Pelvic pain is the most common symptom associated with endometriosis and was also the main symptom in my patients.  In addition, they combined experienced either dysmenorrhea (painful periods), dyspareunia (painful intercourse) and dysuria (painful urination).   In all cases it was severely debilitating to their life and when they were symptomatic 3/4 could not work.

CONTROLLING PAIN WITH CANNABIS INDICA STRAINS

Cannabis indica is a strain of marijuana that is higher in cannabidiol (CBD).   Researches suspect that CBD is responsible for the reduction in inflammation associated with chronic inflammatory states.   Endometriosis is a condition where the cells that line the uterus (endometrium) are present outside of the uterus (most common on the ovaries, fallopian tubes and pelvic wall).  It is these cells that can bleed, releasing inflammatory mediators locally causing pain.

All of my patients reported getting the most benefit from a strain of cannabis called OG Kush, which is an indica strain.   In preparing myself for this blog I could not find any study or evidence that has looked at comparing different strains.   But my patients anecdotal evidence is exciting.

They each had a huge improvement in their uality of life as a result of being able to manage the pain.   One stopped taking any other medications altogether.    Each were able to work when they became symptomatic.  In addition, my one patient reported that “sex was actually enjoyable again.”   This is very exciting and the type of outcomes I am seeing daily in my practice.

I would love to see some more research comparing medical marijuana to some of the more traditional therapies in treating this complex disease (from a pain management standpoint)

If you suffer from endometriosis and are looking for an alternative treatment, I encourage you to discuss using cannabis with your doctor.  If they are unwilling to recommend it to you I will be happy to sit down and see if it makes sense.

I hope this blog gives you some hope!   Hang in there.

Be blessed,

Dr. Breen

To make this simple I am going to use wine as an example.   If you told me you wanted to try a glass of wine to feel better and asked me which one to try (assuming you have never tried wine) I would have a difficult time trying to figure out which one you would like.  I would tell you there are RED wines and WHITE wines.   Within RED wines you have different types such as Merlot or Cabernet.  If you liked Merlot you would then have to find a specific winery that makes that RED wine.   You could then even narrow it down to a specific year that the wine was made.

The same thing applies to WHITE wines.  You have different types, made by different wineries, in different parts of the world and of different years.

This analogy is similar to cannabis (marijuana plant).   Within marijuana, you have two major types being sold in medical marijuana dispensaries.   The first is Cannabis INDICA.  The second is cannabis SATIVA.   They are BOTH cannabis yet they have distinct properties that give a varying physiological effect.  When you go a dispensary they may have 10 different types of indicas.  The same goes for SATIVA’s.  They also combine the two strains to produce what is called hybrid strains: part INDICA and part SATIVA (typically one of them is the dominant strain) So you would have hybrid-indica dominant or hybrid-sativa dominant.

THE TRUTH IS THAT THERE IS NO MEDICAL LITERATURE OR STUDIES THAT SAY ONE STRAIN IS BETTER THAN ANOTHER FOR ANY GIVEN AILMENT.

However we do know that there are general properties of indicas and sativas which are responsible for their varying effects.  The main psychoactive ingredient in cannabis is Delta-9-THC.    It is only one of over 70 different cannabinoids that have medicinal value.  The other main cannabinoid is cannabidiol (CBD) .

What we do know is that indica strains tend to have a higher ratio of CBD to THC and tend to be LESS PSYCHOACTIVE and more SEDATING.   Sativa strains tend to have a higher ratio of THC to CBD.   Therefore, they tend to make you more “high” and are more energizing than sedating.

These are very general statements and every patient is different.  What I mean by this is that two patients can have the same diagnosis and try the same strain.  Patient #1 feels great and patient #2 gets way too “high”.    It is very difficult to predict what strain is going to work best for each specific patient.

What I tell patients is to tell the dispensary owner exactly what you are trying to accomplish.  i.e. You are in pain and need to get more sleep…. OR you are nauseated and need something to stimulate your appetite.    Once he has some general information he can help guide you about what previous patients with your complaints typically do well with.   Then you should try a few different strains and see which one works best for you.   You may find that you do great with sativas, can’t tolerate indicas and hybrids are OK.

