Posted in Health, marijuana, news

Marijuana Lollipop Suspected in Heart Attack Case

For years studies have found marijuana use to increase risk of heart disease and stroke. Now a marijuana lollipop has been linked to a man’s heart attack.

Treating his arthritis and insomnia, an 70-year old man licked a marijuana lollipop and within a half hour experienced crushing chest pain.  The lollipop contained 90 mcg of THC, which is multiple times more potent than an average joint, according to Fox News.

They report he experienced hallucinations and anxiety which led to a spike in his heart rate and blood pressure thereby stressing the heart.  Fortunately he survived.

 

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The lollipop was not intended to be a single use edible but many find it unsanitary to lick a few times and save for later.

Many studies have linked marijuana use to heart attacks, heart failure and stroke.

In 2017, Dr. Aditi Kalla and colleagues from Einstein Medical Center in Philadelphia analyzed 20 million health records of patients who were hospitalized in 2009 and 2010 and found those who used marijuana (1.5% of the patients studied) were at high risk of coronary artery disease, sudden cardiac death, heart failure and stroke.

What’s even more striking is the patients were younger, aged 18-55. Risk factors including obesity, high blood pressure, alcohol use and smoking were already taken into account.

One theory for the link between heart disease/stroke and marijuana use is that cannabis may affect the cardiac muscle cell’s ability to contract, affecting the pumping mechanism of the heart, thereby leading to heart failure. Another theory is marijuana, like cigarette smoking, may be increasing risk of clots.  Below is a report on a study linking marijuana use to Transient Ventricular Regional Ballooning (TVRB). This can also lead to heart failure. Another theory suggests cannabis causes a release of stress hormones, such as cortisol.

In 2016 study out of St. Luke’s University Hospital Network found marijuana to cause stress cardiomyopathy.  This is a temporary condition that causes a “ballooning” of a region of the ventricle known as Transient Ventricular Regional Ballooning (TVRB).  We know that many drugs can cause cardiomyopathy (affect the heart muscle) such as cocaine and stimulants causing dilated cardiomyopathy, but this is new in that a sedating type of drug such as cannabis/marijuana, can cause similar effects on the heart.

The condition of TVRB can mimic many different heart conditions because it presents with chest pain, shortness of breath and dizziness.  So many individuals admitted for these symptoms are evaluated for a heart attack, angina, pneumonia, and a variety of other diagnoses.

In this study, the researchers looked at data from 33,000 hospital admissions who had TVRB and saw a link between 210 of these admissions and marijuana use.  They are unsure how marijuana affects the heart, but theorize that it could be an increase in cortisol and stress hormones.  Although none of the marijuana users in this study died, the TVRB can cause cardiac arrest, heart attack.

History of Lollipops

For centuries civilizations had found ways to satisfy our sweet tooth.  Ancient Egyptians would mix nuts, fruit and herbs into a ball that could be skewered with a stick.  Putting candy on a stick was common as it allowed a sticky sugary or carmelized treat to be eaten easily.

However the modern style lollipop we believe was invented by George Smith of New Haven, CT in 1908.

The name “Lollipop” was trademarked in 1931 after he reportedly named the candy after a popular race horse, “Lolly Pop.”

 

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Learning Medical Spanish is Easy!!!

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

 

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Posted in food, Health, news, sex

Did the Legalization of Marijuana Lead to a Rise in STD’s and Foodborne Illness?

Reports of increasing cases of STD’s appear to correlate with the legalization of marijuana.

Could marijuana be leading to a complacency when it comes to handwashing and condom use?

STD-Trends

 

This Fall the CDC reported a continued rise in cases of sexually transmitted diseases by the following:

Nearly 2.3 million cases of chlamydia, gonorrhea, and syphilis were diagnosed in the United States in 2017, according to preliminary data released today by the Centers for Disease Control and Prevention (CDC) at the National STD Prevention Conference in Washington, D.C. This surpassed the previous record set in 2016 by more than 200,000 cases and marked the fourth consecutive year of sharp increases in these sexually transmitted diseases (STDs).

And this week, the World Health Organization sounded the alarm of rising HIV cases in Eastern Europe.

At the same time more countries are easing up on legal restrictions when it comes to marijuana.  Which leads to the question, has the legalization of marijuana led to the rise in STD’s?

BackgroundChecks.org released this graphic displaying STD rates by state.

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Strikingly, there are some similarities to a map outlining state cannabis programs.

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Cannabis use is known to decrease anxiety and motivation and so an unintended consequence of increasing access to its use may be the decrease in precautionary thinking when it comes to unprotected sex.

