Maxim’s Story: A Path Through Chronic Pain

Background: Brachial plexus injury

Three years ago I was in a terrible accident, and I woke up unable to move my arm.

It resulted in an injury called Brachial plexus palsy and the nerve in my neck, the brachial plexus, had been severely damaged.

The doctor explained to me that both the radial and ulnar nerve had been affected, and they were unsure of a recovery time. I ended up being paralysed for six months.

Through the immense support of my family and friends, I made a slow but miraculous recovery. I surprised not only myself, but the doctors too, who couldn’t believe how well my arm had recovered.

This didn't come without a cost.

For a nerve to repair, it sends out waves of pain, often with a sharp, shocking sensation. So although it is a reminder of how lucky I am, it is tough to live with every day.

My medication journey

The pain was crippling for the first six months, and I’d be crying on the floor because of its intensity. 

At the beginning, I was given opioids to help cope with the pain, and then I continued on gabapentin and then later on pregabalin. After two years, it was officially categorised as chronic pain.

Throughout this time, I’d tried a number of different medicines, but I hadn't found ‘the one’ as such. 

When I was on gabapentin, I was taking only half of the prescribed dose, and as soon as I relayed that information to the doctor they said let's continue to take that dosage down - but that was where I was comfortable. 

When they said they wanted to reduce the dosage, I was really, freaking, scared. 

Without that daily sustained dose, I knew I’d be in constant pain. Every morning when I wake up the effects of gabapentin, or pregabalin (which I’m on now), have worn off, and so I wake up in pain - and I knew it would be worse with a lower dose.

Seeking a second opinion

At the time, my doctor said they would like to reduce it because I was still young, and they said I couldn’t be using gabapentin for too long. But, I really just couldn’t be in that much pain.

With the help of my family, I managed to get a second opinion and booked a private consultation with a Pain Management Consultant at Nuffield Health (huge thank you to my mum for paying for all this, as it wasn’t cheap!).

The specialist said gabapentin is pretty harmless, it's been going for 25 plus years, and we often see people stay on it for their lifetime. He said it treats conditions like mine well and the side effects are pretty minimal. 

But, there was a study that I was reading about blindness in older age - and that was a little scary. He tried to assure me that was not the case, but I still asked him about the other treatments available.  

This was when medical cannabis entered the conversation. 

He said, “I can't prescribe it to you, and I can't recommend it to you - but what I can tell you from my experience is that other people in your shoes with similar conditions have found it extremely helpful to reduce and manage their pain.”

I took this as an indirect recommendation, and took it upon myself to do some more research.

I was told about it, and I read up on it, and much like conventional medications - I’ve now tried a few different ways to manage pain with cannabis, albeit illicitly.

Self-medicating with cannabis

First, I tried to use the cannabis oil pens available online, but soon discovered they weren’t designed for me and my needs. 

When I moved away from home, I felt like I had a bit more freedom to explore because I had my own space. I managed to source a much better quality of cannabis, and the person who’d sell it to me would tell me what strain it was and what sort of strength it was - but realistically, I didn’t know if that was accurate information or not. 

I smoked cannabis for a while because it was another avenue to explore, and I’ve found it worked really really well, especially during a flare up - but, I don’t enjoy smoking, and I struggled with dosing.

I also didn’t really want to smell like cannabis because it's still quite frowned upon in modern society, and I didn’t on’t want to smoke in public either; so I tried another route - making cannabis butter. 

Again, my pain did improve - but there were practical issues to this too. Much like smoking, I found dosing difficult, and edibles can take up to two hours to take effect, which when you’re in a lot of pain feels like a really long time.

But, despite what method - so long as I got the right blend of compounds, the shaking would completely calm down, and it really helped with the pain. I’ve still got desensitised skin, but after taking cannabis the shooting pains are gone, and my arm feels relaxed as opposed to incredibly tense like usual. 

Finding out about Releaf 

During this time, I told my own doctor I was self-medicating with cannabis, and she said there are hundreds of other people that come in and say the same thing. 

