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Podcast: 10 Reasons Eyecare Doctors Get Sued, and How to Avoid Being One of Them

New podcast promises “tips, news and tricks for those who live the optometry lifestyle.”

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TRY NOT TO BLINK (EPISODE 19): EYE FEAR GETTING SUED (59:05 MINUTES)

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GETTING SUED — or, more accurately, how not to get sued — is the topic in this guest podcast from Roya Habibi, OD and Jimmy Deom, OD, of Try Not to Blink.

In this episode, Habibi and Deom discuss the 10 top reasons that eyecare doctors are sued by their patients and what you can do to avoid legal trouble.

The good news? Roya cites statistics that only 20% of lawsuits go to trial, and that only 3% of those cases end up with a judgement in favor of the plaintiff. But there are numerous best practices that will help you protect yourself.

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Try Not to Blink launched in June and have released more than 20 episodes. The podcast’s mission, according to its founders, is providing “tips, news and tricks for those who live the optometry lifestyle.”

Episodes to be featured on INVISIONMAG.COM in the coming weeks will cover eye trauma, the use of cannabis in eye treatment, and vision therapy.

Habibi is a fellowship-trained optometrist practicing in Seattle, WA, not to mention a dog lover, foodie and adventure enthusiast. Two of her major professional interests are solving the problem of dry eye disease and utilizing scleral contact lenses, “particularly when prescribed outside-the-box”.

Deom is a father, husband, beekeeper, chicken farmer, and passionate eye doc. He is an owner of a large, two-location multidisciplinary practice “in the middle of Nowhere, Pennsylvania”. Professionally, Deom has particular interests in scleral contact lenses, advanced dry eye treatment, brain injury and vision rehabilitation.

(Warning: This podcast contains a bit of off-color language for anyone offended by such.)

SHOW CHRONOLOGY
  • 3:30 Guest Trudi Charest, of eyecare marketing consultant 4ECPs, describes her business and her conference, the first ever marketing and technology focused conference for ODs.
  • 6:00 Jimmy says he hears a little “Canadian bacon” in Trudi’s accent, and she admits to being Canadian.
  • 7:50 What inspired Trudi to switch from being an optical professional to the marketing business.
  • 10:45 Her favorite piece of easy-to-implement advice for eyecare professionals looking to boost their marketing. Don’t be stingy. Too many eyecare business owners, says Trudi “don’t see marketing as an investment, instead they see it as an expense.” If you do it right, you can get a 10x return on every dollar you spend.
  • 12:25 Trudy invites readers to her Nov. 6 marketing and technology event, Eye Innovate, with a special offer.
  • 17:40 Roya shares some eye headlines from around the country. South Carolina woman admitted to killing her husband with Visine. Jimmy and Roya discuss the effects of an overdose of tetrahydrozoline. Says Jimmy “No Visine for your patients. I’ve never heard of anyone dying from Lumify.”
  • 24:00 Preparing for Halloween. Roya and Jimmy talk about their halloween costumes of the past, including the time his parents sent him out in a paper bag with a face drawn on it. Roya’s memorable costume? The year she was a fisherman and her dog was a lobster.
  • 28:20 Reasons eyecare professionals get sued. Some fairly reassuring facts: Only 20% of lawsuits typically go to trial. And of those, only 3% of verdicts are in the plaintiff’s favor. In most other cases, a settlement is made before trial or the case is dismissed.
  • 29:00 The top three disorders that are reasons for getting sued — failure to diagnose a retinal detachment, failure to diagnose glaucoma, failure to detect tumors.
  • 29:50 Discussion of glaucoma. Jimmy says ophthalmoglists tend to be much more aggressive about checking for and diagnosing glaucoma than optometrists. Roya disagrees.
  • 34:00 Jimmy and Roya talk about diagnosing patients with glaucoma, and “the pit in your stomach” that you feel when you have to tell a patient something is wrong. And how awkward it feels to diagnose a patient who has been seeing another doctor, who didn’t catch the anomaly. Jimmy says it doesn’t get you anywhere to trash-talk another doctor. “You don’t know what was said, and what was done, it’s just a total hypothesis.” If the patient asks, he’ll tell them, of course. But his general philosophy is to “take care of the problem in front” of him.
  • 36:10 The top 10 mistakes that can land an OD in court. The biggest mistake? Failure to dilate the pupil.
  • 40:00 Roya and Jimmy discuss having waivers for patients who refuse dilation. Roya doesn’t have a waiver; Jimmy does. Jimmy says he mostly uses these to emphasize to his patients the importance of the procedure.
  • 40:55 The second biggest mistake that can get an eye doctor into legal trouble? When doctors do not determine the cause of reduced acuity — i.e. too quickly writing visual deterioration off as “amblyopia”. You have to check for and eliminate other options before deciding the reason for a patient’s issues are merely lazy eye.
  • 42:30 Roya discusses a teenage girl’s case, who was diagnosed with lazy eye. Months later, she was seeing flashing lights and her vision had deteriorated from 20/60 to 20/400 in one eye. She was sent to a neurosurgean where a large brain tumor. After the surgery, the girl ended up blind in both eyes. The optometrist was sued and the family won $9.2 million in the malpractice suit.
  • 47:25 The next-biggest mistake is not referring and not re-calling. Jimmy makes the point how when a patient doesn’t come for an appointment, it can legally be YOUR fault. Roya continues that eye doctors can find themselves in legal jeopardy long after they’ve last seen a patient — if, for example, that patient was found to have glaucoma — because they didn’t emphasize the seriousness of the referral, or set a specific time frame for the referral.
  • 50:30 More mistakes: Not offering impact-resistant lenses when they are requested. Not doing a periodic health exam on contact lens wearers. Not telling patients about suspicious findings.
  • 53:20 And a few more: Not doing a visual field on children. Not following co-management protocol. Not getting informed consent. And, finally, poor record-keeping. (Both Jimmy and Roya share some grumbling about the difficulty and the intensity of the record-keeping required in optometry.)
  • 57:20 Roya offers a couple of take-home points: Dilate and have the best possible relationships with your patients.

