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Medical marijuana: A picture of a patient’s journey

RECORD

To date, medical marijuana is legalized in the United States in 30 states, including:

Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, DC, Florida, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota , Ohio, Oregon, Pennsylvania, Rhode Island, Vermont, Washington and West Virginia.

Each of these states has its own regulations and guidelines on use and qualifications.

Here in Florida, the Marijuana Medical Legalization Initiative, also known as Modification 2, was approved on November 8, 2016 for specialized patients under the supervision of a specialized and licensed marijuana doctor. In addition, this amendment was approved with a total of 6,518,919 (71.32%) YES votes and 2,621,845 (28.68%) NO votes.

The federal government has classified marijuana as a drug in Program 1, making it illegal for doctors to prescribe marijuana to their patients. These marijuana doctors can only make recommendations for medical cannabis under state law that can be valid for up to 1 year. Patients cannot go to a pharmacy to complete a prescription for medical marijuana.

According to strict regulations, marijuana doctors are prohibited from associating with any distributor or medical cannabis clinic.

Only some patients with “debilitating diseases” are provided with legal protection under this amendment. Diseases classified according to its arrangement include PTSD (Post Traumatic Stress Disorder), Chronic Muscle Spasm, Multiple Sclerosis, Seizures, Epilepsy, Glaucoma, Crohn’s Disease, Cancer, HIV / Aids Gerigise or Loural DL (Amyotrophic) ) and Parkinson Disease.

Although the above diseases have been identified as “primary debilitating conditions”, as amended by this provision, Amendment 2 also stated: “or any other illness / condition of similar severity / symptoms, as determined by a physician that medical use of marijuana any potential health risks were exceeded. “

There are currently about 56 known and registered marijuana doctors in Florida.

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

PARKINSON’s disease

A few months ago, I came across a video on Facebook about a man with Parkinson’s disease who was shot by a medical cannabis. The videos before and after were quite impressive. Before treatment, you can see the significant tremors, stuttering and abnormal posture of this man. The post-video showed a very different person. His speech was understandable and acoustic. He had no stuttering, no fright, and showed very controlled movements. This man was walking and talking like any normal person. He also shared how he improved his quality of life.

As a physiotherapist with exposure to a variety of cultural backgrounds, I personally have mixed feelings about medical cannabis. As a healthcare professional, however, it is very positive to watch one of my patient’s significant changes using medical cannabis.

Mr J. L. with Parkinson’s disease

For over five years, Mr. J.L. comes to me for physical therapy and for problems caused by Parkinson’s disease. Knowing the progressive nature of the disease, I watched this gentle soul deal with the effects of this debilitating affliction. His chief physician will refer him for treatment when he begins to develop weakness, stiffness, tremor and, above all, balance problems where he reports falling at home.

We will see him for a period of about six to eight weeks at a time. We worked to improve his coordination, strength, flexibility and balance with the primary goal of keeping him safe and self-sufficient at home as he lives alone. It is also important not to fall, which predisposes him to more serious injuries and complications.

The change

A few weeks ago, he came to the office to schedule Physiotherapy as he was referred again by his doctor. Having worked with this patient all these years, I was trying to figure out what changed in him. I looked and watched carefully as I made my initial assessment. He may have noticed the curiosity that bothered me because he gave me a smile I know. I can no longer curb my curiosity, I asked him, “Mr. J, what have you done?” Mr. J just laughed and asked me why the curiosity!

Well, I finally realized that Mr. J. just had no fear in his right hand, where he used to show the typical trajectories of this disease. His neck was aligned and he did not move to the right. In addition, his speech was clearer! Another thing that impressed me was that he walked better. Not great, but he managed to come back without stirring up something I’ve seen him for years.

He finally told me that he started taking medical cannabis for over a month, as recommended by his neurologist. A friend apparently posted a video on Facebook of a man with Parkinson’s disease. This man was given a medical cannabis and the change was visible after only a few minutes. This apparently prompted him to consult his primary care physician and then his neurologist.

The change I have seen with Mr. J after more than a month in medical cannabis is significant. His speech improved. His voice is deeper and more acoustic. He had no stuttering and more control of his right hand than almost non-existent terror. He also stands stronger. Its balance and coordination have improved, even more so with the advanced balance retraining it is currently receiving.

During his treatments, Mr. J could bounce a ball on the floor faster with better accuracy. We saw him throwing and catching a ball in a standstill without anyone holding it. I used to have someone stand behind us and hold him as he had slow reactions and reflex reactions. His gait has also improved. A few months ago, he dragged his right foot and walked with very short shuffling steps. He will lose his balance with the slightest attempt to turn or raise his leg higher to stand on one leg.

These seemingly subtle changes to him for a little over a month of medical cannabis use have made a difference in his life. He shared that he feels more relaxed and less anxious to fall. He can do simple homework with more confidence and is able to tolerate more advanced therapeutic exercises during physical therapy sessions. He doesn’t feel so tired and is able to do more work all day.

