Medical Cannabis & Intractable Pain: Josh's Story

When Josh of Woodbury, Minnesota was 19, doctors found a blot clot; he was hospitalized for several weeks and put on blood thinners. Following his stay in the hospital, he developed venous ulcers on his feet from damages to his veins. Josh underwent multiple surgeries—including skin grafts—that were unsuccessful in removing his ulcers or bringing him the relief he deserved.

For nearly a decade, Josh lived in constant pain. His daily routine revolved around the meticulous care of his wounds and ulcers and managing his pain levels. A restful night’s sleep was rare; he only managed to sleep for 2 to 4 hours at a time. Half-way through the day his pain would start to increase and by the end of the day his feet were so swollen he would have trouble taking off his boots. Josh likens the pain to having barbed wire wrapped around his feet that was heated with a blow torch; the pain he felt on the side of his leg was like having glass jammed into it.\

Josh was prescribed a lengthy list of pills, including opioids, which brought only minute levels of pain relief and riddled him with a number of side effects, including digestion issues. Other treatments Josh tried consisted of: medical ablation (which was done approximately 10 times), compression socks, air socks, elevating his legs above his head and blood thinners. None of these treatments were successful.

He was told by one physician that he could not be helped, so he looked for care elsewhere.

When one of Josh’s physicians recommended medical cannabis as a treatment option, he was apprehensive. Exhausted and in need of relief, Josh was considering amputating his leg before trying medical cannabis. With the encouragement of his physician and friends in other states who had either experienced or witnessed healing from the medicine, he decided to try it for 2 months. He made an appointment at LeafLine Labs in Saint Paul; it was his last resort.

Within the first week, he began to experience the relief he had been in search of for nearly a decade. He had a surge in energy, he was able to lower the number pain pills he was consuming right away, and was able to sleep for a full 8 hours for the first time in months.

“Luckily, I have seen real healing ever since starting medical cannabis. I never saw that before,” Josh says.

Now, he can focus better. He has been able to get back to the gym and in the last 6 months has lost 60 pounds. He eats regularly.  Josh still takes muscle relaxers and medications for his veins, but has been able to completely ween of all opioids. He feels better in his own body, more alive. His quality of life has drastically increased since he began using medical cannabis, and for the first time in years he has a renewed sense of hope for the future. Both Josh and his wife are eager to continue seeing him make progress and heal.

“…It’s life changing. When you are in a lot of pain, you look at everything with doom and gloom,” Josh shares, “When you are not in pain, there is a lot more joy and happiness. Life is easier.”

Medical Cannabis & Cancer: Amy's Story

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On June 1, 2016, Amy’s life—and all of her loved ones’ lives—changed forever; she was diagnosed with stage 4 metastatic breast cancer.

Amy—a wife, loving mother and entrepreneur who enjoys eating the incredible food made by her wife—lives in Saint Paul, Minnesota. She has started 2 businesses with her wife: Lucille’s Kitchen Garden and Midwest Pantry.

The first 6 months of treatment were especially trying not only physically, but mentally and spiritually as well. Amy took “really hard, tough” drugs, as she describes, and the chemotherapy would confine her to bed for 5 to 7 days each time. Throughout, she found herself anxious, nauseous and sleeping the majority of the time.

Although the combination of chemotherapy and steroids reduced the size of her tumor, it also destroyed her body. A torn rotator cuff left Amy with a limited (at best) range of motion in her shoulder and constant, excruciating pain. After 4 agonizing months of searching for a medication that would bring her relief with no avail, she was admitted to the hospital. Even once she was admitted, Amy went through trial after trial of opioids to find the one that worked best for her body before she could be released.

Having followed the industry and hearing stories of success from friends in her community, Amy inquired with her social worker and palliative care staff about medical cannabis as a treatment option. Once she received approval of her physician and was added to the state registry, she got her confirmation on a Friday and the next Monday she met with a pharmacist at LeafLine Labs.

Now, Amy has gone from taking 17 pills per day to only 4. Chemotherapy no longer robs Amy of precious time spent doing things she loves with the people she loves, like taking vacations to Costa Rica—which would not have been realistic before she began treatment with medical cannabis.

According to Amy, her experience with LeafLine Labs and medical cannabis has been very positive and amazing. She appreciates the kindness and willingness to help from the staff at her patient care center. The medical cannabis not only helps her with side effects of chemotherapy and the pain that comes with her diagnosis, but with her anxiety, depression and PTSD as well. “…this has been a life saver for me and has raised my quality of life,” Amy shares, “I appreciate the simplicity of the cannabis with no side effects.”

Last summer, she was in such a fog from the chemotherapy that she doesn’t remember much of anything that happened. This past summer, medical cannabis helped to ensure that Amy could function in comfort and enjoy time cooking with her wife, playing with her daughter, and enjoying life’s little pleasures. She has her life back, she claims. She has finally found relief.

Pharmacists' Role in the Minnesota Medical Cannabis Program

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Unlike most other states, Minnesota’s Medical Cannabis Program is overseen by the Department of Health and mandates that MN licensed Pharmacists meet with patients to develop a plan of care.  Product selection and dosing are determined by the Pharmacist in consultation with the patient.

Whether you are a prospective patient or you are simply curious about the patient experience at LeafLine Labs, we have consulted with our Pharmacy Team to provide insight on the role of pharmacists in the Minnesota medical cannabis program.

When you first come to a LeafLine Labs Care Center, you will meet with a Patient Care Coordinator to fill out initial paperwork. A Pharmacist then conducts an Initial Consult, which can last 30-45 minutes. As part of the Initial Consult, Pharmacists gather information from you (or a caregiver/guardian). We discuss past medical history, all current medications including other cannabis use, current and past diagnoses, any treatments for your qualifying condition, as well as other conditions or symptoms presently of concern. We screen for elements in past or current history that may warrant special consideration in LeafLine Labs medication therapy initiation, such as drug interactions or other medical conditions. Information you provide to the Minnesota Department of Health on a Self-Evaluation Survey is incorporated into our internal LeafLine Electronic Health Record, and reviewed with you.