Without federal funding it is going to be very difficult to get the research money needed to isolate each individual cannabinoid in the plant and see what it’s exact mechanism of action is and what physiological effects it has on the body.   Until then we are forced to go off anecdotal evidence to provide patients with information of choosing the right strain.

I hope that helps.

Be blessed,

Unfortunately there are not a lot of physicians in traditional practices who are even willing to discuss cannabis use with their patients, let alone provide a recommendation.    For example, at Kaiser they have a policy that doctors are not allowed to recommend cannabis.  Most Kaiser doctors dodge the question or reply to a patients inquiry by saying “if it works you Ok but I can not help you with it.”

Because of the reluctance on the part of physicians to discuss and recommend cannabis there has been an opportunity for physicians to start medical marijuana practices where they not only are willing to discuss and recommend cannabis use for patients but also TRULY educate themselves on the research and have the latest/greatest information to answer patients questions.   In California this has proven to work in the patients favor.   For example, if a patient comes in to my office and asks me questions on methods of using cannabis I can easily explain what a vaporizer is and show them how to use it.

Very few potential patients and doctors have ANY understanding that it can be inhaled SMOKE FREE.   I can not tell you how many patients I speak with that tell me when they bring up the topic of using cannabis to treat their symptoms the response they get is “I would never recommend you smoke anything”.  That is there initial justification for just not even discussing it.    They obviously didn’t have the information and as a result gave bad/incorrect medical advice.

That is only one of many examples where traditional physicians do not have all the information and give patients incorrect facts.

Unfortunately the reality of Prop 19 is that is comes at a time when unemployment is at its highest level in California since the depression.  People are struggling financially and are pinching every penny that they possible can.   Completely understandable.   If Prop 19 passes what makes sense is that patients are going to save the $99 to see a physician to use cannabis for medicinal purposes and just use it because it is legal.    In a perfect world patients would still want to discuss this with a doctor but in reality that is not what is going to happen.

How do we know that is the case?   We have been speaking to all our patients about scheduling their renewals for their existing recommendations.  The majority are saying they are going to wait and see what happens on Nov 2 with Prop 19 so they don’t “waste their money”.

What does that mean for clinics that specialize in offering cannabis recommendations?   Most likely these doctors will transition to more traditional medicine and abandon their practices.  Not out of lack of interest or compassion but because of economics.   Discussing cannabis with patients has been one of the MOST REWARDING experiences professionally for me.   I can not tell you how many patients have improved and returned to tell me how cannabis has changed their life.   I have been blown away by the stories they tell me.

“I am completely off my oxycontin!”  one will say.   This week a patient came in and told me that a good friend of his, also a patient of mine, just died this past week after a hard battle with cancer.   But he told me that this dying patient asked him to relay this message to me: “Cannabis made the last year of his life bearable.  It was the only thing that gave him comfort and brought him hope.  He wanted to thank me for doing what we do.” His story will bring you to tears and I get choked up thinking about the difference we are making in patients lives.

Without clinics like ours patients will be left to fend for themselves.   You will see an increase in the rates of smoking it vs vaporizing because the medical community is the only one pushing this and educating patients.     As a result you will see increases in asthma, bronchitis, pneumonia and probably overall sick visits to the doctor.   I can see it now as doctors start to issue statement about how smoking cannabis increases the risks of illness and death.   Overall I see this as setting back the medical community,

My message to those people and patients who want to see cannabis become main stream in the medical community is to Vote NO on Prop 19. KEEP CANNABIS MEDICINAL

Many patients who suffer from pain experience this same regimen of medications.   All of which may work temporarily but none of which are a good long term treatment plan.  Overuse of ibuprofen leads to stomach and intestinal ulcers and bleeding, heart attack and stroke (potentially).  Overuse of vicodin leads to addiction and dependence, constipation, nausea, itching and mental status changes.  Prednisone, although initially will limit inflammation, will cause many sever side effects (hyperglycemia, osteoporosis, weight gain, psychosis, increased appetite, depression/anxiety, infection due to weakening of the immune system, easy bruising, fatigue).