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Roya Habibi, OD, and Jimmy Deom, OD, are the founders of Try Not to Blink podcast. The podcast aims to provide "tips, news and tricks for those who live the optometry lifestyle."

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Try Not to Blink

Podcast: Try Not to Blink Talks About the Business of Cannabis, and Its Role in Modern Healthcare

This episode blazes a new trail.

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TRY NOT TO BLINK (EPISODE 16): TODAY’S CANNABIS (47:22 MINUTES)


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IN THIS GUEST PODCAST from Roya Habibi, OD and Jimmy Deom, OD, of Try Not to Blink, our hosts talk with cannabis grower Matt Wyatt, owner of Misty Bear Creek Farm, about the science and industry of marijuana.

Try Not to Blink launched in June and have released more than 20 episodes. The podcast’s mission, according to its founders, is providing “tips, news and tricks for those who live the optometry lifestyle.”

Episodes to be featured on INVISIONMAG.COM in the coming weeks will cover eye trauma and vision therapy.

Habibi is a fellowship-trained optometrist practicing in Seattle, WA, not to mention a dog lover, foodie and adventure enthusiast. Two of her major professional interests are solving the problem of dry eye disease and utilizing scleral contact lenses, “particularly when prescribed outside-the-box”.

Deom is a father, husband, beekeeper, chicken farmer, and passionate eye doc. He is an owner of a large, two-location multidisciplinary practice “in the middle of Nowhere, Pennsylvania”. Professionally, Deom has particular interests in scleral contact lenses, advanced dry eye treatment, brain injury and vision rehabilitation.

EPISODE NOTES
  • About CBD Oil: https://www.medicalnewstoday.com/articles/317221.php
  • Cannabis Therapies: https://www.greenstate.com/explained/heres-science-behind-cannabis-therapies-pain-inflammation/
  • Cannabinoids as Novel Anti-inflammatory Drugs: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2828614/

Special Feature: Complete Show Transcript

James (00:11): Welcome to Try Not to Blink, a podcast about the ups and downs, ins and outs, news, tips and tricks of those whose lives the optometry lifestyle. We’d like to thank the amazing people at Valley contacts who’ve made this podcast possible. Of course they are makers of stellar gas permeable lenses and the oh-so-incredible custom stable scleral lens. In case you are wondering, I am on the East Coast and my name is Dr James Deom . I’m joined by the Uber talented, my co host who’s repping the west coast. Dr Roya Habibi. Roya, how are you tonight?

Roya (00:52): Super excited. This is going to be — I feel like a broken record because I’m always excited — but this is maybe one of my favorite topics that we’ve talked about. Cause like how often do we hear about these things?

James (01:03): I think this is a very topical topic . I think people are going to absolutely love it. It’s extremely topical, extremely pertinent and I agree with you. I think it’s. I think we’re going to get it. I’ve never ever seen this in a podcast anyway, you know, so I think we’re blazing a trail in more than one way here. See what I did there?

Roya (01:27): I love what you did. If you didn’t hear our little clip, we tonight are going to be talking about marijuana and the eyes. But yes, we have an extra special guest which I cannot wait to introduce everyone to. But cliffhanger. Before we go there, let’s talk about a non-OD related topic.

James (01:53): Hashtag nothing to do with optometry.

Roya (01:55): Yes. So my technician Hannah. What up? What up girl? She keeps me involved and in the know of all pop culture and she today sent me this article that I almost died listening to. I mean she honestly is bad ass. I never knew that. I would’ve never known this. She’s super cool. She’s like “It Girl” on Twitter. But I think that’s why she knows all these, these super trendy things. But you guys are disgusting. But headline article from BBC. Can everyone stop drinking their own urine? What? Jaw dropped.

James (02:42): You sent me this and I like looked at it like, okay, Onion, like some totally ridiculous, Facebook post or whatever. This is like real stuff.

Roya (02:53): I mean a couple of examples from the article. Thirty three year old yoga teacher. Uh, she’s doing this too and it’s helped her relieve longterm health issues related to Hashimoto’s and fibromyalgia. Another woman, 46 years old … It has helped her lose half of her body weight. She’s lost 120 kilograms. Because she literally can’t eat because she’s so sick from eating her own pee. They call it the magic liquid.

James (03:30 ): So, as you’re saying this and I know that you’ve done some of this research, I’m thinking to myself, well, what is in urine? Like what would be so magical about it?

Roya (03:41): Good question. So for the record, this process of urine therapy is called Urophasia.

James (03:54): Come on.

