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I was employed at Cozen O'Connor, an international law firm. I worked at the largest office in Philadelphia when I had my stroke on April 8, 2009, in the middle of the night. It took me a year to realize I could never go back there. It also took that long to realize I was disabled. I don't embrace the stroke -- not now, not ever -- but I accept it because I have two options: live with the stroke or... well, you know the alternative.

Jun 25, 2016

Brain Parts, Whole Transplant, or a Completely New Head for Stroke Survivors? Um, Seriously?

I was having a rotten day. The mail guy came early and, as a result, my payment was one day late; I received the wrong change at the supermarket that ended up being a thirty-minute wait to get the error corrected; and the bank, PNC, wouldn't eliminate the overdraft charge of $36.00 because it was the website's fault. Small potatoes, right?

Yeah. I suppose so, but that realization came a few days later. A bad day for most stroke survivors means a rise on the anxiety scale and frustration "outta here!" Not all stroke survivors have high anxiety, but most, especially in the beginning. So I got to thinking, I need new parts for my brain to calm the matter. My injuries were to the frontal and parietal lobes. Could I replace them? I was "out there" and knew it, but I did some research to find out anyway.

The first article I came across was this: First Successful Brain Transplant, I read, written

"Recently, scientists at the University of California – North by Northeast performed the first successful human brain transplant. [Frankenstein-ish]

"Said the lead neurosurgeon, Dr. Cranial Head, MD, 'This is a breakthrough of unprecedented magnitude. I’m ecstatic that all our research and hard work finally paid off. We couldn’t be more pleased with how things turned out.'

"The patient, who only agreed to be called Jose Ivanovich O’Malley, III for anonymity reasons, suffered a massive anterior communicating arterial stroke that left him severely incapacitated. He was a veterinarian at a local clinic before his stroke. His family heard about the research Dr. Head’s team was doing with rats and contacted him about the possibility of his first human subject. Dr. Head agreed immediately, 'I saw this as the perfect opportunity to advance our research out of animals and into humans. We’ve had great success – recently – with brain transplants in rats so it was only logical to start human trials.'

“This new brain transplant surgery is quite remarkable, actually,” said Dr. Head. “My colleague, Dr. Inis Wu, and I first came up with the idea 40 years ago while we were competing in a triathlon. It came out of the blue, really, neither of us are quite sure why we thought of it but here we are.”

"What’s remarkable about the surgery is that it is done all under local anesthetic and the patient is kept talking throughout the procedure, except for the time when the brains are switched (during this time the patient is placed on life support).

"In this case, the transplanted brain came from a local high school physics teacher who suffered a sudden and unexpected heart attack. He was not only young but also in good health. His family has chosen to also remain anonymous. The transplanted brain is removed from the original body and cooled to halt neuronal death. The end of the severed spinal column is treated with a new nanoglue that automatically starts splicing individual axons to the new spinal cord when the transplant brain is placed on top.

“It’s incredible,” said Dr. Head, “we actually don’t have that much work to do because with this new nanoglue the process of reconnecting nerve fibers is automatic. It only takes 4 minutes. We just inspect the brain and spinal cord to make sure everything is lined up correctly. The nanoglue is also applied to areas like the optic nerves, that need to be spliced into the new brain.”

"After the surgery, Jose made a speedy recovery. Within 24 hours he was moving his limbs and within a week he was walking and talking. His wife said, 'It’s a miracle. We thought that Jose was gone forever but Dr. Head saved him. He doesn’t know who any of us are, of course, because he has a new brain but we are all willing to work with the new Jose and learn to love him and hope he will learn to love us.' When asked if he planned on returning to work, Jose stated that he couldn’t wait to return to teaching physics. 'I’ve always had a love of physics. There’s something about gravity research that really attracts me.' Jose doesn’t remember any of his past self or his work as a veterinarian but has accepted the story of the doctors and his new family.

"Disclaimer: the previous post is meant to be humorous. Surgeons have not performed and cannot at the present time perform brain transplants. It is not possible to perform a brain surgery at this time, regardless of what you might have read online or heard."

Uh, that comment really wasn't necessary, I said to myself. Dr. Cranial Head gave it away. And so did the erroneous anonymity of the patient. I continued researching.

