For those of you reading this who have no idea what gout is let me give you the basics.  Gout is an acute arthritis that occurs from the build up of uric acid in the blood.   Uric acid is produced in the breakdown of purines (high protein foods) and other nucleic acids.   There are many foods that we eat that are high in purines.  Alcohol! Meats, Fish, Lentils, Beans, Spinach and a few others. There are also medications that lead to the build up of uric acid in the blood.  Diuretics (for blood pressure), low dose aspirin, and niacin.   Either one of two things leads to the build up of uric acid.  Either the body is overproducing it or the kidneys are not excreting it adequately.   So patients with kidney disease can have issues.

What happens is the uric acid builds up and crystalizes in the joints.  Typically it affects the joint of the big toe (1st MCP joint).  Attacks can be extremely painful and the joint will become severely inflamed.   Typically doctors will treat acute attacks with high dose NSAIDS like alleve, motrin or indomethicin.  The problem for many patients is that they can not take NSAID’s because of the side effects.

Cannabis contains over 60 medically active ingredients that we know of.   Collectively they are called cannabinoids of which THC is only one of the them (the main psychoactive ingredient).   We know that we have receptors to these cannabinoids in our nervous system (brain and spinal cord) which are responsible for its analgesis(pain reducing) properties.   We also discovered that we have receptors throughout our immune system (spleen and certain immune cells).  It is by this mechanism that we suspect cannabis can reduce inflammation.

The interesting thing about cannabis is that patients experience many different effects.  Some patients state that they still feel the pain but “don’t care or focus on it as much” and some patients clearly state that the pain is reduced significantly.   I would imagine that there is both a reduction in inflammation in addition to an increased pain thresh hold via a direct  effect on the nerves themselves.  Regardless, cannabis has very few unwanted side effects.     It is not toxic to any of the major organ systems (if not smoked) and there is next to no chance of physical addiction or overdose.

Although most patients do not want to experience the psychoactive effects of cannabis (euphoria, loss of coordination/balance, short term memory loss) I had an 89 year old female patient today who told me that “it actually makes me feel happy!”  She suffered from debilitating pain and the vicodin was no longer working for her.    In comparison to opiate medications it does not cause nausea, constipation, lack of appetite or addiction.

In the end I always tell patients “if this is something that improves the quality of your life… use it!  If not, then simply don’t use it.”  Most people will find SOME benefit.  Improved sleep, less pain, less anxiety, a little better mood, improved appetite etc.

If you would like to be evaluated by me to see if you could benefit from using cannabis I would be happy to take care of you.  Simply give us a call at 877-721-0047 or contact through our website at www.mcsocal.com

Be blessed,

Dr. Breen

Medical Marijuana and Gout; An Alternative Treatment is a post from: Medical Marijuana Blog

My thought is that both would be better off taking small doses of cannabis using either the vaporizer or an edible throughout the day.   It will certainly help them get sleep and should help relive the pain from their arthritis.  They wouldn’t have to deal with the severe nausea and constipation they are having…. and it may actually improve their mood and make their life worth living.   Right now they are both just marking time trying to survive and get through the day.  There is very little quality of life.

Unfortunately on of the lives in Ohio and the other in New York, two states that do not have medical marijuana laws.    So unfortunately they have to suffer or try and get it illegally (not happening).

I personally believe that medical marijuana’s greatest use is with our elderly population.  It helps with all of the things that plague the majority of our elderly population.  Chronic pain, arthritis, difficulty sleeping, depression and loss of appetite/weight loss are all things that cannabis can help very much.  Also, patients who are at the end of their life can at least get some comfort in their last days.  Palliative medicine (to make comfortable) is an emerging application to cannabis.   I know in my heart this will become more and more common place in our end of life community.

I would really encourage sons and daughters to look into medical marijuana for their parents.   It will solve many of their issues or at least improve the quality of their life… even if only minimal.

If you would like to speak with me in person please call 877-721-0047 and make an appointment to come in.  I would be happy to take care of you.

Medical Marijuana and End of Life Care; It’s impact on the Elderly is a post from: Medical Marijuana Blog

61 year old white female who using cannabis for her restless legs syndrome.

