Medical Marijuana


My goal in this article is not to judge the use of marijuana as good or bad, legal or illegal or right or wrong. My intention is to provide information now available from current medical literature of its medical benefits, known side effects, and when not to use it.

Marijuana has been used for medicinal purposes for several thousand years beginning with the ancient Chinese. It was used at that time for a multitude of medical problems, from the treatment of malaria to the treatment of constipation.

Marijuana was introduced to the United States in the mid 1800s and was prescribed by physicians for its therapeutic benefits until 1937 when it was prohibited from being prescribed. Then in 1970 it was legally prohibited for anyone to even possess or use marijuana.

Because of public demand for the medical use of marijuana in California, in 1996 it became legal to use for medical purposes and soon other states followed suit.

The benefits of marijuana are attributed to its cannabinoid compounds of which some 100 have been identified. The two most researched and well known of these are tetrahydrocannabinol which is also the main component for the mind altering effects of Marijuana, and cannabidiol which causes less of a high.

Most patients smoke the dried plant for the quickest results. Marijuana’s active ingredients can also be delivered through capsules, vaporizers, liquid extracts, foods, and beverages. One major problem is that dosing can be unpredictable since the level of active ingredients varies between plants, as well as the fact that absorption of ingested forms varies among patients.

THC has also been synthesized and available in the U.S. for medical use under the generic names of dronabinol and nabilone, both of which can be prescribed by a Physician.

Although many users have found multiple health benefits from marijuana for the treatment of numerous health problems, there are really only of few that have passed scientific testing. They include:

  • Nausea, especially when caused by cancer chemotherapy and AIDS.
  • Chronic pain especially when due to neuropathy, cancer, or AIDS.
  • Glaucoma
  • Multiple sclerosis
  • Epilepsy
  • Appetite and weight loss in cancer patients.

Again, I want to emphasize that there is a myriad of other conditions that may be helped by marijuana but they, so far, are not backed up by scientific evidence. Most medical practitioners would prefer that patients first use traditional proven treatments for most health problems and to use marijuana for treatment failures.

There are known health risks to the use of marijuana including:

  • Impairment of thinking, problem solving skills, and memory.
  • Increased anxiety and panic attacks.
  • Reduced balance and coordination.
  • Increased risk of heart attacks, inflammation of heart muscle, and atrial fibrillation.
  • Possible hallucinations and withdrawal symptoms.
  • Lowering of blood glucose and blood pressure, and increased risk of bleeding.

Smoking marijuana, which is the most common method of use, has its own set of potential problems. It is associated with possible increased chronic bronchitis and lung cancer (although much less likely than smoking tobacco). A review of current literature shows agreement that the possible harm to the lungs from smoking marijuana does not endorse the safety of its use in this manner.

At this time experts recommend limiting the use of medical marijuana to adults older than 18 years of age. There are also other health related conditions where marijuana should not be used including:

  • History of schizophrenia or other psychiatric disorders.
  • Severe heart or lung disease.
  • Severe liver or kidney disease.
  • Pregnancy or planned pregnancy, and breast feeding.

Even with the possible side effects and the non uniformity of doses and strengths of its various forms, I would encourage the use of medical marijuana for the known conditions where it has been proven to be helpful. I can also accept its use in any number of conditions when more conventional treatments have failed.

As marijuana use becomes more widely legalized it should open the door to much needed research which would provide more information as to the best doses and delivery systems for medical use as well understanding the risks and benefits for all users. This information would be of great help to both physicians and patients.

Health Update 2015


As many of you know, two years ago I was diagnosed with multiple myeloma, a cancer of the plasma cells in the bone marrow. It was put into remission after 2 1/2 months of chemotherapy. It took awhile to get back to my old self again but for the past year, other than the neuropathy of my feet, I feel great. I returned to work half time last October and was happy to be “back in the saddle” again, doing the work that I love to do.

The stem cell transplant I was to have had after my first round of chemotherapy two years ago was postponed because it was thought that it could make the neuropathy worse. So I’ve been on a low dose maintenance drug and my oncologist has been following monthly blood tests to monitor the myeloma activity. After about six months the numbers were slowly creeping up but no one was too alarmed. Then it was decided to do a PET scan (a CAT scan using a radioactive dye) which I had done in late August. Surprisingly and unfortunately, it showed a lot of myeloma activity affecting many parts of my bones. In other words my myeloma has relapsed. However, unlike the first time I was diagnosed, I really feel very well and as everyone tells me, “You look great!” I’ll take that as a good sign.

