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It All Started with a Dropped Coffee Cup

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This article features real-life stories from a cannabis patient as well as an on-the-ground cannabis nurse.

Finally getting relief with cannabis after years of battling life-changing crippling pain.

Sometimes the littlest things can make a big difference in your life. You turn your shopping cart left instead of right in the grocery store and run into an old friend. You end up in a movie theater sitting next to your favorite high school teacher and talk about the movie afterwards. Good things like that can happen—coincidences, luck, or karma. But bad things can happen too because, well, that’s life. And suddenly, your life becomes a struggle.

Take the case of Debi Wimberley (1), cannabis educator, life coach, founder, and CEO of a medical cannabis newsletter. In 1995, Debi dropped an empty coffee cup on the top of her foot. Doctors told her that the cup hit the small peripheral C-fiber nerve fibers that carry pain messages to the brain. The peripheral nervous system involves nerve signaling from the brain and spinal cord to all other parts of the body(2), which causes autonomic changes such as sweating and vasomotor abnormalities. Motor changes like weakness and dystonia, and trophic changes such as skin or bone atrophy, hair loss, and joint contractures, are all included. This nerve also controls the muscles in the leg that lift the ankle and toes upward. She experienced a shot of excruciating pain similar to an electrical shock that ran up her leg—and it never left. That excruciating pain was always there, every minute of every day, for years and years.

“I was certainly disabled and unable to work,” Wimberley said. “I had developed what they called complex regional pain syndrome (3) from the coffee cup incident. It’s called the suicide disease (4), and rightly so.”

She realized that her central nervous system had been “short circuited” from the coffee cup incident. “I developed the name for it called ‘The Princess and the Pea (5),’ because even with the CAM [controlled action motion] boot (6) on, I could feel a hair underneath my foot. I became super hypersensitive to anything. I couldn’t stand the wind if it just touched my leg or covers or anything. Everything I did revolved around protecting my leg. In the meantime, my skin had become very thin. You could just barely touch me and my skin opened up,” she said. “So, it wasn’t like I could just go out and be carefree.”

She ended up being prescribed an increasingly larger dose of Oxycontin for 20 years, up to 240 mg a day (a standard starting dose is 20 mg a day [7]). “Because of the opiate crisis, all of a sudden, my doctor decided he couldn’t come up with another alternative because he ran the risk of losing his job or his license. So, I just pretty much was left on my own,” Wimberley said.

At the time she was forced to stop Oxycontin, she was in the middle of contracting black lung disease, on top of chronic obstructive pulmonary disease (COPD), which was helped along because she was so sedentary at the time. Then she ruptured her left foot peroneal tendon, which happened when she situated herself onto a bar stool. "I had no life. I actually needed a 24-hour caregiver,” she said.

She mentioned that she did try to do lots of hobbies during that time. “I taught myself a lot of things to do in my downtime. But being able to be successful at creating something and finishing it to the degree that I would be happy with it was very hard, because I was constantly having to think past the pain of electrical shocks constantly going through my body.”

Her disability didn’t just impact her, but everybody who was involved in her life. “I lost all of my friends. It's just what happens. It’s too hard to be friends with you. I’m not one that complained about it or talked about it because I learned really early on that if you’re always talking about it, you don’t feel good. No one wants to be around you. You have to learn to bury that and when you bury it, it lives inside of you and the thoughts that go on in your head.”

Wimberley was getting increasingly desperate to end her pain. She talked to doctors about amputating her leg, thinking if they could just cut it off, maybe the pain would end. “But because my nerve damage was controlled from the brain, not from the spine, that would have never worked,” she said. “It would have been like having phantom pain all the time.”

The Cannabis Connection

Wimberley was a trained medical technologist earlier in her career and said she had worked with two amazing doctors in the late 1970s in the cancer field who convinced her that maybe she needed to try cannabis because it could be beneficial to help her pain. “They were educating me on cannabis for cancer pain, and the importance of the role that it could play, and we kept trying to get it allowed for use as an experimental thing within our clinic, which they never did approve,” she said. “I live in Arizona, and it’s actually legal here, medically, so I started exploring it and teaching myself everything I could about it.” She first tried cannabis on December 18, 2015.

At the time, she was living at a pain threshold of 10, taking her 240 mg of Oxycontin each day. Her attempt at withdrawal from the drug was difficult, she said, even after it landed her in the hospital fighting for her life, unable to breathe for herself. “So, I had to find some kind of answers.”

She then used cannabis to get off of all her opiates and is now at a pain threshold level of three.

