To Whom it May Concern;

The letter I never sent sits on my desk. I can't do it. I cannot say all that I feel, my anger would overwhelm you. It's not fair to put that on you, but neither is it fair to leave it inside, dwelling and lingering.

Dear person-

While I appreciate your personal pain, please do not assume that you in anyway understand the scope of all that has happened. You haven't taken the time to listen, let alone understand. You assume and perceive my life through your own narrow lens. You make assumption after assumption, imagining that somehow I actually share all my pain. I may write about some of my challenges, more as an expression that they are real, but I in no way dwell on them. My life is made up of more than my injury, of more than my pain and I would much rather amplify the positive aspects of my life. Never fear, I am very aware of the realities, of the pain. Trust me, it never leaves long enough to forget. Please allow me to correct a few of the misconceptions about my life demonstrated in your letter.

"Well, at least you are home..." Factual yes, but this does not encompass the extensive support network that makes me living in my community possible. My husband is sometimes father more than spouse and I feel consistent guilt that I am, as yet, unable to be a full partner in our marriage. Every part of our relationship is a balancing act of my abilities and tolerance levels. My neighbors are aware and available should the unforeseen occur. I have hired help to get me through the days and do simple things like run and play with my children. I am home with oversight, care, and extensive support networks.

"You get to get better..." Yes, but again this is not without extensive support and effort. Every part of my day is weighed and measured. I have made many sacrifices of time and money to do everything I can to heal and improve, those efforts are paying off, but it is not without cost. I exist in a state of pain. That pain can wax and wane with the barometer pressure, dietary changes,  temperature, and even hydration levels. Here's the kicker, I am through less than 1/2 of my lifespan- I will live much of my life struggling with executive function issues, and when it gets bad, even basic bodily functions.

You go on to share your desires, despite what is best for others, with "I want...' Great, so do the rest of us. We all want but all of us must weigh the responsibility of what we want with our capacity. Endangering others for your wants is unacceptable. Period. That's it. You do not get to endanger others for your wants. Wants are not needs.

I love you. I know you are hurting, but I beg you to never assume that you understand the full reality of another persons life. You can share, empathize, and be with them, but you are not them. You can share, but you do not know. As long as you continue to use what you do know to justify your own actions and excuse your wants you will never know. Knowing is placing the needs of others over your own wants. Knowing is moving, even if it hurts, because it will be worth it. Knowing is showing love and hiding pain when it hurts the most because someone else needs the space for a time to grieve themselves. Only by working to really know can we actually see one another as they are, and not as we are.

-Me

To my surgeon

Dr. [AwesomeSauce];

In May of 2015 you treated me for a cerebellum based meningioma tumor.  You saved my life.  I wanted to thank you for your time, attention, and professionalism in ensuring my ability to live and function on any level.

The past two years have been a journey of ups and downs as I confront limitations, face social stigma, and learn to cope with continued challenges.  One challenge that exacerbated the others is that of being able to seek and find appropriate aftercare and support.  I wrote your office in early 2016 and expressed my dissatisfaction with the follow-up care and communication received from one of your associated nurse practitioners, [hewhoshallnotbenamed].  I was put into contact with [clearandconcise] and have appreciated her candor and clarity.  The difference in care is both startling and disheartening when the two experiences are contrasted.  [clearandconcise]  is exceptional both in her knowledge and in her clear communication.  While I struggle with comprehension, my husband was able to understand what [clearandconcise]  explained, even though it varied greatly from what [hewhoshallnotbenamed]  had communicated with us at initial follow-up appointments.

Through many appointments and working with an exceptional team of professionals at [myhomeawayfromhome], I have been able to adapt to functioning at a basic and simplified level.  I am working with vocational rehabilitation to recover professionally, and with a team of specialists to recover functionally.  I have progressed through physical therapy and occupational therapy and can physically function in most of my daily life.  I continue to work with speech pathology to recover cognitive function and the layered reasoning necessary for higher levels of interaction.  I have adapted to being completely deaf on my left side and have learned to understand the origins and nature of my continued tinnitus.  I am encouraged by assessments and support from [sweetestmanintheworld], the neuropsychologist that you referred me to see.

Over this journey I have found many things; 1. A qualified and experienced neurosurgeon is absolutely vital, 2. Goals and consistent, sustained effort by the patient are necessary, and 3. Recovery is best done with a team of experienced and supportive professionals who help to identify and maintain optimum recovery.  I find that many do not experience adequate recovery services and am concerned that while focused on the surgery itself, access to such services is not utilized as effectively as it can be.  Recovery is based upon two standards; physical recovery from surgery, and then functional recovery with any associated limits and challenges of having a brain injury.  It is this second level of recovery that is currently being underserved.