Roya (03:55): And if you Google this, there’s like 100,000 hits on Google for urine therapy, but there really isn’t much to back any of this. I know that’s shocking for everyone to hear, but urine contains mostly urea, of course, uric acid, some creatine, some different electrolytes, phosphates, some trace proteins and of course, hormones, glucose and other water soluble vitamins — i.e. the vitamins we take too much and thus get peed out. But uh, I mean ultimately if you think about it, the poor kidneys that are trying to get rid of stuff that the body doesn’t need, just gets a huge concentration of what it’s already filtered out. So from everything I’m reading, if anything, it’s just putting more strain on that system.

James (04:47): Yeah, you’re out. I’m not down with this. I mean, keto diet, right? I’ll listen about it. We talked about that last episode, you know, I even gave it a try. Urine Diet, urophasia, nope. Not going to do it.

Roya (05:03):One more story. It says that somebody did drink their pee and she used to get mosquito bites all the time and now she only gets little bites that don’t swell. Oh, perfect. I would not drink my own pee for the sake of a mosquito bite. Would you?

James (05:22): No! Bug spray works just fine.

Roya (05:27): Oh my God. Right.

James (05:29): What I’ve heard with peeing, I don’t know if you heard this ever, but I’ve heard that like, oh, we’re getting a little crazy here, but that it’s got that a poison ivy that you’re supposed to or no, no, not poison ivy. I’m sorry. It’s not poison ivy. It’s a, um, a sting from a jellyfish.

Roya (05:45): I have heard that. I think that’s what I’ve heard with the urea that’s in your urea. I don’t have any facts to give that one, but …

James (06:00): Are you making that up? It’s okay if you are.

Roya (06:00): I don’t know. Crazy. But anyway, that’s all for that. What about for our sell pod?

James (06:20): Our sell pod? “Scleral Lens Pearl of the Day.” So last time we talked about how important insertion or removal is. And, and so, you know, on that same train of thought, you know, there’s these really great little, um, uh, insertion stages that people have for people that have poor dexterity or just aren’t able to, you know, bring the plunger to their eye.

Roya (06:39): It’s a lot to do at once.

James (06:39): It is. It is the open your eye, you got to look down, you have to be able to balance the fluid in the, the lens, you know. And again, we said how important getting the lens in is. So getting somebody to be able to do this is, is hugely important because otherwise they won’t be able to use, use it. So Galaxy Adaptives has this little device you can use and um, it’s basically just the end of a PVC pipe, a circular domed PVC pipe, drilled hole in the middle, and then they cut the end off a large DMV, place it in the middle of the lens, sits there, and then you bring your head to it. Well, you could actually make this a pretty much for free. Uh, you could just take a solo cup, put it upside down, take a pen, shove it in the top, make a hole in the Solo Cup, and do the same thing with the DMV. Cut the end, put it in the cup. And Galaxy has this little light that they’ll put in the DMV so that the patient has a fixation point. They call it the see green inserter. And what you could do is you could just take your cell phone, put it underneath the Solo Cup with a light on, and then the light will come through the DMV.

Roya (08:04): Fancy!

James (08:04): Yeah. Yeah. So it works. Works really, really well and easy for the patient to see right there in the office that it works. So that’s our sell pod of the day. Sponsored by Valley Contacts.

Roya (08:17): No, actually I love that sell pod of the day. In fact, I did this the other day for a patient. I have a 84-year-old who is new-ish to scleral lenses, has had multiple transplants, but anyway, he’s wearing sclerals beautifully. He really likes them. But his poor wife has been putting them in for him all the time and obviously that is, you know, a small burden but something that she’s just kind of, she’s helping him but she wants him to learn and it’s a lot for him because he ha d some stability issues as well, but we went over how to do that for himself and he’s actually quite good at it. So, uh, it kind of takes one of the coordinating things away and is very healthy, especially for people who do have issues with dexterity. So. Totally agree on that one.

James (09:06): Cool.

Roya (09:08): Amazing.

James (09:08): So I think we’re, we’re, uh, getting all juiced up here to talk about our main discussion, which I’m going to give a little primer indoor discussion. Do you mind if I do that?

Roya (09:21): Absolutely.

James (09:22): So, so this really kind of, first of all, very topical. We already said it, we’re talking about, but there was a post on OS Docs the other day, uh, by uh, Richard Maharaj and I am sure that I’m saying his name incorrectly, doc, I’m sorry, but he practices in Canada and as you may know, Canada has a wide adoption of legal marijuana recently. So he had a patient come in with an eyedropper for a corneal neuropathy. So she’s using it for dry eyes essentially. Uh, but it, it’s interesting. On the bottle it says 1 THC, 25 CBD. So, you know, does anybody here know what that means? Anyone? Anyone? No, probably not. So you know, this is why we wanted to get a little more information from an expert and, and that’s what we have going on since Roya is on the West Coast where most people are high like all the time … she happens to know someone who is an expert in this area and I’m joking around. But, we’re gonna try and be much more serious about it here. So we’re going to learn all about weed and eyes.

Roya (10:39): Okay, I am so excited to introduce a very near and dear friend of mine, Matt. Matthew Wyatt. Do you go by Matthew?

Matthew (10:49): Only my mother and when I’m in trouble.