Rare STD Evading Doctors and May Become Next Superbug

 

On that same note, multiple outbreaks have been reported in the food industry when it comes to pathogens such as Salmonella, E. coli, Hepatitis A and Listeria.  Could complacency with proper food handling and hand washing be related to marijuana use?

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This could easily be analyzed by screening those with an STD for marijuana use, as well as those involved in a foodborne illness outbreak.

Now the legalization of marijuana allows more studies to be done to to determine its health benefits. I suggest, however, we also study, any links to complacency issues when it comes to home and workplace safety and exposures.

 

Why is food borne illness on the rise?

Multiple issues could be playing a role.

  1. Fresh produce is not cooked like meat and can therefore harbor more germs
  2. Preservatives, used in fast food, help to deter pathogen growth, and more people are shying away from fast food than in the past, opting for “fresh”, healthier options.
  3. On-the-go produce may not be washed after packaging due to a false sense of security that the vegetables are “clean.”
  4. As our population ages, and as more people suffer from immunocompromising disease such as diabetes and cancer, they may be more susceptible to food borne illness.
  5. Our gut microbiome has changed as our diets have shifted to food with more preservatives, hence possibly being less resilient to new pathogens that enter.
  6.  In regards to the ground turkey, it is not the same as ground beef and leaving the patties pink in the center mean you are consuming raw poultry. Turkey meat may need to cook longer until no pink is seen and core temperature is at least 165 degrees for at least 15 seconds
  7. We’re less strict about cleaning than we used to be.  Counter tops used to be bleached and scrubbed for longer periods of time than we do now-a-days with antimicrobial wipes.

Therefore be diligent about cleaning counter tops, cook your food thoroughly, wash produce before eating and be aware of any reported recalls.

 

A Review of Syphilis

Syphilis is also called “the great imitator”.  Many don’t realize they have syphilis as the symptoms mimic so many other diseases.  Syphilis has been on the rise and hasn’t been routinely tested in STD/STI panels.  It’s caused by a spirochete (spiral bacteria) called Treponema pallidum, and can cause infection in stages.

Primary Syphilis can manifest as a painless ulcer on the genitals, mouth or skin.

Secondary Syphilis can manifest as a rash, along with fever, joint pain, malaise…mimicking other illnesses. In this stage it can also manifest as warts on the genitals called condylomata lata.

 

Syphilis

 

As the course progresses, syphilis may become latent. For years one may have no symptoms at all.  The patient may mistakenly feel they suffered the flu and think nothing more of it. But if left untreated, syphilis can enter the final stage, Tertiary Syphilis, which can cause severe neurological disability (neurosyphilis) and can also severely affect the heart.

Penicillin is the treatment of choice for any stage of syphilis, including the latent stage of the illness.

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

 

Posted in Health, marijuana, news

Olivia Newton-John Battles Stage 4 Cancer, Uses Traditional and Alternative Treatments

The 69-year-old singer and actress recently reported she’s using both traditional and alternative medications to treat her metastatic breast cancer.

After successfully keeping the cancer at bay, it returned for a third time last year and metastasized to her sacrum, a part of the low back.

 

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In addition to her current medical regimen the Australian native grows cannabis at her Santa Barbara, California home and uses its oil to help with the pain.  She states, “My dream is that, in Australia soon, it will be available to all the cancer patients and people going through cancer that causes pain.”

In 1992, Newton-John first battled breast cancer by undergoing chemotherapy and by having a modified radical mastectomy (removing the breast and lymph nodes).  She immediately had breast reconstruction and included yoga, acupuncture and massage in her treatment regimen.

In 2013, after a minor car accident, a lump in her left shoulder revealed it was breast cancer.

In an interview with the Susan G. Komen Foundation, she shared her personal story.  “I meditated every day, did yoga, used homeopathy, ate well—I boosted my inner strength as much as I could. When bad thoughts came in, I pushed them right out. I had what’s called a modified radical mastectomy with reconstruction done to my breast immediately—a woman can be traumatized waking up with nothing there.

She remained cancer free for years.

In a recent interview with People Magazine, she states she believes she will win “over it,” but adds, “I don’t go there. I’d be lying if I said I never go there. There are moments, I’m human. So If I allow myself to go there, I could easily create that, you know, big fear.”

 

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OLIVIA NEWTON-JOHN IN 1978’S GREASE

 

Breast cancer is one of the few cancers that spreads to the bone. Other cancers that may rear its ugly head in the bone include thyroid, kidney, pancreas and the liver.

