Updated: Jun 22, 2021
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:
A guide through hardship
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
Requirements for success
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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.