After a thorough consultation, you and the pharmacist agree on an initial plan of therapy designed to meet your goals for symptom relief.  We educate you on all aspects of how to use your new medicine, as well as what to expect for effects and side effects. You will purchase your medicine at the end of the consult, right from the dispensary in the Care Center.

Generally, we like to see you for a Return Consultation after about 2 weeks of using Medical Cannabis, so we can “fine tune” the medication plan to best help you.  From there, you and the Pharmacist have an ongoing relationship for follow-up consultations and dosing adjustments as needed.

Medical Cannabis, Fibromyalgia, & PTSD: Kim's Story

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For Kim of Benson, Minnesota, it happened all at once. In the early winter of 2015, her father—who she adored—passed away and along with him, the remainder of her support system. She was devastated. Shortly after, she was diagnosed with shingles which took the chronic, widespread pain she lived in every day from fibromyalgia and multiplied it; the pain was horrific.

Kim, who has 5 dogs, 7 cats and several other four-legged friends (as well as two-legged), has been an animal lover since day one; when she was younger, she did not have dolls—she had pets. Raising and taking care of animals is a passion she shared with her father. She also loves to spend as much time outside as possible when she’s feeling up to it.

Kim was diagnosed with fibromyalgia back in 1996 and in 2015 when the shingles came, a pain she never could have imagined accompanied it. Although the rash from the shingles virus only lasted about 2 weeks, Kim suffered permanent nerve damage that she will live with for the rest of her life. She tried every solution her doctor recommended—from anti-seizure medications, to opioids and topical medications—but nothing worked. “I tried all of the heavy stuff, and it didn’t touch it. It didn’t even touch [the pain].”

In January 2017 when the pain was so excruciating and debilitating that she had to give up the deer she and her father had raised – all 43 of them – she felt as though she had nothing left to live for; there have been many days when the pain led to her question whether she wanted to live any longer.

“It’s very emotionally painful as much as it is physically painful. People just don’t understand [my situation],” Kim says, “…Take something that you’ve lived for and then never do it again. I don’t know how else to explain it.”

Once Kim’s doctor recommended she look into medical cannabis, she did not hesitate; medical cannabis was her last resort. Once her condition had been certified and she was added into the state registry, she made an appointment at LeafLine Labs.

It took approximately a month for Kim to find her therapeutic dose but now that she has, she has started to feel better than she can ever remember—that’s how long she has been living in pain.

“It’s a necessity is what it is now,” she explains, “To me, it’s no different than somebody that needs heart medication. If you don’t take this, you’re going to die.”

Before medical cannabis, she describes her quality of life, on a scale from 1 to 10, at 1. Now, with medical cannabis there are days where she feels so good, so normal, that she forgets to take her dose. She has been able to stop taking all of her prescription pain killers and is now free of all the side effects that came with them.

“I don’t even take Aspirin or Ibuprofen [for the pain]. At all,” she shares.

Kim feels as though the medical cannabis helps to relieve all pain from the nerve damage caused by shingles and she has yet to experience any side effects from her medicine. She truly believes that if her parents had been able to use medical cannabis when they were sick that their quality of life would have been drastically better before they passed. Medical cannabis helps Kim to care for her pets, spend time outside, and navigate her days in comfort; the relief she experiences gives her hope for the future.

Medical Cannabis, Intractable Pain, & PTSD: Kristina's Story

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For Kristina of St. Cloud, Minnesota, her diagnoses of PTSD, Fibromyalgia, and a traumatic brain injury (TBI) brought a wave of relief for her and her loved ones. For decades, she did not know what was wrong with her; numerous doctors told her she was perfectly healthy and test results seemed to tell the same story.

Growing up, Kristina experienced bullying and harassment that eventually caused her to block out any memories of her childhood before age 10. When she was in high school, she started seeing a counselor to help her work through the feelings she was experiencing. Unfortunately, counseling was unsuccessful in bringing relief and as alternative treatment she was introduced to antidepressants.

During the decades before she was diagnosed, she was prescribed more pills than she could count from her psychiatrists and pain specialists, though the pain relief she experienced was not nearly significant enough to outweigh the side effects. In 2004 while taking her three children for a walk, Kristina and her family were struck by a distracted driver. Luckily, there were no fatalities, but Kristina and her youngest son sustained TBIs—both of which were not correctly diagnosed until years later.

Come 2011, Kristina was diagnosed with PTSD and it wasn’t until 2013—nearly 10 years after being struck by a car—that she was diagnosed with Fibromyalgia (which they believed was in-part due to PTSD) and a TBI. Putting a name to her conditions meant being able to pursue a more targeted treatment regimen, but her health care practitioners continued to prescribe pills—she overdosed several times.

When Kristina inquired about medical cannabis as a treatment option, her neurologist at a major health care system in St. Cloud refused to continue seeing her. This sent her into a dark spiral of depression and she embarked on a year-long journey to find a physician who would certify her for the medical cannabis program. There were times when she believed taking her life was the only way to find relief from her own thoughts and pain.

As she describes it, she lost herself. Kristina was in a constant fog. She was confined within the walls of her home, unable to participate in the world and to be the mother her children needed and she so desperately wanted to be. She could not put on makeup, shower, do the dishes, or even wear shoes because of the pain flares that come with Fibromyalgia. When she was able to muster the strength and will to attend family events, she would be bed-ridden and recuperating for weeks at a time afterwards.

Exhausted and in dire need of something that would improve—and quite frankly save—her quality of life, she was able to find a physician who would certify her for the medical cannabis program in December 2016. Once approved in the registry, she made an appointment at LeafLine Labs.

Although her qualifying condition was intractable pain, Kristina shares that she has seen the biggest improvements with symptoms related to PTSD. She is appreciative of how willing the pharmacists at LeafLine Labs are in treating all of her conditions, not just those that qualified her for the program.