I am asking for your help in educating and sharing with the medical profession that what is being experienced by patients as “normal” is far below the best interests of the patient.  Simple solutions such as appropriate patient education regarding follow-up care of functional challenges, and monitoring of that care by supervising doctors is lacking.  I understand my case is extreme, that it is not common practice for surgeons to be found through the emergency room and that most patients are referred by other professionals.  What I continue to see from the patient perspective is that the trend to disregard or ignore functional healing is common for those doctors as well.  I am privileged to associate with a variety of patients from across the world, many of whom repeatedly express feelings of abandonment, loss, and disillusionment from their initial providers.  They stop seeking help or searching for answers, leading to a decrease in quality of life and fear of follow-up care and procedures.

My surgery and recovery are a pivotal miracle in my life. Your role as my neurosurgeon remains one of my greatest blessings, my healthcare team is another.  I believe without either of those two components I would not be looking forward to a life of decent quality.  I grieve for patients who express that they avoid appointments because they fear being ignored, dismissed, or hearing of another procedure.  None of these options is ideal and all result in decreased outcomes for brain tumor patients.  The question remains, how do we solve this?

I believe that as patients and providers work cooperatively and engage in open dialogue we can improve outcomes for patients, increase functionality post-treatment, and help both patient and provider engage fully in regaining optimum quality of life.  I ask your help in educating providers on providing follow-up supportive care, and creating a team based approach to functional recovery.  I am not sure of the proper format for this type of conversation, in the social work field I would advocate for presenting at local conferences and meetings of professionals.  Maybe the answer, in this case, is to begin one office at a time.  I propose a three-fold solution.

1.       Patients are provided reviewed and approved information regarding aftercare and recovery, to be given at various points along the healing path such as 14 days, three months, six months, and annually as needed.  Correct information helps answer questions that arise after appointments are concluded and gives patients something tangible to hold on to.

2.       Patients are provided access to and information about recovery supports such as speech pathologists, occupational therapists, audiologists, and physical therapists at their 14 day follow-up appointment. It is very easy to compile information of local providers and provide such information to patients to use as needed.  Patients often do not know what questions to ask or what is even possible; by offering the information providers demonstrate patient concern.

3.       At the earliest opportunity, providers and patients must identify a contact professional who will co-ordinate all care and ensure that the patient receives timely responses for any medication and follow-up care concerns.  This provider receives release of information for all reports and appointments so as to ensure that the patient is maintaining a positive healing trajectory.  This works to allow specialty providers to do what they do best and leaves general providers all the tools that they require to adequately do their job, improving outcomes for both patients and providers.

The changes I have outlined are simple and easy to maintain, taking no more time for providers and helping patients avoid medical burnout, improving outcomes for everyone.  Thank you for your care, for my life, and for taking care of people like me.

Neurodevelopment Fun

With study and research I have come to be fascinated by the brain and its impact on various areas of development. I was directed to a TED talk this week and found it to be fascinating as well as the implications for healing and developing healthy neural pathways was quite amazing, and then I found an old favorite. Here to explain the brain in simpler terms are Pinky and The Brain- Parts of the Brain.

So much fun. Here is the lecture of Joe Dispenza- enjoy.

I Am A Faker: The Reality of Living with a Disability

There is so much misinformation and propaganda out in the world regarding the disabled. I hear people talk about the ones that "fake it" and social programs such as SSDI are called "entitlements". Disability Fakers by the Mighty  Being judged without people knowing my story is awful. I worked for 20 years. I have held a job since the time I was 16 years old. To be part of a demographic spoken of as expendable or a parasitic is an awful feeling. Here is the reality, I am different.

I am different. My body is different, my mind works differently, and my ability to recover and respond to situations is very different. I don't fit a mold. I don't fit in the nine-to-five, measured box that is comfortable for society. Interacting with me is harder, I don't get out much, I am not the life of the party. I am not charming and exciting to be around. I will not improve your social cache. Knowing me offers no financial improvement, no special bonus points, no benefit other than my company, but that does not make me worthless or expendable.

