Trevor Moore, the man many associate with magical entertainment and laughter, has been dealing with severe chronic pain for eight years. A treatment that finally brought relief was brought to an abrupt halt as a result of a recent decision by the College of Physicians & Surgeons of Alberta.--NEWS PHOTO GILLIAN SLADE
gslade@medicinehatnews.com@MHNGillianSlade
A local chronic pain patient had finally found a treatment that was providing relief after eight years, and then it was stopped without warning by the College of Physicians & Surgeons of Alberta.
Trevor Moore, a local magician that entertains and brings joy to so many, has had severe pain in his ankle and foot, has seen nine specialists and was finally getting an IV infusion that was addressing the pain and his resulting depression.
Once a week he was being given an infusion that included Ketamine administered by pain specialist and anesthesiologist Dr. Gaylord Wardell at Sante Surgi clinic in Medicine Hat.
Even his young children could see the difference it was making.
“These treatments have been giving them their father back,” said Moore.
Earlier this week he was given the preliminary medication before the Ketamine would be administered. Wardell then returned and explained that he had just received an email from CPSA instructing clinics such as his to immediately cease providing Ketamine.
The email is addressed to “Medicine Directors & Identified Facility Contacts” from “Aria Maier, program Manager – Clinical Accreditation Services at CPSA”.
“It has been brought to CPSA’s attention that some physicians working in Non-Hospital Surgical Facilities may be infusing anesthesia or sedatives for the treatment of pain and/or depression.”
The final paragraph is written in bold type and is underlined.
“If this practice is occurring in your facility, it must cease immediately. At this time these types of treatments administered by physicians in Alberta are to remain solely in the hospital environment.”
The timing could not have been worse at Sante Surgi.
“I was in a complete state of shock,” said Moore, who had to leave without treatment.
The letter did not provide instructions on how to get patients the Ketamine treatment in hospital at short notice.
Dr. Karen Mazurek, CPSA’s deputy registrar, says in retrospect it should probably have been handled differently.
“With the benefit of hindsight you can always do things differently or better,” said Mazurek.
Ketamine is used mainly for starting and maintaining anaesthesia, for chronic pain, sedation in intensive care and depression.
Mazurek says CPSA’s concern was possible complications in a non-hospital setting where there may not be adequate cardiac pulmonary support if there was an adverse reaction in a patient.
“Every single person doing it has to be privileged to do it,” said Mazurek. “We received information that there may be people giving Ketamine for these conditions (pain and depression).”
Mazurek was not sure when CPSA became aware of this information but all 83 non-hospital surgical facilities were sent the email.
She says the memo meant to point out that clinics needed the proper approval to do it and the “cease immediately” phrase did not apply to those using it as an anaesthetic, only those using it to treat pain and depression.
So far the only patient CPSA has heard from is Moore. Mazurek said CPSA had no idea how many patients could be impacted.
Moore says last summer he was in “a dark place.” After he became Wardell’s patient and was put on Ketamine, other possible treatments in hospital could be put on hold. The caring attitude of Wardell and his team of staff also meant he felt supported.
After the first treatment it was like night and day.
“The next day I woke up pain free for the first time in eight years,” said Moore.
After each treatment the length of time without pain increased and he was quickly up to 72 hours.
Then last week it all ended.
Moore wanted answers from CPSA and says initially the person he talked to did not even know the memo had gone out.
“My fear is there are people in a crisis situation in one of the most stressful times of the year,” said Moore.
Mazurek says it is just a case of going through the process to get the approval for this treatment to be administered by Wardell at Sante Surgi.
Mazurek is aware that Wardell is not only a pain specialist but also an anesthesiologist.
“I will say in generic terms that somebody who is an anesthesiologist, who’s also a pain specialist, who offers multi-modality pain treatment is someone we are going to approve,” said Mazurek
Moore questions how CPSA can create a situation such as he has found himself in without any oversight. He feels Minister of Health Tyler Shandro should be asking questions.
On Friday afternoon a spokesperson for Shandro said the CPSA’s memo did not stem from any “government policy or any decision or direction from the Minister.”
The News has been unable to connect with Wardell, who is apparently on vacation.
