Marijuana after quadruple bypass surgery?
August 1, 2015 9:15 AM   Subscribe

I'm having a difficult time finding credible information on this topic.

My dad is having a quadruple bypass today.

I'd like to know about the pros and cons for a cardiac patient using marijuana post surgery:

1) As an alternative to or supplement for opiate pain management medications

2) To replace his habit of drinking several alcoholic beverages every night to unwind

Given that smoking anything is bad for cardiac patients, he'd be ingesting it in edible form instead of inhaling it. Marijuana is legal in his state (Washington) so we shouldn't have a problem sourcing quality edibles/supplements.

Of course we will also consult with his doctors but we suspect that they may not be able to give us a honest answer due to the hospital, insurance company, etc. requiring them to hold to the anti-marijuana party line. They are also unlikely to be up-to-date on the latest marijuana research.

Please advise, thanks!
posted by Jacqueline to Health & Fitness (8 answers total)
I did a search for cannabis+cardiac+effects and came up with a bunch of scholarly articles I am completely unqualified to comment on. So there's that.

On the personal front: From experience, managing the dose in edible form is much more trial-and-error, and having too much tends to make me sweaty, a little sick to my stomach, and gives me a racing heartbeat for a while. YDad'sMMV.
posted by rtha at 9:43 AM on August 1, 2015

As above, edibles are pretty unpredictable. Vaping would be much better.

However, based on quite a bit of experience, pot can be quite tough on my cardiovascular system. Increased blood pressure and heart rate, if I get a bit too high, being common side effects.
posted by humboldt32 at 11:54 AM on August 1, 2015

2) To replace his habit of drinking several alcoholic beverages every night to unwind

I would be very leery of this. You are basically talking about introducing significant drug withdrawal, PLUS a new drug he is not familiar with, on top of major surgery.

Having done lots of drug withdrawal and lots of alternative meds, the fewer variables you introduce at a time, the easier it is on the body and the easier it is to figure out which one is the problem if things suddenly get wonky. If this goes badly, you won't be readily able to discern if he is reacting badly to removing the alcohol or reacting badly to introducing the marijuana (or reacting badly to the anesthesia from surgery or any number of other variables in this scenario). Has he ever consumed mj before? What if he is allergic to marijuana? And what if he is also on other drugs, such as steroids or antihistamines, that tend to mask allergic reactions? How will you have any idea which thing is the culprit?

This is a real bad time to get kind of judge-y about his drinking and try to introduce what would be a substantial change to his life, one that has lots of negative fallout before things get better even under the best of circumstances, which this is so not. I think I would shoot for "Hey, dad, can we maybe knock down the number of drinks per day to a dull roar during the recovery phase from surgery and talk about getting you to quit/significantly reduce it further once you are past the worst of recovery from surgery?"

Sorry to hear about the surgery. Best of luck to him.
posted by Michele in California at 2:16 PM on August 1, 2015 [1 favorite]

There are specific physiological reasons to do with cardiac function that morphine is given in cardiac scenarios; if you are worried about, e.g., past rx medication abuse or other opiate abuse, make his providers aware but unless he's allergic, in the immediate post-op phase, they aren't likely to immediately 'hook' him.

I am not up to date 100% on medical cannabis use because while my state allows medical registration and dispensing, the use in any facility that receives federal funding (eg almost any hospital or rehab facility he may get transferred to) is not allowed to violate federal law. However, from what I can find in review of recent articles today, in the person with cardiac problems it would be disrecommended in my opinion given the increased instances of irregular rhythm that I see notes in multiple studies. In addition, the regulation/consistency/potency of various compounds in purchased (vs assayed & dispensed) marijuana is a problem at this time.

Re the alcohol abuse, if post-op he goes to cardiac rehab at a nursing home, you can look for one that has in-house psych visits to discuss the recovery phase and strategies (including medication) for mitigating alcohol use. A few have AA type groups as well.

Even if he isn't going to post-op rehab, this is forced sobriety, and please be sure his providers know about his use so they can monitor him while he is in the hospital.
posted by cobaltnine at 3:18 PM on August 1, 2015

Greetings from the world of coronary artery disease myself. Marijuana is unlikely to have much of an effect. The main danger which I'm sure his cardiologist will go after like a bulldog is high blood pressure.

But stopping the alcohol might be a bad idea for several reasons. That's likely to increase stress and might induce withdrawal symptoms. It also might be masking something more dangerous. Alcohol gets a lot of bad press for good reason but, like all drugs, it's a drug and can sometimes have beneficial effects. If your father is pre-diabetic it could be keeping his diabetes under control. It took me several tries and figuring it out myself because none of the doctors could some years ago why my health collapsed whenever I stopped drinking. It can be a thing, and it's not a thing you want to find out when you're recovering from surgery.
posted by Bringer Tom at 3:42 PM on August 1, 2015 [1 favorite]

edibles can be surprisingly strong. i'm a large man who is no stranger to pot and i would never eat a whole cookie say, or even half of one. even a quarter of a cookie is to me a strong dose. 1/8th seems to be about right for mildly enhanced functionality, but that is is based on homemade edibles i've encountered in the wild. new-fangled, store-bought edibles are even stronger. the square gummy type are usually marked on the wrapper to indicate dose size and i can't imagine eating as much as they suggest (one quarter of the square is recommended but for me 1/16th or even 1/32nd is about right and even then i do feel pretty high sometimes).

i really don't like to feel high per se, but i do love to micro-dose with pot edibles and i would suggest that route for almost every person i know. if you want to "accidentally" have a great day, then a tiny bite of an edible can kind of magically line up good mood, openness, increased energy and enthusiasm in pretty wonderful ways. i like to take it in very small doses so that it's really just kind of invisible as i go about my day. too much though can seem like the worst bad acid trip from hell with hyper-ventilating and paranoia, which doesn't sound like a great thing for someone with a heart condition. if he does decide to use edibles i would suggest that you personally try them out first to get a sense of dosage and always err on the side of caution. i usually take less than half of what others suggest and whatever the smallest amount is that will get you personally high should maybe be fractioned out even further for your dad. if you think of it somewhere along the lines of an anti-depressant then imagine that the right dosage of an anti-depressant should feel invisible as well and try to aim for that level of dosage as the goal. in that instance i could see edibles being really rewarding and safe.
posted by Conrad-Casserole at 9:06 PM on August 1, 2015

FWIW, you can also get side effects like paranoia from post operative painkillers like morphine. After a lengthy surgery for cancer and while on a morphine drip, my dad decided the long-haired* jeans-wearing hippie doctors were terrorists who had taken over the ICU ward.

* Their hair was longer than a quarter inch. In some cases, it scandalously brushed their collar or obscured the tops of their ears.
posted by Michele in California at 1:11 PM on August 2, 2015

Oops, I forgot to respond to this.

For future Googlers: it seems the consensus is that marijuana is NOT recommended for immediate post-heart-surgery patients because of the blood pressure effect and should be avoided until the patient is cleared to have caffeine again.

Fortunately, my dad responded so well to gabapentin that he didn't need opiates after he was discharged. His doctor also said he could have a couple of beers or glasses of wine per day but to avoid hard alcohol or binge drinking.
posted by Jacqueline at 4:22 AM on January 11, 2016 [1 favorite]

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