A PBS Nova segment focused on growing brains, or parts of them, in the laboratory setting. Tony Atala, director of the Wake Forest Institute for Regenerative Medicine and head of one of the premier tissue-engineering labs in the country, says, "That's kind of out there. As a scientist, you never say never, because you never know what will be within the realm of possibility several centuries from now. But certainly to replace a lobe today, that would be science fiction with current technology."

How about an entire head transplant? Paul Root Wolpe, a bioethicist at the Emory Center for Ethics at Emory University, said, "You are talking about a fundamental kind of change whereby a body becomes simply a means of supporting a head, where your sense of what it means to be a whole human being has been compromised in a very new way," he says.


Wolpe continues, "One's very sense of selfhood would be at stake. In the West we tend to think of the brain as the locus of self, but culturally that is a very new idea, and it's still not shared in many cultures, he says. Consider Japan, where the locus of self is thoracic and abdominal. That's why when you commit seppuku you disembowel yourself, you don't cut your head off, because you're attacking yourself at the seat of selfhood.

"The notion that if you put his head on someone else's body that the resulting individual would be him and not the other person simply because the hybrid had his brain is. What you may end up finding is that when you transfer a brain from one body to another, the resulting organism is not solely what one would think of as the person whose brain it was but also has enormous components of the person into whose body it goes."

Wolpe adds, "It means wiping the slate clean and now having a pre-birth-level brain in a 60-year-old person or whatever. I'm not sure of the medical problem that that solves."

[Neither do I].

The Huffington Post posted this article: Human Head Transplants Now Possible, Italian Neuroscientist Says. [Now we're getting somewhere].
"In a provocative [uh oh] new paper, an Italian neuroscientist outlines how to perform a complete human head transplant, arguing that such a surgical procedure is now within the realm of possibility.

Dr. Sergio Canavero, of the Turin Advanced Neuromodulation Group in the project called GEMINI which was published in the journal Surgical Neurology International, says, “The greatest technical hurdle to such endeavor is of course the reconnection of the donor’s and recipient’s spinal cords. It is my contention that the technology only now exists for such linkage. This paper sketches out a possible human scenario and outlines the technology to reconnect the severed cord."

He went on to say, with the prohibitive cost of $13 million, the procedure might be addressed. And even some commenters on Reddit said they would be willing to donate their heads if given the option. [And so, once again, the wackiness starts].

Dr. Canavero said that "a clean-cut must be performed to disconnect and reconnect the donor’s head at the spine. Then, special adhesives—such as polyethylene glycol (PEG)—would be used to fuse the donor’s head and spine to the recipient."

But not everyone is so inclined to go along with Dr. Canavero's plans.

“It’s complete fantasy, that you could use PEG technology in such a traumatic injury in an adult mammal,” Dr. Jerry Silver, a neurologist at Case Western Reserve University told CBS News. “To sever a head and even contemplate the possibility of gluing axons back properly across the lesion to their neighbors is pure and utter fantasy in my opinion. This is bad science, this should never happen.”

Think about it for a minute. We would have gotten rid of our selves, the people in your life you love,  the people you despise. We would have brand new neuroses and/or psychoses. The easiest part would probably be re-connecting blood supplies, but the broken nerves in the central nervous system and the spinal cord in a mammal? 

That's complicated stuff right there.   

Jun 5, 2016

10 Ways to Know if Your Caregiver is Burned Out, aka Trust Me on This. There Are Other Caregivers!

Everybody makes mistakes--like the cashier giving the wrong change, customer service representatives saying "no" when they should have said "yes," an accountant telling you about a refund when instead you owe the IRS. But a caregiver? Aah. That's bad news any time. Don't read any further if the caregiver is your spouse. You, my fine friend, have to deal with it.

So if you're not married to your caregiver, more than likely, it happens from burnout. I'm an expert in knowing when my caregiver is burned out. It didn't happen all at once for me, and it took a while to figure it out--over 4 years with the same caregiver.  I'm a slow learner and I have a long fuse--bad combination, for sure.

That person didn't understand stroke survivors who, especially during the first few years, are angry, frustrated, hard to please. But I am peaceful now--with that person not screaming hysterically at me, shattering a glass-topped table, generally going ape-shit on me from time to time. That person is probably at peace, too, without me. There's nothing better than peace of mind. The pattern is the thing. Everybody is allowed mistakes randomly as long as it doesn't become a pattern.