I am quiet, unassuming, going about my day which consists of rehabilitations activities, medical appointments, maintaining what part of my life I can, and trying to get better. I am lucky and blessed. I know who I am and what I can do if given the opportunity, but I am still healing. The damage from my brain tumor was extensive and to a part of my brain that is vital to function. I am working to improve and I am so very grateful that I have that opportunity that is denied to others.  I know and have lost dear friends who had no hope of improvement. 

Every three months or so I have to complete another packet from my insurance company assessing my skill level to see if I can return to work; it has been 19 months from the time of my emergency brain surgery. Along with questions regarding daily activities I must submit information from each of my specialists- I see six, soon to be seven medical providers. I must have an assessment of my personal skills completed and I am required to provide documentation in writing with notes and contact information. It takes me days to compile this even though I save copies of everything. No part of my life is left unexplored, no information is too invasive or off limits. I have no private life, everybody knows everything.

Every day I fake it. I fake not hurting, I fake my smile. I fake understanding when things move too fast for me. I fake being thoughtful when I am so overwhelmed I cannot respond without stuttering or freezing up. I fake being calm when I have a new range of symptoms. I fake it at the grocery store where I plot my list well in advance and go during my best time of day when there are likely to be fewer people that I have to interact with.

I get up in the morning and make sure that the first two things I do are to get dressed and make my bed. Why? Because if nothing else goes right it at least keeps me moving forward and less likely to burrow back into bed to hide from the pain. I do have pain. On a scale of 1-10 I live at around a 6, when I let myself think about it. I try to think about it as little as possible. I schedule my day with regulated therapies and a rigid schedule that keeps me moving forward. I have regular ands frequent breaks and try to hold to the advice of my rehab team by setting my schedule "in Jell-o". I try to allow flexibility where I can but with the brain trauma the more predictable my day is, the less stress it creates for me.

I fake competence in any area, doing enough to get through it. I used to excel as a student and took pride in learning for the joy of it. I loved doing research and presenting my findings to my co-workers, preparing handouts and teaching tools for those that I served and worked with. Now, I am struggling to hold on to a "B"- and it is taking everything I have to attend online classes at half-time. It takes me two to three times as long to grasp even a part of what I could learn by reading it through once. I fake humor about the pain, about being dumb, about getting through this and holding on to the lessons that I have learned. I have already done more than what anyone expected but still I "fake it".

Milestones

This week has been full of ups and downs. A dear friend, one who was diagnosed shortly after me with an atypical brain tumor, has passed away. Same primary diagnosis, same surgeon, different outcome. I'm not sure how to confront or deal with this. All I can say is that survivor guilt is real. Just two days later I watched my son pass a milestone that I would have missed out on had statistics had their way with my life.

The greatest joys and the saddest losses, both seem to center on family, on connection, on personal relationships. Hold loved ones close, take solace in quiet moments. Play one more game, read one more book, play for five more minutes with your loved ones. Say the hard things, the real things. Speak the important words and let go of the rest. Hold them close and know that life is eternal and is so worth living.

Do not quit, do not give up. Live every moment with every thing that you are and you have. If you do not love your life take the steps necessary to change it. We all have bad days, we all face hard things, that is not all we are or all we have. The moments with those we love, the quiet of our hearts, the peace we find makes it all worth it. If you do not have peace, change what you need to change about yourself so that you find peace. You know what changes need to be made, stop fearing change and move forward. The time is not endless in this life, use what you have. Connect with those you love, before you run out of time to say what needs to be said and do what needs to be done.

God is good. He loves you. If you cannot have faith in that then begin with hope. God bless.

Room at the Inn or The Night Baby Jesus Came to Stay

The doorbell rang just as we sat down to read. Luke 2, the story of the birth of Jesus was the plan. Wondering who it could be we opened the door, only to stare, stumped at the baby in the manger.

Baby Jesus was on our doorstep. No letter, no note, no idea of why he had come or who had put him there.

"So , what do we do with him?"
"Well, we start by bringing him inside."

There it is, the statement that caught my attention, "we start by bringing him inside". Isn't that the way it all begins? Simply by letting Christ into our hearts, into our lives.

Christmas Eve night and all the next day I pondered the meaning of the question of whether I let Christ into my life. Do I make room at my inn?

We searched for who he might belong to. My sons were certain that someone had given baby Jesus to us, I cautioned them that we had to be sure to try to find his owners. The quality and care with which he was wrapped had me concerned that he belonged in someone's beautiful nativity display. The manger was handmade, animal skins lined the bed, and the babe was wrapped in swaddling clothes. Herbs and hay padded the manger, making a soft and safe place for the baby to lay. Care and love was shown in every part of the bed. I think that Joseph and Mary would have shown such care, still I feared that someone was missing a vital piece to their holiday this year.

