Research Study With Dr. Bob

[Dr. Bob]

I need some help from the medical marijuana community here.  

 

Currently I am working on some research projects that will help with the new 'prove your use, justify your strain' decisions.  As I do not personally have experience with different strains and must rely on reading and discussion with those that do, I'm asking for your help to write some survey questions.

 

Group One:

 

Differences between sativa and indica by effect on the body, not the plant morphology.

 

What are some good effects that will clearly demonstrate the differences between indica and sativa?

 

Here are some I have

 

anxiety

sleep

appetite

 

Limit your response to one word that is a specific effect or feeling

 

If you wish, give me 4-10 characteristics of each as if you were explaining the differences to a friend.  I want to find 20 characteristics that can clearly be characterized as indica or sativa.

 

Group Two

 

These are going to be very common symptoms that we can say are better treated (by personal experience) by an indica, a sativa, or blend.

 

Here is what I am thinking

 

nausea

burning neuropathic pain

dull aching low back type pain

spastic pain like menstrual cramping

migraine type pain

seizures

inability to eat

long muscle cramping (low back)

short muscle cramping (fingers and toes)

 

Finally Group Three

 

Effects of marijuana with other medication

 

Most effective with Narcotic pain meds

Most effective with Anti Inflammatory meds

Most effective with anti-spasm meds

 

Here I am looking for folks that are using marijuana to make their regular medicines work better.

 

Help me out, try and ad a question or two to each of the three groups.

 

My survey will go out to thousands of cannabis patients and be shared on line.  My goal is to get over 1000 thoughtful responses that can then be compiled and published, and as a side effect used as evidence in section 8 hearings.  So please help me out.

 

Please post your responses in this thread or via PM.

 

Thanks in Advance for your Help-

Dr. Bob

Edited February 16, 2014 by Dr. Bob

[trichcycler]

nausea

burning neuropathic pain

dull aching low back type pain

spastic pain like menstrual cramping

migraine type pain

seizures

inability to eat

long muscle cramping (low back)

short muscle cramping (fingers and toes)

 

I register patients that are much like me in lifestyle, suffering from the same

qualifying conditions generally and we each name  the 10-20 strains I cycle "our all time favorites".

The symptoms mentioned above have been reported by most of us in my registry.

 

We've also found that any land race pure sativas or indica strains, although a fun ride occasionally, cause undesired effects for us.

There's a lot I like of a sativa, but some I don't, so I no longer grow those, same as the indica. Our best results come from variations of

a 60/40 to 50/50 to 40/60 sativa/indica hybrids. Repeatability confirmed in other like gardens of past patients/cg's. There are some "real deal" breeders

that have gone beyond the pollen chucking, and guesswork. TGA Subcool is one. His Terpene profiles are near perfection and the medical benefits

of all his creations have been verified many times. If I could have only the choosing of only one breeder gear forever, it would be his. I have dozens of others we enjoy too, but wow. I hope this helps some.

 

peace

They are all 60/40-50/50-40/60..sativa/indica.

[GregS]

Google is your friend Bob. It's old news. This, http://www.medicalmarijuanastrains.com/strain-guide/, (for some reason that page won't open, but click on the strain guide tab) and this, http://forum.grasscity.com/medical-marijuana-usage-applications/147139-disease-specific-mmj-strain-list.html, are examples.  My experience is that strain identification is ephemeral in that it cannot be assured that cross breeding or misidentification are avoided. For instance, I have acquired genetics that the providers assured me were given strains, only to find that they were something quite different. I have known growers whose crop has somehow become cross pollinated with any number of strains. This is especially true when dealing with small, boutique grows and product, which are everywhere and what we use. Strains come and strains go. People grow them with any number of, or no, real standards to assure integrity. Consider that purveyors have an interest in boosting their bottom line and ego by claiming to have something that cannot be assured. Then too, results are subjective, much like pharmaceuticals, which affect patients differently among a given population.

 

What can be assured is that it's all good and playing this game is wildly entertaining. You should try the stuff sometime. Every day would be good. It cured my neighbor's ignorance.

 

You're welcome.

Edited February 16, 2014 by GregS

[t-pain]

which decisions talked about strains? i dont remember that, or is this a thing from other states or canada where they limit the strains available?

 

i want to make sure the questions in the survey will get the answers needed to clarify whatever the judges are asking for.