Amazingly, I expect this patient to get off ALL of these medications and use cannabis daily.   THIS WILL SIGNIFICANTLY IMPROVE THE OVERALL QUALITY OF HIS LIFE.   Eventually, hopefully, he will be able to use cannabis sparingly and be pain free.   BUT, if he has to use cannabis every day the rest of his life… no big deal!   Compared to these other drugs it is much safer.  He can not overdose, it will not cause ulcers and it does not effect any of the major organ systems like these other medications do. If used daily, we just recommend every few months giving your body a break for 5 days or so.

70% of my practice is taking care of pain patients.    Medical marijuana, when used in conjunction with Osteopathy, Chinese Medicine (acupuncture), physical therapy and meditation/prayer, is a highly effective and good long term treatment plan.

For more information about how to make an appointment to see me call my staff at 877-721-0047 and come on in.  We have offices in Irvine and Long Beach California.

Be blessed,

Dr. Breen

GROWTH HORMONE, is a chemical that is produced in the pituitary gland in the central area of your brain.    It’s normal function and secretion is essential to a healthy life.  Specifically growth hormone:

1. Causes the growth of bones and cartilage in growing children.

2. Stimulates the growth of skeletal muscle by increasing the uptake of amino acids.  It facilitates the healing and regeneration of healthy connective tissue.

3. Breaks down fat.

4. Supports the immune system by influencing the production of anti-bodies and the function of many immune cells.

5. Effects mood and behavior.

6.  Effects the production of a compound called IHG-1 in the liver which has MANY important metabolic functions.

So as you can see, GH is essential for living a healthy life.   It’s secretion peaks in adolescence  and slowly declines over time.    THERE ARE MANY THINGS THAT CAN EFFECT THE PRODUCTION OF GH IN THE BODY.

SLEEP HAPPENS TO BE THE NUMBER ONE FACTOR IN ENSURING THE HEALTHY PRODUCTION OF GRAOTH HORMONE IN THE BODY.   GH is primarily secreted in the first few hours of deep sleep at night.  LIke many other hormones GH is triggered by a circadian rhythm and when we fall asleep the body inherently knows to ramp up GH production.

If patients are lying in bed staring at the ceiling until 1 or 2 am and then have to get up for work in 3-4 hours they are missing out on the peak time when their bodies should be secreting growth hormone.   THE RESULT:  breakdown of muscle mass, increases in fat stores, weakened immune systems and overall feeling and looking “much older”

Understanding the importance of getting a good nights sleep, you can now see insomnia in a new light.     Growth Hormone is only ONE of MANY hormones that are triggered by sleep.    Medical Marijuana has some incredible properties.  One of them is sedation.   I can not tell you how many patients of mine use a cannabis INDICA strain 30 minutes prior to going to bed and tell me they “had the best sleep in years.” The good news is that unlike many other sleep pills, patients do not report waking up feeling groggy or feel tired throughout the day.  Most can use a very small dose of the right stain of marijuana and do really well.

So I challenge those who mock physicians who provide medical marijuana recommendations for patients who can not sleep well to do the research and really study what the cost of not sleeping is on the body.   I CAN TELL YOU THAT DOCTORS IN GENERAL LIVE 15 YEARS LESS THAN THE GENERAL PUBLIC…mostly because of not enough sleep, overcompensating with caffeine and poor diets, which leads to chronic disease and early death.

With that… BE BLESSED AND GO GET SOME SLEEP——> If you are not using cannabis to help you sleep and would like to come in and see me feel free to contact us through our website or toll free number 877-721-0047

Dr. Breen

1. The first is to INGEST IT in edible form.  Basically patients can mix the plant and make a cannabutter that is used to cook with.  I have seen some collectives offer it in tincture form in pill caps.  I have seen soda’s and teas.

