ANNISSA JOBB FIRST limped into the office of Dr. Riam Shammaa, a sports medicine and pain specialist in Toronto, in 2017. The personal support worker in long-term care homes was desperate for help after a decade of back pain due to an undiagnosed herniated disc.
"It's been my calling in life, taking care of people," says Jobb, now 54. But working with frail seniors involves a lot of lifting, bending, and pulling. It wasn't an option to rest her injury. So she gritted her teeth through the worsening pain. "I had a drawer full of pain medication. None of it was working. I'd snap. My husband and I came close to getting divorced." By November 2016, Jobb could scarcely walk 200 metres. "My family doctor finally said, 'You will end up in a wheelchair if you don't stop working there."
Jobb was referred to Dr. Shammaa, who began by administering nerveblock injections, similar to an epidural, every few weeks. They held the pain at bay for anywhere from a few days to a few weeks, but then it always returned.
Historically, the treatment of complex, chronic back pain has been less than ideal, sometimes resulting in patients becoming addicted to opioids, or involving major-often unsuccessful-spinal-fusion surgery, which is suitable for only about one in 20 patients. Aware of these limited options, Dr. Shammaa had been reading about groundbreaking stem-cell therapy research in Europe, and began a study with 23 of his patients. Since Jobb fit his inclusion criteria, he asked if she wanted to participate, cautioning that there were no guarantees. The procedure would involve using her own bone-marrow cells, and had been proven safe. She agreed to try it.
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