Because the steroids from my first round of chemo have caused a deterioration of my hip joint, I was to have had a hip replacement last month, but that has now been postponed so that I could begin chemo right away. I have just finished my third week of chemo, still feel very well, still have my hair and my most recent blood test shows very favorable improvement already. That is music to my ears.

I’ve begun an extended leave of absence from work to deal with the new round of chemo and to keep me from exposure to sick patients. I’ll miss seeing many of you but I find myself once again as the patient and now I’ve got to take care of myself.

I will continue writing my articles and, in fact, I will have more time to do so. I’ve been encouraged by many to put my articles in a book format which I hope to do this coming year.

Thanks to all of you who have had me in your thoughts and prayers.

Tick Bites

tick bite

In Santa Cruz County, it is reported that less than five percent of the mature Western black-legged ticks and a somewhat higher percentage of the nymphal (baby) stage, carry the Lyme bacteria. Although many people worry after being bitten by a tick, the risk of acquiring an infection is quite low. In this article I’d like to discuss the tick bite and signs and symptoms of Lyme disease.

Neither the tick’s body nor its head burrows into the skin. Instead, the tick attaches by its mouthparts. An infected tick can transmit an infection only after it has been attached, taken blood from its host, and fed for 24 to 48 hours. If you find a tick on you that is unattached and non-engorged, it is unlikely to have transmitted an infection. Look carefully for the immature nymphal ticks, which are the size of a sesame seed. It helps to shower after clearing brush or walking in wild lands.

The proper method of removing a tick is to use a fine pair of tweezers and grasp the tick as close to the skin as possible. Pull it straight out, gently but firmly, without jerking or twisting. After removing the tick, wash your hands and the skin around the bite thoroughly with soap and water.

If, after removal, you see anything remaining in the skin, this represents tiny mouthparts of the tick. It is not the tick’s “head” and it cannot increase the risk of transmission of Lyme disease once the tick body is removed. If you are unable to remove the mouth parts easily, as you would a splinter, leave it alone and the skin should eventually heal. If you are concerned see your doctor.

Quite often, after an obvious tick bite, a red rash may develop at the site of the bite within the first 24 to 48 hours. A rash that develops this quickly after the bite is usually an allergic reaction to the saliva of the tick. It rarely grows beyond 2 inches, needs no treatment and disappears within a few days.

The actual Lyme’s rash, called erythema migrans, is reported to occur in up to 80 percent of infected tick bites. It is described as a red rash that is usually neither itchy nor painful. It develops a few days to a few weeks after a tick bite and is likely to be the first sign of Lyme disease. The rash most often continues to get larger over a period of time and will grow to be well over 2 inches, possibly 8 to 12 inches or more, and may last for several weeks. This rash may sometimes develop a pale appearance in the center, causing a bull’s eye shape.

Either during the time of the rash or shortly thereafter, other symptoms of Lyme disease may appear which resemble these common flu-like symptoms: fever and chills, malaise (achiness), headache, and achy joints.

The rash and/or the above flu-like symptoms may indicate early Lyme disease and you should see your doctor. When recognized during this early stage, most infections can be adequately treated.

If the above symptoms do not occur, are not recognized or are not treated properly, then one might develop late Lyme disease which can more severely affect different parts of the body such as the  joints, the nervous system, and the heart, to mention a few.

The bottom line is that whether you are aware of a recent tick bite or not, if you develop an unusual, unexplainable rash or if you develop flu-like symptoms (without respiratory symptoms), especially outside of the flu season, you should visit your doctor and discuss the possibility of Lyme disease.

Leg Cramps

leg cramps

Most of us have at one time or another had a nocturnal leg cramp. Some individuals suffer frequently from them. Almost anyone can experience cramps, but they are more common in the elderly. Although they are technically harmless, they can be quite debilitating sometimes lasting 15 minutes or more. Most cramps have no obvious underlying cause.

