Nicolas was 42 when a severe brain hemorrhage changed his life forever. From birth, Nicolas had an arteriovenous malformation (see box below), which had gone undetected until then. This triggered the severe bleeding, as in Nicolas's case, with long-lasting consequences.
Life before
In his "first life," Nicolas is married, has two grown children, a management position, and is passionate about Functional Fighting—a martial art in which all kinds of punches and kicks are allowed, including head strikes. In the spring of 2013, after a training weekend, Nicolas experiences motor deficits for the first time. For example, he is temporarily unable to move one arm. The incidents become more frequent. As a result, Nicolas undergoes various medical examinations. His brain is scanned in an MRI machine a total of four times. His arteriovenous dysfunction remains undetected. Instead, he receives a misdiagnosis that, according to the neurologist, requires no treatment.
The life-changing event
A month later, Nicolas suffers a brain hemorrhage. He is working in the garden when he notices something is wrong. He takes a shower and dresses himself. This will be the last time he does so for a long time. He tells his wife and son to call an ambulance. Then he loses consciousness.
What happened next, Nicolas only knows from what others have told him. He was first admitted to Bülach Hospital, but then quickly transferred to Zurich University Hospital. During emergency surgery, a hole was drilled into his skull to allow the blood to drain. A catheter was inserted into Nicolas's brain via his groin, and two days later, the bleeding was stopped by cauterizing the affected blood vessels. Nicolas remained in a coma throughout this time. When he awoke a week later, nothing was the same. The severe bleeding had primarily damaged his thalamus, a region in the diencephalon known as the "gateway to consciousness." Nicolas's senses no longer functioned; he was paralyzed. He only fully realized all of this weeks later. Nicolas's excellent physical condition saved his life—his heart and other organs suffered no damage despite the severe brain injury.
Life after
Approximately two weeks after the brain hemorrhage, Nicolas was transferred to the rehabilitation clinic in Zihlschlacht (TG), which specializes in neurological rehabilitation. There, he was not only diagnosed with arteriovenous malfunction (AVM), but the young, highly motivated team immediately began his rehabilitation.
"It took me about four weeks to realize what had happened to me. I noticed that I was in a wheelchair and couldn't move my hands or legs. Before that, my brain had been in survival mode the whole time; it had no capacity to assess my condition. Despite my condition, I wasn't afraid, but always hopeful that I would get better," 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 undergoes a third operation. In this procedure, the last traces of blood in his thalamus are removed and the torn area is glued. "It's a strange and frightening thought, having glue in your brain. But this method seems to have proven effective. At the beginning, I had to go for checkups every year and a half, now only every five years," says Nicolas.
Healing body, aching body
Thanks to his rehabilitation and his own training, Nicolas is gradually regaining more and more bodily functions that he thought were lost forever. Today, he can ride a tricycle again, he takes long walks, and he has set up a gym at home. Nicolas describes his gait and the position of his left arm as slightly "uneven"—otherwise, you wouldn't know he had been temporarily paralyzed. His cognitive abilities and concentration have also improved, and Nicolas doesn't tire as easily anymore. Today, he no longer needs assistance from others in his daily life. Everything seems perfect, one might think.
Unfortunately, that's not the case. Contrary to his motor progress, Nicolas is developing neuropathic pain. This can occur as a result of damage to the brain or spinal cord. For Nicolas, this means having to endure a sensation like thousands of pinpricks. He also struggles with severe spasticity in his legs and hands – especially on the left side. "It feels as if my center of gravity shifted to the right after the brain hemorrhage. My right side is my good side; on the left, I experience excruciating pain," Nicolas explains.
To manage the pain and alleviate his spasticity, Nicolas was prescribed medication. However, at high doses, this medication had extreme side effects. "Sometimes I felt completely out of sorts. I wasn't myself anymore. There were moments when my mind left my body, I looked at myself from the outside and asked: What am I even doing here?" Nicolas describes his experiences with the medication. During this time, Nicolas broke off many social contacts. His relationship, which was already strained before the brain hemorrhage, also fell apart. At least he still maintains a good, trusting relationship with his ex-wife and children. Nicolas sometimes felt like a "cripple" and was ashamed of his condition. "I became really strange. I wouldn't have wanted to be friends with myself," he reflects on this difficult time. The pain made life unbearable for Nicolas. He contemplated suicide and registered with Exit, a suicide prevention organization.
Relief through cannabis
For years, Nicolas tried unsuccessfully to manage his neuropathic pain with conventional medications. Nothing helped, so he did his own research and decided to try cannabis. Because his neurologist at the time wasn't open to cannabis as a treatment, he obtained it himself and vaporized it. For the first time, he experienced relief from his pain. "As an athlete, I used to be wary of all kinds of drugs. Today, cannabis makes my life worth living again," he says. However, it's not easy to precisely dose cannabis this way, and obtaining it is also difficult.
in 2022 legal situation in favor of people who self-medicate with cannabis, Nicolas approached his new neurologist and had the spray Sativex prescribed. Unfortunately, he didn't tolerate it well. Through Medcan's patient meetings, Nicolas not only met many new people but also gained helpful knowledge about cannabis and was put in touch with a well-informed neurologistlogin the Hirslanden Clinic in Zurich. She prescribed him—he had received this information from Medcan—a Cannabis sativa oil, of which he placed a few drops under his tongue, depending on the intensity of the pain. Combined with his existing pain management techniques, such as breathing exercises and meditation, the oil provided him with relief after 30 minutes. The pain became bearable. And not only that: thanks to the cannabis oil, Nicolas regained his appetite, was more cheerful, and more adventurous. He reconnected with old friends and was able to rekindle them. "Before cannabis therapy, I just wanted to be alone." "Finally I have the desire and energy to go out among people again," he says.
Better inform the medical profession
Nicolas hopes that, now that the legal framework has been established, the medical profession will pursue further training on the positive properties of cannabis. He also hopes that doctors will recognize that cannabis not only alleviates pain but also has very positive effects on the mental health of patients. Nicolas is living proof of this.
"In my previous life, I was against cannabis. Today, I can no longer live without the active ingredient, because it alleviates my pain."
