Medical marijuana: insight into the patient's journey

background

To date, medical marijuana has been certified in the United States in 30 states including:

Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, DC, Florida, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Hampshire, New Jersey, New Mexico, North Dakota, Ohio , Oregon, Pennsylvania, Rhode Island, Vermont, Washington and West Virginia.

Each of these countries has its own regulations and guidelines on employment and qualifications.

Here in Florida, the Medical Marijuana Rationing Initiative, also known as Amendment 2, was adopted on November 8, 2016 for eligible patients under the supervision of a qualified and licensed marijuana doctor. Moreover, this amendment passed a total of 6,518,919 (71.32%) with YES votes and 2,621,845 (28.68%) no.

The federal government classified marijuana as a drug in Table 1 making it illegal for doctors to prescribe marijuana for their patients. Marijuana doctors can only make recommendations for medical cannabis according to state law that can last up to one year. Patients cannot go to a pharmacy to fill a prescription for medical marijuana.

Under strict laws, medical marijuana doctors are prohibited from affiliating with any distributors or dispensaries of medical cannabis.

Only some patients with "debilitating diseases" receive legal protection under this amendment. Diseases classified under its heading include PTSD (PTSD), chronic muscle spasms, multiple sclerosis, seizures, epilepsy, glaucoma, Crohn's disease, cancer, HIV / AIDS, ALS (amyotrophic lateral sclerosis or Lou Gehrig & 39); Disease) and Parkinson's disease.

Although the aforementioned diseases are referred to as "primary debilitating conditions", under this section, Amendment 2 also referred to: "or any other illness / condition of similar risk / symptoms, as determined by the doctor's opinion that the medical use of Marijuana outweighs any potential health risks. "

There are currently about 56 well-known marijuana doctors listed in Florida.

More information and details on this topic can also be found on the Florida Department of Health website (http://www.floridahealth.gov) on how to become a medical marijuana patient in Florida. More in-depth information about Amendment 2 can be found here.

Parkinson's disease

A few months ago, I watched a Facebook video of a man with Parkinson's who received a dose of medical cannabis. Before and after the videos were very impressive. Before treatment, you can see this man's big orgasms, stuttering and abnormal situations. After the video showed a very different person. His words were clear and audible. He did not have any stutter, shivers and showed highly controlled movements. This man was easy going and talking like any normal person would. He also shared how he improved his quality of life.

As a physiotherapist with different cultural backgrounds, I personally have mixed feelings about medical cannabis. However, as a healthcare professional, it is nap to see one of the important changes for a patient using medical cannabis use.

Mr. JL has Parkinson's disease

More than five years ago, Mr. JL was coming to physiotherapy and stopping him because of the problems caused by Parkinson's disease. Knowing the progressive nature of the disease, I watched this gentle spirit deal with the debilitating effects of this debilitation. His primary doctor will refer him for treatment when he begins to develop weakness, stiffness, tremors, and most of all, balance problems where he is reported to fall into the house.

We'll see him for six to eight weeks at a time. We have worked to improve coordination, strength, flexibility and balance for the primary goal of keeping it safe and self-contained in the home where it lives alone. Avoid falling which predisposes to more severe injuries and complications.

Change

About weeks ago, he came to the office to schedule a physical therapy where he was referred again by his doctor. Having worked with this patient over the years, I was trying to figure out what has changed. I looked and noticed with interest as I did my initial review. Perhaps he noticed the curiosity that bothered me because he gave me a knowledge smile. No longer able to contain my curiosity, I asked him, "Mr. J, what were you doing?" Mr. J just laughed and asked me why curiosity!

Well, it finally became clear to me that Mr. J. He barely had no tremors in his right hand as he used to display the traditional tremors of the disease. His neck was aligned and not moved to the right side. Moreover, his words were clearer! Another thing that struck me was that he was walking better. He wasn't great, but he was able to spin without having to shuffle which I have seen him do for years.

I finally shared that he started taking medical cannabis for more than a month as recommended by the neurologist. A friend apparently mentioned a Facebook video of a man with severe Parkinson's disease. This man received a bullet from medical cannabis and the change was visible only a few minutes later. This seems to have prompted him to consult with his primary physician and then the neurologist.

The change that I saw with Mr. J. More than a month after medical cannabis is important. His words improved. His voice is deeper and more audible. He had no stuttering and had greater control over his right hand than an almost non-existent tremor. He also stands more straight. Its balance and coordination have improved, and more than that is the advanced rebalancing it is currently receiving.