[GregS]

Is that case (is it Hartwick?) being appealed?

[Wild Bill]

There are so few pure strains anymore it's difficult to know if it's really an indica or a sativa. You have to take the seed companies word as to genetic heritage.

 

One of my favorite strains for pain is OG Kush. It's supposed to be sativa dominant but it looks more indica.

 

There is also a difference in effect depending on whether it is smoked or ingested. Clear headed when smoked but can be like a sleeping pill when eaten.

 

Generally speaking I would say sativas are better for neuropathic pain and indicas for spasms.

[cristinew]

It  All works   ,  And having  none  does not work,  Most are  Hybrid Indcia / Sativa    with a THC  content   of 10 to 20 %  Any thing under that does not work well for Medicinal  and the  flavors go .

[GregS]

Retail descriptions and testimonials are unreliable. A description of Haze as a relaxing strain is contrasted with information that it is quite sativa dominant and has a clear headed effect. You don't have to look far to find the same with many vendors and comments. Much is hype. A reliable grower can sorta reasonably assure a strain, but only as far as his or her door.

Edited February 16, 2014 by GregS

[t-pain]

is there any literature on the difference of effects from smoking vs vape? because theres quite a difference for me. obviously edibles are another completely different set of effects with the same strain.

 

limiting marijuana to just 3 or 10 strains is idiotic. its like limiting prescriptions to just oxycontin 10mg and vicodin 30mg or picking 3 kinds of antibiotics. the problem is that people dont react the same to prescriptions, same with marijuana.

 

some people even get the reverse effects from indica and sativa, e.g. indicas keep them up and sativas put them to sleep.

 

its all quite confusing and people have rarely tested, verified or sought out info on the indica/sativa/hybrid they were using.

some breeders make their own version of other breeders strains as well. sometimes they use different plants. now you have different genetics with the same strain name. is it the same percentage of indica or sativa? who knows?

[GregS]

Go to google my friend. There is plenty on vapiing.

 

The answer is obvious. 2 reasons it is better:

 

http://blog.sfgate.com/smellthetruth/2013/11/14/vaporization-vs-combustion-which-is-safer/

 

http://nypost.com/2013/11/14/pot-vaporizers-let-professionals-get-stoned/

[t-pain]

i didnt ask for safety, i meant the effect of the marijuana on your body.

more sleepy? less sleepy? more pain relief? less pain relief?

[cristinew]

Eating it has far better results,  No exhaled wasted vapor or smoke.

[GregS]

i didnt ask for safety, i meant the effect of the marijuana on your body.

more sleepy? less sleepy? more pain relief? less pain relief?

Search terms are limited only by your imagination.

[in vivo]

The higher temps with combustion are believed to result in a higher conversion of cannabinoids to CBN. If you buy into the characteristics of CBN, this should result in a more sedating effect. I feel it resonates with my own anecdotal experiences. There's a study on it in the research section.

 

Like others here I don't put too much stock in sativa vs indica. Short of genetic identification it seems like a bit of a farce to call something a certain percent of one or the other. That being said, I think there's much to be learned from comparing cannabinoid and terpene profiles to anecdotal experiences. I'm still waiting on my results from Iron Labs, but once I get them I'll be posting them to start that discussion. 

[trichcycler]

Available Terpenes, not strain names or origins should be examined, as the true healers of the plant.

[GregS]

Available Terpenes, not strain names or origins should be examined, as the true healers of the plant.

That sounds like a job for a doctor.

[t-pain]

ok it is people v hartwick, where hartwick has to prove 71/77 plants in sec8.

 

people v tuttle contains this nasty business:

It was also troubled by the number of plants found in defendant’s home, stating that 33 plants certainly could be viewed to be significantly beyond the required quantity to treat his patient’s conditions.

tuttle had two patients and was a patient himself, legally allowed to posess 36 plants.
 

so in these two cases, we need answers that explain why someone would have lots of different plants.

 

@dr bob, so the questions you would need to ask your patients would be something like:

 

1. how many different strains have you tried to treat your qualifying condition?

1a. how many different strains have you used at the same time to try to get more relief from your condition?

2. have you found the strain that works best for your condition?

3. are you looking for strains that treat your condition better or have less side effects?

4. have you or your caregiver ever ran out of a strain

5. have you switched caregivers to find more strains

6. as a caregiver, have patients asked you to grow more strains?