Once she began using medical cannabis, it took about 10 weeks for her to be weaned off her pain medications and 5 months until she was off everything, including the medications she was prescribed to treat PTSD. “It was really hard,” she admits.

She felt like giving up many times due to withdrawals, pain and a racing heart, but she remained persistent and patient. Kristina’s loving husband, Byron—as well as her family and friends—were and continue to be supportive, compassionate, and understanding of her journey toward an improved quality of life. Today, she isn’t entirely healed and still must deal with symptoms from her conditions, but both she and her husband agree that her progress has been life-changing.

Kristina is now off of all pain killers and prescription pills she was prescribed for PTSD, Fibromyalgia, and her TBI. Not only is she willing, but also able, to leave her house again. She can do the dishes, put on her makeup, and wear shoes—at least for much longer periods than before. When she is able to attend family events, she can recuperate much faster and isn’t confined to her bed for weeks at a time. “I feel like myself once again,” Kristina says.

Before medical cannabis, she says she had no quality of life at all. Now, each day her quality of life is, on a scale from 1 to 10, anywhere from a 9 to 10. As for her pain, which used to be a 9 or 10 on any given day, it has been reduced to a more manageable range of 1 to 3.

Most importantly, Kristina can once again be a mother to her children. She can take her youngest son, who has been diagnosed on the autism spectrum and who has a fear of dogs, on walks outside. “I found myself. I’m back,” she gushes.

Last year for prom dress shopping, Kristina’s daughter was accompanied by her aunt because Kristina’s conditions prevented her from comfortably leaving the house. This spring, Kristina is overwhelmed with joy that she will be able take her daughter shopping to find the perfect prom dress; she attributes this monumental mother-daughter-first to medical cannabis from LeafLine Labs. Kristina, her husband, and her support system of friends and family are hopeful and excited to see what progress will be made as she continues to use this safe, natural medicine.

Medical Cannabis, Migraines, & Cluster Headaches: Mike's Story

“It feels like someone is pushing your eye out,” says Mike of Lakeville, Minnesota, on describing the pain he endures from cluster headaches. “Don’t worry, my condition isn’t contagious,” he jokes.

Mike is a husband, a father of two beautiful daughters and two dogs, and an avid runner. He has lived with vertigo off and on for most of his life, but it wasn’t until August 2016 that he started to experience excruciatingly painful cluster headaches and migraines. Once he was diagnosed, he spent most of the first four months confined to dark rooms, head on ice, with oxygen tanks ready at his side to help bring down the pain.

In the following months, Mike experienced cycles of pain so extreme and debilitating that he could no longer work or carry on with normal day-to-day functions. To treat the pain, Mike’s physician prescribed him Verapamil. Although the medication was very effective, he experienced low blood pressure and a low heart rate and it often left him feeling out of breath. Mike attempted to lower the doses he was taking, but the headaches would get worse each time. Looking for another option, his physician recommended he try Topamax—a ‘nasty, nasty’ drug as Mike describes it, “It’s almost like you’re on heroin walking around,” Mike says, “it really dumbs you down.”

Other prominent side effects from his medications included slurred speech, tingling throughout his entire body, fatigue and a foggy state of mind.

When Mike’s vertigo was at its worst, he decided to pursue self-medication. As an alternative to smoking—he didn’t care for the way it made his lungs feel or some of the other side effects—he began to make cannabis tea. When the tea helped, it would bring his pain and nausea, on a scale from 1 to 10, down from 8 to 4. “That’s the difference between being stuck in bed or being able to go out and cut the grass,” Mike explains.

The issue with making his own tea was that he was never quite sure what he was getting—what chemicals or fertilizers were used or what combinations of compounds were in the cannabis. Sometimes, he would have one cup and he would experience just the right amount of relief; other times, he would have one cup and would be over-medicated and confined to bed—the outcome he was trying to avoid in the first place.

Looking for more consistency and reliability in his pain management with the cluster headaches, Mike decided to pursue enrolling in the Minnesota medical cannabis program. In search of more information before making an appointment, Mike called LeafLine Labs. He remembers everyone he spoke to as helpful, professional, polite and kind, which gave him the confidence he needed to make his decision. He scheduled an initial consult with a pharmacist at LeafLine Labs.

Today, Mike’s pain generally ranges anywhere from 3 to 5, rather than 7 to 9. On his best days, medical cannabis helps to dull the pain from 2 to 3—which in Mike’s book is considered 0. With 3 on the pain scale, Mike can still do work around his home or spend time with his family, rather than being out of commission and unable to participate in his own life. The other benefit that Mike enjoys with the cannabis is the ability to sleep. When the headaches were at their peak he was sleeping 2 to 3 hours per night. He now regularly gets 8 hours. “The cannabis, it’s been huge. It’s just been huge,” Mike says, “It didn’t cure me or anything like that, but it suppresses the pain… Cannabis is one of my tools in this fight.”

Medical Cannabis, Muscle Spasms, Intractable Pain, & PTSD: Ed's Story

Meet Edmund (Ed), a Marine veteran, husband, father, grandfather, and patient at LeafLine Labs. Ed is a medically retired VA Field Examiner who enjoys hunting, fishing, gardening, and spending time with his wife and two dogs. Ed has been diagnosed with various forms of intractable pain, muscle spasms, and PTSD.

For decades, Ed lived with excruciating pain from a service-related injury (USMC 1979 to 1993), in his neck (cervical spine) and his lower back (lumbosacral strain). In the past, he was only able to sleep four to six hours a night because of constant neck pain or numbness in his arms—which started as radiculopathy and progressed into serious pain over time. In addition to his pain, he began to develop knots half the size of a fist on either side of his low-back which was extremely uncomfortable and painful.