During his treatment sessions, Mr. J can bounce a ball on the ground faster with better accuracy. We saw him throw and pick up a ball to stand without being caught. We used to have someone standing behind him where he had slow and reflexive reactions. His gait also improved. Just months ago, he pulled his right foot and walked with extremely short shuffling steps. You will lose balance with the slightest attempt to wrap or raise your leg higher to stand on one leg.

These subtle changes that appeared to him for more than a month of medical cannabis have made a difference in his life. Share that he feels more comfortable and less worried about falling. He can do simple chores with more confidence and is able to withstand more sophisticated therapeutic exercises during physical therapy sessions. He does not feel tired and is able to do more tasks throughout the day.

Mr. J is still on this journey and wanted to share this experience and to tell his story. Knowing that he and his background, he is not the kind that will take marijuana randomly just for fun and self-boiling.

About Mr. JL

Mr. J is originally from central New York and moved to Florida. He was diagnosed with Parkinson's disease about seven (7) years ago. He used to be a designer for the prestigious Syracuse China manufacturer whose customers include the White House, five-star hotels and prestigious restaurants. He was also a member of the Quartet of the Barber Shop Quartet as SPEBSQSA (the Barber Shop Quartet Conservation and Promotion Association of America) and has participated in several Broadway amateur shows in New York. He was a technical teacher for middle school students who teach drawing.

His life changed when he was called up for service sometime in 1986. He engaged with the healing ministry he revealed was mostly with people who had tumors. He traveled abroad to expand the healing ministry. This aroused so much interest that even the media noticed and did many coverage on his ministry. He is now retired and lives in Palm Bay Florida.

It is an honor to know this special person who did so much during his youth. I have devoted a lot of time and commitment to helping others. I deeply appreciate J's humanitarian service and how his ministry touched so many lives. I consider him another hero unknown in his time.

His desire to make me share a snippet of his story is a privilege. Moreover, being able to work with him to enhance his progress and see his motivations and determination over the years.

Mr. JL's personal battle with Parkinson's disease.

Mr. J was officially diagnosed with Parkinson's disease about seven years ago. He was under the care of an internal medicine practitioner practicing in Palm Bay, Florida.

About Parkinson's disease

As Mayo Clinic staff described it: "Parkinson's disease is a progressive nervous system disease that affects movement. It develops gradually, sometimes with a barely noticeable tremor in just one hand. But while the tremor may be a known sign of Parkinson's disease, the disorder usually causes stiffness or Slowing down the movement. "

Subsequent effects of the disease include: a facial without expression, also known as a persuasive face, hypothermia, and decreased speech quality that can be compressed, tender or stuttering. This is very common in patients I have worked with. The patient's ability to walk is also affected. There swing arm loss of trunk stiffness, stiffness and mixing steps caused by inconsistency.

Unfortunately, this disease is progressive and current medications are intended to improve symptoms but not necessarily cure.

There are currently many ongoing research treatments including surgery to regulate certain areas of the brain and electrical stimulation.

However, there is no standard treatment for treatment at this time, according to the National Parkinson Foundation.

In addition, the use of medications, lifestyle modification, exercise and rest is recommended.

Prescribed medications

Current prescribed drugs include: carbidopa-levodopa, carbidopa-levodopa infusion, dopamine agonists, MAO-B inhibitors, catechol-O-methyltransferase (COMT inhibitors), anticholinergics and amantadine. Source: Mayo Clinic

Parkinson's and surgery

Deep Brain Stimulation (DBS), a procedure in which electrodes are implanted in certain areas of the brain with a generator implanted in the chest area near the collarbone which sends impulses to the brain designed to reduce symptoms. It is not a cure however there are many risks and side effects. Both medication and DBS will not stop the progress of the disease.

Parkinson's disease and physiotherapy

Physiotherapists work with this type of patient during different stages of the disease. This is primarily due to functional decline caused by inconsistencies, dyskinesia (involuntary movements) and rigidity that make purposeful and spontaneous movements very boring.

These problems can make even basic functions such as feeding, grooming, and bathing very difficult. Walking becomes very unstable. Mixing gait is very common as it is difficult for them to take the first step (due to slow motion – very slow motion) but once they leave, it is also difficult to stop. Many of these patients are at risk of falling and many during the advanced stages are completely dependent on care.

