By Dawn Rae Downton
Illustrations by Mike Faille
It started in my feet, which ached constantly whether I wore flats, heels, trainers, or went barefoot. Physiotherapy and orthotics? Useless. Soon the ache climbed my legs, wrecking my knees and seizing up my hips, then my lower back. Eventually I was diagnosed with sacroiliitis, an uncommon inflammatory arthritis that can follow trauma or infection, or, rarely, childbirth. Mine, cause unknown, made one orthopedist say my spine in an x-ray looked like a 90-year-old's. I was 39.
Over the next few years, I made at least quarterly visits to a Halifax pain clinic. I tried acupuncture, meditation, mindfulness, massage and yoga. I tried physical, occupational and cognitive behaviour therapy. I tried injections to block nerves and trigger points, IV lidocaine infusions, anti-inflammatories, anticonvulsants and antidepressants with names straight out of Tolkien — Elavil, Aventyl. I tried cannabis and even (God help me) group therapy.
My pain screamed back. I couldn't sit, lie down, stand or walk.
"One must have a mind of winter," said Wallace Stevens, as if he'd gone through this, and so I did. I was hopeless, bleak — until, with opiates the very last resort under pain management protocol, I was trialed on transdermal fentanyl. It worked almost overnight. I was back!
And then, 12 years later, just like that, I wasn't.
January 23, 2017. Abruptly, at a routine appointment, my GP of 25 years announces she'll no longer prescribe me fentanyl. Yes, she'd done it for more than a decade on the advice of my pain specialists. But now it's me or the College of Physicians and Surgeons Nova Scotia, which licenses her and has called out "weak" doctors for "over-prescribing" narcotics.
"This is politics," I say, snatching up my parka to leave.
"Only half politics," she replies.
She dangles two Rxs in front of me to get me through the next couple of months — then says she'll only give me the second one when I return to hear her out on the perils of opiates. I will have to sit through the sermon at the soup kitchen if I want my dinner. I don't go.
About one million Canadians have by now had similar shocks. We've heard all we want to about the downsides of opioids, whatever they are. Unlike millions of other adults and children with chronic pain in this country (as many as 29 percent of us), we suffer so miserably and relentlessly that we rely on these drugs — oxycodone, hydromorphone, medical fentanyl — to lead remotely stable, productive lives.