Mary Jane and the MS Clinic

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Dear MS Neurologist,

I know you’ve already been to school and learned about all the things related to treating my MS.  You also spend lots of time – hours and even days – learning about the latest and greatest advances in medicine and ways to treat the symptoms of MS.  But I read in the headlines that medical marijuana is coming to our state soon, and this is one more thing you will need to learn to add to your  armamentarium (medical bag of tricks).  You will need to better understand the different pharmacological benefits of various marijuana strains so I want to point you to this site that will better instruct you on the sixteen strains recommended for MS.

This is a web-based  resource to give you the straight dope because you won’t get this in any medical text book or through Continuing Education courses to earn CEUs. As a pre-study course you may want to consult a horticultural guide to better understand the differences between sativas, hybrids and indicas.

 

My first important point in the lesson is you should not be influenced by the names. As mom always told us, don’t judge a book by its cover.  Marijuana names are not as smart sounding as Aubagio, Rebif, Tecfidera, and all the other already established drugs except perhaps for Glatopa which could easily cross over to the medical marijuana name list. For example, Yabba Gabba Goo, has a playful name, but it is listed as effective for both MS and Crohn’s disease and depression and muscle spasms; its benefits are euphoria, relaxation and energy.  Sour Mango says it tastes a bit like a sour patch kid crossed with mango and will help with energy as well but it doesn’t list benefits of treating muscle spasms. I’m sure this sugary tasting high is different than the one you get when actually consuming sour patch kids.

 

One thing different about these names than the usual MS drugs is all of them will be words you already know and won’t have trouble pronouncing, such as Double Diesel, Super Jack and Medicine Man (promoted as a medicinal delight).

 

This resource will also help you to better understand your patients when they come to you with a request such as ‘I want to talk to you about Flo,’ which has nothing to do with urinary streams or moving with the crowd.  Instead, Flo is recommend for muscle spasms and anxiety, but should only be prescribed for nighttime use since its effects are relaxation and sleepiness.

 

There’s so much to learn about these new treatments and no one is expected to know it all, so remember there are tutorials available online and most come with photos and can be used as a refresher course.  This could be useful when patients arrive in your examining room and pull out a fresh bud, and want to know if it will help a particular symptoms but they are unable to tell you what it is. After all, you are expected to be the expert of everything, and able to help weed out the things that don’t work well. Here’s a sample of the pictorial guide as a referencefrom www.marijuana.com, these four strains are recommended for muscle spasms.

muscle spasms

 

There won’t be an exam after you study this information; we know memory is affected by consuming marijuana and we’re unsure of the contact high you might encounter through these photos and your patients.   You also won’t need to worry yourself about an aptitude test on filling a bowl, rolling a J, or sifting seeds, as those skills fall to other sources.  But it would be nice if you could keep some brownie recipes handy when your patients ask for alternative consumption methods.

 

Until medical books and training catch up with contemporary practices, I hope you will find this guide useful.

 

Your best bud,

Laura

 

 

 

 

 

 

 

 

 

Consortium of MS Centers Meeting Roundup

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Late May I had the good fortune of attending the annual Consortium of MS Centers meeting, held this year in Indianapolis.  I am still working on articles from the vast wealth of information I gathered there, but want to share what has been posted on MultipleSclerosis.net.  Following is an index and brief cut from each of the topics; I hope there is something here that catches your attention and you’ll want to read more.

 

Multiple Sclerosis & Aging

More than once I’ve wondered to myself and questioned others about the aging population of people with MS and what adjustments to our care might need to be made. The current state of medical treatments make it possible to live longer, and although that is a very good thing it also complicates our medical care.

http://multiplesclerosis.net/living-with-ms/aging/

 

Challenges of Progressive MS Research

How well do we understand progressive MS today? was the closing keynote address for the Consortium of MS Centers annual meeting, given by Alan Thompson, MD. He is a leading authority on progressive multiple sclerosis and Dr. Thompson  is on the faculty of Brain Sciences, University College London, and serves in high level positions of the boards of MS international Federation, the International Progressive MS Alliances, and the National Multiple Sclerosis Association. He serves as the editor-in –chief for Multiple Sclerosis Journal.