When referring physiotherapy, educating the patient regarding appropriate exercises, movement strategies, task modification, gait training, and fall prevention strategies is part of the overall plan of care and functional intervention. They are also often referred to speech therapy for speech and nutrition problems, and to occupational therapy for basic self-care and hand or upper limb functions.

The battle of Mr. J.

I first worked with Mr. J about 5 years ago. Although it was not in the advanced stages of the disease at the time, it was already manifested in the basic visual symptoms of the disease: hand and neck tremors, masked face, stiffness, and great harmony. He was walking very slowly, mixing and taking a long time walking even from room to room because he was unable to spin fast. When it turns, it tends to lose balance and fall. His reactions were very slow. He can barely catch a ball or bounce. His speech was tight, barely audible and he had a stutter. He had difficulty getting up and down simple restrictions and stairs. He had fallen several times from balance issues.

Mr. J persevered on the physiotherapy program and was always very enthusiastic. For each of the episodes I have transmitted to us over the years, I have always shown improvement and a constant follow-up with the specific exercise program we described. Because of the gradual nature of the disease, it will face physical deterioration and we had to work with it again.

Share the story of how he first noticed the change in Parkinson's disease. Above all he mentioned when he was studying painting for middle school students in his art class in New York. He had gradual difficulty in drawing and using his right hand where he was suffering from tremors. The rest followed including a change in his facial expression, stiffness and feeling throughout. This gradually became worse over the years until his move to Florida.

Once under the care of an internist, Sinemet was prescribed and other medications that he had taken over the years.

The last time I saw him for treatment was in early 2016 where he suffered from tremors in his right hand and a tingling in his neck. His masked face evolved, his face almost dangled and he was walking with a lot of shuffle. He was barely able to move one foot in front of the other. It is also mentioned of falls due to worsening balance problems.

That is why when I saw him in March this year, I saw the great change in him attributed to medical cannabis.

Medical cannabis: capsules and gum

He also shared his story. Upon hearing about the potential benefits of medical cannabis for Parkinson's disease, consult with his primary physician who directed him for further consultation with the neurologist. The neurologist recommended to try medical cannabis because of the evolving nature of Parkinson's disease.

Mr. J then started taking medical cannabis capsules, which he said contained about 30 pieces of 25 mg capsules. It cost about $ 80 or so including shipping. With its shipment came a sample pack of gummies version of about 5 gummies in a pack. The capsules were bitter, he said, and he took one capsule daily.

He added that after taking the first capsule at all, he felt comfortable and calm. He can move, get in and out of bed easily, and get in and out of his seat better. He also noted that his tremors were much less the first time.

Mr. J stated that he liked hemp gum better as it looked like candy and was more tasteful than capsules. What's more, the effect of gum was much faster than that of capsules and was much cheaper. The capsules cost about $ 3, and the gum will cost about $ 1 for the piece he added.

In order to mimic the effect of gum, Mr. J. said. He tried to melt the capsule under his tongue to take off the edge of his bitterness. Candy Bear also chews regular candy. This worked for him.

So far, Mr. J continues physiotherapy where we see him best able to withstand and carry out the high-level training tasks he has never been able to do before. He has very little tremor on his right hand, no longer displays twitching on his neck, and his reactions have improved. I see this through its ability to make a turn and not to lose balance. It is not necessary to hold him while holding, throwing or bouncing a ball to improve his right protective reactions needed not to fall. He could lift his feet when walking and had much less mixing.

Recognizing the progressive nature of the disease, it is inspiring to see this quiet, kind, intelligent and talented person overcome the simple daily functional obstacles caused by this debilitating and irreversible disease.

For a population suffering from debilitating diseases, the daily victory of being able to move and perform tasks that seem trivial to most of us is a blessing.

Currently legalization of medical marijuana, will be an ongoing battle in Congress. We all have different positions and strong opinions on this issue. Research is underway about the pros and cons. I expect more awareness of its existence as an alternative treatment for various diseases that do not respond to medicine and traditional treatment.

However, as a medical professional, it is good to be able to see functional changes in Mr. J., and how he can remain independent and self-sufficient despite his weakness.

I am currently working on finding an individual who can share the negative effects of medical marijuana as well. I'd like to hear from you and be able to share your journey and experience too, anonymously, of course.

Please communicate with me if you have something to share.

Greetings for a wonderful day until my next article!

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