Warren Moore’s personal trainer and life partner, Dina McDermott, walks him through some gentle stretches. She reminds him it’s not a race, but rather a slow process to get his body back in shape.
The last five years have been tough on the couple as Moore lives with chronic pain.
“You’ll do anything,” Moore said. “You will do anything to be out of pain.”
“You become a caregiver, basically. I would do anything in the middle of the night to get him to stop being in pain. He would talk about jumping off the balcony because he couldn’t handle the pain anymore, he would curl up in a ball and howl like a wounded animal in front of me” McDermott recalled.
A life of landscaping took a toll on Moore’s body. He had several surgeries, but the pain to his back was almost too much to bear.
At his lowest point, Moore was consuming alcohol with “20 pills a day of Percocet,” which he acknowledges could kill someone.
“I have been on every opiate known to man, pretty well, the last being the fentanyl,” Moore said. “Morphine, hydro morphine, Oxy — you name it, I’ve tried it, and just nothing seemed to work.”
After one particularly rough visit to the emergency room, Moore ended up at a pain clinic.
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Dr. Leon Rivlin specializes in chronic pain and emergency medicine. His clinic, the Rivlin Medical Group in Mississauga, sees thousands of chronic pain patients every year, including Warren Moore, who received nerve-block therapy from Dr. Rivlin.
“As soon as they gave me these injections, half an hour later I’m walking like I’d had no surgery at all,” recalls Moore.
Dr. Rivlin is concerned about the future, though, because the pain management therapy his patients rely on could come under review by an “Appropriateness Working Group,” (AWG) and that would impact his clinic and many others in the province.
The AWG is made up of physicians from the Ontario Medical Association (OMA) and Ministry of Health officials.
“The purpose of the AWG,” a spokesperson told Global News, “is for the two groups to work together to improve the quality of patient care by deciding which medically unnecessary or inappropriate medical services should be reduced without compromising patient access to medically necessary services.”
The frequency of nerve block treatment is one such medical service.
“We’re going to be reducing our eight nerve blocks every one or two weeks to four nerve blocks four times a year. Essentially, what that means for patients is that nerve blocks will no longer exist as an opportunity to receive pain management,” says Dr. Rivlin.
He noted there are other options, but for “a handful of patients it is just not enough.” Dr. Rivlin draws this parallel.
“Cutting down to four nerve blocks four times a year is like telling a family doctor you can see 10 patients per day,” he said. “At 10 patients per day, you can’t pay the cost of operating a family practice.”
He described what he predicts would be the impact of losing nerve-block therapy.
“Patients going to the emergency department for pain management, some patients have said that they would actually go to the streets to get access to pain medication that they wouldn’t be able to get through regular channels from a pharmacy, so I really worry this could contribute to the opioid crisis,” he says.
McDermott says it would be devastating.
“I think suicides would go up,” she said, adding, “I think people would be desperate and I think people would look for pills from anywhere.”
Warren Moore remembers the feeling of desperation well.
He is doing better now, but still sees Dr. Rivlin as he weans off the pain medication. Still, he says he can’t help thinking of the other chronic pain sufferers.
“I could see a bigger problem with street drugs,” Moore said. “I honestly believe that’s what going to happen.”
Still, the Ontario government says no final call has been made.
“Through the Appropriateness Working Group,” the Ontario Ministry of Health told Global News in a statement, “our government is working alongside the province’s doctors to create greater bandwidth for our front-line health care workers to deliver appropriate care. This work is ongoing and no final decisions have been made yet.”
If you or someone you know is in crisis and needs help, resources are available. In case of an emergency, please call 911 for immediate help.
The Canadian Association for Suicide Prevention, Depression Hurts and Kids Help Phone 1-800-668-6868 all offer ways of getting help if you, or someone you know, may be suffering from mental health issues