Marijuana Man

Marijuana.  As soon as you mention it, images of a bunch of stoner uni students sitting around in a share house with the play station fired up smoking bongs is conjured.  But I am not talking about the recreational use of the drug.  I am talking about the medicinal purpose of the drug. I am talking about Marinol.

Now if you had asked me my to give my opinion on medical marijuana (MMJ) three months ago I would simply told you that I believe if it did have a genuine medical benefit there is no reason why it shouldn't be used but I would also counter it by saying that I have never researched it so my opinion would not be extremely valid and it has never been a viable treatment option for me.  Or has it?

Personally I think my opinion on the subject of MMJ has become a lot more valid in the last four weeks.  Why?  Because I was treated with marinol during my stem cell transplant and it worked great.  I was given a plethora of anti-nausea meds during my hospitalisation and although they did work, the only thing that would allow me to tolerate any food what so ever was marinol.  And during the procedure it is important to eat to maintain your energy levels.

So my question is if it worked so well why has it never been offered to me as a viable option in Australia?  I understand it would need strict regulation but we prescribe far more addictive drugs for far less all the time.  In hospitals narcotic based analgesia is the go to medication for anyone with pain and addictive anti-depressants are being shelled out like M and M's.  However, I have been in hospital in Australia and suffering severe nausea and although this drug would most likely have helped I was not offered it.  I don't even know if it is available over here

But MMJ has such a negative spin.  People always think of pot smoking hippies when you think of marijuana but just because you take the drug medicinally does not mean you'll turn into a pot smoking hippy, just like morphine for pain will not turn you into a heroine junkie.

Now I had the marinol for one reason.  Post chemotherapy nausea.  There are many reported medicinal benefits of MMJ.  We could prescribe it, monitor it, control it and make sure that the product is used safely and for its maximum benefit.  Or we could simply let patients suffer or force them to illegally purchase an uncontrolled substance that is not regulated for quality.

At the end of the day it comes down to patient welfare.  If it can help don't we have a responsibility to prescribe it responsibly as we do with any prescription drug.  Society needs to let go of the stigma associated with marijuana and start thinking about medical benefits.  Then we can start using it for improvement of the lives and easing the suffering of the people that need it.  Until next time, stay well:)

Second Day Back

I still felt fairly ordinary.  The lethargy was overwhelming.  I rose late, and after my shower I had to lie down on the bed for half an hour before I finally made it to the couch for yet another rest.  It was a tough day.  I was still flirting with a low grade fever and was fighting mild nausea, so breakfast simply consisted of salads and cream cheese and a little fruit juice.

To make matters worse my wife insisted that I do a little exercise and have a short walk which I resisted but I was eventually foiled when the doctors surgery called to say that I was one vile short on yesterdays blood test.  So off we went back to the surgery and for good measure and to make sure I got my short walk my wife parked about 100 meters away.  So by the time I had got my blood taken I had walked 200 meters and I was shattered.

When we got home I took my temperature which was flirting with that magic 38C mark at 37.5C.  Up until today I had been controlling the occasional nausea with zofran.  But this time I had not and when I got home I vomited.  In all honesty it was probably a good thing.  Vomiting is the bodies way of expelling something that is unwanted and after the event I felt much better and my fever came down.

I was however completely spent, so I slept most of the day and the following night.  Since then I have felt much better and now I'm probably back to the stage I was the day before I left Chicago.  Until next time, stay well:)

In Transit

Right now I'm sitting in the Virgin Australia lounge room at LAX, and for lack of a better word, I'm buggered.  I woke up this morning and I didn't feel the best.  Maybe it was because I had the busiest day I've had since transplant yesterday, or maybe it was because I was nervous about getting sick on the plane, I don't know.

All I know is for the first time in a couple of days I felt nauseous.  Luckily, I still had some Zofran so I took one of them and I was right as rain.  The other problem I had though that bothered me a little more was for the very first time the site of my PICC line had started to ache.  Not good.  I had planned on phoning Amy anyway that day to let her know I was going home and just to say thanks, so I raised it with her then.  As there was no swelling or redness and I didn't have a fever she said it was most probably nothing but if it still bothered me when I got back to Melbourne to raise it with my doctors there.  Most probably I just slept on it in an awkward way.

Anyway, so far today has been really long.  Not that things have gone badly they haven't.  But airports are tiring at the best of times and we have already had a four hour flight from Chicago to LA and on Chicago time it is currently midnight.  I am looking forward to getting on the plane having a bite and then going to sleep.  Thankfully I have had no trouble sleeping since SCT which I would imagine has made it much easier for me.

