All of the diagnoses presented in this chapter involve the body’s nervous system and are among the most painful of all the chronic pain conditions. Of the various tissues in the human body, nerves take longest to heal. Due to its severity and duration, nerve pain is often disabling and difficult to treat. It typically requires the use of opioids, gabapentin, or Lyrica to relieve the pain, but these often cause a host of unpleasant side effects.
Gabapentin, an anticonvulsant (antiseizure) drug, is commonly used for treating shingles, trigeminal neuralgia, and diabetic and peripheral neuropathy. However, it is often not well tolerated, with uncomfortable side effects including drowsiness, dizziness, loss of coordination, tiredness, blurred/double vision, unusual eye movements, and shaking (tremor). Lyrica, also an anticonvulsant, is frequently prescribed for treating shingles pain and diabetic neuropathy. It can cause drowsiness, dizziness, dry mouth, constipation, and blurred vision.
Fortunately, medical marijuana has proven to be highly effective for relieving nerve pain, regardless of its cause or severity. The MMJ recommendations that follow can be used to treat each of the conditions presented in this chapter.
If you are suffering from any of these four types of neuralgia (nerve pain), and you are in an acute phase, one in which your pain is consistently at a 6–7 or above (this is quite common with neuropathic pain), then please don’t be concerned about relying too heavily on medical marijuana. For fifteen weeks, early in the course of living with shingles, my pain level varied from a minimum of 7–8 at the beginning, to a minimum of 5 toward the end of this nearly five-month ordeal (the acute phase), and I averaged between four and seven MMJ products per day.
When you are attempting to function and live your life as normally as possible in spite of unrelenting incapacitating pain, don’t hesitate to use as much medical marijuana as you need to be reasonably comfortable. But please wait for at least one to two hours after taking an MMJ product (other than through inhalation) before determining if you need something more. Remember that tinctures take approximately thirty to forty-five minutes to begin working, with a peak effect beginning at about ninety minutes and lasting for up to five hours from the time it was administered. Edibles, ingested hash oil, tablets, capsules, or anything else that you take orally, can take up to two hours before the maximum peak effect begins, and this can last for six to seven hours from the time you swallowed the edible. I understand quite well your impatience and your discomfort, but my point here is to make sure you need something more before taking additional medicine. This way you can take the next product as the effect of the first one is beginning to wear off, with minimal overlap.
Although the products that are most effective for relieving pain contain moderate amounts of THC, you need not worry about “getting too high.” It seems that when treating severe pain with products containing nearly equal amounts of CBD and THC, somehow either the CBD or the pain itself (or both) significantly reduce the psychoactive effect of the THC. It’s definitely present but relatively mild.
You should also be aware that it is the psychoactive effect that contributes heavily to your pain relief. I’ve heard several patients tell me in almost the same words, “I’m not sure if the THC is doing anything directly to reduce the pain, but it sure takes my mind off it.”
• Vaporize hash oil—either 1:1, 2:1, or 3:1/CBD:THC or Rick Simpson oil/Phoenix Tears. This seems to be the most effective method for relief of nerve pain.
• Ingest these same hash oils—start with a low dose (an amount equal to 1 short grain of rice) and gradually increase. Please note that the potency of hash oil varies from 600 to 900 mg per gram of oil, so the stronger the oil, the smaller the grain of rice. Eat with a fatty food.
• Vaporize hybrids—either 50:50 or 60:40/S:I, or 60:40/I:S, especially Harlequin (a 50:50 strain with high CBD).
• Dab a concentrate (shatter, wax, resin)—reserve this for only the most severe pain that is unresponsive to other methods. It should be used only as a last-resort treatment if all else has failed. WARNING: Dabbing on a daily basis, especially concentrates high in THC, may result in “burning out” your endocannabinoid receptors, rendering you unresponsive to any form of marijuana. The high-potency THC concentrates can also be addictive. These risks can be mitigated with the use of CBD:THC oils, which are more effective for pain relief. If the higher concentrates are needed, then use a vaporizer rather than a dab rig.
• Nasal spray—1:1/CBD:THC; CBD:THC:CBN, for pain and sleep. This is a new product and should be available by the latter part of 2017.
• Tinctures—1:1 or 2:1/CBD:THC; CBD:THC:CBN, for pain and sleep. With severe pain, tinctures are almost never sufficient by themselves, but do work quite well in combination with other delivery methods, such as the CBD capsules.
