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 (443) Gabriella aus Czech Republic schrieb am 28. Nov 19, 19:18 
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 (442) Agen Judi Slot Online aus Antigua And Barbuda schrieb am 28. Nov 19, 19:17  http://12-naga.site/
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 (441) Jacquie aus Madagascar schrieb am 28. Nov 19, 18:53 
Schoene Seite

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 (440) Jarrod aus Guatemala schrieb am 28. Nov 19, 18:49 
Vielen Dank! Wollt ich nur sagen.

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 (439) Glinda aus Poland schrieb am 28. Nov 19, 18:48 
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 (438) Judy aus Austria schrieb am 28. Nov 19, 18:44  http://www.dokterwahyuskincare.com/
Vielen Dank! Wollt ich nur sagen.

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 (437) Sheree aus Tanzania schrieb am 28. Nov 19, 18:42  http://www.gotanproject.com/node/7669484?---------------------------63558129424%0D%0AContent-Disposition:%20form-data;%20name=%22title%22%0D%0A%0D%0AIs%20It%20OK%20For%20Pain%20Management%20Doctors%20To%20Fire%20Patients%20Using%20Medical%20Marijuana%3F%0D%0A---------------------------63558129424%0D%0AContent-Disposition:%20form-data;%20name=%22body%22%0D%0A%0D%0AWhen%20a%20patient%20sees%20a%20pain%20management%20doctor,%20the%20patient%20may%20receive%20narcotic%20medications.%20Especially%20if%20the%20person%20has%20a%20chronic%20pain%20issue%20and%20there%20is%20no%20surgical%20answer,%20opiates%20may%20be%20part%20of%20the%20plan%20for%20a%20long%20time.%3Cbr%3E%0D%0A%3Cbr%3E%0D%0A%0D%0AThere%20are%20significant%20potential%20side%20effects%20with%20opiate%20medications.%20This%20may%20include%20constipation,%20depression,%20sedation,%20%20%20cbd%20mobile%20apps%20-%20https://approveflow.com/best-cbd-mobile-apps/%20%20euphoria,%20dizziness,%20fatigue,%20anxiousness,%20clammy%20skin,%20confusion,%20respiratory%20depression,%20and%20a%20slew%20of%20others.%3Cbr%3E%0D%0A%3Cbr%3E%0D%0A%0D%0AOne%20of%20the%20biggest%20issues%20seen%20is%20tolerance%20and/or%20addiction%20with%20opiates.%20Tolerance%20is%20when%20the%20patient's%20chronic%20pain%20condition%20doesn't%20change,%20but%20the%20same%20amount%20of%20pain%20medication%20doesn't%20quite%20provide%20adequate%20pain%20relief%20any%20longer.%3Cbr%3E%0D%0A%3Cbr%3E%0D%0A%0D%0AOne%20of%20the%20newer%20options%20in%2016%20states%20plus%20the%20District%20of%20Columbia%20is%20medicinal%20marijuana.%20Treatment%20with%20marijuana%20may%20offer%20substantial%20relief%20that%20may%20decrease%20the%20need%20for%20high%20doses%20of%20opiates%20or%20in%20some%20cases%20provide%20relief%20where%20opiates%20do%20not%20work%20well.%3Cbr%3E%0D%0A%3Cbr%3E%0D%0A%0D%0AFor%20instance,%20opiate%20medications%20are%20not%20a%20great%20choice%20for%20peripheral%20neuropathies.%20They%20just%20don't%20modulate%20the%20pain%20well,%20whereas,%20medical%20marijuana%20works%20very%20well%20for%20these%20issues.%3Cbr%3E%0D%0A%3Cbr%3E%0D%0A%0D%0AMedical%20marijuana%20does%20not%20preclude%20the%20need%20for%20interventional%20pain%20management.%20With%20a%20disc%20herniation%20or%20a%20focal%20problem%20where%20a%20pain%20management%20injection%20would%20help,%20medical%20marijuana%20is%20not%20the%20answer.%3Cbr%3E%0D%0A%3Cbr%3E%0D%0A%0D%0AWhen%20patients%20are%20on%20chronic%20pain%20medications%20with%20a%20pain%20doctor,%20typically%20a%20pain%20contract%20is%20signed.%20The%20%22contract%22%20usually%20states%20that%20while%20a%20patient%20is%20under%20his%20or%20her%20care,%20the%20patient%20will%20not%20use%20illicit%20drugs.%3Cbr%3E%0D%0A%3Cbr%3E%0D%0A%0D%0AUnfortunately,%20marijuana%20is%20still%20federally%20illegal%20despite%20the%20fact%20it%20is%20now%20legal%20in%2016%20states.%20And%20most%20pain%20doctors%20perform%20drug%20screening%20on%20their%20patients.