to the third surgery, and it is this roller coaster where you're like, you go through all of this stuff, and you're a little bit irrational, and you're on these pain meds.


And then you're, you know, you're like leveling out and then all of a sudden you have another procedure, and you're going through all of this stuff, and you have... and it is just this up and down that as a caregiver has got to be, frankly, a little bit of hell. Because you've got the love for this person.


You want to, you want to see this person... you want to help this person... You want to heal this person. And from my side, you guys... there, I am sure I am sure... I said things that were not nice if not downright unkind and perfectly irrational, like jumping your butt. I think you mentioned that I jumped your butt about coasters?


Griff Woodford: Yes. FOR sure (both laughing)


Tammey Grable-Woodford: Right. OK. So...


Do not remember that conversation at all. And you can tell that whatever I did or said, or how I did it had an impact. I'm sorry for that, by the way.


Griff Woodford: That's OK. Well, and again, to me, that apology isn't necessary because I understand, I know the baseline you.


Support and grace

Tammey Grable-Woodford: Well... you thought... would you say that going through especially those two years, where it was surgery every three to six months, that you really questioned if you knew the baseline me.


Griff Woodford: I was very... what was concerning, is I did know the baseline you. What was the concern is that that is not the baseline you any longer. That, that was the real concern.


Fortunately, that did not last very long, but, and I would say the reason why is because a) I was very, very attentive, particularly in those times where, uh, where I don't really know. I mean, is this, is this going to be even feasible is being very, very attentive to you. And not just in the physical sense, but also the emotional and psychological sense, you know, what are you displaying to me on a consistent basis as to what will happen periodically, as explosive as it had been a couple of times that that is not actually the norm.


So now we have to go outside of that and find the actual causation. But, uh, to your question. Yes, it is exhausting. And we've talked about that. And the other caregiver episode is that you know, the caregivers really need care too. And there is a distinct balance between being a caregiver and being a savior.


They are not, not necessarily ones that go in hand in hand, you know, caregiving is, is... results through patience. Being a savior is results through something grand. And, um, you're probably not going to get something grand out of a long-term disease, as a caregiver that, that grand gesture of salvation. That's probably not how that's going to work.


Um, I would say the biggest benefit that I... I have, or the best tool that I had for being a caregiver, is patience and the ability to practice patience and that applied to everything, the physiological aspect, the psychological, emotional, and my own, as well as, because something may be very wrong today.

If I am patient, and I am kind, and I am graceful...


Tammey Grable-Woodford: And forgiving, you are very forgiving. Because there are times that, I mean, I cannot, I frankly do not remember them. And I know that I have hurt you and you, you know, and you've said that you've never, you've not relived it and rubbed my nose and it made me feel bad for it.


Griff Woodford: No, I don't do that.


Tammey Grable-Woodford: And that's important too, but you have, let me know that, yeah, it was, it was, there were hurtful times. But you did not hang onto those and make that a; I don't know, a huge part of our history. You let other things overshadow those uncomfortable or even painful moments.


Griff Woodford: Right. And our... one of our last podcasts... is the whole reason why I stepped up to be that person with you in the first place is because I know how to suffer. And a lot of that comes from psychological counseling and alcohol rehabilitation, addiction, just in general, that was something that was... that took almost two decades of my life away and a lot of things with it. And. In in those moments in particular where that felt like a direct attack, even though I know it wasn't, you know, but in the moment, it's a direct attack.


You don't have the ability to disassociate that. But, um, a really sharp guy once told me in relation to things like that is that hurting people hurt people. And in the context, it was said it was addict behavior. You know, addicts are hurting. That's just, that's it. That's why they're addicts. They're in tremendous pain. They're trying to nullify or eradicate that pain.

And because they are hurting their actions, their... their words as an addict hurt others.


You were in terrible pain all the time, physical, psychological, emotional pain all the time. So having been in similar positions, myself, whether all at the same time or in different parts of my life, I know, I do know that there are oftentimes for rationality and kindness cannot exist because in, in your own internal space, it is so painful. Things hurt so much that the ability to even perceive others is nearly impossible. So, hurting people hurt people.


Tammey Grable-Woodford: So powerful and so true. So. Goodness, a segue after that, that was so powerful.


Learn the skills needed

The pharmacist is your friend.


Griff Woodford: Yes, provided you know how to talk to them.


Tammey Grable-Woodford: Open dialogue with the pharmacist.


Something that you really had to convince me to do, but was really important is to take your meds. (both laughing) so full disclosure it's still an issue.


Griff Woodford: So funny story about this... I am gonna interrupt very briefly, to... and this... does involve the caretaker aspect. And I would actually say this is useful because making executive decisions as a caretaker, right. Is because I know you, and you've literally spat pills out.


Tammey Grable-Woodford: I do not remember that. (both laughing)


Griff Woodford: That's the thing that happened. Um, the first four days of your recovery after surgery, not the expanders, but an actual surgery, whatever that was, I would make sure you were receiving the max dose that is close to interval, as you possibly could. Now don't just give people a big handful of pills. I am a former medical professional.