James (10:51): Perfect. So Matt, we wanted to bring that on because he is the source, okay? So we’ve all been to conferences where we hear from the head researcher talking about research about marijuana, but we thought what better than getting a farmer, someone who’s growing marijuana, who has been in the industry for some years and could talk about it from the raw side of it, you know, we can hear all the pure sterile side of what marijuana is all about, but we want to hear about the raw side of it, the real side of it. So Matt’s been in the industry for over seven years. He actually owns his own farm and Douglas City, California dubbed Misty Bear Farm? No, shoot. Misty Bear Creek farm. Sorry, Matt. It is a, a self operated organically-grown farm of his own. So Matt, I’m so proud of you for doing this. I mean he’s had for four years now, right?

Matthew (11:55): Yes. This is our fourth season as I’ve been for years. It has been. Oh my gosh.

James (12:00): So there are seasons? What is a season, Matt?

Matthew (12:06): So, so, uh, outdoor makes up about probably 65 percent of what’s done here. So the outdoor growing season begins in June and wraps up early to mid October depending on the strains that are running and how long they take to flower out. So all of my outdoor plants, they’re big and beautiful right now. They have probably two to three weeks left. A couple of strains, maybe a little longer, but, you know different types take longer to finish up than others.

Roya (12:36): Jimmy, I’ve had the pleasure of visiting this farm before.

James (12:39): Really?

Roya (12:40): But Jimmy, what do you think a full grown outdoor marijuana plant looks like? Like gimme just a ballpark height guess.

James (12:49): Honestly, I have no clue. I really don’t. I’ve seen them like in raids of people like getting them pulled out of their house from their basement or their attic with like these crazy hydroponic and like light sources. Uh, you know, so I’m going to say three feet, three feet tall.

Roya (13:09): Matt, break it down.

Matthew (13:10): A little taller than that. So we do have a very large number of outdoor plants, but the ones I do are really large, so I average probably 10 to 14 feet in height.

James (13:24): Come on!

Matthew (13:25): Yeah. Yeah, it looks, it’s almost like having an orchard. Uh, I have an apple, an apple orchard right next to my, uh, marijuana orchard and they’re very comparable in size.

James (13:37): Really. So is there a statement like knee high by the fourth of July? Have you ever heard that knee high by the fourth of July?

Matthew (13:44): I have, I have heard that. My girlfriend’s from Iowa, her family grows corn, so I’ve become very familiar with that statement. Um, no, we, if it’s knee high by the fourth of July that I failed at my job. I want them probably already at eight, probably seven to eight feet by the fourth of July. It’s around what I’m, what I’m shooting for.

James (14:07): I just have so much I want to learn. We need to go about this in some organized fashion. I just have a million questions.

Roya (14:15): So first, let’s do just like a basics. Marijuana 101. Cannabis. Marijuana. Cannabis, right, right. Um, give us a breakdown, like we’ve all heard all these words. Marijuana, CBD, THC, indicus, like, what is all of this? Give it to us straight.

Matthew (14:38): Okay. So the general breakdown, a very loose explanation is a cannabis plant itself is very complex plant and they’re discovering that it has over 400 different chemical compounds inside of the plant that, uh, that make it up. And you primarily have four dominant ones. Eeveryone knows about thc, which is tetrahydrocannabinol is the official name of that. It’s a mouthful. That is the psychoactive component of marijuana. That’s the intoxicant. That’s what gets you high. So in the recreational part of marijuana production, that’s what everyone’s trying to achieve. A really high THC content. Now they also have CBD, which is canabidol, which is a lot of the health benefits of the plant they’re discovering of late, and what’s kind of getting this new reputation of being being healthy in all aspects. A lot of people just kinda like, uh, applying to this called a catchall, I guess a medical beneficial compound of, of marijuana and it’s still really unknown what the different effects of CBD on the body are, but they are all the time coming up with new treatment forms. I was just reading an article today about how the FDA and DEA have approved pharmaceutical companies to start using CBD oil and medications for children with epilepsy — two types of epilepsy. It just got approved by the DEA. Just signed off on it today, actually.

Roya (16:15): I saw that. That’s super exciting.

Matthew (16:18): Now that the FDA and the DEA are starting to like actually sign off on it being used in medication. You’re going to see the science that’s not been there in the past. We’ll start the hard science research, the double blind studies, the stuff that we’ve been wanting for years, but until pretty recently, until probably the last five to 10 years, the, the farmers and uh, and the users have been the main researchers and the ones who know the different effects and the different properties of different strains and all. So yeah, so THC, CBD, they’re the two big ones. Then there’s canabidoil Canada in there, and canabidoil was actually the first discovered isolated compound back in the late 1800s. It was discovered and that was thought to be the active ingredients. And then in the sixties they came through with all this scientific information about THC and CBD to kind of fill in the blanks and it’s still growing, like I said, over 400 compounds everyday. They’re coming out with a new compound and what specifically it can interact with in the body to help people. And uh, it’s also important to know.

Roya (17:23): Tell me too, taking a step back, taking a step back real quick, tell me what you know, because everyone hears about these, like indica and sativa. Is that other compounds or what is that?

Matthew (17:37): Okay. So indica and sativa are the two subspecies of the marijuana plant. There’s actually a third that’s not nearly as well known, so we’ll stick to indica and sativa as the two dominant ones. Indica is a shorter plant generally; it has broad deep green leaves, and it’s higher in CBD than sativa. Now, sativa is a taller, more like lime green leaf structure, very skinny leaf, and it is higher in THC. So those are two, the two main subgroups. But right now everything’s about these hybrids. That’s what everyone grows today. So there’s no real true indica or sativa anymore. It’s all mixed and there’s a blend that’s like a 60 slash 40 and the sativa blend and that’s kinda to encompass everything and it’s just very rare to find a true one or the other.