• CBD capsules or tincture—with less than 1 percent THC, 50–100 mg; use in addition to any of these MMJ recommendations. The CBD will enhance the analgesic and anti-inflammatory effect of the other options and help reduce anxiety and the psychoactive effect of THC. The less your anxiety, the lower your pain level.
• CBN capsules are helpful for both pain relief and sleep.
• Indica tablets, both swallowed (Stratos Sleep) and sublingual (Med-a-mints Indica)—excellent for pain and sleep. Stratos tablets are also available in 1:1/CBD:THC (for pain) and 15:1 (for sleep).
• SOS Pain sublingual tablets are also effective for nerve pain.
• Juice raw cannabis leaves. If that’s not an option, use THCa, CBDa, and CBD tinctures as an alternative.
• Topicals—generalized (apply to wrist or ankle for rapid absorption) transdermal patches, especially 3:2/CBDa:THCa; THCa; 1:1/CBD:THC. CBN patches are excellent for both pain and sleep (and are not psychoactive). Also Mary’s Medicinal’s transdermal gel pens THC or CBD in combination with other delivery methods.
• Topicals—localized (apply to painful areas).
• Vaporize indica strains—70:30/I:S or above, for pain and sleep.
• Indica and hybrid edibles—gluten-free, without sugar or dairy; use indica for pain and sleep.
Keep in mind the value of a good night’s sleep when treating severe pain. The less sleep you have, the greater your anxiety, which then typically causes more pain. Good quality sleep is also restorative and very helpful to the healing process of your damaged nerves.
The nervous system is a complex network of nerves and cells that carry messages from the brain and spinal cord to various parts of the body. The nervous system includes both the central nervous system (brain and spinal cord) and peripheral nervous system (somatic and autonomic nervous systems).
Neuropathy is quite common, affecting more than 20 million Americans. It can occur at any age, but is more common among older adults. The term is used to describe a problem with the nerves, usually the peripheral nerves as opposed to the central nervous system. Neuropathy is seen with a number of different underlying medical conditions, such as physical trauma, repetitive injury, infection, metabolic problems, and exposure to toxins and some drugs. But it is most commonly associated with diabetes. In approximately 30 percent of patients with neuropathy, there is no known cause. This is called idiopathic neuropathy.
As with all of the neuropathic pain conditions presented in this chapter, as well as each of the chronic pain conditions described in this book, conventional medicine has no cure, only symptom relief. Therefore, the primary objective for both conventional and holistic medical treatment is to focus on the causes.
Shingles is a viral infection that causes a painful rash. Although shingles can occur anywhere on your body, it most often appears as a single stripe of blisters that wraps around either the left or the right side of your torso.
Shingles is caused by the herpes zoster virus—the same virus that causes chicken pox. After you’ve had chicken pox, the virus lies inactive in nerve tissue near your spinal cord and brain. Years later, the virus may reactivate as shingles.
While it isn’t a life-threatening condition, shingles can be extremely painful. (I describe my personal experience with shingles in the Introduction. It was the severity of the pain and its remarkable response to MMJ that inspired me to write this book.) Vaccines can help reduce the risk of shingles, while early treatment can help shorten a shingles infection and lessen the chance of post-herpetic neuralgia (pain lasting for longer than three months).
The signs and symptoms of shingles usually affect only a small section of one side of your body. These may include:
• Pain, burning, numbness or tingling—typically the first symptom
• Sensitivity to touch
• A red rash that begins a few days after the pain
• Fluid-filled blisters that break open and crust over
• Itching
Some people experience shingles pain without ever developing the rash.
Trigeminal neuralgia (TN), also called tic douloureux, is a chronic pain condition that affects the trigeminal, or fifth cranial nerve, one of the most widely distributed nerves in the head. TN occurs most often in people over age fifty, although it can occur at any age, including infancy. The incidence of new cases is approximately twelve per one hundred thousand people per year, and it is more common in women than in men.
The typical or “classic” form of TN (Type 1) causes extreme, sporadic, sudden burning or shock-like facial pain that lasts anywhere from a few seconds to as long as two minutes per episode. These attacks can occur in quick succession, in volleys lasting as long as two hours. The “atypical” form of the disorder (Type 2) is characterized by a constant aching, burning, stabbing pain of somewhat lower intensity than Type 1. Both forms of pain may occur in the same person, sometimes at the same time. The intensity of pain can be physically and mentally incapacitating.