Wimberley said that she was shocked at how much those two amazing doctors knew about cannabis, especially in light of her training as a medical technologist. “I didn’t learn anything about this (cannabis) in my medical training,” she said. “I didn’t even learn about the plant, so it was very interesting to me.”

There were a lot of patients that were trying cannabis on their own, and that was something she and other doctors knew but couldn’t talk about. “Those patients would talk about how it would relieve their pain, and at least let them be able to relax and sleep,” Wimberley said. “When I was living in that kind of pain, I could never sleep more than four hours, and it was not a good four hours.”

A New Life

Wimberley created a newsletter this year, Effective Cannabis Newsletter (ECN) (8), for anybody—such as the cannabis medical professional, educator, or coach who creates content about cannabis—to share cannabis news straight to the emails of people interested in it. “Communicating with anybody about cannabis is extremely hard, especially when we can’t advertise,” she explained. “So, I said let’s just go find the people that really want this information. And the thing I learned is that patients need education before we can even study it.”

Her medical background is what helped guide her. “Now I’m working to be a speaker and actually go out and talk about the importance of understanding your endocannabinoid system and the role that it plays in your health.”

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With cannabis, she has eliminated 28 prescriptions, and has started improving her lungs.

The Chronic Pain Chronicles

Cannabis nurse Gloria Lynne Smith, RN-BC, BSN, NLC (9), knows all about people suffering with chronic pain like Debi, and the journey they must make to find wellness and true happiness in life.

Smith has an extensive background in the healthcare field, starting in her teens as an emergency medical technician. As a nurse, Smith has worked in specialties such as emergency medicine, telemetry, neurology, oncology, endoscopy, hospice, and the intensive care unit (ICU). Her mom is a nurse.

Smith worked as a bedside nurse until the COVID-19 pandemic hit. The stress it brought to her job forced her to quit that bedside job, and turn to other methods of providing care, including telehealth.

Smith spent years working with top multiple sclerosis (MS) doctors and was heavily involved with their medical cannabis program. “MS is classified as neuropathic pain,” she said. “So, what you would see in diabetes and things like that is a lot of nerve pain, because it’s inflammation of the nerves. And nerve pain is historically very hard to treat with medication.”

People with MS (10) suffer stabbing pains in the face, and a variety of sensations in the trunk and limbs, including feelings of burning, pins and needles, hugging and squeezing, with painful muscle spasms. Bladder and bowel problems can also occur. Smith explained how issues such as skeletal pain and muscular pain can be treated with over-the-counter analgesics that work well, followed by muscle relaxers and opioids if things get worse. “But nerve pain is so indirect to treat,” Smith added. “A person who has the sciatic pain always has that pain going down their leg. There’s just not a direct way to treat it.”

What she found is that cannabis is one of the only ways of providing predictable treatments for neuropathy, much better than the traditional drugs like Gabapentin (11). Gabapentin has a long list of side effects, including swelling of the face and throat, difficulty swallowing, and seizures. “There are a lot of people in their 70s, 80s, and 90s who got diagnosed with multiple sclerosis really late. They have all these symptoms that they weren’t able to treat very well.”

One of her favorite MS patient stories is about an elderly woman in her 80s who had bad nerve pain in her legs. She experienced difficulty sleeping. “When I finally convinced her to try cannabis, I remember her coming back in for a follow up and being just beside herself,” Smith stated. “She said to me something along the lines of ‘I forgot that I deserved to feel this good.’”

That elderly patient had been dealing with this unrelenting, unmanageable, untreatable pain for so long, and not able to sleep.

“We nurses always feel backed up against a wall, and that there are these barriers between us and helping our patients get cannabis. And I think at some point, we just get tired of it and say, well, let them get me in trouble,” she said. “It makes me proud to be a cannabis nurse, because it really embodies what a nurse is, where you want to help as much as you can.”

The lack of general knowledge in our health care professionals about cannabis as a medicine is really doing patients a large disservice, Smith added, especially around learning about the endocannabinoid system. “It’s really relevant science for anybody whether or not you’re trying to manage a symptom or disorder with cannabis,” Smith said. “The ultimate goal would be to teach everybody about their own endocannabinoid system and how they can positively affect it, and how they can regulate it, to enjoy balance, not only in a diseased area, but just for life and in their wellness.”

Smith works with the medical cannabis organization, Cannabis Nurses Network (CNN) (12), which was founded in 2015 and provides free educational and informational resources to the cannabis industry. CNN was directly involved in the authorship, lobbying, and passing of Ryan’s Law in California. A co-author of this law, Ken Sobel, is a legal counsel and educator for CNN.