Roya (18:29): Interesting. What about. Also we hear about all these different variations, right? We hear about the flour, of course we hear about oils, tinctures, obviously they’re there, especially in the medical field, right. Then the medical field, they’re concentrating it and purifying it, but kind of break down all those different things, all those different ways to, I guess harvest the fruit or harvest the, I don’t know how do you say that?

Matthew (18:56): Yeah. So, uh, so the extracts are really big these days and yeah, they were coming up with all kinds of new ways to, to remove the tricombs — because those are the few zoom in very closely on a marijuana bud, you’ll see these tiny little like crystal mushroom-looking things and they’re called tricombs. And when they fill with resin, that’s when it’s time to harvest. And they turn this milky amber color. So basically what these extract people are doing is they’re removing the tricombs and preserving them in their natural state separated from the plant material. So there’s several ways to do this. You can use alcohol, you can use fat. They’re fat soluble, the cold, you can remove them with cold. So a lot of people are doing C02-blasting and ice hash and you know, I’m not really too keen on all the fancy new ways that they’re coming up with, to consume. I’m kind of a naturalist. I grow the flower and then I let the smart scientists who want to take that and turn it into the high concentrate extracts. I pass that on down the line.

Roya (19:59): We all have our strengths and it’s good to know where they are.

Matthew (20:02): Exactly.

Roya (20:02): As a farmer, what qualifies high quality production of cannabis? Everyone gets a little worried. I mean obviously in the past, especially in the recreational field, there are people mixing things or you know, before when there weren’t as many shops, I mean, on the West Coast we have very well regulated shops that will show you the breakdown of all of the ingredients in all of the, uh, uh, I guess chemicals, I’m not sure if that’s the right word, but properties of what you’re purchasing. But how do you know when you’re getting good quality cannabis? So what does it take, what’s the growing season? Is it indoor, outdoor?

Matthew (20:46): So it’s kind of up to the consumer what type of cannabis they prefer. With the testing that’s come along with legalization in California now. We all submit our stuff to labs who run several different screenings. They’re actually about to kick in the third tier of screening in California in 2019. That’s going to start looking for a certain heavy metals that get transitioned or transferred beyond molds and pesticides, which is basically what they’re screening for now. Um, so, so yeah, I mean I don’t, I’m sure you guys probably smoked weed in high school or in college somewhere along the way, bought a bag of weed from a friend or something like that. Those days are pretty much done unless, you know, someone who’s growing, if you buy something through a shop these days is pretty stringent tests that it has been submitted and been passed.

Roya (21:40): I think that’s important for improving the validity of all of it, right? So that it’s not just some like herbal street medication, it has something more value, whether it is the recreational side of it or some of the other medicinal things.

Matthew (21:57): Yeah, you don’t want to smoke something that’s had nasty pesticides sprayed on it and stuff.

James (22:03): No, definitely not. How did you get into this? I mean, where, where did this come from? How do you become a marijuana farmer? I mean, that’s like a pretty unique profession.

Matthew (22:17): Yeah, my dad asks me that question all the time. [LAUGHTER.] So basically, I had an opportunity back in 2011 to come to California and work on a friend’s family farm. I moved across the country and started, you know, just a hand helping with the harvest during the trim season andI kind of took to it and was interested in it. I’d had some interest prior to coming. My brother was diagnosed with cancer, probably 10 or 12 years ago and as he was going through his treatment, I was there with him for a lot of it because of family obligations and he had children and his wife couldn’t be there all the time for his treatment. So I filled in, and we went to Arkansas, so I got to see firsthand the effects of some of this medication. That’s the radiation therapy, the chemotherapy, all that stuff. And just saw how difficult it was for him to eat, to have an appetite after going through these. And, you know, I brought a little weed along and we’d get stoned, and I’d watch his appetite come back and, you know, his pain would seem to subside. So that really kind of was a big factor in pushing me to learn more and just kind of try to help more in the industry. I had a health education background coming out of college. And I never really found anything in that field that kind of fit. And this seems like, you know, in some weird kind of roundabout way, it does fit my degree and it’s something that does provide a lot of help. All it takes is reading the story or talking to someone who has a child who’s epileptic and having 100 micro-seizures a day and then a couple of drops of CBD oil and they’re down to one or two a week and it’s just, you know, it’s an amazing plant that has a lot of benefits and it has unfortunately a pretty nasty stigma that we’re trying to beat down every day. But I think we’re winning hearts and minds and …

Jimmy (24:10): Yeah. And that what you just said I think is a lot of what Roya and I have been talking about and you know that it’s a challenge. It’s a huge challenge from a legislative standpoint. It’s a challenge from a healthcare standpoint. It’s a challenge from an individual standpoint, you know, it just, it has a negative connotation. So how do we transcend that? What kind of words do you use? Do you not say weed or, or you know, like do you do try and use medical terms? Do you try and, you know, like there’s just a lot of slang that’s with it that I think degrades the value of the medical benefits and, and even for recreational use, you know, I mean, it’s not looked at poorly to go have a couple beers with friends. Is it something that we should potentially change the way that we look at somebody’s going to have, you know, a couple smokes with a friend. Is that, is that something that you think is doable and when and how do we get there?