Ed decided to undergo neck surgery in 2008, which was not a success, and had subsequent cervical fusion in 2015, which was also unsuccessful. Ed also had surgery on his lower back in 2012, to no avail. Treatment that followed was conservative, including pain meds when needed, anti-inflammatories, and physical therapy - but these all simply masked the pain, rather than address the underlying reason for it.

With his traditional methods of treatment not providing relief or the results he desired, he decided to research and then enroll in the Minnesota Medical Cannabis Program. Since his first appointment at LeafLine Labs, Ed has been able to drastically improve his quality of life with the help of medical cannabis. Edmund says that he has found 70-80 percent relief from muscle spasms in his back and that, “As for my back resolution, with regards to pain, that’s all gone! I’m able to get up and get around and do things I couldn’t do before. There is benefit [to this medicine]. I’ve seen it. I feel it. What more can I tell you?”

Medical Cannabis, Tourette Syndrome, & Autism: Kyle's Story

Just before turning 3, Kyle Jr. was diagnosed on the Autism spectrum. Within the last year, Kyle, who turns 8 this summer, was also diagnosed with anxiety, ADHD, and Tourette Syndrome. Having tried 8+ different medications that either caused too many side effects or had no effect at all, his parents felt a wave of relief when they found out his Tourette Syndrome diagnosis qualified him for the medical cannabis program in Minnesota; they were out of options, and they so badly wanted to find relief for their eldest son.

Almost entirely non-verbal, Kyle Jr. would often get frustrated when he wasn’t able to communicate what he wanted or how he was feeling. “He was so angry all of the time,” his mother, Kassidy, remembers.

Sometimes, he would harm himself or others. The constant tics in various forms paired with anxiety and aggression left Kyle with little quality of life. Before medical cannabis, Kyle Jr. spent most of his time on the couch—playing or interacting with others was a rarity. Aside from bathing, there were few times he willingly left the couch—it was his safe spot. When he would leave, he would need to have someone’s hand to hold for even the simplest of tasks, like going to the bathroom. Car rides were hard, and going to the grocery store or any other kind of shopping was nearly impossible to do as a family.

Kassidy was pleasantly surprised at how quick and simple it was to complete the enrollment process and become a caregiver for Kyle. Once certified by a health care practitioner, it was only a matter of days until Kyle’s first visit at a LeafLine Labs patient care center. His family began to see a difference within days of his first dose of medical cannabis.

Today, 7 months after adding cannabis to Kyle Jr.’s health care regimen, his parents are astounded at the difference the medicine has made in not only his life, but their entire family’s. Kyle Jr.’s therapy team, dentist, and primary care physician have all remarked at the improvement in his behavior; during his last appointment to the doctor, he went with the nurse by himself for the first time to have his height and weight checked. His communication skills are vastly improving, he’s learning new letters and words, and he’s beginning to ask questions. His tics are less severe and less frequent. Harming himself or others is now rare. He plays. He smiles once again. He’s calmer. Most importantly, he’s joyful.

Kyle’s parents have a renewed sense of hope and are excited by the enormous impact and continuous improvements of medical cannabis on their son’s health and wellness. Kassidy wishes more people understood the benefits of medical cannabis. “It is medicine. They’re not getting high. They’re not getting drugged. There are pretty much no side effects… It’s safer [than other medications],” she says.

Medical Cannabis & Intractable Pain: Randy's Story

In 1989 while serving in the United States Navy, Randy sustained an injury along his cervical spine from C1 to T4. On September 21, 2016, Randy re-injured his cervical spine while undergoing a patient transport that lacked the proper ventilation equipment. His injuries eventually led to marrow edema from C1 to C3. He also developed degenerative disc disease and degenerative arthritis throughout the entirety of his cervical spine, which are both now progressing down into his thoracic spine into T4.

Before medical cannabis, Randy describes his quality of life as non-existent. The multitude of narcotic drugs used to treat his chronic pain robbed him of the ability to breathe on his own, forcing him to use a ventilator while sleeping due to central sleep apnea caused by the Oxycodone. On a scale from 1 to 10, his pain ranged from 7 to 10 and he was sick to his stomach constantly. He would spend his days sitting in a neutral position, moving as little as possible, to subdue his nausea. More often than not, he would go several days at a time without eating, and driving a car was out of the question. At one point, he was taking over 500 pills per month.

Wanting to find a more natural, sustainable path to relief and diminish his long list of prescription medications, Randy decided to enroll in the Minnesota medical cannabis program. Once he found a physician to certify his condition, he found the process to be much easier than he had initially imagined.

Now, his pain is finally under control and he rates it from 3 to 5 rather than 7 to 10. Randy has been able to eliminate Oxycodone, Etodolac, Nortriptyline, Venlafaxine, Tizanidine, Methocarbamol, Cyclobenzaprine and Lisinopril. Aside from an inhaler and allergy medications, he is free of pain killers and prescription medications. His blood pressure is down to a healthy level and he has been able to lose a healthy amount of excess weight. He no longer has central sleep apnea or peripheral pitting edema in his extremities and his obstructive sleep apnea seems to be going away. Finally, Randy feels as though his body is working the way that it was meant to and beginning to heal itself.

“Marijuana has saved the life I was given,” Randy says, “The horror stories are wrong… it’s definitely worth trying.”

Minnesota Medical Cannabis Program Annual Recertification and Enrollment

As a participant of the Minnesota Medical Cannabis Program, each year you must have your qualifying condition recertified by a Minnesota licensed physician, physician assistant (PA), or an advanced practice registered nurse (APRN) and pay the enrollment fee if you wish to continue to participate in the program.

