Alan was disoriented and his words were not making sense. His wife thought he might be having a stroke, so she took him to the emergency room where he was seen by the on-call neurologist. When asked, Alan admitted to using cannabis on a regular basis for many years. The neurologist then brought him a printout with the title: “Marijuana Use Associated with Increased Risk of Stroke, Heart Failure.” That was when I got the call asking me if this was for real.
Stacey Kerr, M.D.
THE ENDOCANNABINOID SYSTEM AND MOOD
Our moods are affected by our environment, life situations, genetics, and brain activity. Some individuals are simply happier than others, and research on CB1 (cannabinoid) receptor genes gives us some clues to why that happens.  However, even though some are seemingy genetically destined to find and maintain happiness easier, other variables in life cannot be minimized.
Charlie Wedemeyer was one of Hawaii’s greatest athletes when he attended Punahou School in the 1960’s. He was the quarterback for the football team, but also excelled at basketball and baseball. Charlie was named the Hawaii Prep Athlete of the 1960’s and went on to play football for Michigan State.
A patient’s perspective
Laura was a physician who spent much of her clinical time treating substance abuse disorders, and she had no recent experience with cannabis herself. Her aversion to using cannabis when she was going through chemotherapy for breast cancer did not surprise me. Nausea, and the anxiety that preceded its inevitable occurrence, were disabling. I trained with Laura in family medicine, and I had appreciated the beneficial effects of cannabis used by my cancer patients, but it was hard getting Laura to accept my advice.
Finally, I introduced her to a calibrated vaporizer – a method of administration that could provide quick relief, but was different than the ‘smoke a joint out behind the barn’ approach she had imagined. She started with a CBD-rich herb that had a ratio of 2:1 CBD:THC, hoping that the resulting intoxication would be mild enough to tolerate.
I received a call from Laura three days after her latest chemo, and quickly answered it to see if her trial of cannabis had been helpful to her. At first I was concerned because she was crying into the phone, but when I could understand her words I was thrilled. She reported, “It worked faster, better, and more completely than any of the prescriptions my oncologist gave me.”
If even reading about nausea and vomiting will make you queasy, you may want to jump to the end of this article and skip the potentially nauseating details. Nausea is like that – easy to feel if you are so inclined.
Nausea and vomiting are each distinctive, different problems – clearly related, but quite different when it comes to cause and treatment. Those who suffer know that nausea is worse to live with than vomiting because it is a continuous sensation, and is harder to control.
What is nausea?
Nausea and vomiting are protective defense mechanisms in the human body, and short-term episodes can be therapeutic, though miserable. But what if nausea is not short-term? What if it is an unavoidable side effect, or chronic, with no relief in sight?
If there is no clear trigger for nausea, a patient should work with their doctor to discover the underlying problem. This is true especially if the nausea does not resolve within a day or two because that may be a sign of more serious problems.
“David,” a 10 year old boy, had his first seizure at 2 months of age. The convulsions were photosensitive generalized tonic-clonic seizures that occurred 1-4 times each day. These events were occurring daily, even though he was being treated with two anti-seizure medications – lamotrigine (Lamictal) and valproic acid. But they had already tried carbamazepine, phenobarbital, zonisamide and levetiracetam (Keppra) without success.
The story of Aubrie Hill and her mom who moved to California to get reliable access to cannabis oil to treat her intractable epilepsy — with positive results.
Pamela is newly pregnant with her third child. She and her husband think this is going to be their last one because she is having a dreadful time with nausea – morning sickness that lasts all day long. She knows all the tricks. Saltines by her bedside, taking Vitamin B6 and B12, and eating frequently even though her stomach is queasy. She tried ginger. She tried acupuncture. She considered hypnosis. None of it is working, and the added stress of two little ones who still need her attention is making her pregnancy a miserable experience.