California Governor Gavin Newsom signed Ryan’s Law on September 2, 2022 (13). The law requires healthcare facilities to allow the use of medical cannabis on their premises for terminally ill patients with a valid medical cannabis identification card or a recommendation from an attending physician.

The law was passed by the legislature with support from a diverse group of organizations including Americans for Safe Access (ASA) (14). It applies to all California health care facilities including acute care hospitals, special hospitals, skilled nursing facilities, congregate living health facilities, or hospice providers (excluding the emergency department of a health care facility, chemical dependency recovery hospitals, and state hospitals).

Ryan’s Law was passed in honor of Ryan Bartell (15) who was diagnosed with Stage 4 pancreatic cancer at the age of 41. As his condition progressed, he was admitted to the palliative wing of a hospital where he spent his first four and a half weeks on fentanyl to treat his pain. Unfortunately, the hospital could not allow Ryan to use cannabis in their facility. He stayed on his usual medication until his family could locate and move Ryan to a hospital that would allow him to use cannabis.

As a result of using medical cannabis, he spent his last two and half weeks lucid and pain-free with his family and friends. Following this experience, Ryan’s father, Jim Bartell, made it his mission to ensure that no other family would have to navigate this choice for palliative care, losing precious time with their loved one.

The Final Word

Wimberley said that suicide is something she talks about a lot just to make sure people are aware of how deeply chronic pain can affect anyone. “Chronic pain is something people can’t see, so they have a really hard time relating that you’re in pain,” she explained. “I can’t tell you how many times people would say ‘But you look fine.’ Yeah, I look fine. Believe me, what’s going on inside is not fine. You get told that it’s in your head, which happens to a lot of people that live with chronic pain. And you get told that it can’t be that bad. That plays a number on how you think and feel. But living with it today, I don’t have those (suicidal) thoughts anymore.”

If we don’t understand cannabis as the medical treatment it is, she emphasized, we’re letting everybody down. “This truly can change lives. I wouldn’t ever be living the life I’m living right now if I hadn’t started medical cannabis, and if I was still following what my doctors told me to do. I am healthier than I have been in a long time,” she said.

Before using cannabis for her chronic pain, she was not able to work, or to be involved with her family, or do her duties as a mom, sister, daughter, and wife. “I lost all of that. And to get some of that back, and be able to be engaged with people, that is huge. It’s a gift. It’s truly a gift,” she added.

When CNN health care worker Smith was asked about other amazing stories of patients who have used medical cannabis, she said that it’s hard to narrow down to one because most of her work with cannabis and patients has been remarkable. “We’re able to introduce cannabis to people who haven’t used it in a medical capacity before,” Smith said. “And it’s so successful, with such little side effects and such little worry, that I feel like every instance that I’ve come across is just truly remarkable in some way. I’m just really hoping for the laws, specifically like Ryan’s Law and things like that are our patient protectors, to get moving and protect our chronically ill patients and our end-of-life patients.”

References

  1. Debi W. - Greater Phoenix area | professional profile | linkedin https://www.linkedin.com/in/debi46a937168/
  2. https://www.hopkinsmedicine.org/health/conditions-and-diseases/peroneal-nerve-injury.
  3. https://www.mayoclinic.org/diseases-conditions/crps-complex-regional-pain-syndrome/symptoms-causes/syc-20371151,
  4. https://rsds.org/anewfourletterword/.
  5. http://hca.gilead.org.il/princess.html.
  6. https://www.thefootandankleclinic.com.au/treatment/cam-fracture-walkers-aka-moon-boots/.
  7. https://www.medicines.org.uk/emc/product/3415/smpc#gref.
  8. https://www.effectivenewsletter.com.
  9. https://www.cannabisnursesnetwork.com/speaker/gloria-lynne-smith-rn-bc-bsn/.
  10. https://www.nhs.uk/conditions/multiple-sclerosis/symptoms/.
  11. https://medlineplus.gov/druginfo/meds/a694007.html.
  12. https://www.cannabisnursesnetwork.com/about-cannabis-nurses-network/.
  13. https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB988.
  14. https://www.safeaccessnow.org/about_asa.
  15. https://www.cannabisnursesnetwork.com/article/the-human-stories-behind-ryans-law-sb-311/.

About the Author

David Hodes has written for many cannabis publications and organized or moderated sessions at national and international cannabis trade shows. He was voted the 2018 Journalist of the Year by Americans for Safe Access, the world’s largest medical cannabis advocacy organization.


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