Here’s what you need to know:

  • As a patient or caregiver, you must resubmit a copy of the certification from your health care practitioner on a yearly basis. Your recertification must be dated within 90 days of submission.
  • Recertification requires an in-person office visit with a health care practitioner who is registered in the Minnesota Medical Cannabis Program. You may recertify your condition up to 90 calendar days prior to your enrollment expiration date.
  • Your enrollment expiration date is based on a rolling year calendar that starts on the day you receive your acceptance e-mail into the program.    
  • You will receive a recertification reminder email at both 60 and 30 days prior to your enrollment expiration date.
  • If you complete the condition recertification and enrollment process prior to your annual enrollment expiration date, you will be automatically reenrolled on your yearly enrollment anniversary date. You will receive an approval e-mail confirmation once your reenrollment application has been reviewed by the Minnesota Department of Health.
  • If you are an approved caregiver in the Minnesota Medical Cannabis Registry, you do not need to complete any type of recertification or reenrollment. Your caregiver’s status is active, as long as the patient in your care is classified in the APPROVED status in the Registry.
  • If you do not complete the recertification process along with your payment before your annual expiration date, you will not be able to visit a Patient Care Center (PCC) or purchase medical cannabis. If you are listed as expired, you must complete the recertification and enrollment process and receive an approval e-mail from the Minnesota Department of Health before you can visit a PCC or purchase medical cannabis.

Questions about the annual recertification and enrollment process? Please comment below, call one of our patient care centers, or send an email to info@leaflinelabs.com.

How to Talk to Your Doctor About Medical Cannabis

Minnesota Medical Cannabis Program Background

In Minnesota, we have established the most rigorous and “medical” law to date. There is no smoking in the program, and we do not classify our medicine by cheeky strain names. We also do not keep plants in jars. All medicine is created using a pharmaceutical process and is independently tested following state mandates. Licensed pharmacists who are trained experts at cannabinoid dosing are responsible for determining the best combination of medical cannabis types and forms, as well as dose amount. Pharmacists can coordinate with doctors to keep everyone on the same page.

A prominent problem patients face is that most doctors are not even aware of the state program’s details (or even that it exists at all). Many doctors do not see cannabis as truly medical, and they still believe that “medical” is just a code word for legalization.  Few know that cannabinoid preparations were the second most prescribed pharmaceutical in the late 1800s, or that the American Medical Association (AMA) advocated for keeping cannabis a medicine just 80 years ago.

5 tips of Advice from Gary Starr

As knowledge is power, we consulted our Chief Medical Officer, Gary Starr MD, to compile a list of advice and resources to educate and empower you in preparing to have this crucial conversation with your doctor.

  1. “Your doctor is likely not aware of the benefits of medical cannabis. Medical school and residency have not included medical cannabis in the curriculum.  Your doctor’s viewpoint is more likely influenced by decades of political rhetoric. Once you find a doctor you trust, ask him or her to objectively and compassionately learn about how medical cannabis is an option for you and may improve your quality of life. You’ll need to guide them towards the educational resources they may be unaware of (see the list provided below).
  2. Be scientific. Know your data, your disease process and the way that medical cannabis has been used to treat it, and the research studies that support your point (don’t be afraid to bring them with you.)  Patients with the most success in managing their complex diseases and symptoms tend to be scientific about their disorders, even if they use alternative medical therapies too.
  3. Most doctors speak in terms of data. There are many doctors who do not believe there is any data to support the use of medical cannabis.  That is because, as explained above, they often don’t know that this data exists.  They learned to say “there’s no data” from someone who learned the same words the same way before them.  It’s likely going to be up to you to introduce your doctor to the data (see #4).
  4. Gently educate; raise the medical cannabis topic after you have developed a good flow to your conversation. Be kind and personable.  Doctors often do not react well to patients “telling them” how to practice medicine.  This may seem unfair when they do not know anything about medical cannabis, but it is your health and wellbeing, so it is up to you to use good communication strategies that work.  Many doctors will be willing to listen to your data and take an interest in learning more if you present it to them in the right way.
    1. Stick to your point. No matter how kind you are, your doctor is still only able to give you 10-15 minutes of time before their next patient.
    2. Tell a story.  Do not just list all of your symptoms. Talk about your illness and how you’ve attempted to treat it.  Discuss how this has made you feel. Remember, you are a patient who needs care, not a customer expecting to get the item you came to buy.  
    3. Discuss your goals. Consider using other local patient success stories to illustrate your points, but be clear and prepared to discuss how and why you feel medical cannabis is appropriate for you specifically. In Minnesota, the state’s registry data has recently been published, showing a majority of patients realizing benefit with medical cannabis treatment. Bring this data and other supporting studies and summaries with you to give to your doctor.
    4. REFRAIN from using recreational cannabis terms to argue your point. AVOID using data from sources on the web that focus on plant strains or different ways of experimenting with cannabis dosing.  Unless your doctor is already supportive of this, it is very likely that this will decrease your credibility.  Most doctors are not impressed with uncontrolled, federally persecuted, smoked plant matter as a medicine.  Do not try to get them to speak that language.
    5. If you can, highlight how one of your goals with medical cannabis is to decrease the use of other medications which cause worse side effects and are not working well for you, such as opiates for treating chronic pain. One thing many doctors are afraid of is “drug seeking”.  If you discuss your desire to decrease opiate or other controlled medication use, it greatly diminishes the fear of “drug seeking”. This will get their attention.
    6. Know the law in your state backwards and forwards. Bring printed material to walk your doctor through the process (see below). Many doctors are afraid of the topic and do not realize they are not writing any prescriptions. They may be unaware–in Minnesota specifically–that another licensed medical professional (pharmacist) is educated in dosing cannabinoid based medicines along with your other medications.
    7. Bring a friend or family member to your appointment. He or she can be your advocate. Whoever you bring should have the same knowledge (see above) as you so he or she can help you keep the discussion focused and on track.
    8. Know the facts about medical cannabis safety, addiction risks, and limitations. Acknowledging these points in your discussion may increase your credibility on the topic.  Doctors are often suspicious of anything that has “no bad side”, so being honest and knowledgeable about a treatment’s negative aspects will help them hear you and at the same time probably teach them something.
  5. If your doctor continues to object to the discussion, or is against certifying you for medical cannabis use, you may be prepared for some “say-it-like-it-is” arguments.  Try to avoid using these unless it seems like a little extra nudge is needed. For example:
    1. “If I was dying…” Your doctor is your best advocate for helping you heal with compassion.  If they would certify you if you were “dying”, why are they holding back as you try to live?  Where is the line?  How close to dying is “ok”?  Many doctors will not have thought through this and it will make them begin to consider it.
    2. “Would you refer me to…”.  There are a lot of things some doctors do not believe in personally, but they would not prevent you from trying. If your doctor had to refer you to an acupuncture therapist before you could see them, would they refuse? …even if they didn’t understand how acupuncture therapy works? In general, most doctors would not refuse this even they did not know anything about acupuncture. Why actively refuse to certify you as eligible to use medical cannabis, then? Any response to this question either highlights their moral objection (which is not sound medical practice), their lack of knowledge (back to the top), or their fear of legal risk (lack of knowledge).