According to the American Cancer Society Stage 4 Breast Cancer (spreading to other parts of the body) has a 5 year survival rate of 22%, as opposed to Stage 3, who’s 5 year survival rate is 72%.  Treatments today are improving survival rates.

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

 

 

Posted in Health, news, opioids

“Drugged Driving” Causes Nearly HALF of all Fatal Crashes

IMAGE ABOVE FROM GRANDPARENTS.COM

 

We commonly think of DUI’s, or Driving Under the Influence, a result of drinking alcohol and driving while intoxicated.  However what many people fail to realize is drugs, including prescriptions, could decrease your ability to drive safely, hence putting you at risk for a DUI when alcohol wasn’t even ingested.

A report from the Governors Highway Safety Association (GHSA) and the Foundation for Advancing Alcohol Responsibility found that more fatal crashes were the result of drug use as opposed to alcohol use.

These findings showed that although alcohol was involved in 38% of fatal crashes, prescriptions and illegal drugs were responsible for 44% of driver- related deaths (similar to last year’s findings of 37% and 43% respectively).

Looking deeper they found 58 % of drug related fatal car crashes were the result of marijuana, opioids or both being on board.

According to their report, entitled, Drug-Impaired Driving: Marijuana and Opioids Raise Critical Issues for States, “44% of fatally-injured drivers with known results tested positive for drugs, up from 28% just 10 years prior.”

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Opioid overdose is currently responsible for 115 deaths per day.  And as marijuana becomes legalized throughout the country, more people run the risk of being on a combination of the two, which can be deadly if they get behind the wheel.

“Drugged driving” manifests in less reaction time, poor coordination, memory loss, and distortion of one’s reality or surroundings.

Now what about prescription drugs?  California Vehicle Code 23152(e) states, “It is unlawful for a person who is under the influence of any drug to drive a vehicle.”

So what prescription drugs could impair one’s driving?

The obvious ones include the following:

Narcotics such as hydrocodone, oxycodone, morphine, codeine…to name a few

Muscle relaxants such as carisprodol, cyclobenzaprine, methocarbamol……

Sleep aids such as zolpidem, eszopiclone….

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Anti-anxiety medications such as diazepam, lorazepam, alprazolam, clonazepam…..

However surprisingly, these next groups of medications can also cause sedation:

Cholesterol medications such as statins:  lovastatin, atorvastatin, etc. may cause fatigue and recent studies have found them to cause “excessive tiredness”.

Stomach acid suppressants such as proton pump inhibitors:  omeprazole, lansoprazole have been reported to cause vitamin deficiencies such as B12 and magnesium which in turn can cause fatigue.

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Antibiotics that treat many common infections:  Amoxicillin, azithromycin, ciprofloxacin have been known to cause fatigue.

Diuretics for blood pressure and water retention:  hydrochlorothiazide, furosemide cause potassium loss in the urine which may contribute to fatigue

Antihistamines:  anti-allergy medications such as diphenhydramine (Benadryl) are very sedating, which is why they are used in some over the counter sleep aids.  There are some reports that the younger generation of medications such as Zyrtec can cause drowsiness as well.

Blood pressure medications:  these can include the ACE inhibitors such as captopril, enalapril;  calcium channel blockers such as amlodipine; beta blockers such as metoprolol as well as the diuretic family mentioned previously.

Antidepressants: many antidepressants additionally help with anxiety through their sedating effects such as trazadone, paroxitine, and escitalopram to name a few.

Mood stabilizers, anti-seizure medications, and antipsychotics can cause fatigue as well.

Despite the rarity of these types of cases, the potential is still there for one to not only receive a DUI but injure himself or others if the prescription makes him less alert, i.e. decreases his “sobriety”.  Discuss with your medical provider if you feel drowsy after you take your medication and if there are less sedating options.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio, KDWN and Board Certified Family Physician

 

Posted in Health, marijuana, news

Marijuana Medical Benefits are Strain Specific

Cannabis users need to be aware that benefits may be unique and specific to certain strains.

Cannabis plants produce cannabinoids, or chemicals that can induce an effect on the body. When cannabinoids are produced by a plant they are called phytocannabinoids.  Humans produce their own cannabinoids, called endogenous cannabinoids.  Laboratory  or synthetically produced cannabinoids are called synthetic cannabinoids.

The human body has a very intricate endocannabinoid (endogenous cannabinoid) system, with receptors throughout our brain, organs, glands, and immune system. Hence a wide variety of physiological responses, occur when these receptors are stimulated by cannabinoids.  These include responses to sleep, memory, appetite, pain, immune response, mood, and cell damage repair and death, Research is currently investigating what endogenous chemicals the human body produces, but the majority of medical discussions surrounding cannabinoids includes the phytocannabinoids.