I had the opportunity to ask Dr. Thompson at an advance press briefing if he could identify what was the driving force behind the recent initiatives to find answers about progressive MS. For quite some time the majority of the research and attention has been focused on Relapsing Remitting MS (RRMS), according to Dr. Thompson, and he strongly expressed the research community should be ashamed of themselves for waiting so long to take a harder look at progressive forms. He said part of the push for progressive MS research is because the MS patient community has been vocal about the need.

http://multiplesclerosis.net/living-with-ms/challenges-of-progressive-ms-research/

 

 

Meet the Professor: Gavin Giovanonni, MD

In almost every area of endeavor there are those people who do work that rises above the rest, making them stars even among others who also accomplish great things. There are a lot of people who write blogs about MS and there are a number of them who shine above the rest with really stellar work. But then there are the superstars – those few writers who can be trusted to always get the information correct and add their own touch, making their blog not only enjoyable to read but also crammed full of information. Gavin Giovanonni, MD., is one of those superstars of the MS blogosphere.

http://multiplesclerosis.net/living-with-ms/meet-the-professor-gavin-giovanonni-md/

 

 

MS Wellness: Body, Mind and Spirit

It was late Friday afternoon at the annual meeting for the Consortium for MS Centers and after three days of intense science and medical discussions, many of which involved words I can barely spell let alone understand, my brain was ready for a break. I scanned the program schedule again and came down to two final options for a happy hour presentation – after all it was after 4:00 PM on Friday.

http://multiplesclerosis.net/living-with-ms/wellness-body-mind-and-spirit/

 

Where to Turn: MS Drugs, Babies and Assistance

Do you know about MotherToBaby or the Assistance Fund? Don’t feel alone if you don’t, because I didn’t either until recently when I attended the annual meeting of the Consortium for MS Centers….

http://multiplesclerosis.net/living-with-ms/where-to-turn-drugs-babies-and-assistance/

 

Lemtrada: Some Facts

The newest multiple sclerosis drug approved in 2014 was alemtuzumab, trade name Lemtrada.  One of the early morning (7:00 AM) presentations I attended at the recent Consortium for MS Centers annual meeting,Independently Supported Symposium (#7): Management of Alemtuzumab Infusions for Patients with Relapsing MS, was sponsored by the drug’s manufacturer, Genzyme, and was for people who work in clinics that administer or plan to give Lemtrada. The presentation was full of facts and an opportunity for me to learn more about the minute details of Lemtrada, since it is still in its infancy of use here in the US.

http://multiplesclerosis.net/living-with-ms/lemtrada-some-facts/

 

MS, Cannabis & Cognitive Function

Anthony Feinstein, MD, PhD. gave the lecture – MS, Cannabis and Cognitive Dysfunction: Insights from Brain Imaging, to a standing-room only crowd at the opening presentation for the Consortium for MS Centers annual meeting in Indianapolis. He is in the Department of Psychiatry at the University of Toronto, and his research into this topic was funded by the National MS Society of Canada.

Dr. Feinstein began by tracing the roots of the drug back to the 9th century and took his audience through a timeline of cannabis use and its forms. One form was in the 19th century here in the US when it was combined with morphine and capsicum to be used as a pain killer.

http://multiplesclerosis.net/living-with-ms/cannabis-cognitive-function/

 

 

Treating Diverse Populations with MS

Practical Strategies for Improving Outcomes in Diverse MS Populations was the Symposium that started the second day of the annual Consortium for MS Centers meeting in Indianapolis. This is a topic of special interest to many people because of the differences in how people react to treatment, depending on their ethnic and genetic background. It was a panel presentation and these are the topics of each presenter and my summation of their text and comments.

http://multiplesclerosis.net/living-with-ms/treating-diversity/

 

Marijuana Use by MS Status and Disability

Do you participate in NARCOMS surveys?  That would be the North American Committee on Multiple Sclerosis and their patient data surveys that are generated twice a year and is a longitudinal study tracking our MS and various symptoms and progression. In addition to their regular surveys, they will on occasion conduct special targeted surveys and such was the case with a survey regarding attitudes toward marijuana use among people with MS. Stacey Cofield, PhD, is the lead investigator for this project and I had the opportunity to talk with her about the survey results at the Consortium for MS Centers annual meeting, held in Indianapolis.