Your caregiver's intentions may not be so overt--subtle even, but the burnout is there if you look for it with my favorite top ten, the list assembled by actual stroke survivors across America to my question: do you have problems with your caregivers? I saved the stories, knowing that one day I would publish them. All but one didn't give the caregivers the keys to his or her place. The names have been changed--not the cities or genders--to protect the survivors, not the caregivers. Just remember, if it's a pattern, there is always someone else to fill the shoes.

BEING LATE ALL THE TIME

When Renee from Philadelphia, Pennsylvania, said come at 8, that number wasn't arbitrary. She based it on her schedule. For cryin' out loud, you decide when the caregiver should come for any reason, even if you don't have appointments. Let's say you're having a crappy day and all you want is company. Then it's the caregiver's job to do that, too. Renee put up with so many excuses: the dog ate the schedule, I thought it was Sunday, my roommate moved my car and I thought it was stolen. Sheesh. Renee finally had enough.

WATCHING TELEVISION RATHER THAN THE SURVIVOR

I've heard from people all over the world and sometimes, this event happens. The awful story came from a lady in Omaha, Nebraska. The caregiver was watching "The Price Is Right" and Lucy was choking on her lunch. Lucy made a gagging sound, which the caregiver heard, because she put up her index finger to indicate, "Wait a minute." The caregiver was waiting to see who would win the "grand prize."

Lucy was able to call the paramedics with her "Life Alert" button and then passed out from lack of air. Did you ever hear the "Life Alert" button activated? It's goddamn loud. Still no response from the caregiver. The paramedics came in 5 minutes when the dispatcher got no response while still connected, but the caregiver wanted to watch the news right after, so she was surprised to see the paramedics. Lucy recovered after being taken to the hospital by ambulance. The caregiver was fired on the spot by the family a few hours later. I mean, WTF!

SNOOPING

From Los Angeles, California, come this email from Charles. He thought his caregiver was snooping around because Charles has an excellent memory. At first, Charles began to second guess himself. He thought it was his imagination getting the better. Maybe the papers were scattered about originally, maybe my checkbook wasn't in the place I remembered. But when he came into the living room rather than going to the bathroom, he saw his caregiver looking at his tax return. He went ballistic and his firing her didn't take long at all.

ASKING TO USE YOUR SHOWER

Helena from New York knew her caregiver moved around a lot, going from client to client. This one time, Helena opened the door and her caregiver looked like she had been in a bar fight. She had dried blood on her cheek and various scratches and open sores on the arms. She stopped at the entrance to her apartment and asked Helena if she could use her shower because she wanted to "clean up." The caregiver had just come from a violent Alzheimer's client. Helena waited a few moments until sensibility ruled, and then said, "Come back when you use your shower." Spoken like a true New Yorker. Three cheers for Helena!

FALLING ASLEEP

Why do you have caregivers? That's an easy one. You need help; caregivers provide it. So it surprised Dan, who had a 2 bedroom apartment and 24-hour care for a week when he first returned from the hospital, that when he called out for his caregiver at 3am to assist him in going to the bathroom, no answer was what he got. After three times, he shouted her name. Still no answer. He somehow transferred to the wheelchair in a sweat because he really had to go and went to her room. She was in a fetal position, sound asleep. Dan, who was not a lunatic, moved his wheelchair next to her ear, and screamed, "MARY!"

She got up and took him, right in time, to the bathroom, and after he was finished, he called for her. Mary said she was offended that a male, meaning Dan, came into her room. Forget the fact that if Dan went to the bathroom by himself, he could have cracked his head open on the tile floor. Mary came three more times, but Dan noticed a change in her attitude, because now, she had an attitude. Dan had the locks changed on his house and phoned Mary not to come anymore. She asked why? Seriously?

FORGETTING THE SOAP

No soap. Radio. Those old enough to remember that punch line in the 70's with a monkey joke in front of it was used to determine if people would laugh at anything. And some did. Finally, most would eventually laugh out loud at the absurdity of it all. This email came from Barbara in Jacksonville, Florida, wasn't as funny. She lives in an apartment and had a bowel accident just an hour before the caregiver came. Once the caregiver arrived, she cleaned Barbara up and got her in the shower. She went to do the wash three floors below and said she'd be "right back."

But the caregiver had to wait until a washer was free and the wait was about fifteen minutes. So she decided, poor judgement in place, to wait until the washer was freed up. Meanwhile, when Barbara, 3 floors above, spotted the washcloth in the shower, no soap. She had to wait, with the water running, 15 minutes until her caregiver returned.

