Neuralgia, unspecified

Date: January 12, 2021

Condition: Neuralgia, unspecified

Comorbidities: Prostate Cancer, Colon Cancer, Mild Obesity, Mild Hypertension

Description:

The patient is an 87-year-old man who is currently in good health. In June 2020 he developed a vesicular rash on his right forehead and down his nose. It was intensely painful. He was diagnosed with Herpes Zoster Ophthlamicus. He was placed on Valtrex and sent to an ophthalmologist for treatment of his corneal vesicles. I talked to him in August of 2020. He was spending most of the day in a dark room with intense pain from postherpetic neuralgia (PHN). He was taking acetaminophen and Gabapentin (unknown dose). He had narcotics prescribed but did not like how they made him feel.

Product Description

He started using a cannabis orally with an oil that contained THC and CBD in a 1 to 1 ratio. He was cannabis naive and did not want to be “high”. He started on with 1.25 mg of each THC and CBD three times daily (TID). He slowly increased to 6.25 mg of each TID over a 4-week period. He had results after 1 week and was 98% better at 6 weeks. He maintained that dose for another month and then slowly decreased the THC while continuing the CBD. He increased the CBD slowly to 20 mg TID with a new oil that was 20 to 1 CBD to THC. The patient was hoping for immediate relief so I knew I had to spend time managing his expectations.

He felt that while taking the 6.25 dose of THC that he was not as active and engaged with the world as he usually was. He also felt fatigued. But I pointed out that he had a serious disease and severe pain. Otherwise, he had no side effects. He and his family were grateful. My success in treating PHN has been dismal. I had no previous experience in treating PHN with cannabis. However, I think the benefits far outweighed any harms. We were both willing to try and thankfully it was successful.