Holistic Practitioner Spotlight with Dr. Philip DiGiacomo, Integrative Physician
We are speaking with Dr. Philip DiGiacomo, MD, who offers telemedicine to help patients who suffer from many chronic conditions.
Tell Us a Story About a Patient Who Suffered from Chronic Pain and How She Was Helped with Medical Marijuana
Sharon, a 67-year-old retired female patient scheduled a telemedicine appointment with me for evaluation of her chronic headaches and joint pain. For fifteen years, Sharon had been suffering joint pain from rheumatoid arthritis, an underlying autoimmune disease. She was diagnosed five years ago with optic neuritis-induced headaches which she described as debilitating. These headaches, located around her eyes, occurred three to four times per week and often lasted all day long. On a severity scale, Sharon ranked her headaches as a four out of five.
Unable to identify triggers for her headaches, they occurred randomly, which made them particularly bothersome. Due to the severity, duration, and frequency of her headaches she chose to retire early from her occupation as a bookkeeper. Sharon’s personal life deteriorated as well, having to cancel social activities frequently due to her severe headaches.
As previously prescribed therapy was not working for her, Sharon scheduled a telehealth appointment with me to discuss medical marijuana as an alternative treatment option to alleviate her chronic pain.
What had Sharon tried before seeking you out?
Sharon had been under the care of several healthcare providers who prescribed non-steroidal anti-inflammatory drugs (NSAIDs) and prednisone, a steroid. She experienced dyspepsia and frequent abdominal pain when taking NSAIDs – which did not even help her pain. The prednisone provided partial relief of Sharon’s symptoms, however, she was concerned about side effects from long-term usage such as weight gain, diabetes, and hypertension.
In addition to these medications she reported also trying yoga, stretching, and acupuncture without any improvement in her symptoms. We then went on to discuss medical marijuana.
How did you arrive at your course of treatment using Medical Marijuana?
Sharon and I discussed her previous therapies and the reasons for seeking evaluation for medical cannabis. Her main motivation was concern of long-term effects from taking prednisone chronically.
Although, it is not a prerequisite in Illinois to have tried prior treatments, most patients have already done so before seeking a medical cannabis evaluation. Medical cannabis can be prescribed for numerous “debilitating” conditions or chronic pain. Sharon qualified for medical cannabis because of her chronic pain from her headaches and joint pain.
What holistic or alternative modalities or therapies did you implement and what was the outcome of the services you provided?
My patient informed me that she had gotten notable relief from her headaches and joint pain from smoking marijuana which she limited to two to three times a week. She did not, however, like the burning discomfort she felt in her throat and chest when inhaling.
Sharon and I then discussed the different delivery vehicles now available for medical marijuana. We covered vaping, dabbing (oil extraction), edibles and topical formulations.
Based on our discussion it seemed that Sharon would benefit from vaping Indica marijuana. This strain of cannabis which contains THC and higher amounts of CBD was chosen because the patient reported – on top of her chronic pain – notable insomnia. This option could help with that symptom as well. The vehicle of vaping is less harsh than smoking marijuana. Sharon’s dosing instructions were to vape as needed for recurrence of her headaches or joint pain until she experienced acceptable relief.
Unless Sharon’s symptoms spontaneously resolve, she will likely need to continue to use medical cannabis for years to come. And depending on how frequently she uses cannabis, there is a possibility she may need to increase her dose in the future. There is always the option of trying different formulations, discussing with Sharon that staff at her local marijuana dispensary are also incredibly knowledgeable and a great resource for her going forward.
Why and When Did You Choose the Holistic, Integrative, or Natural Health Path?
I have been practicing Emergency Medicine for 9 years post-residency. During that time, it had become very clear to me that in addition to our nationwide opioid crisis, often times patients do not experience significant adequate relief of their symptoms with traditional prescribed medications. Additionally, many medications cause significant side effects that cause new issues for our patients.
I have had many patients over the years tell me that medical marijuana was the only treatment that gave them relief of their symptoms. To provide better treatment options for my patients, I have explored and researched medical marijuana. Now, I am happy to offer this treatment via telemedicine to patients living in Illinois.
What Lessons Have Your Work and Personal Experiences Taught You and What Has Been the Affect On Your Lifestyle?
My research into medical marijuana has taught me a great deal about this therapy. I have learned the difference between the two most common cannabis strains (Indica vs Sativa), the indications for each, the difference between CBD and THC, and all of the different delivery vehicles currently on the market for medical marijuana.
I obtained my Bachelors of Science from Villanova University in Villanova, PA in 2005. I then attended medical school at the Sidney Kimmel Medical College in Philadelphia, PA and graduated in 2008.
My training then took me to North Carolina where I completed my internship/residency at the University of North Carolina in Chapel Hill, NC in 2011.
I have been practicing Emergency Medicine full-time since then, and currently live in the Chicago suburbs.
Dr. Philip DiGiacomo, MD
ER and Telemedicine Physician
Naperville, IL, USA
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