I encourage you to use some of the following resources to prepare yourself.

Be well,

Gary Starr, MD & Chief Medical Officer at LeafLine Labs

Resources

State Law Resources

http://www.health.state.mn.us/topics/cannabis/rulemaking/index.html

Patient Checklist

https://static1.squarespace.com/static/5923984ce3df28823044715d/t/59494e5336e5d3af64ba27b2/1497976404530/HCP_Checklist+.pdf

Minnesota Office of Medical Cannabis Data

http://www.health.state.mn.us/topics/cannabis/about/stats.html

Medical Cannabis Deliver Methods: Tinctures

At LeafLine Labs we offer medical cannabis in a variety of forms, intended to help patients obtain the relief they seek in the most efficient way possible. One of these options is a tincture.  In the simplest definition, our tincture is a mixture of cannabis oil and alcohol. Tinctures are one of the easiest cannabis products to use without any combustion, smoke, or even vapor.

Our tinctures are available as drops or sprays that are placed under the tongue.  This type of absorption is referred to as “sublingual”. Sublingual absorption results in a much quicker onset of effects than ingestion because the cannabis bypasses the GI-tract and the liver, entering the bloodstream directly through the lining of the mouth. Oral ingestion will take anywhere from 1 to 2 hours for effects to be felt, whereas sublingual absorption may be as quick as 5 to 10 minutes.

We can provide tinctures in two different formulations, Tangerine and Heather.  Tangerine is our high-THC product with a small amount of CBD. This has proven beneficial at reducing or eliminating pain, nausea, and stress while also helping to stimulate appetite and sleep. Heather is a 1:1 product of THC to CBD. In addition to those benefits mentioned previously for THC, CBD has also been shown to relieve both inflammation and pain.

Tinctures are one of several delivery methods LeafLine Labs has to offer to help patients find the best medicinal cannabis for them. What delivery method(s) have you found work best for you? Comment in the section below with your answer.

The Minnesota Medical Cannabis Program: Setting a Gold Standard

Minnesota’s Medical Cannabis Program is unique - but how, exactly? To help break it down, we’ve compiled a list of components that sets the program here in Minnesota apart from those in other states.

No smoked or ingested plant

LeafLine Labs processes plants into botanical extract-based medications.  Doses of cannabinoids (THC and CBD) are formulated, standardized and tested. Medications are formulated based on researched cannabinoid and terpene data, not simply strain-based, user-experience and marketing lingo common in Colorado, Washington and other locations where smoked cannabis is most common. Here, each medication is the same every month and can be dosed accordingly.

Lab tested medication

A third party independent lab tests all medicine to ensure quality and consistency of medications, just like other pharmaceuticals.

Professional medication therapy management

Minnesota Licensed Pharmacists educated in medical cannabinoid therapy and dosing provide care for patients at every LeafLine Labs Care Center. They are specially trained and responsible for objective dosing with our various medication forms, and they are able to adjust dosing and pharmaceutical management based on a patient’s other medications and disease processes.  They can then coordinate with their patient’s physician, similar to the team-based pharmacy approach utilized in most hospitals.

All Medical Cannabis patients are in the state’s research registry

Minnesota is the first state to focus on capturing data related to all patients enrolled in the Medical Cannabis Program. The registry also functions as a checks-and-balances system to ensure patients are only receiving the medication amount that the pharmacist has approved.

Physicians (Health Care Practitioners) certify that patients have qualifying conditions, but aren’t responsible for “recommending” Medical Cannabis

Just like in the hospital inpatient or emergency department setting, physicians provide a patient’s overall medical care but coordinate with the licensed pharmacist who calculates the complex dosing and titration of this unique medicine. In Minnesota, patients must continue to see their physician in order to stay certified in the program which ensures close follow up.

Questions? We’re here to answer them for you. For more information about LeafLine Labs and the Medical Cannabis Program in Minnesota, visit our website here: http://leaflinelabs.com

My Medical Cannabis Story: A Letter From Lee

Hi,

First and foremost I want to thank everyone at LeafLine Labs for all of your life changing work you do. It is not just a job, a task for you, but a mission to help people live with less pain and more happiness.

A few weeks before I had my first dose of Heather, I was in constant pain. I suffer from severe and persistent muscle spasms, extreme pain from spinal stenosis and nerve damage. I also have fibromyalgia and was not having any luck with a variety of prescription medications. I have two beautiful little girls and I was no longer able to hold them without pain and almost immediate intense spasms. Due to narcotic pain meds, I started retaining urine and had to use a catheter. At 33, this was a crushing moment for me. I started to think about my future and what was in store for me. Was this my life going forward? NO! I refused to take 30+ pills a day to get minimal relief. I did my research and decided to pursue getting registered. I was very apprehensive and was worried about what my family would think. Within an hour of my first dose, my back spasms were gone! My pain had decreased from a 9 to a 3! When I told my family they were not only happy for me but very supportive. With a few consults with Ethan, we added the Tangerine for nighttime use and I have never felt better. I owe LeafLine Labs a lifetime of gratitude. I ask those who are hesitant about medical cannabis to do some research on how it is used in Minnesota. You will find that it is a very structured program and has actually helped many many people suffering from life crippling conditions live a much happier life. Thank you, LeafLine Labs! You folks are amazing!

