Helping Patient Get Their Life Back
by Marissa Fratoni of Holisitic Nurse Mama
Brandy (not her real name) is a 30-year-old woman who will tell you that she once had the world at her feet. Always an overachiever, she had been working in her career as a marketing manager in a large advertising firm for about five years following her magna cum laude finish from a local university. Everything was going remarkably well for her until she veered her car at high speed into oncoming traffic — she was checking a text on her cell phone while driving. She wanted to respond to her best friend who was confirming dinner plans for that fateful evening when she looked up through her windshield in time to witness her own disastrous mistake. She struck an SUV head on, causing the hood of her small compact car to xylophone. Airbags exploded from her steering wheel and dashboard, burning her face and hair. She blacked out at that point and had no recollection of anything until she woke up in an ICU bed two days later.
The accident left Brandy with a head injury, whiplash, and a broken left ankle. Her life was spared, as were the lives of the four people in the SUV that she struck. The family of four included two small children — all were alive and well with only a few scratches on the parents who occupied the front seats of the vehicle. They didn’t press charges. Brandy cried when she received this news. She was relieved to hear that everyone was alive, thanked her lucky stars, and decided that she would never make such a significant, life-threatening mistake again.
While in the hospital, Brandy was placed on a pain pump. She was able to administer a dose of morphine at regular intervals to reduce the pain she experienced post-accident. All with the push of a button, directly into her vein. She noted how well the morphine worked and was grateful for the pain relief. On her way home, the nurse who discharged her provided a couple of prescriptions written by the attending physician — oxycodone for pain, another for Ativan as Brandy had been experiencing anxiety and panic during her time in the hospital. The nurse recommended that she use the oxycodone for as long as she needs, but to switch to Motrin when she’s starting to feel better. “You don’t want to use those pills for any longer than you have to,” said the discharge nurse.
Brandy’s head injury left her with constant headaches and vision changes.Her ankle was held together with pins and screws now — she had orthopedic surgery shortly after being transferred to the hospital following the accident. She didn’t remember anything about that. She was released from the ICU within a few days and spent another day on a step-down unit until she was discharged the following morning. Brandy’s parents brought her home to her apartment — she was ready to get back to her life and move on from this horrific event. Her mother stayed with her for a couple weeks until she was a bit more stable. Little did she know that this accident would be the start of a new life that was unrecognizable to not just herself, but everyone who knew her.
Within a few days of being home, Brandy attempted to dig back into work and realized that for one reason or the other, she couldn’t find the solutions her team was seeking from her. She couldn’t see a task through to completion, nor could she communicate well via email. It took her a half-hour to write one email.
Concerned, she deferred to her Mom who reassured her, “You have a concussion sweetheart. You shouldn’t be thinking about work or looking at computer screens right now. Just rest. Don’t worry right now.” Brandy’s Mom always found a way to make her feel better.
Several weeks later, everything was a still a struggle for her. It took her twice as long to get up and ready in the morning as it had prior to the accident. She not only had to negotiate using crutches to get around, she also couldn’t force herself to work through any particular task in an efficient manner. She would start the coffee pot only to realize after a few minutes that hot water was dripping into the pot — she never placed a filter or coffee in first. She left the faucet in the kitchen sink running for an entire day at one point. Brandy also forgot to close the refrigerator door before leaving for work on a particularly bad day, causing an entire grocery shopping’s worth of food to spoil. And the worst part was finding her rental car in the garage after work. She would walk around and around and around, clicking the key remote in hopes that it would cause the car to beep. She had this car for weeks and she could never seem to remember where she parked it in a familiar garage.
When she visited her primary care doctor, she expressed her concerns about these lapses in memory, but her doctor brushed off her concerns and stated that head injuries take time to heal. He suggested seeing a neurologist if she didn’t see any improvement in a month. Unfortunately, Brandy’s employer didn’t feel the same way after nearly two months of what they considered, unproductive, lack-luster performance. Brandy tried her best, but she admitted her best post-accident was pitiful compared to her performance pre-accident. Ten weeks post-accident, Brandy was laid off from her job.
Brandy didn’t know how to move forward. She updated her resume and sent it off with a cover letter to all of the marketing and advertising firms in the vicinity. No one responded, not even an email to say “thank you for your interest” was received. She continued to take her oxycodone and Ativan daily. Sometimes she took more than the prescribed dosage on the bad days, but didn’t think much of it. These medications made her feel better and so much in her life was upside down, she felt she needed to take both on a regular basis. So she frequented her doctor’s offices for refills on her prescriptions. Her primary care doctor referred her to a pain clinic when he realized Brandy was not about to accept “no” for an answer. At the pain clinic, she was able to acquire a regular supply of oxycodone as long as she agreed to regular physical therapy for her ankle. She rationed the ativan, splitting it up into tiny pieces so she could take little bits with her oxycodone.
Brandy collected unemployment and put an ad on social media for a roommate. She made going to physical therapy and the pain clinic her job, committing herself to every appointment without fail. She did this to ensure her supply of oxycodone would continue, a realization that came much later she admits.