The survey was created as a response to NARCOMS participants’ suggestion that they include questions about medical marijuana use in their surveys.

http://multiplesclerosis.net/living-with-ms/marijuana-use-by-ms-status-and-disability

 

MS & Comorbidities

Comorbidity seems to be the word of the day lately in all types of multiple sclerosis discussions. Medical conversation, reviews and scientific manuscripts, link many other chronic conditions such as obesity, depression,  rheumatoid arthritis and type 2 diabetes to multiple sclerosis as a comorbid companion.

Comorbidity –  the word sits with me like a newly introduced phrase that is popular at the moment because I keep hearing and reading it everywhere, and when I went looking for the root meaning of the word I stumbled upon this handy little tool from Google books which charts the use of words in books over a period of time. Not surprising to me, the word comorbidity does not even appear in a book until the 1980’s, but has taken off in use since that time.1

http://multiplesclerosis.net/living-with-ms/ms-comorbidities

 

 

 

 

 

June Posts on MSnet

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June was another busy month of writing for MultipleSclerosis.net, especially with my coverage of the Consortium for MS Centers annual meeting, held the last week of May. Here’s a peek and links of what I contributed last month.  I hope you see something you want to read more about and even share with others to read.  best, Laura

 

By Laura Kolaczkowski—June 1, 2015

More than once I’ve wondered to myself and questioned others about the aging population of people withMS and what adjustments to our care might need to be made. The current state of medical treatments make it possible to live longer, and although that is a very good thing it also complicates our medical care.

 

By Laura Kolaczkowski—June 2, 2015

How well do we understand progressive MS today? was the closing keynote address for the Consortium of MS Centers annual meeting, given by Alan Thompson, MD. He is a leading authority on progressive multiple sclerosis and Dr. Thompson  is on the faculty of Brain Sciences, University College London, and serves in high level positions of the boards of MS international Federation, the International Progressive MS Alliances, and the National Multiple Sclerosis Association. He serves as the editor-in –chief for Multiple Sclerosis Journal

 

Preparing for your Neurologist Appointment

By Laura Kolaczkowski—June 3, 2015

Everyone gets those reminder telephone calls before their appointment about what time to get there, to bring the most recent insurance card and copay, and of course the list of drugs you are taking. Those are standards for every medical appointment, but what else can you do to make the most of your time? No matter how much or how little time you have with your neurologist, once the exam door is closed you want to make the most of it.

 

By Laura Kolaczkowski—June 5, 2015

The newest multiple sclerosis drug approved in 2014 was alemtuzumab, trade name Lemtrada.  One of the early morning (7:00 AM) presentations I attended at the recent Consortium for MS Centers annual meeting,Independently Supported Symposium (#7): Management of Alemtuzumab Infusions for Patients with Relapsing MS, was sponsored by the drug’s manufacturer, Genzyme, and was for people who work in clinics that administer or plan to give Lemtrada. The presentation was full of facts and an opportunity for me to learn more about the minute details of Lemtrada, since it is still in its infancy of use here in the US.

The talk was given by Christine Cain, MSN, Lori Mayer, MD, and Colleen Miller, MSN, and my article here is a consolidation of their combined comments. The details of the drug, its administration and complications are all factors to be considered by a person before consenting to Lemtrada therapy, and that is the focus of my article here.

 

By Laura Kolaczkowski—June 9, 2015

I can’t agree more with Cathy Chester and her enthusiasm about the recent meetings in Indianapolis for the Consortium for MS Centers annual meeting.  There were over 2,000 health allied professionals in attendance, all there to learn more about improving care for people with Multiple Sclerosis.

Unlike the annual Academy of American Neurology meetings where there seem to always be headline grabbing presentations announcing the latest treatments or breakthroughs in the labs, this meet is much more blue collar.  The people there rolled up their sleeves and got down to the nitty gritty of MS.

 

By Laura Kolaczkowski—June 10, 2015

Comorbidity seems to be the word of the day lately in all types of multiple sclerosis discussions. Medical conversation, reviews and scientific manuscripts, link many other chronic conditions such as obesity,depression, rheumatoid arthritis and type 2 diabetes to multiple sclerosis as a comorbid companion.