Matthew (25:17): I think that it is tough to kind of toe that line because as you say, it has medical qualities and it’s also used recreationally. So there’s not really a whole lot of other things out there. Substances, you know, medication, are meant to be used medically. Some people take it recreationally even though that’s not its intent. That kind of has a negative stigma associated with it. Alcohol used to have more of a medical function than it does in today’s society, but yeah, it’s kind of one of those weird things that has to walk in both worlds a little bit, I think to the people who use it recreationally to get high and have a good time. There are people that focus on that part of it trying to make the highest THC or the best extract. But at the same time there are people who truly see the medical benefits of it and want to explore that more, you know, kind of like the health benefits of having a glass of wine and stuff like that. It’s very tough to be taken serious as a medical function when you also have this recreational application. So it’s going to be a tough one to overcome. But I think slowly, I think you can live in both worlds and I think that you can have people that focus on the recreational side and people that focus on the medical side.

Roya (26:34): Absolutely on that topic, you know, from the medical perspective, especially Western medicine, current modern medicine, we like evidenced-based medicine. We like big studies that are well-controlled and well-designed and it’s really hard to do in fact considering right now back in 1937, there was marijuana prohibition act that actually banned researchers or impeded researchers from conducting basic research on marijuana. And also in the 70s, the Substance Abuse Act actually placed it as a Class One or Schedule One medication, thus deeming it with no medical value. And I mean there’s a ton of research and a ton of history in marijuana. And to give it that sort of branding … obviously for the medical community, no one wants to cause harm to their patient. But also kind of what you guys are saying, I mean a lot of the resources I was finding before going on Pub Med, some of our medical resource searching options is like High Times or Medical Jane or Green Spirit, Inhale MD.

James (27:46): All these like funny, catchy names. But of course for the medical community, everyone thinks all that’s hodgepodge, that’s not real. But I like kind of what we were talking about about the treatment. I mean, a lot of us in the eye community hear about glaucoma obviously. There’s a pretty cool study out of The Journal of American Medical Association back in 1971, where actually one of the doctors will say, you know, I’m noticing my eye pressure is going down because he personally had glaucoma. He was going through treatment himself and then he decided to do a huge study on it or not huge. But he did a study on it actually through John Hopkins where they were monitoring his pressure as well as other participants and they noticed a reduced inflow of aqueous. Thus eye pressure was going down, which is pretty cool. But some of the other things that you mentioned, for instance, is epilepsy. Now you talked about some of the people that you’ve heard. I mean, tell me more that you’ve heard about epilepsy or even chronic pain or nausea. What are some of the street stories about that?

Matthew (28:54): They have all kinds of different treatment plans that they’ve come up with where they find that it helps people out. Anti-inflammatory principals, um, it’s been known to be an aid to quit smoking and they’re finding now that it’s actually beneficial in helping people off of opiate addictions. A lot of mental diseases like schizophrenia, PSTD. It’s proven in some tests to have really good anticancer properties as well. So I think that it’s just been found to be this plant that can be applied to anything. That’s why it’s earned this kind of catchall medical application where even if you don’t know if it’s going to work for a condition you have, people are trying just because the tests haven’t been done and you know, it’s easy to try.

Roya (29:48): Why not?

Matthew (29:48): The dangers aren’t high on it despite, you know, the reefer madness mentality. Like you were saying how it was put on Schedule One? The whole backstory behind that is pretty ridiculous as well. Had to do with the timber barons back in the thirties and this big anti-immigration push that the sharecroppers coming over from Mexico to work the fields in California were smoking it. And so that’s part of the reason that it got demonized so early and I mean, to this day, I feel like I read five or 10 years ago that they were still showing “Reefer Madness” in DC at these hearings to find out whether they would decriminalize or take it off the Substance One list. And the fact that this listed as a Substance One drug with some pretty gnarly stuff, it’s kind of mind boggling that we’re that far behind and that close- minded.

Roya (30:40): Well, in 1986, it actually was changed to Schedule Two. So it’s not as bad anymore. But a judge did. A judge actually did switch it to a Schedule Two, at least per my research. So I could be wrong. But still, regardless, I mean, do you know that I found this research there is confirmed use of cannabis dating back to 3750 BC? That’s crazy.

Matthew (31:10): It is.

Roya (31:11): Emperor Shen Nung in China was an early hemp enthusiast, they deemed him saying that the female plant, which you probably could tell me more about what this means, but the female plant has treatments for absent-mindedness, rheumatic pains, constipation, malaria, and even female disorders. Ha.

Matthew (31:36): Very nice. And a little tidbit on the female plant. The female plant is actually the budding side of the plant. So what you see the buds that you see that people, you know, that is, that is the female plants is what I grow. The males produce pollen. So I use those for cross-breeding and like creating new strains and stuff. But the female plant is the one that we grow and harvest.

James (32:01): I have a quick question for you. Are there any insects that are important for the plant?

Matthew (32:11): There are beneficial pests, they call them predatory pests, predatory insects that eat pests that are bad for the plant. So lady bugs are one. Lady bugs are very beneficial if you have a bunch of them. A Lot of people will release them in their greenhouses and, and let them loose in there, you know, it’s hard to get them to stay in place. But yeah, they eat spider mites, they eat aphids, white flies, a lot of pests that are negative for the plant. So they are known as a predator bugs and there’s a few other types, but the lady bugs are the most commonly talked about.

