Cannabis Interventions for Postoperative Care

Today I would like to discuss how to titrate your cannabis medication when you have trauma, scheduled operations, muscle strains from gardening, washing your vehicle, or any other painful experience coming from normal activities of daily living.

It is important to have some chemistry discussion first. Whenever there is trauma to tissues, whether it is bone tissue, gums, muscle tissue, or skin tissue, the normal physiological response is inflammation. Inflammatory occurs when tissues are injured by bacteria, trauma, toxins, heat, or any other cause. The endocannabinoid system recognizes the body is out of balance and immediately activates the cannabidiol (CBD) receptors in all of our tissues to trigger the release of chemicals including histamine, bradykinin, and prostaglandins. These chemicals cause blood vessels to leak fluid into the tissues, causing swelling and pain from the rise in blood flow that is not normally present bringing the body’s return to homeostasis.

CBD’s main function is reducing inflammation. The immediate response is to grab some delta-9 tetrahydrocannabinol (THC) as THC’s main function is reducing pain. But that would not be the best response. Why, because the inflammation needs to be reduced first. So, the first thing to do whenever there is trauma is to take a dose of pure marijuana/cannabis type CBD or hemp CBD, not the CBD you get from Amazon.

Dosing is dependent on whether you are new to cannabis or already taking cannabis for a chronic medical problem. The novice will start with 10mg and up the dose by 10mg every hour until you find relief. The chronic user of cannabis may have to increase the dose to 40-60mg depending on the trauma. Basic elevation of a limb will facilitate the draining of the blood flow also. It may require bedrest if the trauma is from a concussion or any upper-body injury. A 30:1 (CBD:THC) product is preferred or a hemp full spectrum CBD that also has cannabigerol (CBG). Having a CBD product in your medicine cabinet for future use is an excellent preventive measure.

The reason to avoid Amazon products is they are isolates produced in a lab that have unknown extraction methods and or additives when processed. Synthetic CBD isolates from products on Amazon are not the same purity as the artisanal cannabis product-makers, who craft full-spectrum mixtures of THC and CBD with vivid terpene profiles and other embellishments that imbue the whole plant matrix with unique qualities that can never be fully replicated in a lab.

An anecdotal example is my own use of CBD after having a hammer toe repaired on my left foot. I am a chronic user of cannabis for back pain. My physician gave me a prescription for Vicodin postoperatively. An operation or a bone fracture is acute pain. It is ok to use an opiate for acute pain for the first 24 hrs. postop. Then I switched to 40mg of (CBD:CBG) twice a day with an extra dose when I was awakened during the night with pain.

Leg elevation and ice are paramount with any lower extremity trauma to reduce the dependent edema. After four days I was back to my normal dose of cannabis prior to my operation. I did not need the THC after the third day.

My products came from two dispensaries. The first is “healing essence” licensed dispensary and the second is from Dr. Sulak’s dispensary that produces Cannabidiolic acid (CBDA) the original raw form of CBD. CBDA is for those who have tried CBD in moderate to considerable amounts (25-50mg) and have been unsatisfied with the results. I leave you with this quote:

When asked to compare the synergistic entourage effect of botanical cannabis with a cocktail of isolates concocted by biotechnicians, Dr. Ethan Russo of CReDO Science put it this way: “What would you rather have? Fresh squeezed organic orange juice or Tang?”