Alain Chaloux had suffered excruciating back pain for six years. Frustrated with the long waiting list and after being told it was all in his head, the 31-year old Canadian braved a 20-hour flight to Singapore, National University Hospital for treatment.

Busted At Last – The “Ghost” Pain

Hard manual work was second nature to Alain. He was a heavy machinist for seven years before spending the past five years as a construction worker. As for pastime indulgences, Alain revelled in the physical demands of ice-hockey and skiing, or navigating bumpy off-road tracks on his motorcycle or four-wheeler. In short, Alain was as tough as they come.

But then, sometime in 2001, while working as a machinist, Alain felt a crick in his back whilst lifting heavy equipment. It appeared harmless initially but by the end of the day, the soreness in his back had graduated into an acute pain.

Within days, Alain, who is single and lives in his own house, began feeling the full impact of his injury. “I was walking with a limp and I couldn’t walk for more than 20 minutes or stand for more than five before I needed to sit to relieve the pain. My legs would become stiff too,” he vividly recalls.

When Alain saw a doctor, he was given a painkilling injection, prescribed painkillers and surprisingly told to return to work. Though the pain had receded, the discomfort remained.

All In The Head

Alain was not one to complain so he tolerated the pain and went about his work. However, by 2005, his mobility was drastically reduced as the painkillers gradually began to lose their effect. Alain consulted his doctor again.

He relates, “Without carrying out a full investigation, he told me to forget about surgery because no one would want to operate on me because there would be a 50 per cent chance that I would not walk again after it. Instead, he advised me to stop working and rest at home, while continuing to take my painkillers.”

Appalled, Alain resigned to cope with his wrenching pains. For the next two years, aside from medication (which now included a morphine patch), he continued with physiotherapy, sought reprieve from a chiropractor and consulted with other specialists. Yet, his condition continued to deteriorate.

Alain’s only other sibling, Julie, a 34-year old dental hygienist and mother of two, notes, “He was in pain 24-7. It hurt when he sat up and could not sleep for more than four hours a day. The medication was merely disguising his pain because he was high when he took it but was in terrible pain when it wore off.”

According to Alain, the pain got so bad that he would cringe each time he coughed, sneezed or even laughed. His daily tasks like taking a shower or going to the toilet had also become arduous. Needless to say, Alain’s social life had also come to a standstill.

He laments, “I thought to myself that at 31, this was just no way to live.”

But real as the pain seemed to him, Alain was constantly trying to reconcile with what some doctors had told him.

“They said it was all in my head, like a ghost pain and that there was nothing wrong with me. To be honest, there were times when I kept thinking that maybe they were right and I was just imagining all this.”

Riddled with confusion by the ongoing physical and mental battles with pain, Alain was somewhat relieved that his named had crawled up the top of the waiting list for medical consultation.

In May 2007, a MRI scan was done but then the bombshell dropped, enveloping Alain with utter disgust.

“They told me that I would have to put my name on another list to see a surgeon. Fine, I thought but then they said the appointment would be in 18 months!”

As if not bad enough, they informed him that if the surgeon approved surgery, he would have to wait another two to three years for it.

Alain’s family shared his exasperation. Julie emotes, “That was the last straw. We decided then that we’d find a way to get surgery done outside of Canada - no more waiting. He was 31 and if nothing was done soon, he can forget about getting married, having a family, or enjoying life at all.”

Help, In A Flash

So both Chaloux siblings began their search online, marking hospitals in China, Thailand and Singapore as possible options for treatment. However, Julie admits they were not sure how to proceed from there.

Then they came across a television programme about a woman in Canada, who runs Overseas Medical Services (OMS), Canada, Inc. They contacted Aruna-Th-Hollingshead, the Sri Lankan-born Canadian who runs it.

Julie recounts, “We spoke with Aruna and she immediately explained things to us and quickly made arrangements for Alain. It was incredible how fast she worked. We contacted her in June and by July we were in Singapore on her recommendation. And while there, she would call us twice a day to make sure everything was fine. She’s amazing.”

After a long 20-hour flight, Alain accompanied by sister Julie arrived in Singapore in the wee hours of a July morning. Through customs in a whiz, the pair was met by two officials from the National University Hospital (NUH).

Within an hour, Alain was in the ward and later that same morning, he met the hospital’s Head of Orthopaedic Surgery, Professor Wong Hee-Kit. Alain was delighted to learn that something could be done about his condition. But even better news was when Prof Wong told him that he could have the surgery done that same day.

“Julie and I looked at each other and were stunned but I was rearing to go. I was desperate to be rid of the pain,” he exclaims.

The Plan of Action

Closely studying the MRI scans that had been sent to him earlier and after his own investigations, Prof Wong’s concluded that Alain had a prolapsed (out of place) intervertebral disc, which was due to a degenerative disc disease. This was the cause of his chronic back pain.

Moreover, the prolapsed disc was located on the left side and part of it was in the neuroforamina, an opening between the lumbar vertebrae L4 and L5 through which one of the nerve roots passing through the segment emerges.

In Alain’s case, his leg pain that caused difficulty walking was due to the spinal nerve root compression from this prolapsed disc.

Although the nerve root compression can be treated by surgical removal of the part of the disc that has prolapsed, it will not relieve the chronic back pain.

So Prof Wong decided on performing a Trans-foraminal Lumbar Interbody Fusion (TLIF), which involved decompressing the neuroforamina and stabilising the affected segment by fusing and instrumenting it with titanium. This total removal and reconstruction of the disc is meant to hold the vertebrae together and prevent any recurrence of symptoms.

Although this technically demanding procedure is not unique to Singapore, Prof Wong notes, “Serious complications like spinal nerve root injury leading to partial paralysis and severe pain in the legs, loss of bladder and bowel control, leakage of cerebrospinal fluid, severe bleeding from epidural bleeding or bleeding from the large veins in the front of the spine, have been reported.”

He stresses, “Thus the importance of having such a surgery done in an institution that is highly specialised in spine surgery.”

The three-hour surgery progressed without complications and by the next day, Alain was well enough to have his tubes removed and even sit up for short periods.

“Besides the surgical pains, the pain in my back was gone. The last time I felt this way was six years ago!” declares Alain, who was discharged four days after surgery.

“Everything was perfect from the time we got off the plane in Singapore. Prof Wong explained everything to us, which made us feel confident and the nurses took excellent care of him. I’ve never seen this level of service before. We will certainly recommend Singapore to anyone frustrated with the long wait for medical care in Canada,” Julie insists.

Although Alain is expected to follow up with his doctor in Canada, he is confident that his suffering is behind him. He is rearing to follow Prof Wong’s advice and start his new life.

He quips, “At last, no more ghost pains.”