And to think in just 18 hours time I will finally be able to rest my head on my own pillow in my own bed.  What a luxury.  But it can't last too long as the day I return I have a doctors appointment to organise all my follow up blood tests etc....  It will be interesting to see my counts as I have noticed today I have been getting a little short of breath which would indicate that my haemoglobin is dropping.  It would have been artificially boosted by the transfusion I had the day I left hospital but hopefully my stem cells are starting to engraft properly and my red cell count will start to rise naturally.  Until next time, stay well:)

Day +10

Well I honestly didn't expect to be out of the hospital until at least today so to have been out for a day was very much a pleasant surprise.  And even though I'm not home yet (which would be ideal) there are some luxuries about not being in the hospital.

First, my bed is not constantly inflating and deflating and making noises that keep me awake.  I don't have an IV pole that has numerous flashing lights and when it notices a problem will beep angrily at me.  I am PICCless.  As far as IV access goes, the PICC line was without doubt the most comfortable line I've ever had, but it is still so much nicer not to have it and I don't have to have my arm glad wrapped up to take a shower.  Lastly, it is nice not to be woken up at 2.00am for blood tests and again at 5.00am for weighing, blood pressure, temperature and pulse etc...

So how am I feeling now?  I am still really tired.  It is still quite a struggle to summon the energy to do something like have a shower and afterwards I am completely spent.  I also have a very small appetite although the nausea is no longer around.  On the plus I am feeling a little stronger and a little better every day.  Until next time, stay well:)

Day +5

On day four I made the conscious decision that I should, where possible, cut down on the drugs they are giving me.  In nearly every recovery there is a time where you no longer need them and I personally would rather not take than take them.

So I decided that the anti nausea should cease.  And I stopped taking them for most of the morning of day +4.  However, when I woke up this morning the nausea ha returned with a vengeance.  Not that it was a big problem, one dose of Zofran and back on the marinol I was fine.  I don't want to stay on the drugs much longer, but if they are still necessary.

Well they tell me that your counts stay down until between days +8 and +12, so I feel like I am about half way there.  If I could get out on day 8 that would be awesome, but realistically I think it will be around day 10.

On another note a dermatologist came round to view my rash and biopsy a part of it.  They say that they will want me to put cream on it all the time, and I feel as though with it  still not itching or painful and looking as though it is clearing up I was more for just leaving it.  But with the biopsy already done I guess I will get an answer.

Until next time stay well:)

Ps.  I would like to extend my warmest wishes to Bob, who is having his PICC line placed tomorrow and Wendy who is having a small procedure with the cardiologist.  Here's hoping it will not be a bigger procedure and will delay her from the program.

Day -4

Day -4 has been very similar to Day -5.   The main difference being that today I was foiled by my own procrastination.   My PCT came in bright and early and wrapped my arm up ready for a shower.   I then proceeded to lie in bed for another half an hour because I was feeling extremely lethargic.   Just as I was about to make the giant leap from bed to bathroom a nurse came in to administer my pre-medications.   Unfortunately this meant that I had to postpone my shower again.  

So I decided to remove the cling wrap around my PICC line as the pre-medications were slowly infused.   At this time, my breakfast also arrived which fortunately I managed quite easily.    At this point the combination of Benadryl and Ativan had kicked in quite nicely and I slept through until lunchtime.   After lunch, which also went down quite easily, I had the pre-meds for the Rabbit ATG, which again made me feel sleepy.    Unfortunately, at this point, they also gave me Lasix so, instead of sleeping, I was up every ten minutes to relieve my bladder.   During this time I watched a movie called The In-Betweeners.   It was very funny but I would not recommend it for children or the morally sensitive.

It was at this point things took a small turn for the worse as I started to get a stomach ache and I felt a little nauseous.   Instead of taking more Zofran I decided to take some Composine as I am only allowed one more dose of Zofran between now and midnight.

At this point  I went to the toilet and had diarrhoea.    The nurses were really good and helped me back to bed as I was also feeling a little lightheaded.   They have also put a "hat" over the toilet seat to collect a sample from my next deposit.

Right now the Rabbit ATG is still running and it will be for another 6 hours but I think it is the Cytoxan that is really knocking me around.   And the best part is I get to do it all again tomorrow.   In all honesty I have always said that I have hoped for the best but prepared for the worst, well mentally anyway.   So far the process has not been the best but it has been far from the worst I had expected.

The nurses have been absolutely excellent and extremely diligent about listening to all my complaints and given me all the options associated with them.   I believe one of the best things about North Western Hospital is that they don't use any agency nurses like they do in Australia and, although some of the agency nurses are good, there is always a clear difference between the full and part time hospital nurses and the agency nurses.

Right now, I am starting to feel to better.   I seem to be going in a cyclical up and down pattern and I think  I am heading up at the moment.   Thanks to my mother who is diligently typing this post as I dictate her on my hospital bed.    Until next time, stay well :)