Regards,

Lee

Medical Cannabis & Tourette Syndrome: TJ's Story

Meet TJ, an active 12-year-old boy who loves riding his bike, sports, and legos. In October, we had the pleasure of meeting TJ, his family, and their many furry friends - including a rabbit named Bunny Sanders. TJ is the youngest of four siblings.

TJ has a variety of medical diagnoses, including Tourette Syndrome. Due to constant physical and verbal tics, it was difficult for TJ to be in a classroom, play sports, or even relax. At times, the repeated movements from the physical tics would cause him extreme pain.

In 2015 when the Minnesota medical cannabis program began, TJ was enrolled and after consulting with a pharmacist at LeafLine Labs, started to take the medicine - his life changed completely. He went from 20-30 tics a minute to 20-30 tics per day, and also saw an incredible change in behavioral issues caused by his other diagnoses.

Today, TJ often goes months at a time free of tics. Although the medical cannabis is not a cure for his Tourette Syndrome, it has vastly improved his quality of life, as well as his family's, and has helped TJ find relief from pain.

Intolerable vs. Intractable: A Medical Cannabis Patient’s Story

On August 1, 2016, Ralph became the first patient in the Minnesota Medical Cannabis Program to meet with a pharmacist to treat Intractable Pain. Since beginning treatment with medical cannabis, Ralph has seen an incredible improvement in his quality of life, while his pain has decreased significantly. Here is Ralph’s story:

“As a never before cannabis user (I was already a Dad in the 60s), I bought into the “counter-culture” reputation of marijuana, and didn’t have it on my radar when I became a victim of intractable pain in my eighth decade. Differentiating “intractable” vs. “intolerable” is important because after post-surgical pain never resolved, shingles complicated the healing, and opioids never really eliminated my pain, I continued to slog through days of what I call “functional discomfort.” The pain was always there, dragging me down, and though I could get through the days “tolerably”, I never felt like more than 50% of me was participating in the life I had known. Unable to sleep due to the pain, the opioids only knocked me out enough to doze, and kept me foggy during the day. I expected cannabis to reduce my pain and relieve me from the opioid fog, but the adjunct effects are just as profound: My sleep is much improved, my Essential Tremor is greatly diminished, my sociability is back, I can enjoy my yard work again, and my wife tells me I’m 10 years younger!

LeafLine Labs has restored my enjoyment of life. The pain management is wonderful, too!

- Ralph S.”

Medical Cannabis & Muscle Spasms: Pete's Story

Growing up, Pete LePage was always on the go; he started downhill ski racing as a five-year-old and continued competing through high school. The outdoor enthusiast lost his mobility in a 3-wheeler crash accident at age 21, yet Pete still skis (as a mono-skier), travels, leads a boy scout troop and works on over-the-road trucks as a mechanic – making the most out of every day he can.

Pete’s busy schedule means managing the symptoms related to his spinal cord injury need to be effective. “I’ve had Botox, phenol injections, massages, and acupuncture,” Pete recalls, “They all help out, but not with the same long lasting effects as cannabis.” The list of medications in addition to the therapies had side effects that outweighed the benefits the medicine was supposed to provide.

Once the Medical Cannabis Program opened, Pete signed up and made an appointment at LeafLine Labs. When he did, “I didn’t think cannabis would eliminate all the medications; I had no idea that there were so many benefits to using the cannabis. That I could wean off most of my prescriptions.”

To help with muscle spasticity, Pete uses Heather in the daytime. Before he calls it a night, Pete uses a vaporized format of Tangerine to keep muscles relaxed and sleep the night through.

The effects on easing muscle spasticity are most noticeable for Pete. In the midst of a spasm, Pete says, “You feel like you turn into concrete. Taking the edge off that, I just feel a lot lighter, I can move a lot easier, transfer to chair easier. You go about your day, and everything requires less effort. At the end of the day, I’m not worn out, exhausted, sore and beat up."

Medical Cannabis & Glaucoma: Erin's Story

After suffering a significant traumatic brain injury, Erin Delaney was diagnosed with Multiple Mechanism Glaucoma, a type of optic nerve damage with several difficult factors that make it hard to treat. With the help of her glaucoma specialist, she has explored every avenue to manage her condition’s symptoms.

Like many people managing chronic conditions, Erin’s medication list grew considerably over the years – from the prescriptions to treat her glaucoma to the medications intended to mitigate some of the side effects of her glaucoma meds, and so on. At one point Erin thought to herself, “I’m too young to be on so many pills.”

The conventional treatments weren’t as effective as Erin’s care team had hoped, and after further study the team concluded that the same brain injury that provoked the condition was overriding the treatments. A significant pressure attack brought Erin to her glaucoma specialist for a conversation about a new treatment plan. 

During a pressure attack, pressure on the optic nerve increases rapidly and dramatically, often causing headaches and nausea. Pressure attacks may be triggered by small changes in the weather or a change in the patient’s activity level.  Some glaucoma patients can tell if a pressure attack is about to happen, and take medications to forestall the side effects. Yet, in addition to the pain and nausea, there is fear: “one attack is all it takes to completely cut off circulation to the optic nerve,” Erin explained. The result would be blindness.

Once cleared by the state, Erin made an appointment at LeafLine Labs. “If you had told me two years ago that I would be on medical marijuana, I would have laughed you out of the room,” Erin said. “Like many, I thought it was just a bunch of ‘potheads’ looking for a legal loophole.” Her sentiment has since changed.

Walking through the doors for the first time, Erin remembers, “the facility itself felt like a dignified, serious clinical setting. I learned that my phenomenal pharmacist used to work with the neurologist who treated my aneurysm. His knowledge of the protocols in place and the context let me know he was ‘on it,’ which was a huge relief.” 