34 year old white male who has a diagnosis of anxiety and depression.

61 year old white female who suffers from arthritis

55 year old white male who had surgery to repair C5-6-7 herniated discs following a motor vehicle accident

51 year old white female who is going through menopause.  She has symptoms of anxiety, hot flashes, insomnia and is easily irritated.

41 year old white make who had reconstructive surgery on his right ankle and suffers from arthritis.

27 year old white female who suffers from anxiety since the age of 17.  She uses cannabis instead of xanax.

25 year old white make who injured his C6-7 vertebra surfing.   He uses cannabis for pain management.

59 year old white female who has sciatica and chronic lower back pain.  She uses cannabis instead of oxycontin.

You would be very surprised by the typical patients that I see using cannabis for their symptoms.   I think the majority of people when they think of medical marijuana envision “teenagers getting stoned.”  That is not the case and quite the opposite.

If you are suffering and would like more information on whether or not cannabis can help you improve the quality of your life feel free to call our office at 877-721-0047 or contact us online at www.mcsocal.com

Be blessed,

Dr. Breen

Medical Marijuana Patients In Irvine, CA July 27, 2010 is a post from: Medical Marijuana Blog

Behcet’s Syndrome is not common in the United States.  It primarily affects people from Turkey and the Middle East.   Is is believed to be an autoimmune disorder but the etiology is unclear.   The hallmark of the disease are PAINFUL ORAL AND GENITAL LESIONS (EXACTLY LIKE CANKER SORES IN THE MOUTH).  The sores are exactly the canker sores that most people get from time to time when stressed.    These are NOT herpes lesions as commonly thought by patients and medical professionals.

In addition, 2/3’s of patient develop and arthritis in their knees and ankles. Rounding out the common triad of symptoms is a rash that is commonly referred to as erythema nodosum (google “erythema nodosum picture” to see what it looks like). They are painful red nodules which commonly affect the anterior aspect of leg below the knee.

In this patients case he had gong to his doctor initially because he was having painful ulcers in his mouth.   He doctor told him it was a type of herpes and put him on an anti-viral medication called acyclovir.    Obviously it did not work or go away.   On a separate occasion he went to see another doctor for pain in his lower legs (arthritis from the disease) but was again mis-diagnosed with a muscle strain and given NSAID’s like motrin.

It wasn’t until he visited his ophthalmologist about a year later because he was having some vision changes and wanted to have his eyes checked out.   Behcet’s syndrome can affect the eyes and cause uveitis which ultimately can influence the retina.    His eye doctor had taken a pretty detailed history and asked him about having oral ulcers.   He then asked him about his rash and DIAGNOSED HIM ON THE SPOT!!!! That is pretty amazing that his eye doctor was the one who put all the pieces of the puzzle together.

In the end he was placed on oral steroids to reduce the inflammation throughout his body.   Unfortunately he was having residual pain in his knees and also having a difficult time eating when he had ulcers.   He stated that cannabis really helped him with his symptoms.

I am amazed at the variety of illnesses that I see patients using cannabis for.   It really helps an incredible amount of people who would otherwise have to suffer.

If you would like an appointment to see if cannabis can improve the quality of your life feel free to contact us through our website www.mcsocal.com or by phone 877-721-0047

Behcet’s Syndrome and Medical Marijuana; Case Study is a post from: Medical Marijuana Blog

The study examined the risk of heart attack and stroke in over 1 million patients who averaged 39 years of age and had no significant health problems (high blood pressure, heart disease, diabetes etc) over an 8 year period.    They found that patients who regularly used NSAID’s to treat chronic pain were 29% more likely to have a heart attack or stroke.   This is significant because how many people do you know (you included) head to the local CVS and pick up a bunch of Motrin for that chronic pain or ache without considering the side effects??  They estimate that 20% of the population has been PRESCRIBED (not including those who get it over the counter) NSAIDS at one time or another for pain.

We are beginning to understand in medicine that many treatments that we used to believe were safe are actually significantly dangerous to patients (for example hormone replacement therapy in post-menopausal women).   NSAIDS can cause significant gastro-intestinal bleeding and now we find out increase the risk of heart attack and stroke significantly.