%20So%20if%20a%20patient%20is%20under%20a%20contract,%20gets%20tested,%20and%20turns%20up%20positive%20for%20THC%20(the%20active%20component%20of%20marijuana),%20is%20it%20appropriate%20for%20the%20pain%20doctor%20to%20terminate%20the%20patient%3F%3Cbr%3E%0D%0A%3Cbr%3E%0D%0A%0D%0AIt's%20a%20simple%20answer%20as%20to%20whether%20or%20not%20the%20pain%20doctor%20has%20the%20right%20to%20terminate%20the%20patient,%20but%20not%20a%20simple%20answer%20as%20to%20whether%20it's%20appropriate.%20If%20the%20pain%20agreement%20states%20that%20the%20doctor%20has%20the%20right%20to%20terminate%20a%20patient%20if%20the%20drug%20test%20turns%20up%20positive%20for%20narcotics%20not%20being%20prescribed,%20then%20that%20is%20difficult%20to%20refute.%20If%20the%20patient%20is%20given%20the%20opportunity%20to%20rectify%20their%20termination%20by%20ceasing%20the%20marijuana%20use%20and%20re-testing%20in%20a%20few%20weeks,%20once%20again%20that%20is%20the%20doctor's%20prerogative.%3Cbr%3E%0D%0A%3Cbr%3E%0D%0A%0D%0AEthically,%20the%20situation%20is%20not%20so%20simple.%20Patients%20deserve%20effective%20pain%20management,%20and%20there%20is%20a%20big%20push%20in%20American%20not%20to%20undertreat.%20Medical%20marijuana%20has%20shown%20effectiveness%20in%20a%20number%20of%20chronic%20pain%20conditions%20and%20numerous%20other%20conditions%20such%20as%20severe%20nausea/vomiting%20and%20cancer.%3Cbr%3E%0D%0A%3Cbr%3E%0D%0A%0D%0AHaving%20marijuana%20continue%20to%20be%20federally%20illegal%20and%20placed%20into%20the%20illicit%20category%20puts%20pain%20doctors%20in%20a%20very%20difficult%20situation.%20If%20they%20test%20patients%20for%20THC%20and%20then%20don't%20terminate%20patients%20who%20test%20positive,%20is%20it%20showing%20bias%20with%20regard%20to%20other%20illicit%20substances%3F%3Cbr%3E%0D%0A%3Cbr%3E%0D%0A%0D%0ASome%20pain%20doctors%20do%20not%20view%20marijuana%20as%20an%20illicit%20substance%20due%20to%20its%20medicinal%20value,%20therefore,%20they%20do%20not%20test%20for%20it%20with%20screening.%20If%20a%20patient%20discloses%20the%20use%20of%20marijuana%20to%20the%20doctor,%20the%20issue%20becomes%20the%20same.%3Cbr%3E%0D%0A%3Cbr%3E%0D%0A%0D%0AThe%20point%20here%20is%20there%20really%20is%20no%20clear%20cut%20right%20and%20wrong%20answer%20for%20the%20pain%20doctor%20to%20follow.%20Guidelines%20need%20to%20be%20individualized.%20Hopefully%20once%20federal%20views%20on%20marijuana%20change%20then%20these%20ethical%20issues%20will%20become%20moot.%0D%0A---------------------------63558129424%0D%0AContent-Disposition:%20form-data;%20name=%22field_pays[value]%22%0D%0A%0D%0AAlgeria%0D%0A---------------------------63558129424%0D%0AContent-Disposition:%20form-data;%20name=%22changed%22%0D%0A%0D%0A%0D%0A---------------------------63558129424%0D%0AContent-Disposition:%20form-data;%20name=%22form_build_id%22%0D%0A%0D%0Aform-45d6a0da193582cfba1e5c67835e21d7%0D%0A---------------------------63558129424%0D%0AContent-Disposition:%20form-data;%20name=%22form_id%22%0D%0A%0D%0Alivredor_node_form%0D%0A---------------------------63558129424%0D%0AContent-Disposition:%20form-data;%20name=%22field_ville[0][value]%22%0D%0A%0D%0AReykjavik%0D%0A---------------------------63558129424%0D%0AContent-Disposition:%20form-data;%20name=%22field_email[0][email]%22%0D%0A%0D%0A%0D%0A---------------------------63558129424%0D%0AContent-Disposition:%20form-data;%20name=%22op%22%0D%0A%0D%0AEnregistrer%0D%0A---------------------------63558129424--
Hey Danke fuer die schoene Zeit auf dieser Webseite.
Macht weiter bitte so. Da kommt man gerne wieder. 

 (436) Osvaldo aus Grenada schrieb am 28. Nov 19, 18:19  http://users.atw.hu/dobosok/index.php?title=User_vita:LewisDegotardi
Nette Seite. Danke. 

 (435) Azucena aus Cameroon schrieb am 28. Nov 19, 18:13 
Vielen Dank! Wollt ich nur mal sagen. 

 (434) Glenda aus Western Samoa schrieb am 28. Nov 19, 18:12 
Wollte Dir einfach mal in diesem Gaestebuch einen Gruss hinterlassen.

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