Erin also toured the production facilities where the cannabis plants are grown, oils extracted, and medicine crafted. Learning of the credentials and backgrounds of the lab team, Erin remarked, “I was both blown away and not at all surprised to see all of the protocols and care that go into the extraction process. They are committed to producing a product of consistently high quality.”

After considering her options, Erin decided to try the Heather vaporizer oil cartridges; a product with a 1:1 ratio of THC to CBD.

“I wanted to start light, a decision my pharmacist respected,” said Erin. “Initially I was concerned about mood alterations and possible side effects; I’ve got a 7-year-old to keep up with!”

Within a few minutes of taking Heather, Erin can feel the pressure easing. She has even measured a 7-point drop in her optic nerve pressure at her doctor’s office. Erin has been able to keep her optic pressure readings low enough on Heather to qualify for additional surgical procedures to treat her glaucoma.

Erin notes that Heather is not a cure nor a replacement – but rather it is a key component in her integrated care plan that has helped her reduce the number of her prescribed medications by 50 percent. “For treating the secondary symptoms of my pressure attacks, I now vape for nearly instant relief. Before I would have taken pills that would take time to go into effect and still leave me with stomachaches and uclers. Medications are expensive already, but add in the side effects and over time you question their true value to your quality of life.”

While her glaucoma will continue to progress, Erin is happy with her newfound relief. “I didn’t know what to expect in terms of outcomes, but I am surprised by what a difference it makes,” said Erin. “It’s an investment, but at the same time when I add up what I was paying for all my meds (even with copays), Heather winds up being cheaper. It’s less harmful to my body and definitely has improved my quality of life.”

Medical Cannabis & Cancer: Tom's Story

Shortly after Tom retired in September 2015, he discovered he had skin cancer. He immediately underwent a procedure to remove two areas, one on the side of his head and the other on his cheek. Things went well for several months, but started to take a turn for the worst in the spring of 2016. Come July, after experiencing extreme fatigue, nausea, and a severe lack of appetite for several months, Tom was diagnosed with John Hodgkins Lymphoma and was informed that his right lung was filled with fluid. Tom underwent a procedure to remove the fluid and then pursued a vigorous health plan to regain his health.

Minnesota born and raised, Tom spent the breadth of his career as a hard-working equipment operator while pursuing his passions of skiing and ski jumping (he was a member of the US Ski Team at one point in time) and performing music with his fellow band members of The Terrapin Brothers—a great group of people who love playing music together—in his free time. Before the symptoms surfaced and he was diagnosed, Tom was active and healthy; he had just begun to enjoy life as a retiree.

Within three months of receiving his diagnosis, his symptoms drastically worsened. His oncologist advised him that his next steps should be surgery to remove the lymph nodes in his chest and chemotherapy.

Having witnessed a close friend battle cancer under similar circumstances and seeing the damage that chemotherapy can have, Tom was weary of this path. Against the recommendation of his physician for a treatment plan that was homeopathic and natural. After implementing methods such as natural oils and herbs, chiropractic treatments, and maintaining a healthy diet, Tom decided to incorporate medical cannabis—his relief sky-rocketed.

Not only can he sleep through the night again, Tom can now ski, stay up late playing music with his band mates, and has noticed a remarkable increase in energy and decrease in pain. Tom describes the pain relief from medical cannabis as a Godsend, and he continues his well-rounded homeopathic treatments to help manage the symptoms of his cancer diagnosis. He attests that because of medical cannabis, those who knew Tom before cannot believe he is the same person—the medicine has improved his life that much. “Cannabis is a blessing, and the people who are trying to change the world with [this] healing plant are also very special,” Tom remarks.

Medical Cannabis & Terminal Illness: Patrick's Story

Patrick Harder of Longville, Minnesota passed away peacefully on December 27, 2016. He was surrounded by his wife and family in the comfort of his home. “He passed beautifully. He passed the way he wanted. He got his wishes, he got his miracle. I thank you guys so much for taking his pain away. I can’t tell you the relief he got…it’s huge,” Patti, his wife, reflects.

Patrick was the kind of person who didn’t have a mean bone in his body, according to his wife. He liked everyone and the only trouble he had ever gotten into was in the form of a few speeding tickets, she jokes. “He taught me patience,” Patti says, “This man was the most patient man I knew. Quiet. Gentle. Kind. Everything.”

Patrick lived for deer hunting season and farming, two of his biggest passions. He and his wife used to travel the states showing world class Appaloosa horses together. Patrick also loved to spend time with his family, ride horses, attend picnics in the summer, make maple syrup, and just about any other activity that you can do outdoors.

On April 11, 2016, Patrick was diagnosed with colon cancer. His doctor had found a tumor located between his pelvic bones, making it inoperable. The next steps suggested by his doctor were to remove his anus, colon, and large intestine and then begin a rigorous round of chemotherapy—Patrick didn’t want to take that path.

As an alternative route, Patrick began to receive cannabis in the mail from friends who lived in other states. Because he started to experience success in the form of relief, he decided to legally obtain his medicine and began the process of enrolling in the Minnesota Medical Cannabis Program.

After trying a variety of formulations from the other manufacturer in the state with less than remarkable results, Patrick decided to try LeafLine Labs at the end of September 2016. “He found his level with your medicine,” Patti says, “He never did with the other guys.”

The Harders had a difficult, uphill battle from the appointment of his diagnosis up until coming to LeafLine Labs. They were met with resistance at every step of the way, from finding a certifying health care practitioner, to dealing with hospice care, to speaking with their insurance company. “The only place we felt comfortable was LeafLine Labs,” Patti shares.

Patrick swore he instantly felt relief after trying his first doses of medical cannabis from LeafLine Lab, Patti recalls. Although the medicine was not a cure for his cancer, it helped him to live out his last several months with relief from his pain. “We had 26 years of awesome, and then 8 ½ months from diagnosis to his passing… a lot of people don’t get those 8 ½ months together,” Patti shares with gratitude.