"Are you finished?" her caregiver wanted to know. Barbara said she had no soap. "Water will do just as well," said the caregiver, when both Barbara and the caregiver knew it wasn't true. Barbara gave her a few more chances, with her caregiver repeating major errors like the no soap one, and then she had to let the caregiver go. If it's not right, exclaimed Barbara, I don't want to deal with it. It's my dime! Good for you, Barbara!

GIVING YOU THE CAREGIVER'S MEDICINE INSTEAD OF YOUR OWN

Claire in Richmond, Virginia, sent me an email that wasn't humorous in the least. She said her caregiver had trouble when to take her own medicine, so she took them whenever Claire took her own. One day, she gave Claire the caregiver's own pills. When the caregiver realized it, she immediately stopped. The pills were for constipation and acid reflux. Claire had acid reflux so that pill didn't harm her, but Claire also had loose bowels, the aftermath of a stomach virus. When she took the caregiver's medicine for constipation, Claire had the "runs" for 2 days straight. She wondered how often the caregiver, who had anxiety from a long time before, did that same process? She ended her employment because Claire didn't want to wonder anymore. At least, it gave her the "runs" for 2 days. What if it had been stronger drugs, like Predisone, a steroid, or Coumadin, a blood thinner. What Claire learned was to look at her pills and recognize them by sight instead of her caregiver shoving them in her mouth.

CONSTANTLY COMPLAINING

This email came from Ben in San Fransisco, California. Every time this caregiver would come, once she walked in the door, her complaints were never-ending. "The mail didn't come until 4pm," "I have a blister on my foot," "my cat is sick again." And after each complaint came the details, long and drawn out. But one time, Ben said, when he couldn't take it anymore, she asked to switch the days around because blah, ba-blah, ba-blah. Ben tuned her out. He could have agreed, but he didn't. He said that Tuesday wasn't good for him. A little white lie didn't hurt anyone. Eventually, not too long after, the caregiver went to work for another person full-time and Ben didn't have to listen to her "dramatic sagas" (his words, not mine) anymore. That, indeed, was a win-win situation.

UNMERCIFULLY CAN'T SHUT UP

Elaine in Dallas, Texas, writes that she couldn't get her caregiver to be quiet once in a while. Elaine has a good memory, and she gives the hand-writtten schedule to the caregiver. But still, the caregiver talks non-stop. Elaine asks, "Should I say something?" Damn right, you should say something! If it's bothering you, don't let it. You're in charge, remember? http://stroketales.blogspot.com/2015/10/3-things-you-have-to-remember-about.html

Once in a while, I'll say, "Dome of silence, ok?" to my caregivers and that is a signal that I want to think for a while. It's better than "Can you shut up?" or "Close your trap."

MANIPULATING IN DOING THINGS HER WAY

And finally, this one is from me, coming to you straight from Pittsburgh, Pennsylvania. I used to have a caregiver who pushed my button once too many, manipulating me in doing things her way. When we were going home, and instead of stopping at my place, she said that she had to go meet her son at the mechanic's shop. Since I was new in town, I didn't know all the towns, but it was 20 minutes one-way out of my way for the meetup. She took her 20-something son home and I got home three-quarters of an hour after I should have, and I had to pay her for her time.

The clincher came when she used to not bring my wheelchair along, saying it was good to walk. But when I'm over the limit, nothing overcomes fatigued muscles, as a physical therapist told me later. When she knew I couldn't go on, she changed the subject and talked about something else as I slogged my way around the store. After the third time, I said she was through, to which she replied, "That's discrimination! I have a condition." That was the first time I heard of her supposed and mysterious condition, but I'd love it if she sued me, me in a wheelchair and her on her feet. The judge would laugh himself silly.

So that's why I have 3 caregivers now, each one spending a visit for doctor's appointments, food shopping, pharmacy visits, to assist me on the stationary bike, and give me a shower, for instance. I elevated their status to personal assistant, which they really are, so if they make calls on my behalf, they can say, "This is Joyce's personal assistant" instead of Joyce's caregiver which often gets confused with caretaker, but that is a story for another day.

In America, there is a website called http://www.care.com where you can find all sorts of care, even for pets! The point is, there are plenty of caregivers, or if you prefer, personal assistants, out there. The only trick is finding the right ones. After a year of searching, I have 3 great ones. Don't think you'll get lucky, even though maybe you will, and find them right away.

Maybe I'll do this again with a new batch of stories. The question is: do you have problems with your caregivers?