The problem with ingesting cannabis is that is is VERY UNPREDICTABLE.  Patients can ingest something and not feel the effects for 30 minutes or 3 hours.  When it does hit their system it may be 10X the dose they need or 1/10th the dose they need.   It can create some very uncomfortable experiences for patients who ingest too much at once.

Secondly, edibles are not regulated by ANYONE.   Pretty much you have no idea who is making them, whether or not they have a clean kitchen or even if they wash their hands.   So there are concerns about bacterial, fungal and other contamination.   I WOULD STRONGLY ADVICE NOT PURCHASING EDIBLES AT ALL.   If you are dead set on using them learn how to make them yourself.

2. The second way is to INHALE the medication.  This is preferred because it makes it very easy to determine how much you need.  It will hit your system within minutes and it is very easy to titrate the dose.        You will be much less likely to use too much if you go this route.

Now traditionally people inhaled by smoking the plant.  They actually burn the plant (joint, pipe, water bong etc) leaf itself and inhale the medicine in addition to the by products of combustion which are Carbon Monoxide (deadly), PAH compounds (carcinogenic) and the ash which deposits in the airways of your lungs.  ALL BAD!

However you can eliminate the smoke by using a VAPORIZER.  They allow you to inhale just the medicine without burning the leaf which in turn has NO SMOKE, VERY LITTLE ODOR, and is MORE EFFICIENT.  So you won’t stink, your clothes won’t stink and you neighbors aren’t going to know you medicate with cannabis.   So it is much more private.   You can smell a patient who has been smoking a mile away.

The reason why vaporization works is because all of the medically active ingredients in the cannabis plant on are the surface in glands which the plant secretes.  They are stored in little capsules called Trichomes.  These crystals are dotted all over the surface of the leaf.   SO THERE ARE NO MEDICALLY ACTIVE INGREDIENTS IN THE PLANT LEAF ITSELF (that we know of).  All the medicine is on the surface.   These trichomes will evaporate at a lower temperature than when you burn it.   Approximately 360 degrees fahrenheit.

So what a vaporizer does is heat the plant to 360 degrees (in that range) where the trichomes evaporate allowing you to inhale them… without burning the leaf itself.  SMOKE FREE MEDICINE!

This obviously creates a huge advantage for patients.   I have many patients who suffer from asthma, COPD, or have cancer and can not smoke anything.  They can inhale without coughing, wheezing or feeling that burning sensation in their lungs when they medicate.   It is simply like inhaling a warm breath of fresh air.

If you are a physician reading this I would encourage you to educate yourself on vaporizing so that if your patients ask you about using medical marijuana you can at least give them some basic guidance about how to medicate.

IF YOU WOULD LIKE TO PURCHASE A VAPORIZER PLEASE CALL OUR OFFICE AT 877-721-0047 AND WE CAN ASSIST YOU WITH GETTING ON AT A VERY GOOD PRICE AND DISCOUNT.

Be blessed,

Dr. Breen

Most people today are not familiar with the Polio Virus.   The first epidemic in the United States was in Vermont in 1916 where over 9000 people were affected.   Most famously, FDR contracted Polio in 1921 and when he assumed the Presidency of the United States in 1932 he was for the most part wheelchair bound.   In the early to mid 1950′s there were 50,000 cases per year in the US which led to frantic research on a vaccine.    Thanks to Jonas Salk and Albert Sabin a liver vaccine was created and the last indigenous case in the US of Polio was in 1979.

Polio is a virus which is contracted through the oral-fecal (poor hand washing) route most commonly but is also transmitted from patient to patient through mucus secretions.   It typically causes a febrile illness that can mimic meningitis (fever, neck pain, malaise, headache)  and usually is self limiting.   For many patients the virus also attacks the spinal cord and cause the typical lower leg paralysis (acute and sometimes permanent (less than 1% of Cases).   As a result patients have muscle wasting and chronic weakness. Many times patients with polio have super thin calves and ambulate with a limp.

