Shortage of specialists a pain in the neck
It is estimated that one in five Kiwi adults suffers from chronic pain.
Aclear head is something most of us take for granted. I know I did, before an injury gave me the option of daily pain or high doses of serious pain medication.
This week marked two months since the medical procedures that finally set me on the road to recovery. After three years of chronic pain, having a clear head feels like a daily miracle.
For most of 2016, I had a headache every day — the kind of headache that felt like knives were being pressed into my brain. If I was lucky, I’d have a few manageable hours in the early morning, but by 10am, I’d be holding my head in my hands, willing it to stop. By 11am, I would’ve reached for the tramadol.
Between the end of 2015 and January of this year, I experimented with different cocktails of pain drugs.
I tried tramadol, norflex, naproxen, nortriptyline, gabapentin and pregabalin, and eventually settled into a daily routine of six pregabalin and three tramadol tablets spaced throughout the day, with panadol top-ups to tide me over between doses.
I was finally able to keep the headaches at bay, with an added bonus of dulling the pain in my shoulder. When the drugs wore off, however, I’d soon feel the familiar sensation of a blade slicing through my skull.
A month ago, after two earlier procedures that involved poking heat-conducting needles into my spine to burn a series of nerves between three vertebrae in my neck (fun!), I finally swallowed my last tramadol, and I’ve mercifully been opioid-free since then. The headaches have almost disappeared, my shoulder has improved dramatically . . . the effect has been utterly life-changing.
Who would’ve thought a pillow fight could have such far-reaching consequences? In late 2015, I performed my then-new single on
What Now, and took part in a televised game in which I was knocked off a raised pole into a pool of foam and bubbles — twice. And yes — it is on YouTube. The impact of the falls resulted in a herniated disk in my cervical spine, bursitis in my right shoulder, whiplash, and suspected nerve damage.
And then, chronic pain. Unless you’ve experienced chronic pain, it’s difficult to imagine the reality of living with pain that never goes away. Before 2015, I’d had a few sprains, strains and (as a child) a broken arm, but my various scrapes healed quickly with no lingering problems. My neck and shoulder injuries, by contrast, took over my entire life.
Chronic pain is on the rise in New Zealand. It is estimated that one in five Kiwi adults suffers from chronic pain. Its consequences are wideranging; damaging relationships, causing long-term fatigue and sometimes making it impossible to work.
Currently we have only 11 fulltime pain specialists in the country, though international guidelines recommend four times that number for a population of New Zealand’s size.
Having just navigated the medical system, it’s obvious to me that the workforce tasked with dealing with chronic pain needs to grow. I have been lucky to be cared for by fantastic doctors, but it took over a year for me to be able to see a pain specialist. During that time, my ACC allotment for physiotherapy (the only thing that was providing any kind of noticeable relief, other than the mind-numbing tramadol tablets I was popping like lollies) ran out, was extended and ran out again. By the time I had my first appointment with my specialist, I was feeling pretty miserable.
Strangely enough, pain is supposed to be helpful. It’s meant to alert us to an issue that requires attention, like an alarm during a burglary. Chronic pain, by contrast, is like a faulty car alarm blaring in the street at 3am for no reason. It’s impossible to ignore and (unless you opt for stupefying drugs) you can’t turn it off.
Though many chronic pain suffers will never be fully free of their pain, it can be managed with the right treatment.
Last year, more than two years after my initial injury, I was accepted into the ACC pain management programme. I can’t speak highly enough of it.
Under the programme, patients can access all kinds of support — medical, psychological and holistic. I don’t believe it’s an overstatement to say that the programme, complete with the radiofrequency neurotomy procedures, has given me my life back.
More patients should be able to access programmes like it, with shorter waiting times.
The Faculty of Pain Medicine in the Australian and New Zealand College of Anaesthetists has recently called for a national plan to address chronic pain. They want more funding for training of pain specialists and for more public hospital-based multidisciplinary pain clinics.
Though there are undoubtedly many worthy causes, projects and programmes competing for Government funding, improving the services available to chronic pain sufferers seems like a no-brainer.
Currently it is estimated that the financial burden attached to chronic pain costs the country more than diabetes or dementia, and by 2048 that cost is expected to balloon to more than $24 billion.
Until the systemic shortfall and wait times are addressed, however, chronic pain patients will have to take their chances and hope for the best. I may end up among them again, as there are no guarantees that my neck and shoulder will be better forever.
Nerves eventually regenerate, even when they’ve been burnt.
I’ve been warned that when mine make their reappearance, so too might my pain. I try not to think too much about it.
For now, I’m just thanking my lucky stars — and the brilliant medical professionals who have given me such a high standard of care — that I’m largely pain free for the time being.
It makes for a nice change: the last few years have been a real pain in the neck.