May 25, 2016

BREAKING: New Good and Bad Things to Know About Strokes

This article is shown in its entirety. The study findings were published online May 11 in the Journal of the American Heart Association. It's important and somewhat intriguing.

Stroke Hospitalization Down for Many in U.S.


HealthDay news image Thursday, May 12, 2016
WEDNESDAY, May 11, 2016 (HealthDay News) -- While Americans suffered fewer strokes overall from 2000 to 2010, stroke rates climbed substantially among younger adults and blacks, a new study found.

Hospitalizations for strokes caused by artery blockages dropped 18.4 percent overall during the decade, with greater decreases among the elderly, University of Southern California researchers found.

Within the overall decrease, however, some groups saw an increase in hospitalizations as the burden of stroke shifted to younger adults. For example, although stroke hospitalizations dropped 50 percent for people 65 and older, they increased nearly 49 percent among 25- to 64 year-olds. Stroke hospitalizations also varied by race -- up almost 14 percent among blacks.

Dr. Paul Wright, chair of neurology at North Shore University Hospital, in Manhasset, N.Y., said, "There are things we can do to help prevent strokes." Topping the list: living a healthier lifestyle, which can prevent as many as 80 percent of strokes, said Wright.

The study authors said better control of blood pressure, blood sugar and cholesterol probably accounted for the steep decline in strokes among the elderly. Exactly why strokes are up among younger adults isn't clear, but more awareness of stroke symptoms is the most likely reason, Wright said.

"People are more aware of the risk factors for stroke and seek help when something happens, as opposed to saying, 'I'm getting a little numbness and tingling and weakness, but it will go away,' " he said. "So people are more likely to get help sooner."

Wright believes the higher stroke rate among blacks is largely due to lack of access to care. He also cited a need for more stroke education targeted to this population.

Dr. Amytis Towfighi, senior researcher on the study, emphasized the protective role of lifestyle behaviors in stroke prevention.

"The majority of cardiovascular events including heart attacks and stroke can be prevented through changing seven modifiable risk factors, namely: smoking, obesity, physical inactivity, poor diet, cholesterol, blood pressure and blood sugar," she said.

If you've had a stroke, "it's not too late to change your lifestyle. By making immediate changes, one is on the road to a longer, healthier life," said Towfighi, an assistant professor of neurology at USC's Keck School of Medicine.

Healthier lifestyle habits probably accounted for the hefty decline in strokes for seniors -- down 28 percent for those 65 to 84, and more than 22 percent for those 85 and older, Towfighi said.

For the study, Towfighi and her colleagues analyzed data from a national database that collects information on about 8 million hospital stays each year. They looked at the most common type of stroke, called ischemic stroke. This occurs when a clot in a blood vessel in the brain cuts off the blood supply to that area. Symptoms usually include weakness or numbness and tingling on one side of the body.

The researchers found that stroke hospitalization for whites declined about 12 percent and for Hispanics nearly 22 percent. But it rose 13.7 percent among blacks.
Overall, women saw a steeper decline in stroke than men -- more than 22 percent versus roughly 18 percent.
__________________

So there it is, people. I think that is worth a share.

May 14, 2016

The Feds Outrank States Over Possession of Marijuana

I lived at home when I went to college, the top regret of my life. I never got a chance to be stoned out of my mind until the stars melted slowly to become one across the sky. Why? Because there was always a parent waiting up for me to return home. In fact, I had my first joint at 33 with Thom and his wife, after my second son was born, carefully keeping a watch on the stairs to make sure my oldest, precocious son didn't come down to see the "completed baked" company. 

I had five more pot experiences with other people who had pot on their persons since then. I am now 68 and I wouldn't even know where the fuck to buy it!

Why am I talking about marijuana, or the substance known scientifically as cannabis, at all in a website that should be about strokes? Good question, but a little background first.

Pot, which used to be the forbidden weed, is now totally legal in 4 states and D.C., and for medicinal use in a bunch of other states. But a majority of the states still don't allow marijuana at all.

Mother Jones writer Josh Harkinson sums it up neatly: "With marijuana now legal in four states and the District of Columbia, the movement to end the prohibition of pot continues to gain steam. Another five states are expected to introduce ballot measures to legalize recreational pot in 2016, including California, Massachusetts, and Nevada.... With a slew of polls now showing that most Americans think pot should be taxed and regulated like alcohol, it's probably only a matter of time before legalization sweeps the nation."