I understand the concept of milligrams per kilogram, how to dose that based on time and metabolism, and all the things that are that you need to know about that. But to make sure that you had enough of that pain control, where you could just sleep, just sleep, you would not have done that by your; in fact, you don't do that by yourself.


Tammey Grable-Woodford: I refer to that as just tranquing me out to get me out of his hair.


Griff Woodford: So I can go fly fish, right?


Tammey Grable-Woodford: Right! Cause who knows what happened, but no, I won't, and I didn't, and I don't like that... I like the feeling. I don't like the fuzziness in my head. I don't get any of the fun side effects that people talk about and promise with any of these meds...


Griff Woodford: Yeah. Not really. You don't. No.


Tammey Grable-Woodford: I don't. So I get constipation, and I get sleepy, and I get a fuzzy brain.

So, you know, that's like, and as a Type A personality, you don't like a fuzzy brain...


Griff Woodford: That's the worst. Yeah, I yes... yes, absolutely. Right.


Tammey Grable-Woodford: Absolute worst. So that being said, still got to take your meds because without the rest, and I may have mentioned this on a previous podcast. I don't remember this point, but just that, you know, I think I did.


Me coming home from work and being in a ton of pain. And you saying, take your meds and, and me fighting you on it and saying, no, I'm fine. And him saying, no seriously. And finally, I acquiesce and you know, 30 minutes later, like I felt my face relax. That I had that much pain.


And you guys, for those of you that have friends that are going through this, there are different ways that we deal with pain.


You have to understand, and all of us are different. And I had never, ever in my life, experienced chronic pain. Experiencing it... you will do anything... anything to try and take your mind off of it, whether that is just mindlessly scrolling on your phone because you're, you're focused on the action of scrolling and, and, you know, whatever, instead of focusing on the the pain that you can not escape and is so exhausting. And the only way I can explain it is it's just like having every muscle in your body at the same time, just, Oh, it's awful.


Griff Woodford: So on, I would, yeah, I would suppose that would be a caretaker responsibility. Um, uh, again, the more that you can educate yourself about every aspect of this, the better you're going to be at your job, and the better everything is going to go.


The patient's job is to heal. Your job is to facilitate that. And not just the physical stuff, every other part of what it takes to be a human being. Maslow's hierarchy here, you're responsible in part for that as well.


One of our breakthroughs for your, your psychological health, and which translates into your physical health was I bought you a stuffed monkey and a coloring book.


Tammey Grable-Woodford: That's true. (laughing)


Griff Woodford: And the coloring book thing really stuck. So you know, what you were saying to your point about finding some sort of mechanism that doesn't harm you in the process to take your mind off of what you are physically and in many cases, emotionally and psychologically experiencing that is, was paramount to, to healing, to getting out of that space.


Tammey Grable-Woodford: So was getting outside, I mean, we were hiking and kayaking and so always having activities, doing things that would take the mind, give the mind other food besides just experiencing that pain. And that, that was, that was work.


Being a good patient is key to good care

Another, I just threw in some tips here. So the first one was the pharmacist is your friend and have those conversations.


I would add to that and read your package inserts or have your caregiver read the package inserts. Pay attention to those. Um, take your meds because that is actually important.


I would add to taking your meds; I would add as a number three, be a good patient. Being a good patient is taking your meds, but it's also communicating with your provider.


Griff Woodford: Absolutely. Right, absolutely. Right. I remember the very first time we had that discussion was. You were in a considerable pain attack and were unable to sleep. And we thought something was going wrong with the, uh, one of the drains. This was, of course, early on. And, um, I was insistent that you actually text your surgeon.


And that is part of being a good patient now, pestering or being an asshole to your providers that is not, but openly communicating about the work that that person did to that person is critical. That as part of your responsibility as a patient and part of your responsibility to enforce that as a caregiver.


The, um, the reality is when we started doing that, we've we learned by direct communication ways to make you just nothing else, a lot more comfortable, and undoubtedly sped that process along.


Tammey Grable-Woodford: Yeah. And I want to say that I think a lot of times as women, like, we don't want to bother anyone. It's fine. It can wait until morning. I'm not a priority. The rest of the world is, and maybe, hopefully not for all women, um, and you know, I'm, I'm 49 this month. And so I will say that there's a generational sort of thing, upbringing where, you know, not putting, always putting other people first and it took some convincing, but you did break through with logic, that that is being a good patient. Letting your doctor know before something becomes a big deal is really important.


And I would also add to being a good patient. I would add your doctor needs to also be a good doctor. And if you have a doctor that is not meeting your needs, then please go back and listen to my episode on add self-advocacy because you need to advocate for yourself and make sure that you are getting the care that you need.


Griff Woodford: Which, on the advocacy aspect. Um, this is... it's... it is, is both party's responsibility to understand from the caregiver aspect is it's very common not to know when to speak up or when to shut up. So that is the conversation that you guys need to have individually. And that's the thing too, is just because, and you, in particular, were very, very knowledgeable and very, very precise in your requirements to your providers.


There. I mean, certainly, times where I didn't feel like I needed even needed to speak. Cause you had a down, uh, that is not gonna be the case for everybody else. You know you've, you've done podcasts about how much work you invested, how much time and effort you invested into knowing exactly what your disease, your diagnosis, your treatment plan was.


