No one said recovering would be easy; they said it would be worth it.  

Whilst sitting here wondering how I am going to take nearly 12 years of chronic health struggles and formulate it into a short blog post, I reflect on a 16-year-old: scared, confused, immature and unprepared adolescent. I bring myself back to the day I got the call from the Montreal Children’s Hospital Gastroenterology (GI) department to give me my first appointment, initiating the testing process for inflammatory bowel disease. It seems like so long ago, yet it’s still so fresh in my memory.  

As a medical cannabis patient and medical cannabis clinic employee, I hope my story can help anyone to see a glimmer of light at the end of even the darkest of tunnels. I currently see my daily fight to maintain balance and good health as a blessing and a strength, but as a teenager just starting to experience life, it felt like an absolute curse and weakness.  

The summer I turned 16, I went to see my gynecologist for my usual 6-month follow-up. Even though I was on birth control, I was constantly spotting between periods. Given my family history of Inflammatory Bowel Disease and Irritable Bowel Syndrome, and an additional concern of constant diarrhea for the last 3 months, worry grew that I may be battling an autoimmune disease. My doctor put in a request for me to be seen by the Montreal children’s hospital’s GI department, where I was diagnosed with Crohn’s disease.  

Within a month of my diagnosis and commencing treatments, I experienced an adverse reaction to the medication my doctors had prescribed to control my disease. It left me with pancreatitis – this was the beginning of my living nightmare.  

Due to ongoing complications, I was hospitalized for months at a time, and I was given opioids to control my pain, benzodiazepines for anxiety, and corticosteroids for the inflammation my disease caused. As time passed each hospitalization got longer and my time at home in between got shorter.  

Over time, I started to notice a shift in my moods. I thought I was only mildly depressed because of the cards I had just been dealt. I figured it was normal considering everything I had gone through in a short amount of time. I was watching my adolescence being ripped away from me. I began to feel like a prisoner in my own body. I went from being an outgoing and sociable teenager to being a reserved and isolated young adult. I was terrified.   

Shortly after being told that my pain from multiple flare-ups left me with chronic nerve damage to my intestines and pancreas, I began to realize that the pain I had was both physical and psychological, which in turn brought on severe anxiety. I started to seek unhealthy coping mechanisms.  

Subconsciously, I turned to opioids that doctors prescribed for my physical pain to alleviate my mental pain as well. I did not want to feel anything, I wanted to be numb. From that point on, there was not a day that went by that I did not misuse morphine, Dilaudid, codeine, fentanyl, or Ativan to escape the fact I was chronically ill and depressed.   

I was being followed in cognitive behavioural therapy and talk therapy for 6 months after my Crohn’s diagnosis. I learned I could tell my therapist whatever she wanted to hear just so my specialists would be happy and leave me be. After each session, I would go home and drown my feelings in whatever opioid I had at my disposal.   

Sleeping and avoiding reality became easier than dealing with my issues.  I had lost everything dear to me: school, friends, romantic partners, self-confidence, and, most of all, self-worth. I was doing absolutely nothing to help myself. I had secretly set a goal to do everything in my power not to see my 25th birthday. At this point, I was chronically depressed and had become a danger to myself.   

My cannabis journey began roughly 2 months later. I went into the ER as usually, thinking I was having another flare-up, but the nausea, vomiting, irritability, cold sweats and increased pain that I was experiencing was not disease related; it was withdrawal. I was hospitalized again, but this time was different. The chronic pain doctors and my care team agreed that I was physically dependent on Dilaudid. They proposed a 20-day in –hospital detox. At 17, I felt like I was being treated like a severe drug addict – little did I know, that was exactly the road I was heading down.  

My older brother came to visit me one day and was appalled with the approach the hospital was taking. Yes, on the one hand, they were doing right by getting me off the opioid causing more harm than good; but on the other hand, I had nothing in the short-term to control the constant pain that I was in. He decided to bring me outside and shared a joint with me. After smoking, my pain diminished, and I was able to finally eat something without vomiting. Since I was a minor my doctors were legally unable to recommend me using cannabis, but if it meant that I would use less opioids, they were not completely opposed to it. The doctors found less habit-forming derivatives of opioids for me to use during pain flare-ups; but with the help of cannabis, I did not need to use as large of doses as I used to.   