Four months post accident, Brandy’s bills were piling up. Her parents paid her rent in an effort to help. Brandy still couldn’t afford to pay anything other than food and utilities with her unemployment check. She had to return the rental car because she couldn’t afford it any longer, nor could she afford to buy a new one. And as far as finding a roommate, Brandy cancelled every appointment that potential applicants made in favor of sleeping. Depressed and anxious, Brandy repeatedly turned to the only things that made her feel better — oxycodone and Ativan.
A few more weeks passed and Brandy’s parents said that they could no longer afford to pay her rent. Upset, Brandy demanded to know where she would live. They offered their basement to her and agreed to help her move out of her apartment in a month. She agreed and felt it was the best option she had.
Brandy admitted that she would hole up in her parent’s basement and sleep for days at a time. The only time she would emerge from her underground lair was to fly up the basement stairs in a rage over someone making too much noise during the day, or if she had a pain clinic appointment where she would basically demand that one of her parents cancel their day to get her there. The once vibrant, strong, unstoppable girl had become an irritable troll who hated her life and everyone around her. Brandy blamed the accident, the head injury, and the loss of her job on this behavior until her parents found her unresponsive in the bathroom nine months after her accident. Brandy had overdosed on a deadly combination oxycodone and Ativan. She had stopped breathing. Paramedics administered narcan and revived her. And she got to spend another few nights in the hospital.
“I was taking handfuls of pills all day long. I don’t even know how much,” Brandy admitted when she reached out to me following a white-knuckled experience in detox, “I’m still in so much pain. I haven’t had so much as a Tylenol since I detoxed, but I can’t live like this. It’s constant.”
Brandy’s suffering was legitimate, but for a person who had just entered recovery, treatment options are sorely lacking. “I can’t get hooked again, I can’t believe that happened! But I can’t live like this!”
“What is your experience with cannabis? Have you ever tried it?” I inquired.
“Yeah, in college. Wasn’t really my thing. I don’t want to smoke…”
“You don’t have to. You don’t even have to be high, but a little THC may benefit you.”
Brandy considered this option for a few minutes. We reviewed the endoCannabinoid System, how nourishing this system with whole plant medical cannabis could potentially help her relieve pain and improve her overall quality of life.
“It’s not addictive?” I could hear a glimmer of hope in Brandy’s voice.
My response — “Every substance can be addictive. There are support groups for people who are addicted to chapstick to give you an idea! Compared to many prescribed medications, the addiction rate for cannabis users is low. It’s much safer than many prescribed medications and of course, illicit street drugs. If you do abuse it, it won’t kill you. And you can come off it without needing medical oversight.”
With that, Brandy decided it was worth a try. She acquired her medical marijuana recommendation and visited a dispensary. With my recommendations, she acquired a high ratio CBD tincture with twenty parts CBD and one part THC. She also picked up a vape pen that the dispensing agent recommended for sleep, and a pack of low-dose edible fruit chews recommended for pain management. Along with her therapeutic cannabis regimen which we planned together, Brandy agreed to eat a diet rich in plant-based foods, drink plenty of fresh water, and to drastically cut in processed, sugary foods.
During our last follow up phone call, Brandy reported that she was feeling much better. Her pain was greatly reduced, and her parents seemed to like her again. She wasn’t out of the woods citing constant cravings for the oxycodone she had become dependent on, but she noted that the cannabis definitely helped.
“This cannabis is helping me stay in recovery. I go to meetings and I tell people about it. I don’t know why doctors don’t prescribe it. I am very grateful that I reached out to you. I am getting my life back — still in pain, but I can manage it with the cannabis. And I think my brain is working better! But yeah, when I want a pill so bad, I use some cannabis. It helps.”
“That’s all so great Brandy. Keep doing what you’re doing — keep up the good work.” I happily responded.
“Oh and one more good thing happened! I went on an interview today and got the job!” I could hear how elated Brandy was to report this positive event.
“That’s awesome Brandy! Congratulations! You did it!” I exclaimed while smiling on the other side of the phone, I shared in Brandy’s excitement, “Such wonderful news!”
As I ended the call and pulled up my notes, I could only sit for a second in a moment of pure gratefulness. Another beautiful soul, that was almost extinguished by bad decisions and abused prescription medications, was now able to move forward and carry out her life with the help of a little cannabis. Thank goodness for “this cannabis.” It really can be a life-saver for people struggling with addiction who require a solution to chronic pain and relentless anxiety. According to the National Institute on Drug Abuse, 30% of opioid related deaths from overdose involved benzodiazapenes like Ativan. Bottom line, cannabis is a harm reduction tool, it should be on the table with every other treatment for substance abuse and addiction to combat this drug overdose epidemic. The proof is in the stories shared and yet to be told.
Special thanks to “Brandy” for allowing me to share your story. It will help others!
GreenNurse Marissa Fratoni RN
Holistic Nurse Mama