We talked about legality, and how the NHS rarely prescribes cannabis medicines, and because I wasn’t in so much pain that it's immobilising me, or making me bed bound, it wouldn’t really be an option through the NHS. 

But then, later through word of mouth, I heard about Releaf. 

I didn’t even know there were legal, private medical cannabis clinics or dispensaries in the UK - but once I knew this, it felt like I’d struck gold. 

Being able to access this knowledge, and legitimate, safe and effective medical grade cannabis, all above board and legally, was life-changing. 

The doctors are also specialists, and knowledgeable about the medicines they’re prescribing, they can tell you what compounds in that particular strain of medical cannabis are likely to work best for you, or advise you on dosing concentrations or routines. Having this knowledge, and a person who is held responsible for its safety, is a very different environment than going to see a shady guy in the park to pick up some weed. 

It’s properly regulated and responsibly monitored, and that’s what I needed.

My first Releaf Consultation

When I first spoke with Dr Alex, I told him about my brachial plexus injury and what kind of pain this causes, I explained where I feel my pain points are, and what sort of time of day the pain is usually triggered. Dr Alex used all this information to build up my patient profile so that he could fully understand my needs, and what I’ve tried in the past. 

He gave me a full rundown of what medical cannabis is in comparison to the cannabis you can buy on the black market, and how carefully calculated dosages, and the right concentrations could make the world of difference. 

He also explained how medical cannabis patients can travel with their medication, whether that's just on a local train or going abroad on an aeroplane, which would of course not be an option if I was still sourcing it illegally. It was also great to know that Releaf could provide me with a travel certificate if I ever needed one - I’d heard stories about people having to go to the Home Office for this, so it was good to know I could do everything in one place.

He then suggested a few different treatment approach options that we could try, and I chose medical cannabis flower and cannabis oil.

After I got off the phone, I could access a copy of the prescription that had been written out for me, and at that moment it fully hit me: this really is a prescribed medicine. 

Of course, realistically I knew there would be a prescription, I just didn’t know what it would look like or be like, but seeing the cannabis strain name, and the quantity prescribed in grams, just felt slightly surreal on an official medical document. 

But, it was definitely a good surreal. 

Taking medical cannabis for the first time

For me, my pain bothers me most in the evening. Although I really did want to use the vaporiser when my medication first arrived, I decided to save my first impressions for when I knew it would make the most difference, and so I tried the cannabis oil first. 

It said to take 1mg of the oil before bed, but I wasn’t exactly sure how much 1mg actually was, so I played it safe and put three drops underneath my tongue. I went to sleep like any other night, really, but how I felt in the morning was a remarkable difference to how I usually feel. 

Normally throughout the night my pregabalin would wear off, and I’d usually wake up before my alarm because I was in pain, or, if it didn’t wake me up when my alarm went off, pregabalin was the first thing I’d usually reach for. 

But, this time, pain wasn’t the first thing on my mind. 

I didn’t think about it instantly as soon as I woke up, like every other morning, and I was able to lie in bed for a few minutes without having to reach for a painkiller. 

That might not sound like much to some, but that has never happened to me since I got this diagnosis - ever. 

Integrating Medical Cannabis into my daily life

I’ve now managed to integrate medical cannabis into my lifestyle in a way that works for me, and almost every night, without fail, I’ll take my cannabis oil. 

I am still taking my regular pregabalin, but I know I’m not as reliant on it any more, which is great. 

There will be the odd occasion, if I’ve had a late night down at the pub maybe and had a few drinks and I don’t take it before bed. But on occasions like this, I also tend to forget to take my NHS prescribed medications too, and then I won’t sleep well, and I wake up in so much pain. 

When I do take my medications as and when I should, I can tell that the medical cannabis has made quite a substantial difference in my everyday life and to my pain management, and that in turn, has had a domino effect and improved my mood. Especially in the mornings!

I feel like I’ve got my dosages and timings all right, but being able to carry the OMURA device around with me everywhere is great, it’s just in my rucksack, and it kind of acts as a safety net for me if I need it.

Honestly, I haven’t really had the ability to mitigate pain management effectively over the last two or three years, and now, I feel lost for words. Medical cannabis really has made a significant change.