Christmas night I received a message- Baby Jesus had come to stay for the next year. A reminder to make room at our inn. After focusing on the beauty of the gift of that life and offering a year of random acts of service, we will have the opportunity to pass him on. We will choose a family and gift baby Jesus to them, a note will explain all, what a fun way to remember what is important.

I pray that my sons will always remember the year that baby Jesus came to stay. God bless and keep you.

Is Medical Marijuana a Viable Alternative for Pain Management?

 

Pain is a constant in my life. I live every moment breathing and working through this layer of distraction so that I can engage and function as normally as possible. I have worked with my doctors to exhaust any and all tools for pain management but the options available fall short. In my research on pain management tools to use in addition to a regimen of meditation and mindfulness, yoga, physical therapy, occupational therapy, nutritional decisions and physical activity I continually come across the idea of medical cannabis as a pain management tool. This is an emotionally charged subject and has been the cause for recent social upheaval and political discussion. Misinformation is rife and everyone seems to have an opinion. Voices cry on every side of whether the use of prescription cannabis is necessary. Some insist that medical need is an excuse for habitual users to avoid legal prosecution. Others argue that medical cannabis is the only option for competent pain relief without violent side-effects. Both sides are impassioned and express the belief that they are solely right. So, where is the resolution? Is there middle ground on the issue of medical cannabis?

I started my search to first find reputable resources that offer an unbiased and real look at the issue; science journals and medical texts often offer the most current information. I found many articles published by the National Institute of Health in their effort to share information as part of their report on activities and research.  In their article, “Marijuana and Cannabinoids”, the NIH explores the connection and statistics given in 2015 regarding what is known.  Currently, there are three classes of cannabinoids undergoing research as to the implications on management of pain for various conditions and disorders. In the year 2015 a total of $111 million dollars was spent to research funding regarding the use and properties of medical cannabis. A total of 49 projects currently underway are examining the therapeutic benefit of cannabinoids, with a total of $21 million dollars in funding provided in 2015. (“Marijuana and Cannabinoids”) Given these statistics and the vast amount of funds currently dedicated to solving these concerns I am left to conclude that there is enough encouraging evidence to support the use of cannabinoids as pain management tools.  So, why is there confusion? It appears to me that the research is being done, studies relating to neurobehavior and development are encouraging, and yet there remains a steady stream of vitriol against the idea of legalizing medical marijuana.

I found in a grant connected to this article that further studies are being conducted and about grant options available by the National Institute of Health that support the supposition that cannabis offers therapeutic benefit for chronic pain. According to the NIH, “Pain is a substantive health issue, where it is estimated that 100 million Americans suffer from chronic pain. Opioids have been increasingly used to treat chronic pain, and there has been an increase in the number of opiod prescriptions, which has caused a noncommitant rise in prescription opioid abuse. While opioids may be effective in treating chronic pain in some cases, other treatment options are desperately needed.” (“Developing the Therapeutic Potential”) I fall into this category and can offer real experiences of multiple opiates being used to mitigate pain and induce a sedative effect, allowing my body to recover and heal. Following the acute phase of my trauma I then had to find an alternative way to cope with the pain, more than a year later, multiple appointments, and alternative pain management options continue to leave me coping with daily pain. The problem of living with chronic pain has far reaching effects, leaving no part of a person’s life untouched. Additionally, side effects such as addiction and dependence occur with prescription medications at an increasing rate for patients. In recognition of the need for help and support of patients, multiple agencies have joined together to pursue options and share findings; agencies such as the National Institute on Drug Abuse, the National Cancer Institute, the National institute of Neurological Disorders and Stroke and many others (“Developing the Therapeutic Potential”). Specifically, research is being reviewed for study in areas of inflammation and pain. Review is set to evaluate therapeutic applications of cannabidoils in the specific areas of chemotherapy induced peripheral neuropathy, pain perception and general analgesia (“Developing the Therapeutic Potential”).  What the grant opportunities demonstrate is that multiple support agencies recognize the need for non-synthetic options that integrate well with the central and peripheral nervous system. Current pharmacological options are not meeting the need and are creating additional problems for patients and society in general. Patients need and deserve answers and options that do not create side effects such as addiction and dependence.