My patient suffered from sever muscle wasting and has had difficulty walking since he contracted it as a child.   Unfortunately he fell three years ago and fractured his femur.   Since he has had significant pain.  Because of his limp he also has severe lumbar spine pain (lower back).  His doctor gave him the standard cocktail of Motrin, Vicodin and Trazodone to assist with sleeping.   All of these medications had side effects which were intolerable.

He had tried cannabis a few times in the past week in edible form and had significant relief.   He was told it was an indica strain (LA Confidential) which is more sedating and less psychoactive than the sativa strains.   He came to my office in hopes of a treatment that he can use the rest of his life to improve his sleep and limit his pain.    With the use of a vaporizer he can inhale it SMOKE FREE and ODORLESS.

If you suffer from chonic pain or contracted polio and would like more information about how cannabis can improve the quality of your life contact us through our website or by calling 877-721-0047

Be blessed,

Dr. Breen

Before I discuss what is currently known about marijuana’s affects on the central nervous system short and long term I want to stress that you always have to weigh the benefits and risks of any medication that you take.  And in the case of marijuana you have to consider what medications you WOULD BE TAKING instead of using cannabis and the risks that they pose as well.   Most of the time cannabis is much safer and effective.

Most people have heard someone say at one time or another “that guy is burnt!”… meaning their brain is pretty much fried and they are not solving any calculus equations anytime soon.   The question becomes: does long term use of cannabis adversely affect the brain.   Short term, while acutely medicated, it is pretty clear that cannabis has an affect on short term memory, attention, coordination, balance, reflexes and hinders higher executive functioning (learning and problem solving).   It is for this reason that patients must be very responsible when medicated.   Researches believe that most of these symptoms are a result of THC (tetrahydrocannabinol) which is that main psychoactive ingredient in the plant.   There are over 60 other cannabinoids that we know of in the plant which also exert their effects on the body. An example is cannabinol which is believed to have anti-inflammatory and analgesic properties without the psychoactive affects that THC has.   This is significant as we move forward with therapeutic applications of the plant.

In the long term the research is less clear.   There have been studies that have shown that long term (chronic  daily) heavy users do exhibit some impairment in higher cognitive function (executive functions such as learning and problem solving) but it is difficult to distinguish from the loss of cognitive functioning that occurs naturally with aging.   There have been studies that demonstrated that chronic cannabis users also have a higher incidence of psychiatric comorbidity like anxiety, depression and irritability.    Certainly I have discussed cannabis use with patients who have been medicating for 30 years or more and they do say that if they don’t have access to cannabis they experience increased irritability, mood swings, insomnia and at times depression.   These are considered moderate withdrawal symptoms that some patients can experience.  It is for this reason that we suggest patients take “drug holidays” every few months for about 1-2 weeks to give their bodies a break and chance to “reset” their natural endogenous cannabinoid system.

One of the other questions is if regular heavy use of cannabis affects an individuals drive or motivation.  People describe users having “amotivation syndrome.”   They question whether cannabis affects their ability to reach goals etc.     My personally feeling is that in recreational users this can be the case.    However using cannabis as a medication is completely different.  Patients typically use less psychoactive strains of cannabis and are using much smaller doses.   Most patients just want relief of their symptoms and nothing more.   In these situations I have not found cannabis to affect a patients ability to work or reach goals.   Most get more sleep, are less stressed and have less pain which allows them to be more productive.

Overall I would say that cannabis in therapeutic doses for medicinal purposes poses very few adverse affects to overall patient functioning.  The major organ systems are not affected and the the acute psychiatric affects of the medication are limited.   Long term, patients do much better because 1) they are not dependent on other medications and 2) their day to day quality of life is improved.  I clearly think that the benefits most patients receive outweigh the risks of using cannabis long term.

If you have questions or comments feel free to contact me at any time or come in for an appointment. 877-721-0047 or www.mcsocal.com

We have two full time offices in Irvine and Long Beach California.