It is believed that cramps may be associated with dehydration, prolonged sitting or a deficiency of certain electrolytes such as magnesium, potassium or calcium. Some medications have also been implicated, including diuretics, oral contraceptives, and beta blockers. Cramps have also been related to conditions such as pregnancy, diabetes and thyroid disorders.

There is weak evidence that B complex vitamins and magnesium supplements may help to prevent cramps. Most food and natural supplements have not been found to be helpful.

What to do for a leg cramp? First try massaging the cramped muscle. Next, try flexing your feet by bringing your toes up toward your knees. Try applying either hot or cold compresses directly to the painful muscle. Lastly, if you’re not in too much pain try to get up and walk around.

Here are some suggestions for reducing the frequency of cramps:

  • Maintain adequate hydration by drinking plenty of water throughout the day. This is especially important if you’ve been working out and/or sweating.
  • Massage and stretch your calf muscles before retiring. For stretching, try standing two or three feet from a wall with one foot forward. Lean forward with forearms up against the wall, keeping rear knee straight with the rear heel flat on the floor. Hold for 20-30 seconds then switch legs and repeat.
  • Loosen or un-tuck bedcovers and sheets at foot of bed in order to give your feet plenty of room.
  • Avoid high heels as well as completely flat shoes. Wear shoes with good support.

In the past, quinine was traditionally used as a treatment for leg cramps, but due to its dangerous side effects, it is no longer recommended. In fact quinine products are no longer sold over the counter.

If you have tried all the above suggestions and still suffer from nocturnal leg cramps, see your doctor.

Smartphone Medicine

smartphone medicine

It is estimated that one in five Americans have a health ‘app’ on their smart phone. One of the first uses of such an ‘app’ was to monitor vital signs such as a runner’s heart rate, by connecting a sensor from the body to a smart phone.

Smart phones are already in use to take blood pressure and even do an EKG. Currently in development is a product called iTest which will begin by testing for strep throat. This is done by swabbing the throat, placing the swab into a vial of liquid, which is then placed into the iTest device, and in turn, is plugged into the phone to be analyzed.

The producers of iTest are also developing tests for HIV and MRSA, a common infection that is particularly difficult to treat. They are also working on tests for the flu, malaria and sexually transmitted diseases. Another test can detect troponin which will help verify if someone has had a heart attack. The iTest is anticipated to sell for about $150 plus the test kits.

Other tests may soon be integrated with the cell phone. For blood, it includes cholesterol, potassium, hemoglobin, kidney, liver, and thyroid function, and some toxins (poisons). For urine, it can test for infections, protein, and HCG (a hormone to monitor high risk pregnancies.) Saliva can be tested for influenza. It will even test one’s breath for alcohol level, heart failure, and drugs like marijuana, cocaine, heroin, and amphetamines. In development are tests for certain cancers such as lung, ovarian, breast, and prostate, which will be detected by analyzing one’s breath.

In the works are ‘apps’ that will allow one to wear wireless sensors to detect blood oxygen and blood glucose levels, blood pressure and heart rhythms. This information can be sent to your health care provider.

We now have the ability to take a picture of a rash with a smart phone and download an ‘app’ to process the image and receive a text with the most likely diagnosis. Then it will advise whether you can treat it yourself, or if you should see your doctor.

Also in development are hand held devices that can take X ray, MRI, and ultrasound images which will incorporate the use of smart phones.

The goal of the smart phone in medicine is not just for an individual’s use. It has tremendous applications for use in third world countries as well as remote and resource poor areas. Some of the information I have provided may seem quite farfetched, but I do believe it will become a big part of our future.


probiotics, digestion

Probiotics are microbes (bacteria) that are believed to provide health benefits when consumed, and can be found in certain foods or supplements that contain them.

Let’s consider the human lower intestinal tract, which is home to some 100 trillion microbes. This is ten times the total number of cells that make up the entire human body. These microbes are considered “good bacteria” and help to digest food, fight some harmful bacteria, and according to some research, may help boost the immune system.

An imbalance of good and bad bacteria in your intestines can make you sick. The most common problem from this imbalance comes when we take antibiotics, which can kill the good intestinal bacteria leading to diseases that cause diarrhea. It’s fairly common to have an episode of diarrhea during or after taking an antibiotic. Recent studies have shown a significant decrease of antibiotic associated diarrhea when taking probiotics during and up to a week after taking antibiotics. For greatest effectiveness, do not take probiotics within two hours of taking an antibiotic.