The trigeminal nerve is one of twelve pairs of nerves that are attached to the brain (cranial nerves). The nerve has three branches that conduct sensations from the upper, middle, and lower portions of the face, as well as the oral cavity, to the brain. The ophthalmic, or upper, branch supplies sensation to most of the scalp, forehead, and front of the head. The maxillary, or middle, branch stimulates the cheek, upper jaw, top lip, teeth and gums, and the side of the nose. The mandibular, or lower, branch conducts nerve impulses to the lower jaw, teeth and gums, and bottom lip. More than one nerve branch can be affected by TN.
TN is associated with a variety of conditions. It can be caused by a blood vessel pressing on the trigeminal nerve as it exits the brain stem. This compression causes wearing away or damage to the protective coating around the nerve (the myelin sheath). TN symptoms can also occur in people with multiple sclerosis (MS), a disease that also causes deterioration of the trigeminal nerve’s myelin sheath. Rarely, symptoms of TN may be caused by nerve compression from a tumor or a tangle of arteries and veins called an arteriovenous malformation. Injury to the trigeminal nerve (perhaps the result of sinus surgery, oral surgery, stroke, or facial trauma) may also produce neuropathic facial pain.
The intense flashes of pain associated with Type 1 can be triggered by vibration or contact with the cheek (such as when shaving, washing the face, or applying makeup), brushing teeth, eating, drinking, talking, or being exposed to the wind. The pain may affect a small area of the face or may spread. Bouts of pain rarely occur at night, when the affected individual is sleeping.
TN is typified by attacks that stop for a period of time and then return, but the condition can be progressive. The attacks often worsen over time, with fewer and shorter pain-free periods before they recur. Eventually, the pain-free intervals disappear and medication to control the pain becomes less effective. Although not fatal, TN can be quite debilitating. Due to the intensity of the pain, some individuals may avoid daily activities or social contacts because they fear an impending attack.
Conventional treatment for TN includes medication and surgery. Anticonvulsant medicines, used to block nerve firing, are generally effective in treating TN1 but often less effective in TN2. Although these drugs, including carbamazepine, oxcarbazepine, and gabapentin, might be effective in relieving symptoms, many patients have difficulty tolerating their side effects. This is also true of the tricyclic antidepressants such as amitriptyline or nortriptyline, which can also be used to treat pain. Common analgesics and opioids are not usually helpful in treating the sharp, recurring pain caused by TN1, although some individuals with TN2 do respond to opioids. Eventually, if medication fails to relieve pain or produces intolerable side effects such as cognitive disturbances, memory loss, excess fatigue, bone marrow suppression, or allergy, then surgical treatment may be indicated. Since TN is a progressive disorder that often becomes resistant to medication over time, individuals often seek this surgical option.
Complex regional pain syndrome, also known as reflex sympathetic dystrophy syndrome (RSD), is described in the medical literature as chronic arm or leg pain developing after injury, surgery, stroke, or heart attack. It’s rare, with fewer than two hundred thousand U.S. cases per year, and is considered incurable, but treatment may help. CRPS is believed to be caused by damage to, or malfunction of, the peripheral and central nervous systems. The syndrome is characterized by prolonged or excessive pain, mild or dramatic changes in skin color and temperature, and/or swelling in the affected area. It can last for years or a lifetime, and is among the most debilitating of all chronic pain conditions. I have seen several patients suffering with CRPS, and it is devastating.
CRPS symptoms vary in severity and duration. Studies of the incidence and prevalence of the disease show that most cases are mild and individuals recover gradually with time. In more severe cases, individuals may not recover and may have long-term disability.
Anyone can get CRPS. It can strike at any age and affects both men and women, although it is much more common in women. The average age of affected individuals is about forty, and CRPS is rare in the elderly. Children do not get it before age five and only very rarely before age ten, but it is not uncommon in teenagers.
The key symptom is prolonged pain that may be constant and, in some people, extremely uncomfortable or severe. The pain may feel like a burning or “pins and needles” sensation, or as if someone is squeezing the affected limb. The pain may spread to include the entire arm or leg, even though the precipitating injury might have been only to a finger or toe. Pain can sometimes even travel to the opposite extremity. There is often increased sensitivity in the affected area, such that even light touch or contact is painful (called allodynia).