The Drug Enforcement Agency, or DEA, recently made some remarks concerning the legal status of medical marijuana. In a report they refused to alter the federal legal status of marijuana.  Studies cited by the DEA, as recently as August 2016, maintain that marijuana is a Schedule 1 drug. (Leger) Schedule 1 drugs are drugs that offer no verifiable medical properties and are thus considered to be used for recreational purposes only. In the same release of information the DEA indicates it has found that marijuana cannot truly be considered a “gateway drug” (Leger).  A gateway drug is one that leads to further experimentation and use of additional substances by the user. Going by what the DEA claims I am left to conclude that they have no evidentiary support to change the legal status of medical cannabidoils and until substantive research findings are produced to dispute that claim, there will be no change in the federal status of marijuana. Currently any use of cannabis is illegal, despite individual states making its use pharmacologically approved. Federal law trumps individual state mandate. The DEA makes allowances here and does not pursue prosecution of medical users, despite having the law on their side to do so. This ambivalent stance is confusing and leaves patients at a loss for where to go and what to do. After reviewing the statements made by the DEA I am left feeling like I have whiplash. On one side they refuse to recognize potential therapeutic benefit, on the other they refuse to pursue enforcing the laws that are in place to regulate the use of illicit drugs.  There has been no indication of a timeline or what may cause them to reconsider either the Schedule 1 classification or pursuit of prosecution for users. What has been created here is an unenforced law, one that weakens the status and value of the DEA in their unwillingness to make a decision about this issue.  I wondered what reasoning may be contributing to the position of the DEA; I turned to the FDA, the Food and Drug Administration.

In April of 2016 Bertha Madras, an expert in the field of medical pharmacology and biology, helped to clarify the position of medical cannabis and the FDA, or Food and Drug Administration.   Madras clearly explains that according to the definition and requirements of pharmacological drugs, cannabis simply does not fit the profile for medicine (Madras).  The FDA holds to five primary requirements for a drug. Those requirements include:

1.      Drug chemistry that is known, consistent, and replicable.

2.      Adequate safety studies have been conducted and reviewed.

3.      Sufficient number of controlled studies documenting measurable value.

4.      It must gain acceptance by qualified experts.

5.      Evidence and documentation must be widely available.  

Looking at the requirements for the FDA it then becomes easy to see why cannabidoils have not yet gained recognition from a legal standing as medicine (Madras). Like any flowering plant, cannabis plants and buds all produce differently in relation to potency, chemistry, and even vary by plant type. The NIH is currently working to address the need for testing and safety studies even while it works to distill and refine various cannabidoils such as THC and CBD. Acting to refine the oils acts to make effort to profile consistent chemistry and determine value to the oils themselves. After this process is refined and completed then concerns such as dosage and potency can be addressed and medical trials can begin. Increasing use of studies and grants will either prove or disprove that medical cannabis is an option for patients. 

Continued testing and refinement of the process is needed to help patients and provide safe medical supervision.  I found that in June 24, 2015, Dr. Nora Volkow testified before the Senate regarding International Narcotics Control. In her report she reviewed the limits and challenges of conducting medical research, potential outcomes and promising studies, and also reviewed what is currently being done to address the needs of patients. At that time, studies on specific neurological conditions offer glimmers of hope but have yet to offer substantive proof that marijuana has therapeutic properties (“Testimony of Nora D. Volkow”). Dr. Volkow went on to further explain that while some preliminary studies have been done into various cannabidoils, specific oils seem to be the key in treating chronic pain. The emerging research supports two emerging oils that relate the most to therapeutic benefit, CBD oil and THC. THC is the cannabidoil that contributes to the hallucinogenic effects, the “high” of marijuana use.  The CBD oil is being used currently as a plant extract base by some patients for regulation of seizures and other neurological trauma. Because it has no hallucinogenic effects, CBD oil is not illegal, nor is its use regulated. Studies into the effectiveness of CBD oil with chronic pain, however, are not promising. There has been no indication, to date, that CBD oil without THC offers any analgesic therapeutic benefit. There have been preliminary studies that demonstrate that THC and CBD oil, when used together, offer an analgesic effect for central and peripheral neuropathic pain (“Testimony of Nora D. Valkov”).  Peripheral neuropathy is a potential side effect of neurotrauma and surgery. Therefore a patient can survive and recover from a violent or traumatic injury such as concussion or brain tumor only to have the nervous system flare up. No known trigger, no known cure. The sensory nerves of the body simply fire as if they have been activated by some unknown trauma. I looked into providers. Who is using cannabidoils with patients?