Be blessed,

Dr. Breen

OK here it is.  The brain is considered our central nervous system.  The spinal cord and the nerves that exit the spinal cord that project to all of the organs, muscles, vessels and skin are considered the peripheral nervous system (there is also an autonomic nervous system but ignore that for now)   Think of nerves like the electrical wiring that runs throughout the house.   To keep this simple let’s take the bones and tissues of the knees (a common complaint I see is arthritis of the knee)  If you have pain in the knee it is because the nerves (wires) that originate at the knee are in a very excited state.  They get activated and send the signal through the nerve (headed to the brain ultimately) which makes it first connection in the spinal cord.

Once at the spinal cord that nerve typically connects and communicates (via neurotransmitters… chemicals that allow one nerve to communicate with another) with a new nerve in the spinal cord which runs all the way up the spinal cord and terminates in the brain.

Once in the brain that signal is processed and it sends it back down a new set of nerves (originating in the brain) which run back down through the spinal cord.   So thus far we have knee—–>Spinal Cord—–>Brain—–>Back down spinal Cord—–> lastly a nerve leaves the spinal cord and ends back at the knee where ultimately the patient feels pain.

They way marijuana works (that we know of thus far) is that it specifically binds to a receptor on the nerves themselves and blocks or slows down the transmission of pain up and down the spinal cord to the brain. The electrical wiring (nervous system) in our body has what we call receptors on it along the way (Think of receptors as door locks).   Each of these locks has a specific key that opens it and causes it to have a specific function.   When you inhale cannabis you inhale specific “keys” that go and search out these specific locks on the nerves.   When they find them they bind to them and cause the nerve to be less excitable which ultimately slows the transmission of pain throughout the nervous system.

Now, in my effort to keep things simple and stupid I know that there are scientists out there who will read this and say… “yeah but thats not exactly how it works.”  However, in a more general sense this is how marijuana reduces pain in the body.

If you are a person that wants to get into the nitty-gritty science behind this you can read plenty of studies which discuss the physiology of CB1 and CB2 receptors.   The CMCR at UCSD has published a study on cannabinoid analgesia and it is accessible online.

If you suffer from pain and would like to discuss using cannabis to improve the quality of your life please feel free to make and appointment to come in and see me at my Irvine or Long Beach CA office.   Simply call 877-721-0047 or pre-qualify for FREE at www.mcsocal.com

Be blessed,

Dr. Breen

Behcet’s syndrome is very rare in the United States.  It mostly affects men and women who live in the middle east and asia.  It is a disease that causes inflammation of the blood vessels.   It is characterized by painful ulcers in the oral mucosa (mouth, gums and tongue) and genital region.   They look like your typical “canker sore”.  Patients also can suffer from visual changes as a result of inflammation of the blood vessels in the eye.   Two thirds of patients suffer from arthritis in the knees and ankles (most commonly).  Less commonly patients can have lesions in the brain that affect patients balance and coordination.  Also some patients can form clots in their veins.

The reason why patients with Behcet’s syndrome can experience relief using cannabis is because the plant has over 60 cannabinoids which influence the immune cells and reduce inflammation.   It also binds to the nerves directly and reduces the amount of pain that patients experience.

My patient reported using cannabis on 3 occasions in the past month and on each occasion experienced a significant reduction in the pain in her knees.   Even though she felt “anxious” about coming in to see me she could not deny the benefits she experienced.  After speaking with her and going over both the risks and benefits of using cannabis she felt relieved that she will finally get regular relief.  I expect that she will do very well and cannabis will become a routine part of her treatment plan.

If you suffer from Behcet’s Syndrome or pain for any reason and would like a professional medical evaluation to see if cannabis can improve the quality of your life simply make an appointment to come in.  My staff will be able to answer many of your questions and schedule an appointment.  877-721-0047

Be blessed,

Dr. Sean Breen

Medical Cannabis of Southern California is the most respected clinic for providing patients with medical marijuana recommendations.  Our offices are located in Irvine and Long Beach California.