After my bowel resection at 20 years old, I recall that my family doctor noticed I was very depressed and needed help. He referred me to the best psychiatrist I’ve ever met. For the first time since getting diagnosed, I felt like I could make considerable progress. I felt like I could open up and be vulnerable with this doctor. I felt like finally someone other than my gastroenterologist genuinely believed in me and did not think I was just a drug seeker, that there was more to my substance abuse than the desire to get high. Despite that, it still took me 6 months to actually let her into some of the deepest, darkest parts of me.     

During one of my countless hospitalizations, I was assigned to the family medicine unit. Dr. Jean Zigby was following me. He was aware that I was trying to reduce my intake of opioids and substitute them with cannabis, but I had no guidance, little cannabis knowledge, nor did I have a clue what was in the cannabis I was consuming. Dr. Zigby changed all that and at 22, I was introduced to Santé Cannabis  

From there, I was blessed with a structured, positive, and organized care team. Confidently, I was able to find healthy approaches to put into practice and regain some balance in my life. I was able to gradually reduce my opioid use for anything other than pain management during my Crohn’s flare-ups. I no longer needed my benzodiazepines, not even for severe anxiety attacks. I was finally taking care of myself, and things began to look up for me. The one thing I did not expect was for the “rollercoaster” I called my life to sporadically have such horrific lows.     

After 7 years of being sick, I had hit rock bottom, attempted to overdose, and to commit suicide multiple times. It took me countless hospitalizations, substance abuse issues and 6 different mental health professionals for me to take my mental and physical health disorders seriously. I had a romantic partner at the time who gave me an ultimatum: it was drugs or her – and clearly, I chose her. I have been on a constant journey of recovery since.   

Due to a long-term use of steroids, I was diagnosed at 23 with ankylosing spondylitis in my sacroiliac joint, as well as rheumatoid arthritis. I was constantly waking up with swollen joints and pain in my lower back, hands, and knees. After being in constant pain for months, I had gone to the emergency room where they had done scans and blood tests. And sure enough, I had a new chronic autoimmune disease that I needed to deal with.  

I was already sober and well into recovery at this point. My medical cannabis care team and I had found a proper THC-rich cannabis regime for my neuropathic pain. Unfortunately, following my care team’s suggestion to add a CBD oil regime to control my ongoing inflammation was too costly for me, as I did not have an income at the time. I had no choice but to start methotrexate, which is a disease-modifying anti-rheumatic drug (and a cancer treatment at higher doses) with debilitating side effects. However, I was able to control my arthritis with it, to a point where I could keep a steady employment.  

Eventually, I was able to afford CBD oil, which in turn helped control the inflammation caused by arthritis. It almost seemed too good to be true, but following a strict ratio of THC:CBD, ALL my chronic health conditions were now under control. I was able to stop 98% of the medications I was prescribed.   

However, with my life headed in the right direction, a part of me still felt unhappy. There was still that little voice in my head, determined to think that I was going to fail, reminding me about the promise I made to myself that I would not see my 25th birthday. I hated the person I saw in the mirror daily. The only emotion I was able to feel was self-hatred. I overthought everything and anything, and I developed chronic social anxiety – I could no longer be in large groups or crowds of people.  

Instead of using drugs, I was now using romantic relationships and close friends to fill the empty hole deep within where self-love used to lie. I simply transferred addictions. I had not completely dealt with my trauma of the last 9 years. I was barely functioning. I hurt people and got hurt. I always had a superhero complex, but by the time I was 24, it was out of control. I thought I could deal with my “baggage” once a week in therapy without applying therapy tools to my daily life. My days revolved around my career and my partner; I was living and breathing for two things and none of them was me. I ended up burning myself out and nearly relapsing.  

I was a week away from the 2-year mark of my sobriety, 4 months away from my 25th birthday and I was once again ready to end it all. I had to take a sick leave from work and broke up with my then-partner when everything was getting hard. I had a plan to end my misery and give up on myself. The day I planned it, to overdose and close my eyes for good, somehow, with my hand full of pills, reality hit me. I realized how far I had come and could see my worth for the very first time in my life. Instead of relapsing and giving up, I decided it was time to go to rehab.  