With an excellent reputation for patient care and breakthrough treatment, The Mayo Clinic has forwarded studies into the use of medical marijuana and patient care. In a web article the Mayo Clinic outlines some of what they are doing for patients to fight the battle of peripheral neuropathy and other chronic pain conditions experienced by patients (“Medical Marijuana”).  Cannabidoils are seeing accepted use with patients experiencing such complications as seizure disorders, Amytropic Lateral  Sclerosis (ALS), and even chronic pain. According to the Mayo Clinic “Medical marijuana is marijuana used to treat disease or relieve symptoms. Marijuana is made from the dried leaved and buds of the cannabis sativa plant. It can be smoked, inhaled, or ingested in food or tea. Medical marijuana is also available as a pill or oil.” (“Medical Marijuana”).  Providers are reaching past recognized legal structure to provide patient care. A medical provider, seen as an authority in patient care and treatment, is using an unrecognized form of treatment for patients even while the regulating authorities refuse to make changes in classification and legal standing. 

Further supporting the idea that providers are moving beyond legal boundaries is the research being done in behalf of the National Cancer Institute. Working with complementary and adjunctive medicine, studies are being conducted into the use of cannabis and its impact on the side effects of cancer related treatment. Use of THC and CBD are showing a positive impact for patients experiencing such complications as loss of appetite, pain, and depression while undergoing chemotherapy (“Cannabis and Cannabinoids”). Along with alternative therapies such as massage and acupuncture, treatment of side effects with cannabis is currently being used to help patients in recovery. Initial findings support the idea that, working through the central nervous system and immune system, cannabidoil is able to have a therapeutic effect upon the body. Since these systems are both largely affected in cancer treatment, the benefits demonstrated to patients indicate that cannabis is effective in treatment (“Cannabis and Cannabinoids”).

What can I conclude based upon all the documentation and research being performed? What am I able to determine since recognized medical authorities are using medical cannabis in treatment and recovery, despite the legal status being one of a controlled Schedule 1 drug? Can medical marijuana be an option for patients who suffer from chronic pain? Maybe. The answer is, maybe. That is all that research and information can tell us at this time. Indications are enough to continue to fund research and development of dosage amounts and efficacy studies. Regulating agencies continue to be hesitant to change legal status due to lack of safety studies and sufficient data. Patients and providers are required to go outside recognized medical models because the options, opiates and NSAIDS, simply do not meet the needs of patients. In thinking about my own experiences and the possible implications, I am willing to consider the options and will simply give it more time. Medical providers and researchers are doing their best to find answers, patients are doing their best to live and function, and regulating agencies are making efforts to be good stewards in protecting the public. Patience and empathy are required as everyone works to do their best in finding answers. 

Resources:

“Developing the Therapeutic Potential of the Endocannabidoil System for Pain Treatment. PA-15-188.” NIH, Office of Extramural Research.  www.grants.nih.gov/grants/guide/pa-files/PA-15-188.html . Web. November 2016.

Leger, Donna Leinwand. “Marijuana to remain illegal under federal law, DEA says.” USA Today. August 11, 2016. www.usatoday.com/story/news/2016/08/11

Madras, Bertha. “5 Reasons Marijuana is not Medicine.” The Washington Post. April 29, 2016. www.washingtonpost.com/news/in-theory/wp/2016/04/29/5-reasons-marijuana-is-not-medicine. Web. November 2016.

 “Marijuana and Cannabinoids.” NIH, National Institute of Health.  www.drugabuse.gov/drugs-abuse/marijuana/nih-research-marijuana-cannabinoids. Web. November 2016.

 “Medical Marijuana.” Mayo Clinic. Healthy Lifestyle Consumer health. http://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/medical-marijuana/art-20137855. November 2016.

 “Testimony of Nora D. Volkow on Cannabidoil Barriers to Research and Potential Medical Benefits Before Senate Caucus on International Narcotics Control.” NIH, National Institute of Health.  http://www.hhs.gov/about/agencies/asl/testimony/2015-06/cannabidiol-barriers-to-research-and-potential-medical-benefits/index.html. Web. November 2016.

“Cannabis and Cannabinoids- Health Professionals Version.” NIH: National Cancer Institute. http://www.cancer.ca/en/cancer-information/diagnosis-and-treatment/complementary-therapies/medical-marijuana-and-cannabinoids/ Web. November 2016.