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Medical marijuana: a deep understanding of the patient’s journey

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To date, medical marijuana has been legalized in 30 US states, including the following:
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Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, Vermont, Washington and West Virginia.
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Each of these states has its own usage and qualification regulations and guidelines.
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In Florida, the Medical Marijuana Legalization Program (also known as Amendment 2) was approved for qualified patients under the supervision of a qualified and licensed cannabis doctor on November 8, 2016. In addition, the amendment was passed with 6,518,919 (71.32%) votes in favor and 2,621,845 (28.68%) votes.
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The federal government has classified marijuana as a Schedule 1 drug, which makes it illegal for doctors to prescribe marijuana to patients. These cannabis doctors can only make recommendations for medical cannabis in accordance with state law, and the validity period is up to 1 year. The patient cannot go to the pharmacy to prescribe medical marijuana.
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According to strict regulations, medical marijuana doctors are prohibited from being affiliated with any medical marijuana distributor or pharmacy.
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According to the amendment, only certain patients with “debilitating diseases” are protected by law. Diseases classified according to their regulations include post-traumatic stress disorder (PTSD), chronic muscle spasm, multiple sclerosis, seizures, epilepsy, glaucoma, Crohn’s disease, cancer, HIV/AIDS, ALS (muscular atrophic lateral cord Sclerosis or Lou Gehrig’s disease) and Parkinson’s disease.
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Although the above-mentioned diseases are expressed as “major weak conditions”, in this article, Amendment 2 also states: “or other similar diseases/severity/symptoms/conditions are considered by doctors to be more useful than any Potential health risks.”
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Currently, there are about 56 well-known and listed cannabis doctors in Florida.

You can also obtain more information and details on this topic from the Florida Department of Health website (http://www.floridahealth.gov) to learn how to become a medical marijuana patient in Florida. You can also find more in-depth information about revision 2 here.
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Parkinson’s disease

A few months ago, I saw a video on Facebook about a man with Parkinson’s disease who was injected with medical marijuana. The videos before and after were very impressive. Before treatment, you can see the person’s obvious tremor, stuttering, and abnormal posture. The subsequent video shows a very different person. His speech was clear and audible. He did not stutter, tremble, and showed very controlled movements. This person walks and talks like an ordinary person. He also shared how it improved his quality of life.
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As a physiotherapist with different cultural backgrounds, I personally feel different about medical marijuana. However, as a health care professional, it is an obvious phenomenon to witness the significant changes in my patients due to the use of medical marijuana.
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Mr. J.L. has Parkinson’s disease

For five years, J.L. My husband has come to me for physical therapy to solve the problems caused by Parkinson’s disease. Understanding the progress of this disease, I watched this gentle soul deal with the consequences of this debilitating pain. When he started to show weakness, stiffness, tremor, and most importantly, he balanced the problems he reported at home, his attending physician would ask him to be treated.
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We meet him for about six to eight weeks each time. We are committed to improving his coordination, strength, flexibility and balance. His main purpose is to ensure his safety and self-sufficiency at home when he lives alone. It is also necessary to prevent falls, which makes him vulnerable to more serious injuries and complications.
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About a few weeks ago, he was again referred by a doctor to the office to arrange physical therapy. Working with this patient for many years, I tried to figure out what happened to him. I will observe and observe carefully during the initial evaluation. He may have noticed the curiosity that made me gg, because he gave me a knowing smile. I can’t stand curiosity anymore, I asked him: “Mr. J, what are you doing?” Mr. J just smiled and asked me why I was curious!
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Well, it finally made me realize that Mr. J.’s right hand had almost no tremor, and he once showed the typical needle-roll tremor of this disease. His neck was aligned and did not move to the right. In addition, his speech is more clear! Another thing that shocked me is that his pace is better. Although not very good, he was able to turn without having to shuffle for many years.

Finally, he shared with me that his neurologist suggested that he start taking cannabis for more than a month. A friend of his apparently mentioned to him on Facebook a video of someone with severe Parkinson’s disease. The man received a shot of medical marijuana and the changes can be seen in a few minutes. This obviously prompted him to consult his attending physician first and then the neurologist.