7. as a patient, have you tried growing more strains to find one that works for you, even though your condition does not require that many plants?

8. as a patient, would you like to use one strain in the morning that does not have a sleepy effect, and then use a strain at night that does have a sleepy side effect, to control your qualifying condition but still allow you to be active during the day and get rest at night?

9. do some strains relieve portions of symptoms associated with your condition, and other strains relieve other portions of your condition? but neither strain relieves all of your condition?

10. when growing or looking for a caregiver, are you satisfied with just one strain , or do you require a variety of strains ?

11. have you or your patients ever had plants die due to bugs, disease, water, light, nutrient or other problems?

12. how many marihuana plants have died in your care?

13. have you or your caregiver ever lost their entire garden all at once?

14. have you been without medication because of a crop failure?

15. how many seperate times have you been without medication because of crop failure, inability to grow, prohibition due to city ordinance or other disadvantage?

16. how easy would you say it is to grow from seed to finished usable marihuana?

17. is it better to grow many plants at once or one plant every few weeks?

 

maybe i dont know what point you are trying to make with the indica/sativa questions in your first post. maybe you could clarify.

Edited February 16, 2014 by t-pain

[trichcycler]

Importance of Terpenes

 

 

By Nathan Spaulding

Terpenes are volatile compounds produced by many plants, as well as some insects. Plants that produce terpenes often possess smells and flavors we find pleasing and are known as aromatic herbs. These aromatic plants have been used by cultures around the world, not only for perfumery and cooking, but also as medicine. The distinctive flavor and smell of each aromatic plant is caused by its unique blend of terpenes. 120 distinct terpenes are produced by the genus Cannabis, with the relative concentrations of the individual terpenes varying greatly among the 700 distinct strains currently in cultivation. Aside from taste and smell differences between varieties, this helps contribute to the broad diversity of potential medical applications of Cannabis. Laboratory experiments have shown that the full range of psychoactive and medical effects of Cannabis resin cannot be re-created simply with the use of pure cannabinoid type drugs like THC (tetrahydrocannabinol). Marinol and Dronabinol, two drugs containing synthetic THC that have demonstrated limited medical benefits when compared with the use of Cannabis material containing the full range of cannabinoids and terpenes. These observations indicate that in addition to the psychoactive properties present in Cannabis resin, secondary components including terpenes are either psychoactive themselves, or are able to modulate or potentiate the affect of the cannabinoids when ingested in combination. GW Pharmaceuticals has invested extensive research into Cannabis based medicines, concluding that terpenes played a significant role in the effectiveness of the medication. GW is now manufacturing the most widely used medical marijuana product in the world an oral spray called Sativex, which contains a standardized mixture of Cannabis terpenes in addition to a mix of THC and CBD (Canabidiol).

From a chemical standpoint, terpenes are a large and varied class of hydrocarbons that make up a majority of plant resins and saps. The name “terpene” comes from turpentine, a terpene-based solvent distilled from pinesap. Essential oils, composed primarily of terpenes, have a long history of topical and internal medicinal use. Cannabinoids like THC are chemically classified as terpenoids, meaning they are derived from terpenes themselves. This explains the common practice among marijuana users of judging the quality of dried cannabis or hashish based largely on the quality and intensity of the smell. In high-THC cultivars, because the THC is made from terpenes, their content is usually correlated with psycho activity.

The resinous trichromes of the cannabis plant contain both the cannabinoids as well as the terpenes, which are constantly being replaced as they evaporate from the resin. The resin of high THC cannabis contains approximately 20 percent terpenes, and 50 percent cannabinoids by weight. The essential oil has traditionally been used as a treatment for skin conditions such as eczema or psoriasis, as a topical antibiotic agent, and to increase circulation. In addition to these topical uses, it is now known that terpenes present in Cannabis do possess neurological effects, altering the production of the neurotransmitters seratonin and dopamine, as well as acting as type 2 cannabinoid receptor agonists. Another significant action when used in combination with cannabinoids is their ability to alter the permeability of both cell membranes and the blood/brain barrier, causing THC and other active cannabinoids to have a faster onset and more thorough absorption. Myrcene and several other terpenes are known to act as mixed agonist/antagonists of cannabinoid receptors, modulating the effects of THC in a similar fashion to CBD (cannabidiol).