As of April 2016: 


Marijuana Legalization Status
Dark green
Medical marijuana legalized
 Neon green
Marijuana legalized for recreational use
 Grey
No laws legalizing marijuana







A criminal defense website offers this chart: 



Alabama
Marijuana possession, sale, and distribution is regulated by both state and federal law. In Alabama, marijuana is regulated as a “Schedule I” controlled substance.
Alaska Under Ballot Measure 2, adults age 21 or older in Alaska may possess up to one ounce of marijuana. In addition, adults may grow up to six plants (with up to three flowering) for personal use.
Arizona Possession of marijuana is a criminal offense. The penalties for possession depend on whether the marijuana was intended for personal use or for sale. In addition to the penalty of jail time, anyone convicted of possession will be required to pay a fine of up to $150,000, as determined by the court.
Arkansas Possession of a relatively small amount of marijuana is a misdemeanor, but possessing marijuana in larger quantities is a felony. Also, penalties are increased for repeated offenses.
California Possession of marijuana is a criminal offense. Penalties depend on the amount. Possessing marijuana for sale is treated as a separate offense.
Colorado In Colorado, marijuana is regulated as a controlled substance. (Co. Rev. Stat. Ann. § 18-18-102.) But as of 2012, Amendment 64 made it legal under state law for adults (people 21 years old or older) to possess and cultivate certian amounts of marijuana for personal use.
Connecticut Possession of marijuana is a criminal offense. Penalties depend on the amount. In July of 2011, the Connecticut legislature passed a bill decriminalizing possession and personal use of less than one half ounce of marijuana. Such possession is now considered a civil violation, subject to a fine of up to $150.
Delaware Knowingly possessing, using, or consuming any amount of marijuana (even small amounts for personal use) is an unclassified misdemeanor, punishable with up to three months in jail and a fine of up to $575.
D.C. Voters in Washington, D.C. resoundingly passed Initiative 71 in November 2014, legalizing the possession and personal, nonmedical use of marijuana by adults in the District.
Florida Possessing 20 or fewer grams of marijuana is a first degree misdemeanor, punishable with up to one year in jail. 
Georgia It is a crime in Georgia to possess marijuana for personal use; or to buy, manufacture, or sell marijuana (or to possess it with the intent to do any of these things). Unlike most states, Georgia does not differentiate, for sentencing purposes, between possession for personal use and manufacture or sale.
Hawaii A person who knowingly possesses marijuana (in any amount) is guilty of a petty misdemeanor, punishable with up to 30 days in jail, a fine of up to $1,000, or both.
Idaho A violation is a misdemeanor, punishable with up to one year in jail, a fine of up to $1,000, or both. A violation is a felony, punishable with up to five years in prison, a fine of up to $10,000, or both.
Illinois
Up to two and a half grams: A violation is a class C misdemeanor, punishable with up to 30 days in jail, a fine of up to $1,500, or both. Between two and a half and ten grams: A violation is a class B misdemeanor, punishable with up to six months in jail, a fine of up to $1,500, or both.
Indiana It is illegal to knowingly or intentionally posses marijuana in Indiana. Someone who cultivates marijuana plants (or fails to destroy marijuana plants that the person knows are growing on the person’s property) is also in violation of the possession law. Penalties vary according to the amount possessed.
Iowa First offenders will face up to six months in jail and a fine of up to $1,000. Penalties for a second offense include up to one year in jail and a fine of up to $1,500. Any subsequent offense is a felony, and carries up to two years' imprisonment and a fine of between $500 and $5,000.  
Kansas It is a crime to possess any amount marijuana (including small amounts for personal use) in Kansas. (Kan. Stat. Ann. § 21-5706(b)(3).) Violations are a class A misdemeanor, punishable with a fine of up to $2,500, up to one year in jail, or both. Second and subsequent convictions are level 4 felonies, punishable with up to 26 months in prison, and possible fines.
Kentucky It is a crime to possess any amount marijuana (including small amounts for personal use) in Kentucky. Violations are a class B misdemeanor, punishable with a fine of up to $250, up to 45 days in jail, or both. (Ken. Rev. Stat. Ann. § 218A.1422.)  
Louisiana It is a crime to knowingly or intentionally possess any amount marijuana (including small amounts for personal use) in Louisiana. (La. Rev. Stat. § 966(E).) Penalties vary according to whether the violation is a first or subsequent offense.
Maine It is a crime to knowingly or intentionally possess marijuana Maine. (Me. Rev. Stat. Ann. § 1102.) Penalties vary according to the amount possessed, and may be increased for aggravating factors. Additionally, someone who possesses more than two and a half ounces is presumed to be in possession with the intention of selling marijuana
Maryland It is a crime to knowingly or intentionally possess any amount of marijuana Maryland (even small amounts for personal use). A violation is a misdemeanor, punishable with up to one year in jail, a fine of up to $1,000, or both.
Massachusetts It is a crime to knowingly or intentionally possess marijuana in Massachusetts. Penalties vary according to the amount possessed, with additional penalties for minors in possession of marijuana.  
Michigan It is a crime to knowingly or intentionally possess any amount marijuana (including small amounts for personal use) in Michigan. Penalties include a fine of up to $2,000, up to one year in jail, or both.
Minnesota It is a crime to knowingly or intentionally possess marijuana in Minnesota. Penalties vary according to the amount possessed, measured as the total amount possessed within a 90 day period before the date of arrest.
Mississippi It is a crime to knowingly or intentionally possess any amount marijuana (including small amounts for personal use) in Mississippi. Penalties vary according to the amount possessed.
Missouri It is a crime to knowingly or intentionally possess any amount marijuana (including small amounts for personal use) in Missouri. Penalties vary according to the amount possessed.
Montana
It is a crime to knowingly or intentionally possess up to 60 grams of marijuana or up to one gram of hashish (including small amounts for personal use) in Montana. Penalties vary according to whether the offense was a first or subsequent violation. 
Nebraska It is a crime to knowingly or intentionally possess marijuana (including small amounts for personal use) in Nebraska. Penalties vary according to the amount possessed, and whether the offense was a first or subsequent violation.