People with CRPS also experience constant or intermittent changes in skin temperature and color, and swelling of the affected limb. This is due to abnormal microcirculation caused by damage to the nerves controlling blood flow and temperature. An affected arm or leg may feel warmer or cooler compared to the opposite limb. The skin on the affected limb may change color, becoming blotchy, blue, purple, pale, or red.
In more than 90 percent of cases, the condition is triggered by a clear history of trauma or injury. The most common triggers are fractures, sprains/strains, soft tissue injury (such as burns, cuts, or bruises), limb immobilization (such as being in a cast), or damage from surgical or medical procedures (such as needlestick). CRPS represents an abnormal response that magnifies the effects of the injury. In this respect it is like an allergy. Some people respond excessively to a trigger that causes no problem for other people.
• Medication—Nearly forty drugs are known to cause neuropathy.
• Diabetes—The most common cause of chronic peripheral neuropathy (high blood sugar levels in people with poorly controlled diabetes damage nerves).
• B12 or folate vitamin deficiencies—can cause nerve damage and peripheral neuropathy.
• Poisons (toxins)—Insecticides and solvents can cause peripheral nerve damage.
• Cancers—Peripheral neuropathy can occur in people with some cancers; e.g., lymphoma and multiple myeloma.
• Alcohol excess—High alcohol levels in the body cause nerve damage.
• Chronic kidney disease—If the kidneys are not functioning normally, an imbalance of salts and chemicals can cause peripheral neuropathy.
• Chronic liver disease.
• Injuries—Broken bones and tight plaster casts can put pressure directly on the nerves, and this can also cause CRPS.
• Infections—Damage can be caused to peripheral nerves by some infections, including shingles, HIV infection, and Lyme disease.
• Guillain-Barré syndrome—the name given to a specific type of peripheral neuropathy triggered by infection.
Remove the cause: Stop the medication, eliminate the toxin, control the diabetes, treat the infection.
Follow the anti-inflammatory diet in Chapter 5. Since neuropathic pain often involves some degree of dysfunction or damage to the myelin sheath surrounding nerve cells (neurons), nutrients that help repair the myelin (composed of 70 percent fat) will help to heal the painful nerves. These foods are relatively high in the amino acids choline and inositol, and include avocados, olive oil, fish, raw nuts, cocoa, whole grains, legumes, spinach (raw), beans, eggs, and beef. Choline assists in preventing fatty deposits from forming in the body. Inositol supports a healthy nervous system by helping to create serotonin. These two amino acids combine to produce lecithin, which reduces unhealthy fats that are known to prevent myelin sheath repair.
Especially with shingles, foods high in the amino acid arginine should be avoided. These include seafood, liver, seeds (sesame, sunflower, pumpkin), soy, fish, turkey, pork, game meat, beef, spinach, and most common nuts (including almonds, brazil nuts, hazelnuts, macadamia nuts, pine nuts, pistachios, and walnuts). Foods high in the amino acid lysine can help prevent recurrence of shingles outbreaks. These include legumes, eggs, yogurt, fish (including salmon and tuna), and chicken.
NOTE: Supplements used for diminishing nerve pain may take three to twelve months to have a noticeable therapeutic effect.
• PhosphaLine (Xymogen): PhosphaLine provides 2.7 gm of pure polyenylphosphatidylcholine (PPC) per serving plus the highest concentrated source of 1,2 DLPC (dilinoleoylphosphatidylcholine). Choline, and specifically phosphatidylcholine, is a major component of the myelin sheath. Unlike most other phosphatidylcholine products on the market, aside from PPC and DLPC, PhosphaLine contains no other phospholipids, which may compete for absorption. Studies suggest that PPC ingestion increases choline levels in the blood and brain and supports acetylcholine synthesis for healthy neuronal and cell function. Daily supplementation of PPC may help maintain healthy brain and liver function, and provide gastric mucosal protection. Recommended dosage is 2 to 3 softgels daily with food.
• Inositol: Take up to 1,000 mg daily; it can also be found in nuts, vegetables, grains, soy, and bananas.
• B-Activ (Xymogen): This is an exceptional blend of methylated B vitamins. The recommended dosage is 1 tablet two times daily with food. Both B1 (thiamine) and B12 are components of the myelin sheath. B1 can also be obtained by eating rice, spinach, lentils, and pork. Foods rich in B vitamins include whole grains and dairy products. High-dose (5 mg) vitamin B12 injections can sometimes be helpful for relieving shingles pain, and possibly help some people with neuropathy. High-dose combinations of B12 and folate are available from health professionals.