The Major Terpenes of Cannabis Resin and Their Effects

Borneol – Borneol is a major component of cannabis resin that can also be found in cinnamon and wormwood (Artemesia spp). In Chinese medicine herbs containing borneol are recommended for fatigue and overstress. Borneal is mentioned to be a calming sedative.

Corryphyllene – Corryphyllene is a major component of cannabis resin that can also be found in black pepper and cloves. It is a fairly weak agonist of the type 2 cannabinoid receptors (cb2). As a constituent of a salve or lotion corphyllene is an effective anti- inflammatory and analgesic. Drug dogs are trained to specifically sniff out corphyllene epoxide, a similar compound produced only by cannabis.

Cineole/eucalyptol – Cineole/eucalyptol content is quite variable across varieties of Cannabis, but is often a major component of the essential oil. It is also found in rosemary and eucalyptus and is used to increase circulation, and reduce pain and swelling when applied topically. It readily crosses the blood/brain barrier, possibly helping cannabinoids to cross more readily as well. The effects of cineole, when combined with oral or smoked Cannabis, are reported as being very uplifting, noticeably increasing mental and physical energy. This terpene, or others like it, may be responsible for the reported difference in effect between indica and sativa strains with a similar cannabinoid profile.

Limonene – Found in cannabis resin as well as tropical fruit rinds, limonene is an anti-bacterial, anti fungal and anti cancer agent. Currently undergoing trials for use as an anti depressant, it is also known to increase the absorption of other terpenes by making cell membranes more permeable. The presence of this anti fungal agent may be helpful in protecting against Aspergillus infection in those with compromised immunity when using spoiled or poorly cured marijuana. Limonene is currently in trials to study its ability to prevent breast cancer formation.

Delta-3-Carene – A component of cannabis, rosemary, pine, and cedar resin. Aromatherapy oils that contain high levels of delta3carene are used to dry excess fluids from the eyes, nose, or mouth. It is thought to be at least partially responsible for the dry mouth and eye problems that are common side effects of the use of cannabis.

Linalool – This major component of cannabis and lavender oils is believed to possess anti anxiety and sedative properties. Strains that are high in linalool and similar compounds may be particularly beneficial for patients who experience insomnia when consuming Cannabis.

Myrcene – Significant concentrations of myrcene are present in cannabis resin. It is also found in mango, hops, lemon grass, East Indian bay tree, and verbena. Because of its appealing fragrance, myrcene is used in the perfume industry. It has a similar modulating effect on the binding of Cannabinoid agonist drugs as Cannabidiol, possibly reducing effects of Cannabis resin that are found to be unpleasant for some medical users. It has anti microbial, anti septic, analgesic, anti oxidant, anti carcinogen and anti-inflammatory properties. It has shown some promise when used as an anti depressant, or as an additive to other anti depressant drugs and is also used in massage therapy as a muscle relaxer.

Terpineol – Minor component of Cannabis resin, used extensively in the perfume industry. Interestingly this terpene decreases motility of lab rats by 45 percent, this observation coupled with the fact that this is a terpene produced primarily in Cannabis indica plants indicates terpineol could play a role in decreased motility sometimes referred to as “couch lock”.

To get the greatest possible benefits from medical Cannabis products, its important to be aware of the common methods being used to produce this medication, and how this will affect the terpene content of the finished product. When Cannabis is exposed to heat the volatile terpenes quickly evaporate, causing the majority of hash oils currently produced for medication to be nearly devoid of terpenes. When purchasing hash oil products it is important to ask if the terpenes have been retained during processing. Ask your dispensary staff if they are aware of the manufacturing processes used in their products, and the properties of the finished medicines.

Cannabis-based salves or lotions have become a popular treatment for skin conditions, and terpenes play a major role in the effectiveness of these at treating a range of skin problems. When purchasing these types of products you should talk to your dispensary about the terpene content of the different products available as well as the cannabinoid content. When topically applied, cannabis terpenes are very effective for treating a range of skin problems. If you are a medical marijuana user who prefers to smoke or vaporize cannabis, you can increase the effect of the terpenes in you’re bud by slowly breaking it up and inhaling the aromas prior to smoking. Some concentrates that have become popular retain very little of the original terpenes. This is true of most hash oils that are extracted or dried with heat, as well as bubble hash that have lost much of the original terpenes to the water used in processing. The most concentrated terpenes are found in freshly dried buds, as well as high quality dry sift hash or kief.