James (32:55): What about like a natural pesticide for you?

Matthew (32:59): It is, yeah. Now that everything’s happening to go organic, most of the treatments that I use are essential oils. Neem oil is one that’s been used for a really long time. Those are sprayed on at different times, and now that you can’t use the nasty pesticides anymore, iIt’s not so much a prevention more than a treatment for your plants. So by putting these stuff on early, you build up the waxes and oils on the leaf and that will prevent the bugs from being able to eat them. So you don’t necessarily have to use the gnarly stuff, like they still use on the produce that we eat. It’s really funny how my industry has become super overregulated compared to the pretty much the rest of the agricultural industry in this country. So that’s my little axe to grind on that subject.

James (33:54): That’s cool.

Roya (33:56): Why don’t you also talk a little bit, I mean, California just recently legalized the marijuana industry. Why don’t you talk a little bit about what you had to go through in getting yourself to be kosher and legal?

Matthew (34:09): Oh, I’m still going through it. It’s a process. California waited, I feel like in my mind, they waited and let Colorado and Oregon and Washington go to kind of sit back and see because they had so much invested in it. They didn’t want, they didn’t want to be the first and fumble it. So they kind of let these other states and then they learned lessons from them and then they implemented their own plan and fumbled it anyway. But it’s a process. I think that their initial concern was that so many people growing here were doing poor practices and stuff, which I definitely am seeing an exodus of the industry of these people that maybe aren’t giving the rest of us the best reputations, are still using some, some, some chemicals and some fertilizers that they shouldn’t be using. They’re slowly starting to exit the scene now, but they’ve made it very difficult. I think it’s been a practice of deterrence by the government to try to make a lot of red tape and a lot of hoops, so the truly dedicated people will jump through them. And they’ll weed out — excuse the pun — a bunch of the people who aren’t doing things properly. So, it’s been a challenge, but we’re sticking with it. I’m still in my temporary state status. I’m waiting for them to go ahead and approve all my applications. And it’s a process. It’s cost a lot of money. It takes a lot of time and energy. It requires a lot of paperwork, a lot of red tape. But I feel like it’s worthwhile. If this is truly an industry that’s going to grow and develop, it needs some regulation. But I feel like maybe they over- corrected a little bit. The pendulum has swung too much the other way to over-regulation and it’ll find its way back to the middle. But I think that, for now, it’s good.

Roya (36:07): Totally agree. I want to touch a little bit more on some of the other treatment options and some of the different studies that I’ve read about. Matt, you mentioned the recent FDA approval for epilepsy and I wanted to give a little bit more detail for our listeners about that. They actually approved CBD oil. It’s a 98 percent pure CBD oil. It’s called Epidiolex and it’s actually used. It’s currently got granted a orphan drug status by the FDA and it’s also currently in Phase Three trials as treatment for refractory seizures in childhood epilepsy. Kind of a cool cute-sy story. It’s called in the playful world, it’s called Charlotte’s Web. This is the strain of the CBD, I guess, cannabis they were using because Charlotte was one of the first patients that they treated with this medication and obviously like the story you just told, her seizure rate dropped dramatically. And, in fact, in 2014, Devinsky and his group did a study called Efficacy and Safety of Epidiolex in Children and found that there was a 50 percent reduction in epilepsy in over 40 percent of the children that were treated with this. A different study, also saying the same thing, found there was a third of the patients that had a 50 percent reduction in epilepsy. So that’s huge. I mean, if your kid was going through epileptic seizures, Jimmy, what would you do? Would you give your kids?

James (37:46): Absolutely. Yeah. No, absolutely. I mean, and I feel like I’ve seen these videos of parents saying, you know, they’ve traveled across the country to go get this treatment. And absolutely. I mean I would do anything for my kids and it’s just sad that this has to be like the last resort, you know? It’s sad that asked me the last resort. It’s sad that you have to have the negative connotations with it and that when people hear these stories, I think deep down inside they do ask themselves, is that something I would do? Is that something that I’d even believe in? And you know what,? We need the research, we need the data, and hopefully now with all this new ability to have the product and the material in schools and in research institutions, we’re going to get more information and hopefully it helps many, many people.

Roya (38:40): Absolutely. I’m going to read off all of this, but I just wanted to talk about just highlight a couple other conditions that it is been shown to positively treat even in studies. So nausea, Matt mentioned that earlier. So, actually in 1985, there was a treatment for, or it was a study done on the treatment of cancer, chemotherapy-associated nausea and vomiting. And in this study, over 90 percent of the participants had a significant or total relief from their nausea due to cannabis or they used a synthetic THC, which is awesome. Now there are newer anti-emetics, sorry, anti-nausea medications that have comparable results without the potential addiction, quote unquote. Another thing to mention, spasticity and MS. So multiple sclerosis, the neuropathic pain and disturbed sleep. And these patients, there’s been a significant improvement with a oral spray that they found, I guess, from some sort of oil that they’re extracting. Chronic pain is another one, especially related to cancer and other neuropathic pains. There are some either vaporized THC and that was even a combination between an oral version of a synthetic THC and a smoke version. There is a decrease in pain sensitivity — so a 30 percent reduction in pain in both populations who smoked or took the THC compared to any other types of pain-relieving options that they were getting. Last one, PTSD, of course, the endocannabinoid system plays a huge role normally in our own brain. And so patients who took the, I forget what they are, I didn’t record what form that they were given, but essentially they had significantly suppressed symptoms of PTSD, improved sleep quality, decreased frequency of nightmares. And then their hyper-arousal symptoms all improved with the low levels of THC. So recreational levels can actually cause the opposite, or higher levels of THC, but CB and lower concentration of GSE had a huge improvement. So, one last thing I do want to bring up. Actually in 2008, there was a study on endo cannabinoids in the retina talking about marijuana and neuroprotective functions to the retina. So Matt, retina is the tissue that sees in the eye. And actually, especially in correlation with studying glaucoma, we worry about not only lowering the eye pressure, which we’ve seen that there’s an improvement or a decrease in pressure, but also it has some signs of protecting the tissue from actually dying, which of course we need a lot more research to understand this. But if it’s also protecting our nerves and our body from damage, then that’s a big deal.