I finally focused on myself and was able to get back to work. I took therapy seriously and was able to find new ways to appreciate the life I fought so hard for. I surrounded myself with positive and supportive people. I got through the darkness and celebrated my 25th birthday in June 2019.   

By sharing my story, I wanted to show you that anything is possible with a positive support system, a proper care team, and an individualized treatment plan. You can be dealt the worst cards imaginable, but it is the approach you choose to take that can lead to success or failure. I ventured down both roads and believe me when I say: once you learn to love yourself and embrace everything about yourself, you can overcome any obstacle.   

I found the positive before it was too late. I found my purpose and found my place in the world. No matter how dark the road gets for me, I can always manage to find a way to bring a glimmer of hope to the obstacle I am facing. I grew tired of letting my illnesses, my disorders and my struggles define my life, and learned to live with them.  

When I concentrated on caring for myself and dealing with my trauma, I could prevail through the darkness. I could not find the light in my darkness, so I became the light.  

Author: Rebecca Fogel, Patient Care Coordinator, Santé Cannabis   

Rebecca Fogel has worn many hats for Santé Cannabis since October 2017. She works as a Medical Office Assistant, Patient care coordinator and Patient advocate. She leads patient events and support groups, is passionate about public speaking, and is dedicated to providing medical cannabis patients a place to speak freely and to be heard. 

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I often get patients wondering in the same manner. There is still much reprehension about cannabis. Our society is unceasingly finding fault with it, no matter how its status has evolved. The public has yet to fully and intuitively confirm its moral direction. Cannabis perception is changing at a very slow pace. 

Even the method of administration is very much compatible to its malignant opinion. ‘’ I don’t want to smoke cannabis. I’m not a druggy.’’ one of our patients did say. The current terminology, slangs precisely, is still and probably throwing people off. Many of our patients do not want to be taking weed or puffing on a spliff. Our treatment plans are based on scientific data, and accordingly we make sure to use the appropriate terms to the purpose. 

Our esteemed doctors do not prescribe marijuana. They recommend inhaling dried cannabis for breakthrough pain. I would gently remind a patient when he or she uses such words as “pot” or “ganja”. The old proverbial ‘’to-may-to/to-mah-to’’ would ring out. So, what is the difference? Really? 

I believe words and how we understand them are very consequential moving forward. I remember back in the 1990’s, the semantics affecting the scope of the term ‘’death tax’’ eventually became the ‘’estate or inheritance tax’’ in the US? Basically, politicians and advocates tried to kill the bill by putting stress on how it harmed family farms and small businesses. They knowingly coined the term ‘’death tax’’ to get the public to consider their cause. Dying has more impact and meaning in the collective conscience. 

I think the transition toward a proper nomenclature in medical cannabis practice must be imposed, applied and supported by all parties involved. Indica dried cannabis, THC-rich, 3-4 inhalations at bedtime or as needed does serves as better example of a positive and trustworthy interpretation than 3-4 puffs of weed before going to bed. 

– Pheng Lim, LPN 

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It’s very rewarding to know that as a research clinic we are collecting data for the advancement and development of medical cannabis. Much of the data we collect shows differences in effectiveness and side effects of cannabinoid treatments allowing us to better understand and therefore create valuable treatment plans. I’ve also noticed our research helps shift the mindset of some professionals who might know very little about this subject and tend to be apprehensive because of the limited evidence available. Similarly, we see a pattern that many physicians continue referring their patients to us, probably because they are encouraged by the results achieved.

Medical cannabis is a field where we treat our patients in a fairly multifaceted way. Most of our patients come to us for chronic pain relief, depending on the etiology. We also work in the mental health domain which, let’s face it, became more important due to the current pandemic. Each patient has a personalized treatment plan with the goal of reducing their symptoms.