It is now understood that the psychoactive and medicinal effects of the cannabis plant can’t be explained by THC and other cannabinoids alone. In order to develop a more thorough understanding of the range of medical conditions alleviated with Cannabis use, terpenes, flavonoids and alkaloids that are produced by different strains of cannabis will need to be studied to determine how they interact with cannabinoids to produce the unique healing properties of organic Cannabis resin. The importance of terpenes in medicinal cannabis is becoming more evident as the research progresses. They are responsible for many of the subtle differences between strains and in how they perform medically. As patients become more aware of the complexities of the various compounds in cannabis, they will become more discerning when choosing their medicines. Hopefully, as patients become more aware of the full potential of Cannabis preparations, it will help increase the quality of available medications, and the quality of information. Educated patients can be the driving force for further research into the almost limitless potential for the medical uses of this amazing plant.

 

For further reading on the effects of many lesser-known chemical constituents of Cannabis visit www.ProjectCBD.org

References:

www.cannabishealthnewsmagazine.com/medical/963/terpenes

[phaquetoo]

There are so few pure strains anymore it's difficult to know if it's really an indica or a sativa. You have to take the seed companies word as to genetic heritage.

 

One of my favorite strains for pain is OG Kush. It's supposed to be sativa dominant but it looks more indica.

 

There is also a difference in effect depending on whether it is smoked or ingested. Clear headed when smoked but can be like a sleeping pill when eaten.

 

Generally speaking I would say sativas are better for neuropathic pain and indicas for spasms.

Generaly Id say its all good when you eat it lol, yea we have no clue as to what strains we are getting, I have some beans im finaly gonna try, I know who made them and ive been blessed to try it a few times with that person, I only had to deal with my friend and his friend, his friend did the polinating and we know there are 3 strains involved and where they were made, it is a proven strain in my eyes, but it is not what they were working on,  It was supposed to be 2 strains, it is 3 strains by an honest mistake, and id have to say it was a realy good mistake, ive not heard any one mention the strain, it has been around for a lil over 3 yrs and I gotta tell ya ive tried alot, and if I had to compare it to a strain, I would say it is in the top five ive ever tried,

 

about 35 yrs ago I picked me up some black african, has anyone tried that?  it was def commercial and had a ton of seeds in it, but I have to say it was one of the buzziest strians ive ever had the pleasure of trying...I was young so they were selling me shake lol, jokes on them it made me and my young friends stupid, I have no regrets, especialy since halfs were nickles for 5 bucks and lids were oz's for 10 bucks, they measured with their fingers a nickle was 2 finger up from the bottom of bag, lid/dime bag was 4 fingers from bottom of bag, I used to get lids that were most def bigger than oz's,,,,oh them were the days, but we also had to deal with that b.s shtuff they (gov) sprayed on the stuff to screw it up, paraquat? I dont remember! and im glad I didnt write it down lmao!

 

Peace

[phaquetoo]

i didnt ask for safety, i meant the effect of the marijuana on your body.

more sleepy? less sleepy? more pain relief? less pain relief?

I find with just about any strain I use in a vape helps me with my lower back pain, and my nerve pricked legs and numb hands and feet, but they all also motivate me more than any other way of using it, vaping is a good way for me to medicate in the morning if I have lots to do! plus it dont use as much and there are plenty of things you can do with the vaped mm, always save it, i have  a few recipes for it and if you make oil put the vaped in with what your using for oil, there is still some thc in it.

 

Peace

[t-pain]

Group One:

 

Differences between sativa and indica by effect on the body, not the plant morphology.

 

What are some good effects that will clearly demonstrate the differences between indica and sativa?

 

Here are some I have

 

anxiety

sleep

appetite

 

Limit your response to one word that is a specific effect or feeling

 

If you wish, give me 4-10 characteristics of each as if you were explaining the differences to a friend.  I want to find 20 characteristics that can clearly be characterized as indica or sativa.

 

ok i see what you are trying to do here, but i think it maybe difficult to explain to laypeople.

what you're trying to do is explain there are different plants for different effects.

except , while there are 1000s of strains, thre are only 2 (well 3 + hybrids) genus/species.