Probiotics may also help traveler’s diarrhea as well as diarrhea caused by the common “stomach flu.”

Some other health related conditions have been thought to also be helped by taking probiotics. However, there are few good scientific studies to substantiate these claims. Some of these conditions are:

  • Ulcerative colitis and Crohn’s disease.
  • Celiac disease and lactose intolerance.
  • Constipation and irritable bowel syndrome.
  • Bacterial vaginal infections.

Probiotics are thought to be generally safe for anyone, but due to a rare risk of infection, those with a known immune deficiency or anyone being treated for cancer should avoid them.

Some foods that contain probiotics include yogurt, a fermented dairy drink called Kefir, and some fermented vegetables such as sauerkraut and pickles. While they may contain probiotics, there’s no guarantee that they have them in the amount or type that may have health benefits. Only dietary supplements containing probiotics have been tested and may be helpful.

Most supplements contain freeze dried bacteria which come alive in your digestive system. These products can be found at most drug stores, supermarkets, heath food stores, and online. They come as tablets, capsules, or as a powder.

You need to look for a product that hasup to 10 billion colony forming units per day in a single dose. Check for the expiration date for the live bacteria found on the label and follow directions for proper storage.

In summary, although probiotics are touted for treatment of a variety of conditions, the only treatment which seems to hold up to scientific scrutiny is to help prevent antibiotic associated diarrhea. That being said, there appear to be no significant side effects or known health problems for healthy adults who use probiotics for other conditions.

Although there are a number of products on the market, from my research, three commonly used probiotics which have some evidence of being helpful are Culturelle, DanActive, and Florastor.

Talk with your doctor if you have any questions about the use of probiotics.


The benefits of exercise are no longer theoretical. All recent studies concerning exercise and its effect on people conclusively state that exercise will help most people live longer and healthier lives. Whether you are young or old, overweight or underweight, or even if you have a disability, exercise will benefit you.

Most of us at any age wish we were more fit. Becoming older doesn’t mean we have to become weaker and more fragile. Most physical changes of aging are due to inactivity and lifestyles that do not include regular exercise. Becoming and staying physically fit is the most important thing we can do to maintain our ability to continue doing the activities we now enjoy. The more fit one is, the more independent one may remain, as well as being happier and more satisfied with life.

It’s truly never too late to begin a fitness program of regular exercise. In this article I would like to list the beneficial reasons of exercising and also give valid reasons for not putting it off any longer.

Reasons to exercise:

  • Live longer. Those who exercise regularly have been proven to add years to their lives.
  • Help to lose weight. Combined with proper diet one will lose weight.
  • Strengthen your heart. A stronger heart pumps blood more efficiently and doesn’t have to beat as fast.
  • Lift your mood. People who exercise tend to be happier and less depressed.
  • Improve chronic conditions. Exercise has been found to lower blood pressure and to improve diabetes and arthritis.
  • Defend against illness. Exercise can boost the immune system and help fight off illness, especially flu and colds.
  • Improve stamina. Exercise can provide more pep and energy and less fatigue.
  • Improve circulation. Exercise can improve our blood cholesterol and help keep our arteries clear.
  • I say so. Just wanted to see if you’re paying attention. I really do exercise, bicycling and swimming, and I feel so much better for doing so.

Overcoming excuses for not exercising:

  • Not enough time. Wake up earlier. Do several shorter periods of exercise throughout the day. Drive less, walk more.
  • Tried it before didn’t work. Set realistic goals. Pace yourself. Reinforce in your mind the benefits of exercise.
  • I might injure myself by exercising. Start with a beginning exercise group. Pace yourself. Consider working with a trainer.
  • It’s too expensive. Joining a gym or having expensive equipment at home would be nice, but are not necessary. Watch an exercise video at home. Try just plain walking or climbing stairs.
  • I’m not athletic. Most people are not particularly athletic. It is not a prerequisite for routine exercise. Anyone can and should exercise.
  • It’s just too much work. If exercise is just too much to do for your own good, then do it for those who love you. They will have you around longer, and will enjoy your health and happiness.

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