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Monday, January 6, 2014

more docs, medical marajuana, and a potential trip to Baltimore

This morning I had my follow-up with Dr. Schurgin. Craig and I had a few objectives heading into today's appointment. As this whole process has trudged on, defining these clear-cut "goals" has become increasingly important for me. The idealist in me wants to leave every doctor's appointment with an answer to my pain so when I walk out of a visit without the solution, it's easy to let the feelings of discouragement take over...an emotional state that I can't afford to entertain. Instead, we create simple and achievable objectives (that can make otherwise shitty appointments still feel successful). So on today's agenda was:

1. Ask Dr. Schurgin why I haven't yet experienced relief from the pulsed radiofrequency nerve ablation that he performed on 12/19.

2. Get his take on trying cannabidiol (CBD), the non-psychoactive plant cannabinoid. I've obviously known about the use of marajuana for medicinal purposes (having even discussed the option earlier this year with my Mayo neurologist, Dr. Dodick, but opting not to pursue it out due to my concern that it wouldn't be more than a band-aid pain fix), though it wasn't until just recently that Craig and I stumbled upon Project CBD, a non-profit educational service dedicated to promoting and publicizing research into the medical utility of cannabidiol (CBD) and other components of the cannabis plant. Here's a quick blurb from their site...

"Cannabidiol — CBD— is a compound in cannabis that has significant medical effects, but does not make people feel 'stoned' and can actually counter the psychoactivity of THC. The reduced psychoactivity of CBD-rich cannabis may make it an appealing treatment option for patients seeking anti-inflammatory, anti-pain, anti-anxiety, anti-psychotic, and/or anti-spasm effects without disconcerting lethargy or dysphoria. Scientific and clinical studies underscore CBD’s potential as a treatment for a wide range of conditions, including rheumatoid arthritis, diabetes, alcoholism, MS, chronic pain, schizophrenia, PTSD, antibiotic-resistant infections, epilepsy, and other neurological disorders. CBD has demonstrated neuroprotective and neurogenic effects, and its anti-cancer properties are currently being investigated at several academic research centers in the United States and elsewhere."

After researching AZ's regulation and Craig stopping at a local dispensary, we confirmed that CBD-rich strains are available here (which is great because we could have easily shot up to Denver for it but then flying home, etc. could get messy).

3. Find out if Dr. Schurgin thinks it would be worth seeing the doctor that he originally mentioned who performs nerve blocks at C1 and C2 (as it's a bit riskier and outside Dr. Schurgin's scope of practice).

4. Is there anything else he thinks is worth trying??


1. He explained that there's still a chance the ablation could help, though he seemed fairly confident that it would have by now. He admitted that he wasn't quite sure why I would have had a positive response to the diagnostic but not the procedure itself. Perhaps placebo? (I don't think so) Perhaps the injected numbing agent went higher than he intended during the diagnostic and was actually closer to C1?


2. Though he hasn't had ample experience prescribing CBD for pain, Dr. Schurgin was open to me giving it a shot and would be happy to provide me the necessary recommendation to acquire a license. The conversation was actually kind of funny...
Doc: "Have you never tried it?"
Me: "No."
Doc: "Not even with friends?"
Me: "Ah, no."
Doc: "Not even in college?"
Me: Still no.


3. He agreed that it'd probably be a good idea to see this other guy, Bogdan Anghel, MD, at Pain Management and Rehab Medicine Center, first for a consultation and then to discuss whether it was worth trying a block at C1/C2.

4. While admitting that his "bag of tricks" was running low, Dr. Schurgin suggested a trial of Topamax, the anticonvulsant drug that I had discussed a few months back with another neurologist, Dr. Kauffman. I had been immediately turned off after discussing some of the potential risks and side-effects, including hormonal changes that could interfere with pregnancy, etc. Dr. Schurgin also added that immediate discontinuation or missed dosage of the drug causes acute withdrawal, which can lead to seizure. He also suggested we look into a headache clinic in Michigan, Michigan Headache & Neurological Institute.


For now, I'm continuing to put Topomax on the back burner. I immediately scheduled a consult with Dr. Anghel, but it won't be for a few more weeks, so have decided to give the CBD a try in the meantime. I go back to Dr. Schurgin's office tomorrow morning to review the required certification paperwork. Once that's completed, I'll submit my application to the public health department and should receive the license within a week or so. Hoping that process is speed bump-free.

On a separate note, Craig has also been in contact with a neurologist based in Maryland, Dr. Crutchfield, MD, Director of the Comprehensive Sports Concussion Program (who Mark Verstegan knows through the NFL Player's Association). Here's an interesting 2 minute video of Dr. Crutchfield discussing his area of expertise. I would also highly recommend checking out this video about Brianna Scurry's career-ending struggle with post-concussion syndrome and her (lifesaving) treatment under the care of Dr. Crutchfield (scroll to bottom). Stories like these touch and inspire me in ways I could have never imagined.

I'm in the process right now of putting together all of my medical records, doctors notes, imaging reports, etc. to send to Dr. Crutchfield. He'll review them first before letting us know whether it's appropriate for us to fly out for a consultation.

I have a few more things going on this week too, including PT, massage, and an energy work session called The Emotion Code, so will likely post a recap of that later in the week.

To end on a happy note, here's some pet-therapy in action from my trip home for the holidays. I miss this alarm clock already!

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