• Omega-3 fatty acids (OmegaGenics EPA-DHA 720 from Metagenics): 1 capsule three times daily with food. Foods high in omega-3s include flaxseeds, fish oils, pumpkin and chia seeds, salmon and other deep-sea fish, walnuts, and kidney beans. Oleic acid is also a major component of the fatty myelin sheath, and can be found in the following foods: olive oil, avocados, and nuts.
• ALAmax CR (Xymogen): Timed-released alpha-lipoic acid in a high dose has been shown to potentially reduce peripheral neuropathy, especially in diabetic patients. ALAmax CR delivers 600 mg of timed-released alpha-lipoic acid. The recommended dosage is 1 capsule thirty minutes before breakfast and 1 capsule thirty minutes before dinner. It may take a few months before you notice any difference. Intravenous alpha-lipoic acid administered on a daily basis while gradually increasing the dose over a two-week period has been shown to help some patients with peripheral neuropathy.
• Vitamin D: A dosage of 2,000 units daily for three months was shown to decrease diabetic neuropathy pain by 47 percent. I recommend testing your vitamin D level (blood test). The goal is to maintain it around 80. You may need more additional Vitamin D than 2,000 units, but only increase the dose with professional supervision.
• Acetyl-L-carnitine: This has been shown to help some patients with diabetic neuropathy. The recommended dosage is 1,000 mg twice daily between meals.
• Copper: Helps to create an enzyme essential to lipid development. Lipids are needed for regeneration of the myelin sheath. Copper is found in lentils, almonds, pumpkin seeds, semisweet chocolate, oregano, and thyme. A health professional trained in Functional Medicine can measure your copper levels.
• Alpha-GPC (L-Alpha Glycerylphosphorylcholine): This is another very stable and rapidly available form of choline found in the brain and in the myelin sheath. It has been shown to protect and repair damaged brain cells. The recommended dosage is 600–1,200 mg per day.
• L-lysine and Vitamin C: These can accelerate the healing process from shingles and reduce the risk of further outbreaks. I recommend 1,500 mg per day of L-lysine and 6,000–10,000 mg per day of vitamin C (as Ester-C). High-dose (50,000 mg) IV vitamin C can also be helpful.
Low-impact exercise, yoga, creative visualization, aroma therapy, and meditation are all useful in promoting well-being, and as a result help to relieve neuropathic pain.
Acupuncture, aromatherapy, chiropractic, and other types of bodywork; biofeedback and relaxation techniques; and especially energy medicine techniques, such as Healing Touch, can be helpful for treating each of the neuropathic pain conditions. As a certified Healing Touch practitioner, I’ve been amazed at the effectiveness of this modality for treating a wide variety of chronic pain conditions.
There have also been reports that injections of botulinum toxin, to block the activity of sensory nerves, offers modest pain relief to some sufferers of trigeminal neuralgia.
Chronic neuropathic pain can be very isolating and is frequently associated with profound psychological symptoms for affected individuals and their families. People with this level of disabling pain may develop depression, anxiety, posttraumatic stress disorder, and sleep disorders, all of which heighten the perception of pain and make rehabilitation efforts more difficult. Psychotherapy or supportive counseling can be beneficial for many of these patients. I recommend a cognitive, behavioral, or spiritual psychotherapist, rather than a psychiatrist, since the latter are generally far more focused on drug therapy than counseling. Treating these secondary conditions with psychotherapy is important for helping people cope and recover from chronic neuropathic pain.
As with all chronic pain conditions, there are several potentially life-changing lessons inherent in your dis-ease. As I mentioned in the Introduction, for me the primary message of shingles was surrender. When dealing with disabling pain, you really have no choice but to let go of trying to control your life. You feel helpless, hopeless, and powerless. And it is blatantly obvious that you’re not in control.
With pain of this severity, you have the opportunity to build greater faith and trust that this condition has happened to you for a reason, one that will ultimately benefit you and change your life for the better. I believe that my soul chose my life’s experiences prior to birth, and my life is unfolding just as it needs to in order to fulfill my purpose and greatest potential.