Mr. J is still on this trip and he wanted me to share this experience and tell his story. Knowing him and his background, he is not the type of person who would take indiscriminate marijuana for simple leisure and enjoyment.

About Mr. J.L.

Mr. J is originally from Central New York and has moved to Florida. He was diagnosed with Parkinson’s disease about seven (7) years ago. He was a designer for a very famous Chinese Syracuse manufacturer whose customers include the White House, 5-star hotels and prestigious restaurants. He was also a member of a barber’s haircut as a tenor for the SPEBSQSA (Company for the Preservation and Encouragement of the Barber Song Quartet in America) and has participated in several Broadway amateur performances in New York. He was an art teacher to high school students who teach drawing.

His life changed when he was called to serve in 1986. He worked with a Ministry of Health that revealed that he was mostly with people with tumors. He has traveled abroad to expand his Ministry of Treatment. This has attracted so much attention that even the media has noticed and made enough coverage of his ministry. He is now retired and lives in Palm Bay Florida.

It is a privilege to know this special person who has done so much in his younger days. He has devoted so much time and dedication to helping others. I deeply appreciate the humanitarian service provided by Mr. J and how his ministry has touched so many lives. I consider him another hero of his time.

His willingness to let me share an excerpt from his story is a privilege. In addition, being able to work with him to promote his progress and see his motivations and determination over the years is a very inspiring experience.

The personal battle of Mr. J.L. with Parkinson’s disease.

Mr J was officially diagnosed with Parkinson’s disease seven years ago. He was cared for by an internal medicine doctor at Palm Bay in Florida.

About Parkinson’s disease

As described by the staff of the Mayo Clinic: “Parkinson’s disease is a progressive disease of the nervous system that affects movement. It develops gradually, sometimes with an almost palpable tremor in a single hand. But while tremor may be the known A sign of Parkinson’s disease, the disorder also usually causes stiffness or slowing of movement. “

The subsequent effects of the disease include the following: a face without expression, also known as a covered face or hypomia, and a decrease in the quality of speech that may be vague, mild, and even stuttering. These are very common in patients I have worked with. A patient’s walking ability is also affected. There is a loss of arm oscillation from trunk rigidity, rigidity and redirection steps from the resulting tuning.

Unfortunately, this disease is progressive and current medications aim to improve the symptoms but not necessarily cure it.

There is currently a lot of current research on treatment, including surgery to regulate certain areas of the brain and electrostimulation.

However, there is currently no standard treatment for this, according to the Parkinson’s National Foundation.

In addition, medications, lifestyle changes, exercise and rest are recommended.

Prescription drugs

Prescription drugs include: Carbidopa-Levodopa, Carbidopa-Levodopa infusion, Dopamine Agonists, MAO-B inhibitors, Catechol-O-Methyltransferase (COMT Inhibitors), Anticholinergics and Amantadine. -Source: The Mayo Clinic

Parkinson’s and Surgery

Deep brain stimulation (DBS) is a procedure in which electrodes are implanted in specific areas of the brain with a generator implanted in the chest area near the neck that sends pulses to the brain to reduce symptoms. However, it is not a cure and there are many risks and side effects. Both the drug and DBS will not stop the progression of the disease.

Parkinson’s and physical therapy

Physiotherapists work with these types of patients at different stages of the disease. This is mainly due to the functional decline resulting from the coordination, the dyskinesia (involuntary movements) and the rigidity that make the intentional and spontaneous movements very tedious.

These problems can make even the most basic functions such as feeding, grooming and toilet. Walking becomes very unstable. Random walking is very common where it is difficult for them to take the first step (due to slow motion – very slow movement), but once they go, it is also very difficult to stop. Many of these patients are at high risk of falling and a large number during advanced stages are completely dependent on care.

When it comes to Physiotherapy, patient education on appropriate exercises, movement strategies, work modification, walking training, and fall prevention strategies are all part of the overall care and functional intervention plan. They are also often mentioned in Speech Therapy for Speech and Eating Problems and in 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 he was not in the advanced stages of the disease at that time, he had already shown the main visible symptoms of the disease: hand and neck tremors, masked faces, stiffness and significant coordination. He walked very slowly, shuffled and took a long time walking even from room to room as he could not make quick turns. When he turns, he tends to lose his balance and fall. His reflexes were very slow. He couldn’t catch a ball or bounce it off. His speech was vague as soon as it was heard and he was stunned. He had difficulty climbing and descending simple arches and stairs. He had sometimes fallen out of balance.

Mr. J insisted on a physiotherapy program and was always very excited. For each of the episodes we’ve been told all these years, it always showed improvement and always followed the specific exercise program we set. Due to the progressive nature of the disease, however, it would have a natural decline and we had to work with it again.

He shared his story of how he first noticed the change from Parkinson’s. He mainly mentioned that it was when he was teaching drawing to high school students in his art class in New York. He said he gradually found it difficult to draw and use his right hand as he developed horror. The rest followed, including a change in facial expression, stiffness and a feeling of stiffness all the time. This gradually got worse over the years until he moved to Florida.

