Living with chronic pain
Woman able to walk again after turning to McMaster pain clinic
Laura Farraway lies face down on a hospital bed, a fluoroscopy X-ray machine positioned over her lower back.
Carefully watching the continuous image on the screen, Dr. Vlad Djuric reaches for a long needle with a slightly curved tip, and with quick precision, aims it between vertebrae.
“Tell me when you feel something,” he asks. She quickly notices the shooting sciatic pain that feels like an electric shock going down into her little toes. That rush of familiar pain is a good sign — it shows Djuric hit the right spot, injecting anesthetic and a steroid along the nerve.
The whole procedure lasts maybe 10 minutes and she’s out in the recovery area at the Michael G. DeGroote Pain Clinic inside McMaster University Medical Centre.
Farraway came into the clinic that morning in a wheelchair, but she stands and confidently walks to her chair, and does a little demonstration, happily bending her knees like a ballet dancer’s plié. She knows she has to be careful, the anesthetic will wear off soon and it will take several days for the steroid to take effect.
For everyone around her, the transformation is near miraculous.
“I feel like dancing out of here,” she said.
Since 2015, the pain clinic has grown from about 7,000 patients annually to 22,000 expected by the end of the year. It’s multidisciplinary, drawing together physicians who specialize in pain, with psychologists, physiotherapists, nurse practitioners, pharmacists and more.
Djuric is a physiatrist (specializing in physical medicine and rehabilitation) and works at the clinic two days a week, mostly treating patients with spinal pain. He specializes in “advanced interventions,” including the procedure done on Farraway, and nerve ablations that involve burning the affected nerve. Both can provide relief that lasts months.
Djuric came to Canada from the United States about six years ago and said he was surprised that these “advanced interventions,” which had become commonplace in the United States, were not widely available here.
“I think Canada lags behind places like the U.S. for resources, training, funding,” he said. “I started doing these interventions in the U.S. in the mid-90s ... when I came to Canada I was really awestruck how few people were doing these advanced interventions.”
For these procedures, he sees patients as far away as Thunder Bay. Wait lists can be months long, in part because there are a limited number of hours he gets per week with imaging — most procedures are done during Xray or ultrasound.
This is the second time Farraway has had the procedure done at the clinic. The first time was six weeks ago.
Her husband, Scott, by her side since they were in high school, recalled being called into the recovery room by a nurse who said “your wife is crying.” At first he thought “oh great,” but the nurse added, “they’re tears of joy.”
“I walk around the corner and there’s Laura standing and she’s saying she has no pain,” he said, adding those were words he “couldn’t compute” after decades of supporting his wife.
The pain did come back after the anesthetic wore off, but when the steroid began working it reduced her pain by about 40 per cent — a huge improvement. It allowed her to walk at her daughter’s wedding recently.
Dr. Djuric remembers her “really miraculous improvement,” he said. “We don’t see too many of those moments, it was something to behold.”
Nearly all of Laura and Scott Farraway’s adult life has been structured around her pain. She has catamenial sciatica — a rare condition caused by endometriosis that affects the sciatic nerve.
As a young woman she would black out from the pain during periods, but said she had a doctor that would just “pat me on the head” and say she’s just one of those “unlucky women who get painful periods.”
It would take 17 years, a selfdiagnosis and a change in doctor before surgery would confirm she had stage four endometriosis, with the tissue growing outside her uterus, stretching like a spiderweb onto her bladder, colon and ligaments in her back.
Medication didn’t work; surgeries, even a hysterectomy, didn’t cure her. She eventually became permanently disabled, forcing her to leave a job she loved as a research assistant at McMaster University and into a long and “humiliating” fight with insurance.
The couple adopted two children — a son, now 27, and a daughter, now 25 — from Romania. And Laura had to learn to parent from bed. Her dad made her a wooden board so that she could sit with her daughter and play games, do puzzles or read, while Scott was often taking their son to hockey.
“I missed a lot,” Laura said. There were times when she would lose consciousness and Scott would have to call an ambulance. Years later their son told her he thought she was dying.
Laura, who also has fibromyalgia, said so much of her life is about trying to plan around her pain. She knows that if she wants to do something, she will pay for it with more pain later.
“You have to decide what’s worth it, because you have to live,” she said.
Finding the pain clinic — and Dr. Djuric — came at a time when Laura was struggling to find anything to make her pain manageable.
Over the last two years, she’s been forced to be weaned off
opioids as doctors face pressure to stop prescribing the powerful painkiller amid an opioid crisis. But Laura, who took Dilaudid (hydromorphone) for years, said she never abused her prescription, was monitored closely and had been offered little alternative.
Yet, through it all, Scott said Laura has the right personality to keep fighting.
“Laura has a wicked sense of humour, very sarcastic, stubborn as an ox,” he said. “She’s also extremely compassionate.”