Matthew (41:51): Absolutely.

Roya (41:52): Because right now we don’t have anything that does that.

James (41:56): I’m going to play devil’s advocate now because you just laid out beautifully researched, hard data that, that goes across the healthcare spectrum. All reasons why we should, we should embrace this. But we’ve all heard, you know, the reasons why people still balk at the idea and probably the most cited issue is people are going to drive while high and, and kill themselves or someone else.

Roya (42:30): Or addiction?

James (42:31): I don’t hear that quite as much but you know what I hear? That it’s a gateway drug. It leads people to other things. So Matt, what do you think first about the driving issue?

Matthew (42:43): So for people who recreational use, I feel like that is definitely something that needs to be explored and regulated, obviously. But I think as far as the medical side of it goes, what you’re finding now is that you’re able to, um, to isolate these compounds and get them down. Basically every, every plant has both CBD and THC in it. But usually if you have a high level of THC you have a low level of CBD and vice versa. So I think that now that you’re finding these treatments like these, this medication that they’re doing for children for epilepsy that doesn’t have THC, they are extracting the CBD and making the compound solely out of the CBD, which has no psychoactive effect, it has no intoxicant properties. Basically, it’s just the healthy stuff on it. So I think if you’re on a CBD regimen, it’s not a concern. It doesn’t impair you in any way. So I don’t think it does affect you if you’re using it medically. But you do have to be careful because a lot of the edibles and stuff, now they’re doing two to one, CBD, THC. So even though you think that you’re getting something that could potentially contain CBD and has CBD in it, it can also be mixed with THC. So that’s when you have to be mindful as a consumer going into a dispensary and just talk to your, your bud tender or whoever is working …

Roya (44:01): … Bud tender …

Matthew (44:01): … and they can usually steer you in the direction that you want to get. It’s still all evolving like the process we’re playing catch up for, you know, 20 or 30 years of dragging our feet and just ignoring the science andjust this old-school mindset mindset of like you said “a gateway drug”. Well now they’re finding it’s not a gateway drug, they’re calling it an “exit ramp drug” because they’re finding that it helps people coming off of opiod addiction and it helps them get off of these drugs and it’s a nice step down for them. So I think that every day, we’re learning more and we just need to put this old mindset that it’s evil and it’s going to make us put our babies in the oven and you know, neglect them or whatever this cornball “Reefer Madness” from the 50s mindset is, and embrace the fact that, like any recreational drugs you can take too much, you can be abused. But fortunately they’re finding out — no one’s ever OD’ed on marijuana, no one’s ever died as a result of taking too much marijuana. No, sure we may have taken so much that we’ve become very paranoid and we have a bad experience from it. That comes back to people’s body’s chemistry and how different people react differently to different compounds. And I’m a stringent believer that if one strain maybe doesn’t affect you in the best way, don’t give up and think, oh, it affects me poorly. I think keep playing, you know, if it was a sativa, try an indica. I feel like there’s a strain out there that fits everyone’s body chemistry and you have to kinda, you know, just like just like a medication that your doctor would prescribe you and there’s going to have certain side effects that may be you’re susceptible to the rest of the population is not, but it shouldn’t deter you from trying to find that right compound that works for you.

Roya (45:50): Love that. Slow clap.

James (45:55): Clap it out.

Roya (45:57): Love it.

James (45:58): This was good. This is really good. And I feel like we could talk for literally days and, and just have a whole podcast on, on this topic and I’m sure there probably are podcasts on this topic. But thank you, Matt for sharing everything with us and taking time out of your growing season to chat with us a little bit. And, if I’m ever, you know, in, on your side of the country, I’m going to come check your farm out. It sounds really.

Matthew (46:28): Absolutely. You’re welcome. Open invitation.

Roya (46:30): Absolutely. Love it. Thank you, Matt, so much. Check out Misty Bear Creek Farm, if you ever see it on the shelves, folks. But, thanks again Matt, and I’m, I know everyone’s going to be super interested. If anyone has any questions, feel free to send us a note on our Facebook or Instagram account. But again, for today that does it. We’d love to thank our sponsor, Valley Contacts, for their support, not only making our amazing scleral lenses, but also, of course, the great people they are to work with. Stay tuned as we continue our spooky series through the month of October, because we have some other fun stuff we’re going to talk about that are extra spooky. But until then … try not to blink.

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