Monday 18 June 2018

Dealing with neuropathic pain

Dr Annette Hunter
Dr Annette Hunter

Joy Orpen

Surgical procedures have left Dr Annette Hunter with a rare condition called neuropathic pain. She tells Joy Orpen of the devastating effect the condition has had on her previously idyllic existence.

If living in a beautifully restored cottage in one of Donegal's loveliest settings is your dream, then you may envy Dr Annette Hunter. And, if you love the sea, long sandy beaches, donkeys, horses, dogs and sheep, then you might envy her even more.

Now, step back and take a closer look at this svelte, attractive, 47-year-old woman as she moves about her lovely home with its magnificent views of Horn Head.

You will notice that she does her chores slowly, gingerly even, and that her pretty face sometimes grimaces in pain.

For Annette is suffering from an invisible but incapacitating condition known as neuropathic pain (NP).

Annette says it is probably the result of one of the surgical procedures she has had in the past, including a hernia operation when she was seven years of age, followed, much later, by a hysterectomy and culminating in an exploratory laparotomy early in 2007 when there were suspicions -- thankfully unfounded -- that she might have cancer.

Referring to that particular scare she says: "I was one of the lucky ones. Instead they found I had endometriosis resulting in adhesions throughout my pelvic region."

Consequentially the surgeon removed Annette's fallopian tubes, ovaries, omentum and appendix -- and the adhesions where possible.

"My abdomen is like a snakes and ladders board from the scars, which criss-cross each other," says Annette. However, she's keen to emphasise that "it is no one's fault" that she developed this constant, debilatating pain.

She points out that her condition could have been caused by any one of the procedures she has had. She says only a small percentage of people suffer NP following physical trauma.

"For the most part when your nerves get damaged they are able to regenerate themselves," she explains. "But in certain cases the nerves don't heal and end up taking on a life of their own, firing off chaotic --and very painful -- signals."

And while Annette may not know for certain when her pelvic nerves were damaged, she does know exactly when the pain hijacked her life.

Following the cancer scare, she began to appreciate that life was finite, so she chucked in her job as a city doctor and moved to the remote cottage in Donegal which she and her husband had bought a few years earlier, and she began working in a local medical practice.

The next stage was to set up a pet sanctuary -- a longtime ambition of Annette's -- and soon various members of the animal kingdom moved in.

They included two horses -- Jenny, 32, and the much younger Blackie, who came from the Irish Horse Welfare Trust; two adorable donkeys from the Donkey Sanctuary in Co Cork; four disparate yapping, happy dogs from Limerick Animal Welfare; and 10 sheep.

In spite of the pain, things were utterly idyllic for a couple of months until one fateful day.

"I will never forget May 16, 2007," Annette recalls. "The pain in my groin got so bad I could not even get out of my chair to call my patients. Up to that point, I had managed to keep on working. Now, having collapsed on the floor, I had to accept that the pain had won. I finally had to admit to myself I could not work any more."

It was a devastating realisation for Annette.

"Could not work? Never mind work -- I couldn't even walk," she says. "The life that I had always dreamed of -- living in Donegal and having my own animal sanctuary -- was now about to be threatened by a silent, invisible, destructive force called neuropathic pain." Annette says it feels as though she is being stabbed in the groin with a sharp, jagged knife which never ceases its relentless stabbing.

Consequentially, she cannot do any of the things she so enjoyed in the past, activities such as running, cycling, surfing or riding horses.

Now, she can only move slowly, and with the help of a walking stick.

"I often joke about the pain when I am with other people, but when I am alone, I cry.

"Simple things I used to take for granted, like getting into the car, are now painful challenges. Stepping in and out of the shower means pain," Annette says frankly.

"Standing in the shower means pain. Just standing means pain. Just being means pain. There is no relief -- the pain is constant."

Annette's medication definitely does help her, but she admits that "I still feel pain and it makes me drowsy though I am not on a high dose."

As if all that suffering wasn't enough, Annette now faces considerable financial hardship, as she was self-employed at the time of the collapse, and so was not entitled to sick leave, or other benefits.

And she will have to face that challenge alone, as she and her husband have divorced.

"My beautiful cottage and farm are now up for sale, as I have to repay my mortgage and I have no choice but to relocate," she says.

Annette says, while she can glibly say that last sentence in 10 seconds, it took her more than a year to admit the truth of it. "I live in an idyllic part of Donegal. I never thought, when I moved here, I would have to leave," she says sadly. "How did my life turn into such a tangled, twisted bundle of barbed wire? The answer is neuropathic pain."

However, Annette says she is extremely grateful to the medical team at the pain clinic at St Vincent's Hospital -- especially consultant Dr Paul Murphy -- because he understands her pain and because he always takes the time to really listen to her.

She says the team is trying really hard to find a solution to her pain, but in the meantime she must soldier on.

Nonetheless, Annette is one of the brightest, funniest people you could ever meet. When she is with her rescued animals she cannot refrain from loving utterances as she nuzzles them, a blissful smile on her face.

Despite the constant pain, Annette's attitude is positive: "This has taught me to be humble and to live in the present moment -- to live in the now."

L

See www.hornheadpetsanctuary.com

A three-part documentary series, 'Reeling in the Pain', which features Dr Annette Hunter, will be launched at the Lighthouse cinema on Thursday and may thereafter be viewed at the ICPA's website. The Irish Chronic Pain Association (ICPA), tel: (01) 804-7567, or visit www.chronicpainireland.org

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