Posted on 04/26/2008 8:16:13 PM PDT by BenLurkin
SEATTLE - Timothy Garon's face and arms are hauntingly skeletal, but the fluid building up in his abdomen makes the 56-year-old musician look eight months pregnant.
His liver, ravaged by hepatitis C, is failing. Without a new one, his doctors tell him, he will be dead in days.
But Garon's been refused a spot on the transplant list, largely because he has used marijuana, even though it was legally approved for medical reasons.
"I'm not angry, I'm not mad, I'm just confused," said Garon, lying in his hospital bed a few minutes after a doctor told him the hospital transplant committee's decision Thursday.
With the scarcity of donated organs, transplant committees like the one at the University of Washington Medical Center use tough standards, including whether the candidate has other serious health problems or is likely to drink or do drugs.
And with cases like Garon's, they also have to consider — as a dozen states now have medical marijuana laws — if using dope with a doctor's blessing should be held against a dying patient in need of a transplant.
Most transplant centers struggle with the how to deal with people who have used marijuana, said Dr. Robert Sade, director of the Institute of Human Values in Health Care at the Medical University of South Carolina.
"Marijuana, unlike alcohol, has no direct effect on the liver. It is however a concern ... in that it's a potential indicator of an addictive personality," Sade said.
The Virginia-based United Network for Organ Sharing, which oversees the nation's transplant system, leaves it to individual hospitals to develop criteria for transplant candidates.
At some, people who use "illicit substances" — including medical marijuana, even in states that allow it — are automatically rejected. At others, such as the UCLA Medical Center, patients are given a chance to reapply if they stay clean for six months. Marijuana is illegal under federal law.
Garon believes he got hepatitis by sharing needles with "speed freaks" as a teenager. In recent years, he said, pot has been the only drug he's used. In December, he was arrested for growing marijuana.
Garon, who has been hospitalized or in hospice care for two months straight, said he turned to the university hospital after Seattle's Harborview Medical Center told him he needed six months of abstinence.
The university also denied him, but said it would reconsider if he enrolled in a 60-day drug-treatment program. This week, at the urging of Garon's lawyer, the university's transplant team reconsidered anyway, but it stuck to its decision.
Dr. Brad Roter, the Seattle physician who authorized Garon's pot use for nausea, abdominal pain and to stimulate his appetite, said he did not know it would be such a hurdle if Garon were to need a transplant.
That's typically the case, said Peggy Stewart, a clinical social worker on the liver transplant team at UCLA who has researched the issue. "There needs to be some kind of national eligibility criteria," she said.
The patients "are trusting their physician to do the right thing. The physician prescribes marijuana, they take the marijuana, and they are shocked that this is now the end result," she said.
No one tracks how many patients are denied transplants over medical marijuana use.
Pro-marijuana groups have cited a handful of cases, including at least two patient deaths, in Oregon and California, since the mid-to-late 1990s, when states began adopting medical marijuana laws.
Many doctors agree that using marijuana — smoking it, especially — is out of the question post-transplant.
The drugs patients take to help their bodies accept a new organ increase the risk of aspergillosis, a frequently fatal infection caused by a common mold found in marijuana and tobacco.
But there's little information on whether using marijuana is a problem before the transplant, said Dr. Emily Blumberg, an infectious disease specialist who works with transplant patients at the University of Pennsylvania Hospital.
Further complicating matters, Blumberg said, is that some insurers require proof of abstinence, such as drug tests, before they'll agree to pay for transplants.
Dr. Jorge Reyes, a liver transplant surgeon at the UW Medical Center, said that while medical marijuana use isn't in itself a sign of substance abuse, it must be evaluated in the context of each patient.
"The concern is that patients who have been using it will not be able to stop," Reyes said.
Dale Gieringer, state coordinator for the California chapter of NORML, the National Organization for the Reform of Marijuana Laws, scoffed at that notion.
"Everyone agrees that marijuana is the least habit-forming of all the recreational drugs, including alcohol," Gieringer said. "And unlike a lot of prescription medications, it's nontoxic to the liver."
Reyes and other UW officials declined to discuss Garon's case.
But Reyes said that in addition to medical concerns, transplant committees — which often include surgeons, social workers, and nutritionists — must evaluate whether patients have the support and psychiatric health to cope with a complex post-operative regimen for the rest of their lives.
Garon, the lead singer for Nearly Dan, a Steely Dan cover-band, remains charged with manufacturing weed. He insists he was following the state law, which limits patients to a "60-day supply" but doesn't define that amount.
"He's just a fantastic musician, and he's a great guy," said his girlfriend, Leisa Bueno. "I wish there was something we could do legally. ... I'm going to miss him terribly if he passes."
___
That it is ‘legally used’ does not change the physiology.
Prayers for Timothy Garon.
