martes, 10 de noviembre de 2009

Routine Checkups Work, Ask Kareem

After disclosing his diagnosis with myeloid cancer, Kareem Abdul Jabbar, told journalists how routine checkups (for him every two years) help find his cancer early. His confidence in telling his medical story was utterly genuine. What a smart patient! He revealed that his symptoms were clues that something was awry with his health. His complete blood count (CBC) helped his doctor find the cancer. He further expressed his savvy by discussing his family history and that cancer was present. This is valuable knowledge for every patient.

Prevention and early detection in addition to education are key for great health. You must help your health care team with your health plan. Information like family history, your present medical and past medical history are the basic building blocks for your individual health maintenance plan. Take the time to put this down on paper and share with your present doctor and each new doctor you see. As you go along research your findings from medical records you have, and be sure they are accurate, correct and yours.

Routine checkups work. Ask Kareem.

by J.L. Richardson, MD, family medicine doctor and patient advocate, author of Patient Handbook to Medical Care: Your Personal Health Guide, recipient of Writer's Digest International Self Publishers award in reference books.

http://www.mypatienthandbook.com/
www.twitter.com/MD4U
www.blogtalkradio.com/drjfpmd - readings by author
http://short.to/vb5e - excerpts & bookstores on Google Books

domingo, 1 de noviembre de 2009

Marijuana for Pain: Up Close & Personal

Such a timely question, medical cannabis. I live in a state that has all but decriminalized possession of small amounts of marijuana for personal use. Police may write tickets and confiscate, but even that minimal enforcement is rarely performed.

While I empathize with my cohorts with a variety of pain issues, I can only speak from my own experiences, so here's my first person perspective.

I was in the music business in Nashville when it became known as the "Third Coast" in the early-mid 1980s. Drugs were everywhere. The same people who smoked dope were into exotic highs like mushrooms, and then cocaine swept over us like a wave. Not wanting to raise my daughters in that environment, I left - the business, and the state.

Having been in the environment, I am one who unfailingly believes that marijuana is indeed often a "gateway drug" to more hard core substances - but for a different reason. The people I saw moving on to harder substances were a personality type - those who pushed the envelope. Perhaps for some it is the thrill of living dangerously, i.e. breaking a law, rather than the effect of the drug. I honestly
don't think I ever met anyone who suffered withdrawal symptoms from either being without a supply of pot, or from discontinuing it cold turkey.

Alcohol and tobacco are legal, controlled and taxed. There is an expectation that the ingredients (including the toxic ones) are of a consistent strength and character. Not so with illegal cannabis, which may be laced with angel dust or rat poison for that matter. No two highs are the same, or so I'm told.

The fact that there is no guarantee of safety or consistency, nor a legal way for me to try cannabis medicinally (and that I obey the speed limit when no one is watching) prevents me from experimenting. But some nights the painful systemic neuropathy drives me to the very brink of sanity.

With liver function tests consistently out of normal range, I'm in a terrible place for pain control: I have none. Neuroleptic drugs like gabapentin are notoriously hepatotoxic. Hydrocodone/apap or stronger narcotic/acetaminophen combinations are not only not effective for neuropathic pain, the acetaminophen is contraindicated in the presence of suspected or confirmed liver disease. So is alcohol.

I'm not aware of any research indicating cannabis in liver disease.

Medical cannabis can be delivered through smokeless methods, important to folks with respiratory disease. I've read that atomized cannabis is particularly effective and I'd love to try it, prescribed and monitored by my physician. Surely it would be safer pain control than the corticosteroid that only helps a little.

I've been a good Doo-Bee. I passed up the pipe, the rolled dollar bill, the magic mushrooms, and the Jack Daniels bottle under significant peer pressure. I'm so careful with my prescribed pain medications that I'm considered "narcotic naive". I've had surgical pain interventions, but there is no rhizotomy for systemic neuropathy.

Would it be too much to ask my government to permit me compassionate use of a natural substance to alleviate the pain that prevents me from being the person I can be?

Rachel Rosenfeld
http://www.twitter.com/NanaRCR

Thanks to guest blogger Rachel Rosenfeld for this great post on medical marijauna as it relates to her personal health issues. Medical research by doctors has shown it to be effective for safe treatment of pain and many other medical conditions that have been failed by traditional medication (including Marinol pills). Legalizing marijuana will have a great positive impact on patient comfort and quality of life.