THC Dronabinol Finding the Optimum Dose For Me…

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It has been hard to get the optimal dose of  dronabinol to provide the greatest nausea and pain relief, without exacerbating the uncomfortable reactions the drug provokes. This morning in desperation, we decided to increase my 06:00 dose by 2.5 milligrams, making it 7.5 mgs of the 10.0 mgs daily dose, I am now prescribed by my internist.

The reason I adjusted my morning dose today was because I knew it would relieve my agonizing pain.  The pain was caused in part, from my swim earlier in the day, and its consistent aggravation to the radiculopathies throughout my lumbar spine. Added to the irritation of the nerves by swimming, at 20:00 yesterday, I decided to switch out my closet. In so doing, I set myself up for a very severe bout of lumbar pain that set in around midnight.

I have had fractures throughout my spinal vertebrae with resultant radiculopathies. Now, eighteen months later my spine has healed but I am left with spondylosis and that has continued the radiculopathies, made worse by excessive movement and strain on that region of my body. This morning the pain was so bad, it set off waves of extreme nausea.

Following this morning’s higher dose of dronabinol,the pain has now completed abated. I am now feeling free from pain and nausea, and have been since forty minutes after the dose. Unfortunately I do have some runs of palpitations but now, two hours in, at 08:00, they are starting to become further apart.

Because dronabinol is so little understood, I thought it may be helpful to go through the physiological changes in chronological order, so that others can understand how this drug reacts on various aspects of my body.

The best way to describe how it works for me is to proceed from my first dose of the day, which I take at 06:00. I will do my best to describe the progression of effects on the different systems of my body.

Dronabinol 7.5 mgs taken  @ 06:00

06:10

1. I feel tingling on the right side of my tongue and down the right side of my face.

2. I have a feeling of fullness in my chest that makes me cough a couple of times.

3. I notice a very slight change in my perception of my surroundings and I am a little more relaxed.

06:40

1. The tingling is profound, and now includes my lips, and all of my tongue.

2. I am getting frequent but intermittent palpitations, and my heart rate has climbed from 70 to about 120 beats per minute. Mindful breathing helps this effect.

3. I am completely free from pain and nausea, but not yet hungry.

4. As one example of the obsessive compulsive behavior this drug appears to enhance, I am seeing spots on cupboard doors and and I feel the need to clean them immediately.

5. During this phase, my affect changes as my brain turns away from pain and nausea. I am able to find distraction and focus that drives me to organize a
plan for the day ahead. Be it writing an essay/blog, or preparing for a cooking and baking session, or anything that I may decide to focus my attention on, any given day.

6. Now nausea free, I can focus on preparing breakfast. This involves a prolonged preparation time, delaying eating up to three hours from when I take the dose. The delay used to leave me feeling hypoglycemic by the time I ate. To overcome that feeling, my husband brings me a little snack of grapes and peanuts with my morning pills. Without nausea, I am free to enjoy the smell of the fruit as I cut and arrange it as a fruit platter. I love to smell the mix of ground up dried figs, dates, and raisins,’ninja’d’ with walnuts. A salad of celery, cucumber, tomato, and red onion; and the ritual of making my morning cup of tea,tops off my breakfast preparation.

7. I am at most risk of falling, and accidents, 40 minutes into my higher dose 7.5 mg of dronabinol. There are two reasons for this. 
The first is that I am so focused on ‘the end game for the day’, playing out in my mind. My plan of writing or cooking or whatever the plan.
The second cause for caution, is that my vision is temporarily slightly blurred, and I have a problem with visual depth perception.

I did have a nasty fall and hit my head during winter, about an hour after my morning dose, when I went to feed the birds out back. Proving how quickly the analgesic effect of my THC kicks in, and lasts for me, I felt no pain until five
the next morning!

8. I am lucid and can write this post. The safest place for me for the next
two hours is sitting in this chair and not moving around.

9. The tingling in my face and lips is subsiding and the only area now
particularly affected is my right tongue, and right corner of my lip.