Recently, I even observed a rather interesting pediatric case. We don’t see many minors, but we have a few isolated cases where we work closely with the patients’ doctors, and consider contraindications and proceed with caution. Liam, my pediatric patient, presented with a severe case of Gilles de la Tourette’s syndrome, which caused him to have a long series of associated symptoms including vocal tics, hyperactivity, generalized spasms, aggressiveness and self-injury.

Liam was very lucky to have incredibly involved parents who continued to look for solutions for their son. During his last follow-up, his mother was moved to tell me how he had been doing. It’s not easy to live with this type of syndrome and the current pharmacological treatments are quite limited. During the meeting, she explained to me that Liam has been able to considerably reduce his list of medications, many of which were not very effective. The CBD based treatment we had advised him on taking (a cannabis molecule called cannabidiol) provided a significant improvement in his overall condition, and according to his teachers, his behavioral problems had significantly decreased and his class periods were more enjoyable. There was a decline in his aggressive and impulsive behaviors, the elimination of dark thoughts, a proper and peaceful sleep and a decrease in his spasms. These changes were greatly appreciated by Liam, and those who surround and love him.

Certainly cannabis did not cure him and we don’t expect it to. However, I am proud to say, we were able to provide him with new and additional tools and support required to improve his quality of life. Our physicians work hand-in-hand with Liam’s specialists to ensure quality follow-up, and they have been pleased with the effectiveness of the treatment established.

*names have been changed to protect identity of our patients

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Author: Laura Libralesso

Most of us have experienced the healthcare system, in times of darkness, stress, confusion, and often, in those dark places we find nurses as a beacon of light. At Santé Cannabis, our nurses are a primary point in our model of care. They’re the first medical professional our patients see, and the ones who stay by their sides through their treatment plans.

Medical cannabis is a journey, and for many patients, it’s one filled with unknowns and pitfalls, and our nurses are expert navigators. Our nurses listen. They get asked the tough, scary and embarrassing questions. They educate. They guide. They advocate. We wouldn’t be anywhere without them.

This year’s National Nursing Week’s theme is “We Answer The Call”, which speaks to the deep calling and commitment that our nurses have for their role in patient care. But during COVID many of these calls are literal – from patients from across Quebec, who are looking to access a treatment from someone who understands, cares and holds the highest level of expertise. Our nurses have shown incredible tenacity and spirit as they shifted from our clinics and into their homes as we began telemedicine last March, and soon back to the clinic. 

Our nurses at Santé Cannabis are a dedicated and diverse group of individuals that are driven by our purpose to positively impact the health of our community. Their compassion and dedication to see improvements in their patient’s lives is demonstrated by the positive feedback that is received from our patients and through the increasing demand of our services. 

Santé Cannabis would like to thank our nurses for their exceptional work and continued dedication to our purpose, not only for this week but every day.

Meet some of our nursing team

Naomie Parrot, Nurse Coordinator

I work at Santé Cannabis to have a unique experience as a nurse in a private practice. I feel valued at work and am challenged every day; with a team that is stimulating and we feel very close to each other. The most significant and rewarding part of my job is accompanying patients in the relief of their symptoms and improving their quality of life. 

We adapt treatment plans to be specific to each patient, and provide them with comprehensive education about medical cannabis as well as support for their treatment. We teach about the different molecules (THC/CBD), indications, side effects, precautions/contraindications as well as titration and administration of the product, allowing patients to be guided in their journey.

I enjoy the progress I’ve made at Santé Cannabis over the years, from nurse, to team lead to coordinator. I found flexibility and a balanced lifestyle working in private practice rather than the hospital. 

I’d also like to introduce Gigi, a little 4lb toy poodle, who arrived at my house during Covid. Telecommuting, I now have a new co-worker who fills my days with even more happiness. She makes a few surprise appearances in some meetings and gives us a good laugh!

Derek English, Research Nurse

I’m passionate about helping people, chronic pain and medical cannabis. I come from a background in orthopaedic surgery where I had experience treating people with all kinds of pain conditions, which helped be more understanding, patient and compassionate. I dealt with many frustrated patients who were not getting what they needed out of the healthcare system and I began to understand that traditional medicine isn’t always the answer for everyone. 

Since joining Sante Cannabis I’ve been fortunate to have many meaningful and amazing experiences, but being able to contribute to many of our patients having a more active life, increasing their overall health-related quality of life has revitalized my enthusiasm for nursing.