One thing the study did find is that if you really need to use an NSAID for pain the safest one in the study was Naprosyn, commonly known as Aleve.

You may not know that there are over 60 cannabinoids in the cannabis (marijuana) plant that exert their effects on the body.  Many of them specifically decrease the inflammatory response and thus reduce pain.   Cannabis has very few unwanted side effects.  You can not overdose from it!   It does not effect your kidneys or liver.  It is not addictive.  It does not cause ulcers or bleeding.  It is one of natures best remedies for pain and inflammation.

I can not tell you how many older patients I see everyday that want to stop taking their “pain pills” for chronic pain.   The stories I hear about how cannabis has improved the quality of their life are truly remarkable.  They love being able to vaporize it as opposed to having to smoke it.

I HIGHLY recommend that if you are suffering from chronic pain (for any reason) that you come into my office and we can discuss the benefits and risks of using marijuana to treat your symptoms.   Simply call 877-721-0047 or pre-qualify for free online and one of my staff will contact you shortly.

Dr. Breen, Medical Director, Medical Cannabis of Southern California

NSAIDS (motrin, voltaren) increase risk of heart attack and stroke study finds; Medical Marijuana as an alternative is a post from: Medical Marijuana Blog

Cystic fibrosis is a genetic disorder that effects 1/4000 newborns in the United States.   The main defect in patients with cystic fibrosis is in a protein that regulates chloride transport across the cell membrane.   The result is that CF patients produce large amounts of mucus in the lungs and pancreas leading to difficulty breathing and poor digestion.  It is typically diagnosed when newborns fail to grow properly or when children have breathing difficulties early on in life.  The average life expectancy is 38 years.

This 19 y/o patient uses numerous medications to loosen the mucus secretions in his airways.   At the time of my evaluation he was being treated for active tuberculosis which is not uncommon in patients with CF.  Because of the thickened mucus in his airways, bacteria typically can grow without an appropriate immune response.    All of these medications that he was taking was causing nausea, GERD, lack of appetite and joint pain.  For his pain he was prescribed oxycontin and given trazodone to help him sleep. His mother was concerned about the high addictive properties in opiate narcotics and wanted her son off them.

Cannabis was an excellent supplement to his medication regimen.  He will be able to stop taking oxycontin for pain.   He will be able to eliminate the trazodone for sleep.  In addition his appetite will certainly improve and his GERD symptoms should be reduced greatly.  As his mother explained to me in my office, “when he uses cannabis his quality of life improves.”   If that is the goldstandard for prescribing a medication then certainly this is a case where you can easily make an argument for medical cannabis.

If you would like to visit with Dr. Breen to see if cannabis can help you with your illness simply visit our website at www.MCSoCal.com and pre-qualify for free online.   Or call 877-721-0047.  We have clinic locations in Encinitas, Long Beach and Irvine.

Marijuana (Cannabis) and Cystic Fibrosis; A Case Study is a post from: Medical Marijuana Blog

For patients who are unaware of cannabis and its effects on decreasing pain and inflammation this is a very exciting discovery.   In the mid 1980’s scientist discovered that the human body contains two specific types of receptors which cannabinoids bind to in the body.   They are primary located in the nervous and immune systems.  As a result of medicating with the plant patients almost feel an immediately relief of their pain and joints become inflamed.

The reason why I think patients should give cannabis serious consideration is because it is very safe when compared to many of the NSAIDS (non-steroidal anti-inflammatory drugs) such as motrin and tylenol.  NSAIDS can cause ulcerations in the lining of the digestive tract and as a result many patients have developed bleeding which can potentially be life threatening.   Tylenol can also be very toxic to your liver.    Cannabis does not have a negative affect on any of the major organ systems (if vaporized)  and is easily tolerated.    Typically patients can vaporize a small amount prior to going to bed and they end up getting a very restful sleep and wake up feeling much more rested and pain free.

For more information on cannabis and how it can help you please visit our website at www.MCSoCal.com  Dr. Sean Breen specializes in discussing the benefits and risks of medicating with cannabis with patients.  His offices are located in Long Beach, Irvine and Encinitas.

Treating Arthritis With Marijuana (Cannabis) is a post from: Medical Marijuana Blog