When Peter looks back on his life so far, it is clearly divided into two parts and two states: the time before the stroke and the time after. And life without pain and life with almost unbearable pain.
In 2006, at the age of 36, Peter suffered a stroke. This was preceded by what he calls a "not very healthy lifestyle"—smoking, alcohol, and long work shifts late into the night. However, the stroke was caused by something else: an oval, roughly two-franc-sized, undetected hole in one of his heart's septa. For years, he had been mistakenly diagnosed with asthma and allergies—yet his heart defect remained undetected despite frequent medical checkups. The hole in his heart caused a blood clot to form there, which then traveled to his brain. "At that time, I was happier than I'd ever been in my life. I was the assistant manager of an Irish pub in Estavayer-le-Lac and in a new relationship," Peter recounts. After a long shift, he lay down to sleep next to his girlfriend. The next morning, he woke with paralysis on the left side of his body; his left hand was exhibiting severe spastic cramps, and the left side of his face was drooping. More than six hours may have passed since the stroke—when every minute counts to prevent brain damage. Peter was taken by ambulance to Payerne Hospital and then transferred by helicopter to Lausanne University Hospital. There, the clot was dissolved, and Peter survived.
The martyrdom begins
Peter didn't have to stay in the hospital long. And his paralysis also subsided. For a short time, he hoped that with the help of physiotherapy, occupational therapy, and speech therapy, he could return to his normal life. Unfortunately, this hope didn't last long. About a month after his stroke, Peter felt burning pain in the fingertips of his left hand for the first time. "Like touching a hot stove. Only constant," he describes the sensation. A year later, this so-called peripheral neuralgia, accompanied by severe allodynia, had already taken hold of his entire hand. Peter couldn't touch anything without almost screaming in pain. The clothing on the left side of his body burned like fire. Peter therefore got into the habit of wearing a loose-fitting garment reminiscent of traditional Arab clothing. And he cut off all the cuffs. Because anything that lay directly on his skin hurt. For the first year and a half after the stroke, the pain spread further and further across his left side. Peter is undergoing occupational therapy, trying "rabbit fur therapy" or mirror therapy. All with the aim of reducing the pain. Nothing helps. Only strong painkillers provide him with any relief.
About a year after his stroke, the hole in Peter's heart was closed using minimally invasive surgery. "I was out of the hospital after just one day. What all could I have been spared if it had been discovered?" he sometimes wonders. The neuropathic pain, however, persists and worsens. Peter is prescribed increasingly stronger painkillers. At times, he receives intravenous infusions of the painkillers ketamine and propofol, but these only provide relief for two to three days. Two years after the stroke, he takes OxyContin for the first time: its effects begin after about half an hour. It is taken as a sustained-release medication, meaning the active ingredient is released gradually. This ensures that the effect lasts for several hours. At the same time, he is prescribed the fast-acting, morphine-based Sevredol. The combination of the two medications reduces Peter's pain. However, there is a problem: OxyContin is an opiate and is highly addictive. Peter also has to constantly increase his dosage – up to 300 milligrams per dose. Overdosing can lead to respiratory arrest. In the US, medications containing the active ingredient oxycodone, found in OxyContin, are one of the causes of the current opioid crisis, which claims tens of thousands of lives annually. Despite the dangers and high potential for addiction, medications containing this active ingredient are also prescribed in Germany – albeit under strict regulations.
The “wired” Peter
Because Peter's pain level was consistently very high, he became the first patient in Switzerland to receive a Motor Cortex Stimulator (MCS) after a stroke in 2010, undergoing a seven-hour operation. This technique is otherwise used for Parkinson's patients. The MCS uses electrodes implanted above the brain's surface to selectively stimulate the brain regions responsible for the painful parts of the body. Peter's MCS runs—imperceptibly to him—for one hour at a time, then takes a one-hour break, and is also switched off at night. For a while, thanks to the stimulator, Peter experienced about 35 percent less of the burning pain in his face and back. Five years later, Peter underwent another therapy. At the renowned Paraplegic Center in Nottwil, he received a Spinal Cord Stimulator (SCS). This was designed to stimulate the nerve pathways between the fourth and fifth cervical vertebrae and alleviate Peter's pain. The operation was successful, and the pain subsided, at least initially. Unfortunately, Peter is so underweight due to his opiate use that the spinal cord stimulator is working inaccurately. It stimulates not only the intended nerves but also other nerve pathways. This results in painful bursitis in his knee, requiring further surgery. Therefore, Peter has to limit the SCS stimulation to a minimum, meaning the implant cannot provide its full pain relief.