Shingles was possibly the greatest physical and emotional challenge I’ve ever faced, but at this point I’m quite sure I would not be writing this book had it not been for this horrendous virus and the relief I was provided by medical marijuana. And in spite of the thousands of patients I’ve seen who have been able to live reasonably well with chronic pain as a result of using MMJ, I doubt I would have been as passionate a proponent of this remarkable medicine had I not personally endured the pain of post-herpetic neuralgia.
Admittedly surrender and letting go of trying to control is a difficult lesson to learn for those of us who feel we need a large measure of control in order to feel safe, be successful, or to even survive in a hostile world. But as with every chronic pain condition, there are multiple lessons.
The issues in your tissues that have the strongest association with your physical pain can reliably be identified by the anatomical location of the pain and the chakra to which that location is most closely related. The neuropathic pain conditions (or any neurological dysfunction) described in this chapter—neuropathy, trigeminal neuralgia, CRPS, and shingles—are all associated with the sixth or brow chakra. At the top of the list of this chakra’s mental/emotional issues is self-evaluation—i.e., being highly self-critical and too hard on yourself (not loving yourself). The other issues contributing to your physical pain may be: feelings of inadequacy, truth, intellectual abilities, openness to the ideas of others, ability to learn from experience, and emotional intelligence.
The issues for neuropathy, CRPS, and shingles sufferers whose pain is in a location other than the face and head may also include those associated with the closest chakra. In my case, the rash and pain extended across my abdomen and were related to the third chakra. The primary issues there are: trust, power and control, sensitivity to criticism, fear and intimidation, self-esteem, self-respect, care of oneself and others, and responsibility for making decisions.
Donna B. is a sixty-one-year-old with a stressful job as a child support enforcer and a twelve-year history of neuropathy in both legs. It affects her feet, ankles, and legs, extending upward to just below her knees. The pain is constant at a level of 4–5, but is worse with increased stress. She does not have diabetes and the cause of her pain is unknown.
Throughout the course of the neuropathy she has relied on marijuana for relief. She was originally prescribed gabapentin but did not like the side effects. She found that the marijuana she obtained “off the street” (nearly all of which was a sativa or high-THC strain) was quite effective. After MMJ became available, and for the past seven years, she’s been smoking indica strains on a daily basis after work. She rotates different indicas every few days, and usually has three or four different strains available to avoid developing a tolerance. It nearly always reduces the pain to a 2–3, in addition to significantly relieving her stress and helping her sleep. During workdays, she applies the topical MMJ cream Apothecanna Extra Strength to her legs. She says it helps, but not nearly as much as smoking indica.
Marilyn F. is fifty-eight years old, unemployed, and on disability as a result of the trigeminal neuralgia that began five years ago. Her medical treatment started with Tegretol, which was moderately effective for relieving the pain when taken in high doses, but caused her to break out in “huge hives,” which she scratched until she bled. That was followed by Neurontin, which caused a host of severe side effects—including weight gain, vision loss, kidney damage, and a speech impediment—and no pain relief. She suffered with these for two years, along with suicidal thoughts on a daily basis. She then had two surgical procedures, the first of which relieved her pain for seven months and the second of which for approximately one year.
Rather than have additional risky brain surgery, offering only temporary relief, she obtained an MMJ license, began growing her own plants, and started making Phoenix Tears (Rick Simpson Oil). She’s been ingesting the oil two to three times daily (in amounts that vary from one to two grains of rice), and her pain level while using it is reduced to a 2–3. Without it, her pain was a consistent 9–10, with twenty to thirty attacks daily, and these attacks would leave her unable to speak, smile, laugh, eat, or drink. She was essentially incapacitated, but now the MMJ in her words “allows me to have a life.” There are times when she has no pain at all.
In 2001, at the age of twenty-four, Beth C. was in good health with no physical pain or significant emotional stress. She was physically active and either hiked or walked daily. According to her, “life was fine.”
Then, in an instant, her life changed dramatically, when she rolled her SUV down a hill, flipped five times over a highway exit and landed right side up. She had fallen asleep on her way to work at 8:30 am. She lost all of her skin from her ankles down to her toes on both legs. She had apparently walked through a foot of snow while waiting for help.
She was admitted into a hospital with severe frostbite, a badly broken left ankle, and a seriously sprained right ankle. The physicians waited seventy-two hours before performing surgery on the ankle, in order to first determine whether they could save her toes. They decided to keep all ten toes. The surgical procedure resulted in a six-inch plate inserted in Beth’s left ankle. She was in the hospital for more than a week, then transported to a rehabilitation facility for three and a half weeks.
