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According to the Canadian Pain Society, one in five adult Canadians suffers from chronic pain. Living in extreme discomfort affects every aspect of their lives, and many don't find relief through conventional treatments such as medication.
Dr. Angela Mailis knows this conundrum all too well.
As director of the
Comprehensive Pain Program at the Krembil Neuroscience Centre, Dr. Mailis has spent over 30 years working with patients to relieve them of debilitating pain. However, once patients find their way to Dr. Mailis, they have often been suffering for months or even years.
"Not every patient living with chronic pain should end up at a hospital for treatment," she says. "I wanted to come up with a model of care that would allow me to help these patients at an earlier stage in their illness."
So Dr. Mailis took her extensive pain management expertise out of the hospital and into the community.
With a team of practitioners from several health disciplines including chronic pain management, surgery, psychology, manual therapy, naturopathic medicine, osteopathy, and meditation, she officially opened the Pain and Wellness Centre in Vaughan in September 2014.
The clinic – which serves communities north of the 401 including York, Peel, Durham, Dufferin, and Simcoe – receives patients suffering from a wide variety of pain disorders such as complex regional pain syndrome, neuropathic pain syndromes, cancer-related pain, concussion, chronic pain conditions with unclear diagnosis and much more. Treatments are covered by extended benefits.
Only open a few months, referrals to the Pain and Wellness Centre have already increased from one or two a week to five to seven per day.
"I'm very excited about the clinic's potential. This model is the missing link between academic centres like UHN and communities that don't have the resources to offer specialized care," says Dr. Mailis. "In this setting, I can offer a wider range of treatment options, I can intervene earlier in a patient's condition but, if needed, I can still refer patients to the UHN in order for them to see other specialists."
"This partnership is the first of its kind in Ontario and creates a novel model of bringing academic pain care to the community," Dr. Mailis continues. "It not only offers evidence-based interdisciplinary care, but also education for medical students, residents, practicing physicians and the public, as well as conducting relevant community-based research. "
This model of care was exactly what Paula Velez, a young mother and administrative assistant from Brampton, needed.
Two years ago, Paula began to experience pain in her foot. She was unsure what had caused it, but the pain continued to worsen and quickly became unbearable.
"Before this happened, I was a pretty healthy person," she says. "And then almost overnight I became unable to take care of myself, my young daughter, my family. Chronic pain really takes a toll on a person, everything changed for me physically, mentally and emotionally."
Putting her full body weight on her foot caused extreme pain so Paula started using crutches for support. Her immobility caused her to gain weight and she relied more and more on her husband. Simple things such as showering, getting dressed and even going to the washroom required extra help since Paula couldn't keep her balance.
She consulted several doctors, specialists and even surgeons who all diagnosed different conditions and were unsuccessful in treating her pain.
"I was extremely depressed and even had suicidal thoughts at times because of the pain and not getting answers," she recalls. "It was so hard to live with this pain and miss out on activities with my daughter. For two years, I couldn't take her to the park, go strawberry-picking or out for Halloween with her. I was starting to lose hope."
Finally, after asking her neurologist if there was any other specialist she could contact, Paula heard about Dr. Mailis. Within two weeks of contacting her, she was referred to the Pain and Wellness Centre for an evaluation.
"Every other doctor's appointment I had prior to meeting Mailis left me feeling sad and hopeless," says Paula. "The day I left her centre, I was still in excruciating pain but I knew right away that she would finally be the doctor to help me. The way she talked to me, the way she explained things, I knew she was good."
Paula's condition required more investigation and she was admitted to Toronto Western Hospital (TWH) for a four day inpatient program. Roughly ten per cent of patients seen at the Pain and Wellness Centre require further follow up at a hospital.
Paula was prescribed medication that has relieved her pain dramatically. She is still undergoing treatment and seeing specialists at TWH to pinpoint her exact diagnosis and its cause. But the collaboration between the clinic and the hospital has already greatly improved Paula's life.
"I'm still using crutches so my activities are limited, but I'm much happier," says Paula. "I'm now able to get in and out of the shower without help, I'm able to stand in the shower without using a stool, and I can do more things with my daughter and husband. I still have a ways to go but I'm more hopeful that I will get better."
"I really owe all this to Dr. Mailis. If she didn't care for me the way she had, I would still be in a dark place. She truly cares about her patients and she is amazing at what she does."