A life in an opiate fog
Despite all efforts, therapies, and two implants, Peter's severe neuropathic pain persists. He also suffers from sacroiliac joint pain, osteoarthritis, and severe bursitis, as he can only sleep on his pain-free right side. For 15 years, he takes opiates. These, he says, are gradually "destroying" his body. He is plagued by constipation, wastes away to 55 kilograms at 1.80 meters tall, and develops a drug-induced tremor, a severe shaking of his hands. And Peter is no longer himself: the medication is changing his personality. He is irritable, depressed, and his emotions are dulled. So much so that he can't even properly grieve for his beloved mother when she dies at the age of 93 in the spring of 2023. "Inside, I was torn apart. But nothing came out—not a single tear, not a sob, not a scream, nothing." Peter decides: This can't go on. He wants to get off his painkillers.
Breaking free from addiction – under anesthesia
Peter researched extensively and finally found Opiostop, a way to undergo medication withdrawal under anesthesia. On June 24, 2023, he was given naloxone under anesthesia—an "antidote" to the opiates he had been taking for years. Up until then, nine hours of anesthesia had been the record for patients. For Peter, it was the first time he had been under anesthesia for 18 hours. A nurse later told him he had writhed and struggled under the anesthesia. Then came the "cold turkey": Peter suffered weeks of indescribable withdrawal pain and symptoms. He was delirious for a day and a half, naked, unable to bear even the hospital gown against his burning skin. He had muscle cramps, stomach and intestinal cramps, felt cold for over ten days, and all food tasted awful for days.
After the withdrawal of the high-flying
Once the initial difficult period is over, Peter experiences a second youth. His body's own endorphins take effect. He listens to music from his teenage years, feels better, and his relationship with his partner and his 13-year-old dog, Nahla, deepens. He is finally able to grieve for his mother. "For 15 years I lived like a cocoon; now a butterfly is emerging," he says. Instead of taking opiates, Peter smokes medical cannabis, which lifts his spirits.
While opiate withdrawal has improved Peter's mental state, his pain has intensified. Even sun and wind burn excruciatingly on his skin. He prefers to walk his dog, Nahla, in the woods when it's overcast and windless. There, he can relax: he strolls from bench to bench, takes a few puffs of cannabis, and can suppress his pain for a few minutes. But most of the time, Peter suffers. He rarely leaves the house anymore and lives in isolation—apart from his partner and a few remaining friends. "When you've been addicted to medication as long as I have, very few contacts remain. Because the medication makes you live as if under a constant veil. It lulls you, makes you passive. The only things that kept me alive were my girlfriend and my dog, Nahla," he says sadly.
A computed tomography scan with serious consequences
In 2024, Peter underwent a routine CT scan of his kidney. The contrast agent used in the procedure further damaged his already strained nerve pathways. Since then, Peter has been plagued not only by physical pain but also by internal neuropathic pain in his mouth, esophagus, and stomach. He has been consuming only liquids—lactose-free protein drinks—since solid food is too painful, making swallowing nearly impossible. "I have stomach cramps, hot flashes, and the internal nerve damage is incredibly painful. It feels like someone is cutting my stomach open with a knife," he describes his neuropathic pain. To drink the drinks, he bends his upper body to his right, pain-free side. He can only manage three or four puffs of cannabis at a time before the pain in his mouth and throat becomes unbearable. Peter may need a feeding tube in the future. "Not being able to eat or drink at all is a terrible thought for me." "Especially since my cannabis therapy has given me back my appetite and I've even gained six kilograms," he says.
The battle with the health insurance company
Although Peter is officially considered to have exhausted all other treatment options, and medical cannabis has had very positive effects on his physical and mental health, his health insurance company is still awaiting approval for coverage of his prescription. His initial application was rejected after just ten days, but Peter appealed. "It's so frustrating. The harmful opiates were covered, but with medical cannabis, I have to bear the considerable costs myself. Furthermore, I can't simply get medical cannabis from a pharmacy; I have to obtain it illegally. Even though it demonstrably helps me. Is that fair?" Peter asks. With his so-called reconsideration request, he included a landmark Federal Supreme Court ruling in his application to his health insurance company. He also submitted the prescription to his login – not to his family doctor as before – to emphasize the urgency of his situation. Peter hasn't given up hope that coverage will be approved this time. Medcan is keeping its fingers crossed for him and continues to advocate for easier access to medical cannabis – for people like Peter.