Cannabis plants produce many phytocannabinoids, but the most well known and studied include CBD (cannabidiol) and THC (Tetrahydrocannabinol).  The latter is psychoactive, meaning it can give the user a feeling of euphoria.   The former, CBD, in non-psychoactive and researched more than others for its medicinal benefits.

Now plants, just like animals, are classified from Kingdom (Plantae) down to Genius and species.  Cannabis comes in a variety of species, including the major ones:  C. sativa, C. indica and C. ruderalis. 

 

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C. ruderalis is less popular as it has a lower THC content. However it has “autoflowering” qualities, making them useful to cultivators, and if bred with C. sativa or C. indica could enhance the new hybrid in its reproduction.

C. sativa has a higher THC/CBD ratio, hence can provide more euphoria.  It reportedly helps decrease anxiety, treat depression and increase appetite.  It’s been touted to increase energy and boost creativity.  Its also used to help manage attention deficit disorder.  Although not approved yet in the US, an oral spray, nabiximol, has been developed and sold in multiple countries to treat neuropathic cancer pain.  Its brand name is sold, by prescription, as Sativex® .

C. indica has a higher CBD content and has been used for its sedative properties.  Its also used to help anxiety and induce appetite, but will additionally be used to treat pain and muscle spasms.

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Epidiolex has received FDA approval to treat some seizures.  Its high CBD component is credited for its anti-seizure activity.

There are multiple other strains, each touted to have their own unique properties.  420medbook.com provides the below table.

 

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The challenge, however, is the lack of medical research in each of the different strains.  And when a study does come out discussing the medical advantages or disadvantages to using cannabis medicinally, the specific strain may not be mentioned or easily found in the report.

I believe that various strains do have unique properties and there is an art to the field of medical marijuana but more research needs to be done and quickly to avoid random use of cannabis products for treatment of medical conditions.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in Health, news

The Latest Trend in Getting High: Bug Spray

Multiple states are reporting an alarming increase in people overdosing on…..bug spray.

Bug spray, such as RAID contain pyrethroids, man-made versions of pyrethrin, a compound made by flowers to repel insects. The compound acts as a neurotoxin, overly exciting the nervous system leading to paralysis and death of the critter that gets exposed.

But humans are spraying the insecticide on their marijuana, tobacco, or spice before smoking it, in an attempt to increase the high. These bug spray-laced drugs, called KD, could cause serious illness.

In December, a Tennessee man went on a violent bender and was arrested after he smoked a mixture of  methamphetamine and bug spray to make “wasp“.

“Hot Shots” are even crazier.  The DenverChannel.com reports one takes a screen, sprays bug spray on it, hooks up a battery charger to  heat it, and once the solution crystallizes, melts it and injects the liquid into their veins.

Health officials are warning using any of the above drug mixtures can produce various symptoms including:

  • nausea
  • vomiting
  • headache
  • dizziness
  • fatigue
  • aggression
  • tremors
  • seizures
  • respiratory failure
  • cardiac arrest
  • coma
  • death

Because of the ubiquity of bug spray, anyone, including a child, can become exposed to toxic doses using it by itself or mixing it with other chemicals and drugs.

As a kid we used to collect bugs and play with them.  Now kids are getting high on bug spray.  What could possibly be next……

 

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and Board Certified Family Physician

 

Posted in Health, news

Meningitis from Marijuana?

A 48 year old California woman reportedly acquired life-threatening meningitis from marijuana contaminated with fungus.

Dr. Bryan Shapiro explains in a case study published in the British Medical Journal that she contracted Cryptococcus neoformans from her 3-6 joint-a-day smoking habit.

Crytococcus infections can commonly affect those who are immunosuppressed, but this patient was believed to be relatively healthy.

Her symptoms included feeling fatigued and dizzy but began getting combative, reportedly assaulting a coworker.  She eventually was seen at Cedars of Sinai Medical Center in Los Angeles, where they tested the cerebral spinal fluid surrounding the brain, revealing the life threatening fungus.

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After she was successfully treated, Dr. Shapiro investigated the dispensary in Bakersfield from where she purchased her marijuana.  Nine samples tested positive for the fungus.

Its been established that marijuana leaves are contaminated with pesticides, chemicals and mold.

This is one of the first cases reported of one acquiring meningitis from marijuana use.

This is a developing story.

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician