Nova Scotia

N.S. man hurt in workplace accident faced with paying for own migraine treatments

An Annapolis Valley man still experiences migraines after suffering an injury at work in 2009. His family may be faced with paying for his migraine treatments.

In 2019, he was told his pain treatment would no longer be covered

Mark Perry of Berwick shows where his migraine pain begins. (Jack Julian/CBC)

A father in Berwick, N.S., who suffered a serious head injury at work says he was left to pay for pain treatment after his therapy was cut off. 

In 2009, Mark Perry was struck in the face by a piece of wood that flew off a spinning lathe. 

That was in the sheltered woodworking shop where he was working at the time in Waterville. 

"When I got to the hospital and they did the CT scan, I had three orbital socket fractures and the cheekbone was broken, the facial nerve was severed," Perry said. "My sinuses were full of blood."

After emergency surgery in Halifax, Perry faced a long road of rehabilitation.

"I was no longer able to be steady on my feet," he said. "I compare it to, like, a drunken sailor. I couldn't walk down a hallway without listing to one side."

Physical activity would trigger symptoms. "Nausea, fatigue, unsteadiness, the inability to focus," he said. 

It took 18 months for Perry to partially overcome those issues and return to work full time. 

But he says he was left with debilitating migraine headaches. 

Migraine struggle 

Perry said migraines interfere with his ability to earn a living, and his role as a father. 

"It's incredibly painful," he said. "It's all through that right eye and in the top of my head.

"The rest of my body doesn't really get affected by that. It's just that your brain is in a lot of pain, and it's difficult to then focus or do any of those tasks that you just do in the run up a day."

Mark Perry faced emergency surgery after the injury he sustained on the job in 2009. (Submitted)

After trying different combinations of drugs and nerve-blocking injections without any success, Perry found that Botox injections helped.

Perry said he still suffers from migraines almost daily, but Botox numbs the pain to the point where he can function at home and work. 

Covered for 8½ years

Perry said the treatments, performed every two to three months by a neurologist in Halifax, were paid for by the Workers' Compensation Board of Nova Scotia for approximately 8½ years. 

But in 2019, his doctor informed him the procedure was "no longer approved" by MSI. 

Perry said his case worker at the compensation board was mystified, and instructed him to call MSI, which is administered by the non-profit insurance company Medavie Blue Cross.

He said he "could never get anywhere." 

Life untreated

Perry works as health and safety manager at the Kings Regional Rehabilitation Centre, but the frequency and severity of his migraines is making that a challenge.

"There have been times when I've had a migraine that's lasted for up to a week without breaking at all," he said. 

"I was functioning every day in blinding pain. There were days when I would have no vision in this eye and working and doing everything I could, and it wasn't getting any better," he said. 

It was Perry's wife who convinced him to resume Botox treatments even if the family had to pay.

"[She] just said, like, you have no quality of life right now.... And it seems like that would be much easier just to not work, but I can't do that," Perry said. 

Financial relief

Perry said he's been experimenting with painkillers and other therapies through his Halifax neurologist in the meantime. 

Perry said his doctor wrote him a Botox prescription as a last resort, and Perry drove to the supplier that day to pick up the drug. 

He performed the injections on his face, head and neck immediately. 

Mark Perry began to heal after surgery, but it would be another 18 months before he could return to work. (Submitted)

That was close to three months ago. 

He said the WCB eventually reimbursed him $1,700 for that treatment, but with the caveat that his Botox regimen is still not approved, and with no guarantees moving forward. 

Unique treatment

Perry said he's contacted the Office of the Worker Counsellor in Halifax and his MLA about his plight. 

"We don't provide comment on individual workers who access our services," said OWC spokesperson Rachel Barbour in an email. 

The compensation board would not comment directly on Perry's case. 

But spokesperson Allison Himmelman said the coverage process for Botox "is a little unique" because of the nature of the treatment.

Botox, best known for its cosmetic uses, is also approved in Canada for preventing chronic migraines. (Damian Dovarganes/Associated Press)

"Botox treatments for chronic migraines are an example of the type of specialized, less common treatment that require a special authorization to be in place with Medavie Blue Cross," she said. 

Himmelman said special authorizations expire after a set length of time, and it's up to the health-care provider to reapply to have it renewed. 

"Sometimes it may be the unfortunate case that there are delays in parts of the process that are simply not in our control," she said.

"Should a delay such as this occur, we try to connect with those involved to help resolve the situation, as we understand and appreciate the significant impact any delays in treatment can have on those who depend upon them."

Medavie Blue Cross did not respond to requests for comment. 

Still waiting

Perry said he's scheduled for his next Botox therapy at the end of June. 

He said he'll go ahead whether or not he's reimbursed.

"The alternative is that I don't work at all and I'll be on WCB for the rest of my life," he said. "It's depressing. There's no light at the end of that tunnel. It's the end of the tunnel."