Since COVID, I’ve been keeping busy with all sorts of exciting new hobbies, from making yogurt in with the instant pot, and diving into the world of art via blogs, smarthistory youtube channel, and art apps and developing my interest drawing animation.

Tania Pellegrino, Educator/Team Lead

It’s meaningful to me to make an impact in our patients’ wellbeing. I believe that cannabis is a complementary medicine that helps a lot of people suffering from different medical issues. The legalization of cannabis in October of 2018 was really a milestone for us, giving medical cannabis much more credibility and interest. At that point the clinic also got involved in more meaningful research, which allowed us to hire many more employees. It’s been incredible to see this transition and growth.

I’ve always enjoyed making impactful bonds with clients and prior to graduating from nursing I worked in telecommunications in sales for 10 years where I got to make many connections with clients. I continue to make those bonds, with both the clients and the team I work with daily. My team is a great pleasure, and I appreciate the flexibility in our schedules and working from home during the pandemic. 

I’d like to introduce Sophie, my 2 and a half year old French Bulldog. She is great because she is playful, energetic and silly. In addition to everything that makes her great, she unfortunately suffers from anxiety. She is totally dreading my return to the office and staying alone all day – I’ll miss her too, but will be happy to see our clients again in person. 

Isabelle Fournier, Nursing Assistant/Educator

I work at Santé Cannabis to help people. For many, we are the last resort and we often hear from our patients that we have given them back a quality of life that they no longer thought possible. I really enjoy the respect and support within the entire medical team, and think our patients do as well.   

I’ve had many important experiences, but one that stands out for me is a pediatric case, where we were able to work towards the family’s health goals. One day I received a call from the father of the child who explained with tears in his eyes the difference he had experienced. 

I feel I am uniquely qualified to work at Sante Cannabis, as I experienced a work injury that has given me permanent limitations. I live with constant pain, insomnia and anxiety, and so can relate to many of our patients on a personal level. I’ve appreciated the ability to work from home over COVID, and to be able to meet with our patients on telemedicine, as for many of them travelling can be a barrier. I hope that post-COVID the government will continue to fund telemedicine visits, as has been a positive for our patients, many of whom have told me about reduced anxiety with their visits. 

Words of appreciation 

Vi Dam, RN, Director of Clinical Education

I am so happy to be celebrating our nursing team this week! Nurses and auxiliary nurses at Santé Cannabis play such a vital role in our operations and their actions stretch across all departments, they are really our essential workers! For me, particularly this past year with the pandemic, they have really embodied totally and absolutely what it is to be a nurse. 

I cannot express the immense appreciation I have for our nursing team; and for nursing coordinators who take on so much and have marked themselves as true leaders. They showed professionalism and adaptability when we needed to switch to virtual consultations. It was not an easy task, and they were a true support for our physician colleagues as well as for our patients. 

We put in them our trust and rely on their empathy, compassion and skills as advocates and communicators for our patients and for medical cannabis as a treatment. I couldn’t be prouder of the team we have put together. Happy Nursing Week 2021!

Erin Prosk, President

We wanted to take time to emphasize our respect and appreciation for the individual and team contribution that our nurses make to Santé Cannabis and to the thousands of patients who have benefited from the care, compassion and informed education that they provide. Our nurse team is the backbone of Santé Cannabis, from each individual patient consultation to the critical role that they play in the medical community to support the thousands of referring doctors and nurses across Quebec who trust our team. I can say emphatically that I am in awe of your work on a daily basis.

Please know that from myself and our entire team, we have this appreciation in all weeks, not just this one. Wishing you a great week!

Michael Dworkind, MD, Medical Director

I know that it goes without saying that I appreciate our nursing team immensely, on this week and every week, every day and sometimes every minute for all of the support and expertise that they provide to me and the other doctors to provide excellent care to our patients. I feel so privileged to work in their company and with such passion together towards our important purpose. 

I hope each nurse feels proud of their contribution and their medical cannabis leadership for all nurses and auxiliary nurses across Quebec.

Thank you to all our nurses from all of us. 

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