After taking medical marijuana for just over a month, the changes I saw with Mr. J are huge. His speech improved. His voice was deeper and more audible. He didn’t stutter, and there was almost no vibration, so he could control his right hand better. He also stood upright. His balance and coordination skills have improved, and this is becoming more apparent with the advanced balance retraining he is currently receiving.

During the treatment, Mr. J can bounce the ball to the floor faster and more accurately. We saw him standing and throwing the ball, and no one caught him. We once had a person standing behind him and hugged him because of his slow response and reflexive reaction. His walking has also improved. Just a few months ago, he would drag his right foot and walk at a short pace. If he wants to turn around or raise his leg to stand on one leg, he will lose his balance.

In the nearly a month of using medical marijuana, these seemingly subtle changes have changed his life. He shared that he felt more relaxed and less worried about falling. He can do simple housework with more confidence, and can tolerate more advanced therapeutic exercises during physical therapy. He will not feel tired and will be able to complete more tasks throughout the day.

Mr. J is still on the road, hoping to share this experience and let me tell his story. Knowing him and his background, he is not the kind of person who indiscriminately smokes marijuana just for entertainment and self-indulgence.

About Mr. J.L.

Mr. J originally came from Central New York and has now moved to Florida. About seven (7) years ago, he was diagnosed with Parkinson’s disease. He used to be the designer of a prestigious Syracuse China manufacturer whose clients include the White House, five-star hotels and famous restaurants. He was also a tenor of SPEBSQSA (American Barbershop Quartet Singing Protection and Encouragement Association), a member of the Barbershop Quartet, and has performed in several amateur performances on Broadway in New York. He is an art teacher in painting class for middle school students.

Sometime in 1986, his life changed his life. He began to participate in a rehabilitation department, and he revealed that most of them are people with tumors. He has traveled abroad to expand his health department. This caused so much attention that even the media noticed his ministry and reported many times. He is now retired and lives in Palm Cove, Florida.

It’s an honor to meet this special person who has done many things in his youth. He has invested a lot of time and is committed to helping others. I deeply appreciate the humanitarian services provided by Mr. J and how his ministry moved so many lives. I think he is another unknown hero of his time.

It is an honor for him to let me share a fragment of his story. In addition, being able to further develop his progress with him and seeing his motivation and determination over the years is a very inspiring experience.

Mr. J.L.’s personal struggle with Parkinson’s disease.

When Mr. J shared with others, he was formally diagnosed with Parkinson’s disease about seven years ago. He has been under the care of a physician in Palm Bay, Florida.

About Parkinson’s disease

As the staff of the Mayo Clinic said: “Parkinson’s disease is a progressive disease that affects the nervous system of the motor. It gradually develops, and sometimes there is almost no obvious tremor in one hand. But the tremor may be Parkinson’s disease It is a well-known sign that this disease usually also causes stiffness or slowed movement.”

The subsequent effects of the disease include: expressionless faces, also known as cover-ups or low vision, and reduced speech quality, which can cause slurred speech, softness, and even stuttering. These are common among patients I have worked with. The patient’s ability to walk is also affected. The stiffness of the torso, the stiffness, and the reorganization pace can lead to uncoordinated arm swings.

Unfortunately, the disease is progressive, and current drugs are designed to improve symptoms, but they are not necessarily curable.

Currently, there are many ongoing treatment studies, including surgery and electrical stimulation to regulate certain areas of the brain.

However, according to the National Parkinson Foundation, there is currently no standard cure.

In addition, it is recommended to use medicine, change lifestyle, exercise and rest.

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

Parkinson and Surgery

Deep brain stimulation (DBS) is a procedure in which electrodes are implanted in a specific area of ​​the brain, and a generator is implanted in the chest area near the collarbone, which sends an urge to the brain to relieve symptoms. However, this is not a cure and involves many risks and side effects. Neither drugs nor DBS will prevent disease progression.

Parkinson’s disease and physical therapy

Physiotherapists can work with such patients at different stages of the disease. This is mainly due to incoordination, dyskinesia (involuntary movement) and stiffness leading to functional decline, which makes purposeful and spontaneous movement very boring.

These problems may even make the most basic functions (such as eating, grooming and toilet flushing) very difficult. Walking becomes very unstable. Where it is difficult for them to take the first step (because of slow movement-very slow movement), shuffling gait is very common, but once it goes on, it is difficult to stop. Many of these patients are at high risk of falling, and a large number of patients are completely dependent on care at a later stage.