No open mind for this doctor. Hope he never has a family member suffering.
God Bless his body and his soul.
"..Hepatitis C is a blood-borne infectious disease that is caused by Hepatitis C virus (HCV), infecting the liver.[1] The infection can cause liver inflammation (hepatitis) that is often asymptomatic, but ensuing chronic hepatitis can result later in cirrhosis (fibrotic scarring of the liver) and liver cancer.
The hepatitis C virus (HCV) is spread by unprotected sex, sharing needles and by blood-to-blood contact..."
Perhaps if he did less dope, he'd be able to think more clearly and would be less confused.
This rule has nothing to do with the physiology.
Timing is everything. UCSD researchers have discovered that they can block a protein that causes excess fibrin production in the liver, in mice. By not producing excess fibrin, the liver halts further damage and heals itself.
If their research extrapolates to humans, a lot of liver disease may have a definitive treatment.
Ironically, the herb milk thistle contains a substance called silymarin, that had amazing protective and recuperative effects on the liver. However, it could not reverse excess fibrin.
Indeed. My doctors have asked me if I wanted to go that route when I lived in California and I said with my family’s background in Law Enforcement it was too touchy an issue. There will be a day when the pain meds I am on now will damage my liver so much, I will not have a choice.I really feel for those people that are at that point and have no other recourse.
May the Lord bless and comfort Timothy. May he be healed body, mind and soul,for the Glory of God, in Jesus Name, amen.
http://www.hcvets.com/
this guy is trying to get a rare resource, i.e. a liver.
Yet his disease, hepatitis C, can reoccur in the new liver, leading to liver failure.
Second, Hepatitis C is a “marker” for drug abuse. Normal people don’t abuse drugs (they might use drugs, including medical marijuana, but not abuse them). This means he is not as stable mentally as another person. People with emotional problems might not take their rejection medicines correctly, and the liver will end up being rejected.
Third, the presence of his large abdomen suggests he is in bad shape (hypoproteinemia, clotting problems from end stage liver disease). I’ve had people die of these problems while awaiting a liver to be found.
Four, people with substance abuse (usually severe alcoholics) have other medical problems. If a person remains off alcohol and other drugs for several years, they can be placed on a transplant list. This gentleman states he “needs” medical marijuana...apparantly the docs figure he is misusing it. (again, medical marijjuana can be used as a drug or abused by someone using it as a drug, just like Codiene or other pain killers can be abused).
Again, this is a judgement call, but I suspect the docs are dubious of his claims.
Finally, by going to the press, it suggests he feels he is “entitled” to a tranplant.
These types turn off doctors, who know many patients just as sick, who need a transplant, and who would probably do better after getting a transplant, but who will die because someone has a big mouth and manipulates the system.
In other words, it’s not the marijuana alone that makes him a bad risk for a tranplant.
At 56? Ignore the facts and speculate wildly. This guy has a guaranteed position as a global warming scientist if he ever wants to give up medicine.
Well said & prayers for you my FRiend. ~Pandy~
Read the story again, the part about fatal infections with Aspergillosis, a mold found in the marijuana plant. Post-transplant, all patients are put on immunosuppresant drugs: Exposure to Aspergillosis would certainly be fatal.
Food for thought.
Medical marijuana patients face transplant hurdles
"..Garon believes he got hepatitis by sharing needles with "speed freaks" as a teenager..."
AspergillosisAspergillus species are ubiquitous molds found in organic matter. Although more than 100 species have been identified, the majority of human illness is caused by Aspergillus fumigatus and Aspergillus niger and, less frequently, by Aspergillus flavus and Aspergillus clavatus. The transmission of fungal spores to the human host is via inhalation.
Other sources cite stored grain and dead leaves and compost piles. I guess if you eat any vegetables, have a garden, house plants or live anywhere where plants grow you should be excluded from transplants as well.
‘Was’ being the operative word. At 56 his teen years are far behind him.
I was told 12 years ago that at best I had a year or two to live. I tried their Interferon & it darn near killed me. However I decided to live & I went natural. I saw what my liver looked like in the first biopsy. When I had my biopsy in March of this year the doctors were shocked there is NO DAMAGE. I will never get rid of Hep C but I have learned to live with it & protect myself & others from my blood. However a liver like mine would be fine to give this man as it is already infected with the virus. I truly don’t think doctors know all that much about Hep C. I saw many doctors over the years & all disagreed on everything. It was very confusing. My doctors don’t believe that I have helped myself with things like liq silver & milk thistle. All I know is I am alive, at 41 yrs old I gave birth to a healthy Hep C free daughter.And I have a liver that is fine. At present my viral count is 3 million & my doctors don’t even want me to get treated with Pegatron now thankfully. I believe in the power of prayer very much & I believe that all the prayers I got from the many FReepers who prayed for me helped greatly.
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