There she began relearning to walk, which took approximately eight months, during which time she regrew the skin on both ankles and feet. Also during this time the pain worsened. Her doctors reassured her that it would go away, but each month it got worse.
Her life, as she described it, “was pretty bad; only doctors, pain and more problems. I tried water therapy, land therapy, exercises, stretches, but nothing helped.”
The excruciating pain persisted. The injury had left her with chronic severe pain around the clock; leg soreness; severe leg cramping in her calves; constant aching legs with intermittent shooting and dull pain in both legs and ankles; stiffness in both ankles; severe back pain; neck pain; shoulder pain; and no sleep. Even a mild breeze of air would make her body hurt.
She had “no life left.” She could no longer walk, sit, stand, or sleep without pain. Her pain level was a 10 every day and all day. She had severe restless leg syndrome, and couldn’t sleep much at all. She would toss and turn for hours, with excruciating pain and leg soreness. The bedsheet would create more pain just by lying on top of her legs. She slept with multiple pillows at night lifting her legs and separating them so they wouldn’t touch. She could no longer drive a car because the back pain was so horrible. She could no longer work, sit in a chair, watch TV, see friends, or even leave her house.
The narcotic medications she was prescribed would help for a short time, but her condition continued to worsen. She was also taking a variety of drugs for neuralgia (nerve pain), including gabapentin and Lyrica, in addition to muscle relaxants. None of the medications made a significant difference in her overall condition. They would help to a minimal extent when she increased the dosage or changed to a new medication, but the beneficial effects lasted for only a few months.
In 2006, she was finally diagnosed with complex regional pain syndrome (CRPS) or reflex sympathetic dystrophy syndrome (RSD). The diagnosis was made at Beth Israel Hospital in New York City, considered one of the region’s top medical centers.
Unfortunately, having a definitive diagnosis had no positive impact on Beth’s condition. She was still severely disabled. It had been several years of struggle with severe insomnia as well as nearly a 100 percent memory loss as a result of the medications. She was unable to remember things from two minutes earlier. The depression worsened, accompanied by suicidal thoughts and extreme anxiety. Severe anxiety attacks were more frequent and occasionally required a visit to an emergency room. During this period, she was also traveling monthly into New York City for a spinal injection and a visit to a psychiatrist, who prescribed several antidepressants and antianxiety medications. She was also prescribed drugs for sleep.
A recreational user of cannabis prior to the accident (she also used it to relieve anxiety), Beth started to smoke it much more frequently after her accident. She was having difficulty with stomachaches from all the medications, especially those with aspirin, acetaminophen, and added filler. Cannabis was the only effective way to settle her stomach. She also found that it helped to relieve her overall pain, muscle aches, and anxiety.
However, it was extremely difficult for her to medicate herself with marijuana in a state where it was illegal. In spite of having to rely on whatever strain she could find (usually high-THC sativa, which is not as effective for pain as the high-CBD strains), and being drug-screened monthly, she continued to use cannabis because of its beneficial effects on her condition. Every month she experienced the stress of being tested and not knowing if she was going to lose her doctor and be treated differently as a marijuana user.
In April of 2013, no longer able to afford medical insurance, grieving the recent loss of her father, and the divorce from her husband, she decided to stop seeing her doctors, stopped all of her medications, and moved to Colorado. These major changes took a toll on her, both physically and emotionally. But she believed that having legal access to medical marijuana in Colorado would be worth it.
She currently uses medical marijuana daily as her only medication. It not only keeps her feeling comfortable, but her disease has been in remission since she moved to Colorado.
The medical marijuana also controls Beth’s anxiety, which decreases her pain. She occasionally has minimal pain with excessive physical activity, but “When I use the medicine [cannabis] it alleviates most of my symptoms instantly.”
Since moving to Colorado, she has essentially created a new life. She developed a much more positive attitude and decided to “make every day a great day.” She does yoga regularly, and takes her new dog for hikes and walks daily. After two months in Colorado she met her future husband while dancing at a concert. Although music had been a passion of hers before the accident, she hadn’t attended a concert or danced in over ten years. Her passion for music, dancing, and a love life have all been rekindled. She remarried in August 2015.