And you were insistent upon getting the best possible one for your exact case.


That is both both parties, responsibilities. That is the patient's responsibility. And that is the caretaker's responsibility to help facilitate that in any context or as many contexts as one can. Ultimately it is the patient's decision on what their standard of care is. As a caretaker, help facilitate those decisions as best as, as well, as best as you were allowed by law. Put at that way,


Pro Tips

Tammey Grable-Woodford: And I think the last tip I would add is that it's OK to ask for more help, or for outside help.


Mental health is a big part of this, and it's OK to you ask for, whether counseling help, whether it's, um, medication. It's OK to ask for help. What's not OK is falling into that abyss and losing your life in that regard. Losing your joy and really sitting for too long in the darkness, without a way back towards the light of your life.


Griff Woodford: Yes. And something to be aware of as a patient who has a caregiving relationship, um your wellbeing has a distinct impact on that caregiver's life. Whether you want it to or not, whether you choose to accept that are not, yes, you were the one that's going through the disease in particular, but so is that other person.


And I can say at least in my case, and I'm, I am generalizing, but the, the humanistic rationality behind that, of placing... investing a lot of, even in some cases, identity in the person going through the disease and how well you are able to facilitate, care for, love and just to help that person. So when you. As the patient, when you feel yourself beginning to fail psychologically or physiologically, it is your job to communicate that. You have to do that. Because if you do fail, then the caregiver also fails.


Whether that's the actual case or not, that is how it is perceived. And that is devastating.


Tammey Grable-Woodford: And you did a great episode on caregiving and you, and I mentioned it just briefly in a previous episode together, as the caregiver, if you need help.


Griff Woodford: That's a big part of it. Um, I remember it was about a year and change, about a year and a half into it for me. And I realized I was really hitting significant walls. Like I, I felt... because we've been doing the same cycle so much. Um, there, there are things that I was beginning to resent, and being able to just be aware of that and say, wait a minute, this is not, this is not what I'm, this isn't what I'm actually feeling.


This is not what my, my feeling towards you are. I need to start... at least attempting some self-care and talking to people who, which I would say ultimately that is kind of the thing is we, you know, we are verbal processors. We are social creatures. So finding that person or people that you can even just vent to - just have someone listen to you in confidence.


Um, It goes a very long ways. And self-care. Cause that's the thing, you know if the, um, if the caregiver fails, the patient often fails and nobody, nobody wins. So it is equal responsibility of self-care, self-advocacy, and caring for each other as well. Um, I know there were certainly times where you were just unable to, you know, kind of pull me aside or out of my, my apex of vision and say, "Hey, you're, you're not, you're not completely on." Um, but there were times that you did, and they were absolutely necessary.


Tammey Grable-Woodford: Yeah, a real team effort.


Griff Woodford: Yes.


Tammey Grable-Woodford: And I think that that's, that's the other and not necessarily drug-related, but I will say that whether it's counseling or whatever it is for the caregiver or reaching out, finding groups, whatever it is that they're there is, the very real depression, anxiety, frustration, overwhelm, all of that stuff that also hits the caregiver.


Griff Woodford: Yes.


Tammey Grable-Woodford: So, yeah, but back to drugs...

  • Pharmacist is your friend.

  • Take your meds.

  • Be a good patient.

  • It's OK to ask for help.

  • Is there any, oh, and always logs are really important.


Take, take things as prescribed, and anything else we would want to add to that as we wrap up.


Griff Woodford: I don't think so. I think we actually covered quite a bit.


Tammey Grable-Woodford: I think we did too. A little bit of extra stuff, maybe. So yeah. So I, uh, I don't miss the drugs. I'm not gonna lie.


Griff Woodford: No. (both laughing) No. No.


Sign off

Tammey Grable-Woodford: So... um, you know, I guess until, until next time for me in the O.R. whenever that next time is, but yeah, we'll just stick with the nice Aleve and Advil and...


Griff Woodford: Yeah. That works for me. (both laughing)


Tammey Grable-Woodford: Over the counter good stuff for right now.


So thank you all so much for joining us on the podcast. We are so excited to have you here and goodness, you know, please feel free to share this with anyone you know who's going through any of this.


If anything resonated with you, please drop us a note. We would love to hear from you because that just helps us keep going. And gosh, I guess until next time, keep...


Griff Woodford: I would like to add actually. So if anyone would like to drop something in the comments or, uh, talk to us directly about how to, um, how to find the right counselor, how to elicit the right counseling and therapy help when we both have a pretty good handle on that, just through experience and research alone.


So if that is something, whether it's pertaining to, um, longterm illness or not... the, um, the, the processes and the goals are, are certainly applicable. So please let us know if there's something that you're interested in.


Tammey Grable-Woodford: I love it. Reach out - we'd love to hear from you.

All right, until next time, keep building, keep building Your Killer Life.

Remember the conversations you hear on the show are based on unique experiences and varying diagnosis. And we all had our own medical teams. We are not giving medical advice. So if you hear something inspiring, please talk with your providers.

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