10. I remain totally nausea and pain free.

09:30

I have just enjoyed a leisurely breakfast and back to writing this blog. I feel fabulous. I am pain free and nausea free, and able to soak in the sounds of life around me. This drug makes me feel as though I can truly appreciate the moments of my day in their entirety. My mind is still focused on getting this information down on paper, so I am concentrating on each aspect of dronabinol that makes me feel better, as the result of taking the higher dose this morning.

10:30

I am now beginning to type the wrong characters and I am getting a little muddle minded. After just three hours sleep last night, I figure I am probably exhausted and so I am headed upstairs to nap for a while.

12:50

I awoke well rested after going straight off to sleep when I went upstairs. My heart rate is now seventy and my blood pressure is 110/74. Just a very small amount of tingling remains in the corner of the right side of my lower lip. Other than that I am feeling great. I have absolutely no pain and just a faint hint of nausea that I will treat with a tablespoon of apple cider vinegar and a small salad. I will hold off on lunch for half an hour.

Since I took three of my four pills this morning, I will hold off until around 18:00 before taking the final dose for the day.

THE DIFFERENCES BETWEEN TAKING 7.5MG  & 5.0 MG @ 06:00

The greatest difference is that the lower dose maintains a more even pain relief without the intensity of of unwanted effects like palpitations. I have diastolic heart failure and I need to be careful when incorporating other drugs that can affect my heart rate. One recognized side effect of dronabinol is tachystasis, or permanent rapid heart beats. So I try not to cause any problems by be very careful with my dronabinol dose.

I got relief in forty minutes from dronabinol this morning from both the nausea and pain. Relief is not as complete and instantaneous on the 5.0 mg 06:00 dose. That has a more gradual effect, taking almost four hours before I have complete relief to the lumbar spine. Whereas, the 7.5 mg dose, is effective in 40 minutes.

With the lower dose I usually feel mellow enough to drift back to sleep after my dose, and by remaining in bed, I reduce the risk of falls and injury.

On the lower dose, the effect is mild enough to make me less hyper-focused and I do not feel the irrational need to get my tasks completed as quickly as possible for fear of losing the plot. Therefore I only resort to this higher dose in the morning, if my nausea is at the point of dry retching, and my pain is so severe I cannot move my position from laying to standing, as was the case this morning.

Ideally, the dose for me is 5.0 mg @ 06:00, 2.5 mgs @13:00,(after exercise so as not to produce palpitations), and the final 2.5 mgs @20:00. The success of this dose I can measure in the 7-8 hours of sleep I now get,rather than the 3-4 hours I managed for four years because of breakthrough pain and nausea.

I am at my healthiest and I have more energy than I have had in decades for decades. As a result of taking my therapeutic THC, sleep, diet, and exercise has made me well. Exercising has improved my balance, so my falls risk has diminished considerably. My mind is much more settled and I can think a lot more clearly these days because I am no longer distracted by nausea and pain. 

On a final note, I think it is worth mentioning that on this morning’s higher dose, I totally forgot my lisinopril and furosemide at 08:00. Furosemide is important to clear my body of excess fluid because with heart failure I am already at risk for fluid retention, and dronabinol can cause fluid retention. Luckily, my husband checked around 10:30 and found I had missed the dose. I was two hours late with my cardiac drugs. On the lower morning dose, my mind is not so singularly focused and I am less likely to forget my pills.

Perhaps the single best measurement of my health status after two and a half years of taking synthetic THC is the cost of my health care. In 2016 my total costs, covered 100% by medicare and my secondary insurance, ran around $30,000. Contrast that with 2017, when I was taking dronabinol, and it was less than $3000!

My healthcare costs seem to becoming less rather than more – as lawmakers and insurance companies would have us believe that elders cost more health dollars. I am happy to reverse the trend. These days my focus is on health and wellness, rather than doctors, drugs and illness. Thanks to dronabinol, I love my life!

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Caveat: As always I am writing this as a form of diary about my interactions with dronabinol and I am in no way advocating that it works like this for anyone else. I know how it works or me and as a 73 y/o female with quite a medical past, I am grateful to find relief and regeneration through the use of synthetic thc.

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