Comorbidity –  the word sits with me like a newly introduced phrase that is popular at the moment because I keep hearing and reading it everywhere, and when I went looking for the root meaning of the word I stumbled upon this handy little tool from Google books which charts the use of words in books over a period of time. Not surprising to me, the word comorbidity does not even appear in a book until the 1980’s, but has taken off in use since that time.1

 

By Laura Kolaczkowski—June 11, 2015

In almost every area of endeavor there are those people who do work that rises above the rest, making them stars even among others who also accomplish great things. There are a lot of people who write blogs aboutMS and there are a number of them who shine above the rest with really stellar work. But then there are the superstars – those few writers who can be trusted to always get the information correct and add their own touch, making their blog not only enjoyable to read but also crammed full of information. Gavin Giovanonni, MD., is one of those superstars of the MS blogosphere.

 

By Laura Kolaczkowski—June 15, 2015

Anthony Feinstein, MD, PhD. gave the lecture – MS, Cannabis and Cognitive Dysfunction: Insights from Brain Imaging, to a standing-room only crowd at the opening presentation for the Consortium for MS Centers annual meeting in Indianapolis. He is in the Department of Psychiatry at the University of Toronto, and his research into this topic was funded by the National MS Society of Canada.

Dr. Feinstein began by tracing the roots of the drug back to the 9th century and took his audience through a timeline of cannabis use and its forms. One form was in the 19th century here in the US when it was combined with morphine and capsicum to be used as a pain killer. Well into the 20th century, cannabis was recognized and used by the medical field for its analgesic properties. “Cannabis has a long powerful lineage of medicinal use,” Dr. Feinstein said.

 

By Laura Kolaczkowski—June 15, 2015

Do you participate in NARCOMS surveys?  That would be the North American Committee on Multiple Sclerosis and their patient data surveys that are generated twice a year and is a longitudinal study tracking our MS and various symptoms and progression. In addition to their regular surveys, they will on occasion conduct special targeted surveys and such was the case with a survey regarding attitudes toward marijuanause among people with MS. Stacey Cofield, PhD, is the lead investigator for this project and I had the opportunity to talk with her about the survey results at the Consortium for MS Centers annual meeting, held in Indianapolis.

The survey was created as a response to NARCOMS participants’ suggestion that they include questions about medical marijuana use in their surveys.  The information entered through the NARCOMS registry is linked to our personal records, and to address the privacy concerns about gathering information on a drug that is still illegal in many parts of the US, they asked the questions via SurveyMonkey, an online survey tool. I am a member of NARCOMS and did complete this survey in 2014.

By Laura Kolaczkowski—June 21, 2015

Practical Strategies for Improving Outcomes in Diverse MS Populations was the Symposium that started the second day of the annual Consortium for MS Centers meeting in Indianapolis. This is a topic of special interest to many people because of the differences in how people react to treatment, depending on their ethnic and genetic background. It was a panel presentation and these are the topics of each presenter and my summation of their text and comments.

 

By Laura Kolaczkowski—June 22, 2015

I’ve done it and the odds are you have, too – many of us have good intentions and when we get our driver’s license we check the box that holds the option to be an organ donor. We want to help and know there are so many people waiting for organ donations to heal their ill and broken bodies.

According to the DonateLife website –

Currently, nearly 124,000 men, women and children are awaiting organ transplants in the United States. For specific numbers visit unos.org.

  • Approximately 77,633 Multicultural Patients*
  • Approximately 2,146 Pediatric Patients*
  • 29,532 Organ Transplants Performed in 2014
  • 14,414 Organ Donors in 2014
  • More than 47,000 corneas were transplanted in 2013
  • More than 1 million tissue transplants are done each year and the surgical need for tissue has been steadily rising.

 

By Laura Kolaczkowski—June 25, 2015

Do you know about MotherToBaby or the Assistance Fund? Don’t feel alone if you don’t, because I didn’t either until recently when I attended the annual meeting of the Consortium for MS Centers, a four day event jammed full of seminars, classes, lectures and much more.  There was an exhibit area, which was the showcase presentation point for all of the MS pharmaceutical companies, health care delivery businesses and more.  The familiar non-profit advocacy groups were there as well, including Accelerated Cure Project (iConquerMS™), Multiple Sclerosis Association of America, CanDo MS, MS Foundation and the National Multiple Sclerosis Society. These groups, along with a few others make up the MS Coalition, organized to leverage limited resources and collaborate with each other.

Among these better known MS organizations were a few lesser known non-profit organizations that I was not familiar with and am especially glad I had the opportunity to learn more about two of them that are associated with MS drugs and can share their information with you.