Nicolas was 42 when a severe cerebral hemorrhage changed his life forever. Nicolas has had a previously undetected arteriovenous malformation since birth (see box below). This triggers severe bleeding, as in Nicola's case, with long-lasting consequences.
The life before
In his "first life" Nicolas is married, has two grown children, a job in a managerial position and he is passionate about functional fighting - a martial art in which all kinds of punches and kicks are allowed. Also against the head. In the spring of 2013, Nicolas experienced motor deficits for the first time after a training weekend. For example, he can no longer move one arm for a short time. The incidents are increasing. Nicolas subsequently has various medical examinations carried out. His brain is scanned in the MRI tube four times. His arteriovenous painting function remains undetected. Instead, he receives a misdiagnosis that, according to the neurologist, does not need to be treated.
The life changing event
A month later, Nicolas suffers a cerebral hemorrhage. He is working in the garden when he notices something is wrong. He takes a shower and gets dressed on his own. The last time for a long time. He tells his wife and son to call the ambulance. Then he falls unconscious.
Nicolas only knows what happened next from stories. He is first admitted to Bülach Hospital, but then quickly transferred to Zurich University Hospital. During an emergency operation, a hole is drilled into his skull so that the blood can drain out. A catheter is placed in Nicolas's brain through the groin and two days later the bleeding is stopped by cauterizing the affected blood vessels. Nicolas is in a coma the whole time. When he wakes up after a week, nothing is the same. The severe bleeding primarily damaged his thalamus, a region in the diencephalon that is called the “gateway to consciousness.” Nicola's sensory system no longer works and he is paralyzed. He only realized all of this weeks later. Nicola's very good physical condition saved his life - his heart and organs were not damaged despite the severe brain injury.
The life after
Around two weeks after the cerebral hemorrhage, Nicolas was transferred to the rehabilitation clinic in Zihlschlacht (TG), which specializes in neurological rehabilitation. Not only is the diagnosis of arteriovenous malfunction (AVM) made there, but the young, very motivated team immediately begins his rehabilitation.
“It was only after about four weeks that I realized what had happened to me. I realized that I was sitting in a wheelchair and couldn't move my hands or legs. My brain was in survival mode the whole time before, it had no capacity to evaluate my condition. Despite my condition, I wasn't afraid, but always hoped that I would get better again," he says.
And Nicolas is making progress: During the three-month, very intensive rehabilitation, he manages to get up again and take his first steps. He is operated on a third time. During this procedure, the last traces of blood in his thalamus are removed and the torn area is glued. “It's a strange and frightening idea to have glue in your brain. But this method seems to have proven successful. At the beginning I had to be checked every year and a half, now only every five years,” says Nicolas.
Healing body, aching body
Thanks to his rehab and his own training, Nicolas is gradually regaining more and more bodily functions that he thought were lost. Today he can cycle again on a tricycle, he goes for miles-long walks and has set up a gym at home. Nicolas describes his gait and the position of his left arm as slightly “unrounded” – otherwise his temporary paralysis is no longer noticeable. His ability to think and concentrate has also improved again and Nicolas no longer gets tired so quickly. Today he is no longer dependent on the support of others in everyday life. Everything is fine, you might think.
Sadly, this is not the case. In contrast to his motor progress, Nicolas develops neuropathic pain. These can occur as a result of damage to the brain or spinal cord. For Nicolas this means having to endure a feeling like thousands of needle pricks. He also struggles with severe spasticity in his legs and hands - especially on the left. “It feels as if the center of my body has shifted to the right after the cerebral hemorrhage. The right side is my good side, the left side is where I feel unbearable pain,” says Nicolas.
Nicolas is prescribed medication to combat the pain and to relieve his spasticity. However, at high doses they have extreme side effects. “Sometimes I felt like I was off track. I was no longer myself. There were moments when my mind left my body, I looked at myself from the outside and asked: What am I actually doing?", says Nicolas, describing his experiences with the medication. During this time, Nicolas breaks off many social contacts. His relationship, which was already in crisis before the cerebral hemorrhage, is also falling apart. After all, he still has good, trusting contact with his ex-wife and children. Nicolas feels like a “cripple” at times and is ashamed of his condition. «I became really weird. “I wouldn’t have wanted to be friends with me either,” he says, looking back on this difficult time. The pain makes life miserable for Nicolas. He thinks about suicide and signs up for Exit.
Relief from cannabis
For years, Nicolas has tried in vain to get his neuropathic pain under control with “conventional” medication. Because nothing helped, he did his own research and decided to try cannabis. Because his neurologist at the time was not open to cannabis as a medicine, he got it himself and vaporized it in a vaporizer. For the first time he experiences relief from his pain. «As an athlete, I used to have reservations about all kinds of drugs. Today cannabis makes my life worth living again,” he says. However, the cannabis cannot be dosed so precisely and obtaining it is also difficult.
legal situation in 2022 , Nicolas approaches his new neurologist and is prescribed the Spray sativex . Unfortunately, he does not tolerate it well. through Medcan's patient meetings , but also receives helpful cannabis knowledge and contact with a well-informed neuro login at the Zurich Hirslanden Clinic. She prescribes him-he had the information from Medcan-a cannabis-sativa oil, from which he drives a few drops under his tongue depending on the pain intensity. Together with his "backpack" of measures against pain such as breathing exercises or meditation, the oil provides him with 30 minutes of relief. The pain becomes bearable. And not only that: thanks to the cannabis oil, Nicolas has more appetite again, is more and more entertainment. He ties in with old friendships and can revive them. «Before cannabis therapy, I just wanted to be alone for myself. Finally I have the desire and strength to go among people again, »he says.
Better inform the medical profession
Nicolas wishes that - now that the legal basis for this has been created - the medical profession would receive more training on the positive properties of cannabis. And that doctors recognize that cannabis not only relieves pain, but also has very positive properties for the mental health of patients. Nicolas is living proof of this.
«In my previous life I was anti-cannabis. Today I can no longer live without the active ingredient because it relieves my pain.”