 

so when you go to a judge and say

"patients find relief of some symptoms with an indica, some other symptoms with a sativa and some symptoms with a hybrid."

the judge says 

"indica + sativa + hybrid = 3" "three plants is all anyone would ever need."

and from there you then have to explain strains.

i think its best to drop the indica/sativa/hybrid part , at best it introduces 3 plants. at worst, it just confuses everyone.

 

 

Group Two

 

These are going to be very common symptoms that we can say are better treated (by personal experience) by an indica, a sativa, or blend.

 

Here is what I am thinking

 

nausea

burning neuropathic pain

dull aching low back type pain

spastic pain like menstrual cramping

migraine type pain

seizures

inability to eat

long muscle cramping (low back)

short muscle cramping (fingers and toes)

 

sharp muscle pain

sharp joint pain

sharp back pain

muscle spasms

bone pain

eye sight (glaucoma)

probably some more.

 

i think it would be a better idea just to ask patients to write down what strains help them with each symptom you have there.

would it be a bad idea to show a judge the dumb strain names like 'alaskan thunderfuck' and 'green crack' ? could be. i cannot predict the future.

 

Finally Group Three

 

Effects of marijuana with other medication

 

Most effective with Narcotic pain meds

Most effective with Anti Inflammatory meds

Most effective with anti-spasm meds

 

Here I am looking for folks that are using marijuana to make their regular medicines work better.

 

most effective with cancer radiation meds

most effective with appetite meds

glaucoma meds

which strains help with chrons or chrons meds symptoms like heartburn , diarrhea and headache

 

i like this idea. if you ask for strain names not indica/sativa status.

 

 

My survey will go out to thousands of cannabis patients and be shared on line.  My goal is to get over 1000 thoughtful responses that can then be compiled and published, and as a side effect used as evidence in section 8 hearings.  So please help me out.

 

Thanks in Advance for your Help-

thanks bob, i wish more doctors would conduct more mmj research.

Edited February 16, 2014 by t-pain

[Norby]

i didnt ask for safety, i meant the effect of the marijuana on your body.

more sleepy? less sleepy? more pain relief? less pain relief?

I've found that the bong is the best way to this man's stomach.  Vaping works after a while but not like smoking for some reason. I think I get too "high" and since anxiety affects my stomach it's counteractive.  For some reason a bong hit relaxes my stomach muscles and brings on the munchies better. Although this may change when I can get more indica dom strains or just strains or mothers that work better for the munchies.  Medibles seem to keep me in a better head to ward off getting anxiety and triggering an attack and have a more full 5-7 hour affect.  This is for IBS so the nausea isn't the same as non anxiety induced nausea's I'd think.  They may not be as picky.

Edited February 17, 2014 by Norby

[GregS]

Soo Bob. Controlled, double blind, peer reviewed, and reproducible studies are all you need. What could be more simple? We will breathlessly wait to see your published papers.

Edited February 17, 2014 by GregS

[Dr. Bob]

I was about to abandon the thread and start another while reading these responses.  The LAST one is the only one that came close to what I was asking for.

 

This is not about strains, vap vs smoke vs edibles or anything else related to any conditions.

 

All I am asking is very simple.

 

What is a characteristic that will help to separate what is considered an 'indica' quality from a 'sativa' quality?

 

anxiety?  increased appetite?  Help me out here.  I want to come up with some basic properties that help folks tell indica from sativa, I will then create a poll and let you go wild on it.  Strain names mean nothing, I am looking at specific properties.  They will then be put out on a poll, with 5 available answers.  Pure Indica, Indica Indica Sativa, Indica Sativa, Indica Sativa Sativa, Pure Sativa.  We'll then do some math and calculate bell curves.

 

Similarly, I want list of one or two word conditions that people typically use cannabis for...  migraine pain, chemo nausea, etc.  I'll then put that in a poll and let people use the same 5 point scale to grade what the 'perfect cannabis' for that condition is.

 

So let's try again to keep to the point of the question.  And yes, this is for a paper.

 

Dr. Bob

Edited February 17, 2014 by Dr. Bob

[Dr. Bob]

By the way, it appears that someone is trying to disrupt this thread.  Let make one thing clear, some of us actually do our OWN work, we don't base our opinions on what we read, copy and past from google.  

 

This is a study designed to provide specific information about Michigan Patients to help them in Section 8 defenses and provide some hard data that people can cite.  Let's leave your personal idiocy out of it Greg.  Professional adults are trying to do some good work here.

 

Dr. Bob