Nevada Up to one ounce. Penalties for a first offense include a fine of up to $600, participation in a drug treatment program, or both. A second offense carries a fine of up to $1,000, drug treatment, or both. A third offense carries a fine of up to $2,000, up to one year in jail, or both. And a fourth or subsequent offense carries a fine of up to $5,000, between one and four years in prison, or both.
New Hampshire It is a crime to knowingly or intentionally possess marijuana (including small amounts for personal use) in New Hampshire. Penalties include a fine of up to $2,000, up to one year in jail, or both.
New Jersey It is a crime to knowingly or intentionally possess marijuana (including small amounts for personal use) in New Jersey. Penalties vary according to the amount possessed. Second and subsequent convictions may be punished with up to double the penalties.
New Mexico It is a crime to knowingly or intentionally possess marijuana (including small amounts for personal use) in New Mexico. Penalties vary according to the amount possessed, and whether the offense was a first or subsequent violation. Penalties increase if the violation occurs within a posted drug-free school zone.
New York Up to 25 grams: New York has decriminalized possession of small amounts of marijuana (at least as far as first and second violations are involved). Violations are considered civil citations (similar to a traffic violation), which incur a fine, but no jail time. There is a fine of up to $100 for a first offense, and up to $200 for a second offense.
North Carolina Up to one half of an ounce: Penalties include a fine of up to $200, up to 30 days in jail, or both.  Between one half ounce and one and a half ounces: Penalties include a fine of up to $500, between one and 120 days in jail, or both. The judge may order probation or community service in addition to, or  in lieu of some or all of the jail time.
North Dakota Up to one-half of an ounce:  Penalties include a fine of up to $1,000, up to 30 days in jail, or both.  Between one-half ounce and one ounce: Penalties include a fine of up to $1,000, up to one year in jail, or both.
Ohio It is a crime to knowingly or intentionally possess marijuana in Ohio. Penalties vary according to the amount possessed, with increased fines and jail time for second and subsequent convictions, and for offenses committed within 1,000 feet of a school. For offenses involving more than 100 grams of marijuana, the judge will suspend the defendant’s driver’s license for at least six months (and up to five years).
Oklahoma It is a crime to knowingly or intentionally possess marijuana (including small amounts for personal use) in Oklahoma. In addition to a possible fine, the judge will sentence a defendant to up to a year in jail for a first offense, and between two and ten years in prison for a second or subsequent offense.
Oregon Up to one ounce: Oregon has decriminalized possession of small amounts of marijuana. Violations are considered misdemeanors that incur a fine between $500 and $1,000, but no jail time. However, if this offense occurs within 1,000 feet of a school, penalties increase, with a fine of up to $1,250, up to 30 days in jail, or both.
Pennsylvania It is a crime to knowingly or intentionally possess marijuana in Pennsylvania. For amounts up to 30 grams, penalties include a fine of up to $500, up to 30 days in jail, or both. Convictions for possessing 30 grams or more are punishable with a fine of up to $5,000, up to one year in jail, or both.
Rhode Island
It is a crime to knowingly or intentionally possess marijuana in Rhode Island. Penalties include a fine of between $200 and $500, up to one year in jail, or both; and may increase for second and subsequent convictions. The judge may also order participation in a drug counseling or education program, and community service. 
South Carolina It is a crime to knowingly or intentionally possess up to one ounce of marijuana in South Carolina. Amounts exceeding one ounce are treated as trafficking crimes, explained below in "Manufacture, Distribution, and Trafficking." Penalties for possession vary according to whether the offense is a first or subsequent conviction.
South Dakota Two ounces or less: Penalties include a fine of up to $1,000, up to one year in jail, or both.  More than two ounces but less than one-half of a pound: Penalties include a fine of up to $2,000, up to two years in prison, or both.
Tennessee It is a crime to possess marijuana in Tennessee. It is also illegal to causally exchange (that is, with no payment) up to and including one half of an ounce of marijuana. Penalties vary according to the conviction, and increased penalties apply to offenses involving a minor.
Texas Two ounces or less: Penalties include a fine of up to $2,000, up to 180 days in jail, or both.  More than two ounces, but less than four ounces: Penalties include a fine of up to $4,000, up to one year in jail, or both.
Utah It is a crime to possess marijuana in Utah. It is also illegal to causally exchange (that is, with no payment) up to and including one half of an ounce of marijuana. Penalties vary according to the conviction, and increased penalties apply to offenses involving a minor. 
Vermont Less than two ounces; up to two plants (first offense): Penalties include a fine of up to $500, up to six months in jail, or both.  Less than two ounces; up to two plants (second and subsequent offenses): Penalties include a fine of up to $2,000, up to two years in prison, or both.
Virginia First conviction: Penalties include a fine of up to $500, up to 30 days in jail, or both.  Second conviction: Penalties include a fine of up to $2,500, up to one year in jail, or both.
Washington It used to be a crime to knowingly or intentionally possess marijuana in Washington. However, with the passage of Initiative 502 in 2012, adults are now free to possess up to one ounce of cannabis for their own private use.
West Virginia It is a crime to possess any amount of marijuana in West Virginia. Penalties include a fine of up to $1,000, between 90 days and 6 months in jail, or both.
Wisconsin It is a crime to possess any amount of marijuana in Wisconsin. Penalties vary according to whether the offense is a first or subsequent conviction, with 100 hours of community service in addition to these penalties for possession within 1,000 feet of a school, youth center, public park, pool, housing project, jail, or drug treatment facility.
Wyoming A defendant convicted of using or being under the influence of marijuana will be fined up to $750, spend up to six months in jail, or both. And while not covered here, additional penalties apply to driving while under the influence.