When referring to physical therapy, patient education about proper exercise, exercise strategies, task adjustments, gait training and falls prevention strategies is part of the overall care and functional intervention plan. They are also often referred to as speech therapy for speech and eating problems, and basic self-care and hand or upper limb function are also called occupational therapy.

Mr. J’s fight

About 5 years ago, I worked with Mr. J for the first time. Although he was not in the advanced stages of the disease at that time, he had already exhibited the main visible symptoms of the disease: tremors in the hands and neck, disguised phases, stiffness, and obvious incoordination. He walked slowly, he was walking slowly, and because it was impossible to turn quickly, it took a long time to walk from room to room. When he turns, he tends to lose his balance and fall. His response was slow. He hardly catches the ball or rebounds. His speech was vague, almost inaudible, and stuttered. It is difficult for him to go up and down the simple curbs and stairs. He fell several times due to balance problems.

Mr. J worked tirelessly on physiotherapy plans and was always very active. Over the years, for each episode he mentioned to us, he has always shown improvement and has always followed our specific exercise plan. However, due to the progressive nature of this disease, his body will decline, we have to cooperate with him again.

He shared the story of how he first noticed the change in Parkinson’s disease. The most important thing he mentioned was when he taught painting for middle school students in an art class in New York. He said that due to shaking, he gradually had difficulty drawing and using his right hand. The rest included his facial expressions, stiffness and stiff changes until he moved to Florida, which has become worse and worse in recent years.

Under the care of a physician, he was prescribed Sinemet and other medicines he had taken over the years.

The last time I saw him receiving treatment was in early 2016. His right hand was trembling and there was involuntary convulsions in his neck. His masked expression is improving, his face is almost drooping, and his steps are difficult. He could hardly move one foot to the other. He also reported that he fell due to worsening balance problems.

That’s why when I saw him in March this year, I saw that his major changes were attributed to medical marijuana.

Medical marijuana: capsules and gummies

He further shared his story. After learning about the potential benefits of medical marijuana for Parkinson’s disease, he consulted his attending physician, who instructed him to further consult a neurologist. Due to the continuous development of Parkinson’s disease, his neurologist recommended trying medical marijuana.

Mr. J then started using medical marijuana capsules, which he said contained about 30 25-mg capsules. Including freight, it cost him about $80. Along with his goods came a sample pack of a gum version of about 5 gums. According to him, these capsules are very bitter and he takes 1 capsule daily.

He added that after taking the first capsule, he felt very relaxed and calm. He can move around, get on and off the bed more easily, get on and off the chair better. He also noticed that his shock was much smaller than the first time he came.

Mr. J said he prefers hemp jelly because it tastes like candy and is more delicious than capsules. Even more so, fudge seems to work much faster than capsules and is much cheaper. The cost of each capsule is about $3, and the cost of each gum is about $1.

To mimic the role of fudge, Mr. J said he tried to melt his capsule under his tongue to remove its bitter edge. He also chewed the ordinary fudge gummy bears. This worked for him.

So far, Mr. J has continued physical therapy, and we see that he can better tolerate and perform high-level balance training tasks that he could not do before. His right hand hardly shook or even shook, his neck no longer twitched, and his reflexes improved. I can see this through his ability to turn without losing balance. When he catches the ball, throws it or bounces it, we don’t have to catch him to improve the protective righting reflex he needs to not fall. He can raise his feet while walking, and the dragging action is much less.

Still aware of the gradual nature of this disease, it is encouraging that this clever, kind, intelligent and talented person overcomes the daily dysfunction caused by this debilitating and irreversible disease.

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

The legalization of medical marijuana is currently and will continue in Congress. We have different positions and strong opinions on this issue. Research on its advantages and disadvantages is ongoing. I foresee more understanding of its existence as an alternative treatment for various diseases that do not respond to traditional medicine and treatment.

However, as a medical professional, it is really satisfying to be able to witness Mr. J.’s functional changes, even though he is ill, he can remain independent and self-sufficient.

I am currently looking for someone who can share the negative effects of medical marijuana with me. I hope to hear from you, and of course you can share your journey and experience anonymously.

If you have anything to share, please contact me.

Greetings for a good day until the next article!

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