Once under the care of a physician, he was given Sinemet and other medicines he had taken over the years.

The last time I saw him for treatment was in early 2016, when he had significant tremors in his right arm and involuntary contractions in his neck. His veiled faces had advanced, his face almost tilted and he was walking with so much agitation and difficulty. He could not move one foot in front of the other. It also reported declines due to worsening equilibrium problems.

That’s why when I saw him in March of this year, I saw a significant change in the one he attributed to medical cannabis.

Medical hemp: Capsules and Gummies

He further shared his story. After hearing about the potential benefits of medical cannabis for Parkinson’s disease, he consulted with his primary care physician, who gave him instructions for further consultation with his neurologist. His neurologist advised him to try medical cannabis because of the evolving nature of Parkinson’s disease.

Mr J then started medical cannabis capsules where he said it contained about 30 pieces of 25 mg capsules. That cost him about $ 80, including shipping. With his shipment came a sample package of the gummies version of about 5 gummies in one package. The capsules were bitter, according to him, and he took 1 capsule daily.

He added that after taking the first capsule, he felt so relaxed and calm. He could move, get in and out of bed more easily, get in and out of his chair better. He also noted that his terror was much less for the first time.

Mr J said he liked cannabis gummies better as it had a lot of caramel and was tastier than capsules. Even more, the effect of gummies seemed much faster than that of capsules and was much cheaper. The capsules per piece cost about $ 3 each and the gummies would be about $ 1 per piece added.

To mimic the effect of gummies, Mr J said he tried to melt the capsule under his tongue to remove its bitterness. He also chewed regular caramel with bear. That worked for him.

To this day, Mr. J continues with physiotherapy where we see him better able to tolerate and perform high level balance tasks that he was not able to do before. Έχει πολύ λίγο έως καθόλου τρόμο στο δεξί του χέρι, δεν εμφανίζει πλέον τις συσπάσεις στο λαιμό του και τα αντανακλαστικά του βελτιώθηκαν. Αυτό το βλέπω από την ικανότητά του να κάνει μια στροφή και να μην χάσει την ισορροπία του. Δεν χρειάζεται να τον κρατήσουμε ενώ πιάνει, ρίχνει ή αναπηδά μια μπάλα για να βελτιώσει τα προστατευτικά αντανακλαστικά διόρθωσης που είναι απαραίτητα για να μην πέσει. μπορεί να σηκώσει τα πόδια του ψηλότερα όταν περπατά και η ανακατεύωσή του είναι πολύ μικρότερη.

Ακόμα έχοντας επίγνωση της προοδευτικής φύσης αυτής της ασθένειας, είναι απλώς έμπνευση να δούμε αυτό το πολύ απαλό, ευγενικό, ευφυές και ταλαντούχο άτομο να ξεπερνά απλά καθημερινά λειτουργικά εμπόδια που προκαλούνται από αυτήν την εξουθενωτική και μη αναστρέψιμη ασθένεια.

Για τον πληθυσμό που πάσχει από εξουθενωτικές ασθένειες, η καθημερινή νίκη του να είμαστε σε θέση να μετακινούμαστε και να εκτελούμε εργασίες που φαίνονται τόσο ασήμαντες για τους περισσότερους από εμάς, είναι ευλογία.

Η νομιμοποίηση της ιατρικής μαριχουάνας είναι επί του παρόντος και θα είναι μια συνεχής μάχη στο συνέδριο. Όλοι έχουμε διαφορετικές στάσεις και ισχυρές απόψεις σχετικά με αυτό το ζήτημα. Οι έρευνες βρίσκονται σε εξέλιξη σχετικά με τα υπέρ και τα κατά. Προβλέπω περισσότερη επίγνωση της ύπαρξής της ως εναλλακτικής θεραπείας σε διάφορες ασθένειες που δεν ανταποκρίνονται στη συμβατική ιατρική και θεραπεία.

Ωστόσο, ως επαγγελματίας ιατρός, είναι απλώς ικανοποιητικό να είμαστε σε θέση να παρακολουθούμε τις λειτουργικές αλλαγές στον κ. J., πώς είναι σε θέση να παραμείνει ανεξάρτητος και αυτάρκης παρά την εξασθένησή του.

Προς το παρόν προσπαθώ να βρω ένα άτομο που μπορεί να μοιραστεί μαζί μου τις αρνητικές επιπτώσεις της ιατρικής μαριχουάνας επίσης. Θα ήθελα να ακούσω από εσάς και να μπορέσω να μοιραστώ το ταξίδι και την εμπειρία σας, φυσικά, ανώνυμα.

Παρακαλώ επικοινωνήστε μαζί μου αν έχετε κάτι να μοιραστείτε.

Οι χαιρετισμοί μου για μια υπέροχη μέρα και μέχρι το επόμενο άρθρο μου!