But the problem remaining is this: A Federal agent can arrest you anywhere in the United States if you possess marijuana or have the remains of pot on your smoking apparatus, like a bong, a pipe, or a hookah, despite some of the states allowing it for recreational use, medicinal purposes, or both. Marijuana is illegal for it is a controlled substance under federal law, with no recognized legitimate value. 

Inflammation, stress, spasms, and seizures apparently don't count when it comes to "no recognized legitimate value." The cannabinoids and cannabinoid receptors in the brain are known to regulate inflammation by acting on the cannabinoid receptors of immune cells and works on the aforementioned conditions as well.

Some people argue that it is a gateway to stronger drugs, but from all indications, that isn't true unless you want it to be. Painkillers can lead a person to heroin and other strong drugs but not marijuana by itself. And nobody ever died from marijuana use. The most that happens is that people fall asleep from inhaling too much, depending on their size and weight. 

People shouldn't drive if they smoke too much because they might be pulled over by the police and charged with Driving Under the Influence(DUI). The nation's largest automobile club, AAA, says marijuana tests are bogus when it comes to DUI and cops rely on the strong smell of marijuana alone.

Josh Harkinson says that "it's probably only a matter of time before legalization sweeps the nation." For me, who gets inflammation and spasms every night, "a matter of time" isn't soon enough.