The following is the entire oral testimony written for the public hearing. There was only 3 minutes to speak everything and I was kindly given just enough extra time to get the remaining point across.
“First I would like to thank the Department for the extensive proposed list that they have created of qualifying neurodegenerative diseases, all of which are incurable by definition themselves. As well, I would like to thank the department for adding the proposed code that a treating physician of an individual suffering from a neurodegenerative disease not listed may submit that disease to be added to the qualifying list. It is essential that as this field of medicine advances that the health code can advance with it.
I would like to discuss something that on the surface, would not appear to be neurodegenerative disease, but in fact is very much a form of the disease and that would be autoimmune disorders and Encephalopathy diseases.
The definition the department has lead with is accurate in stating that this is a condition, injury, or illness that 1. Occurs when nerve cells in the brain or peripheral nervous system lose function over time; and 2. for which there is no known cure.
Examples of autoimmune disorders that can cause nerve cells in the brain and peripheral nervous system to lose function include Sjogren’s syndrome, systemic lupus erythematosus, rheumatoid arthritis, celiac disease, Hashimotos, and Guillain-Barre syndrome. All can result in the immune system attacking the peripheral nervous system with Guillain-Barre being the rare disorder in which your body’s immune system specifically attacks your nerves.
These conditions amongst other autoimmune inflammatory diseases need to be considered as they typically are not classified as neurodegenerative despite causing peripheral neuritis and are also incurable.
The national health institute has an article that states “Paradoxes abound. Neurodegeneration is a major element and is often the cause of the disability in many diseases not usually classified as degenerative—for example, multiple sclerosis, epilepsy, some inborn errors of metabolism, schizophrenia, and even tumours. Conversely, inflammatory processes are activated and vascular compromise occurs in some degenerative diseases. A Napoleonic view could encompass most brain diseases under the rubric of being neurodegenerative. “
Brain diseases such as Encephalopathy should be listed as a qualifying disease as long as the disease is causing brain damage or malfunction as that would fit within the prescribed definition by the department. A few of these are already listed but it would be much easier to rectify this issue now by just using the language added of brain damage and malfunction. With that in mind and the current definition, it would be of the utmost concern that the department include traumatic brain injury to this list to ensure that those injured from accidents and those injured in the line of duty as first responders or veterans can get the proper medicine they need for symptoms of their qualifying ailment,even if they don’t present the symptoms of epilepsy that are typically shown in TBI.
As well, it is not always going to be a neurologist that treats these conditions and the department could rectify any ambiguity via codification for both the benefit of physicians and patients. These conditions may be treated by a neurologist, endocrinologist, rheumatologist, or psychiatrist depending on which disease they are treated for. This would keep in line with HB3703’s language that states in Sec. 169.002. PHYSICIAN QUALIFIED TO PRESCRIBE LOW-THC CANNABIS TO PATIENTS WITH CERTAIN MEDICAL CONDITIONS. (a) Only a physician qualified with respect to a patient ’s particular medical condition as provided by this section may prescribe low-THC cannabis in accordance with this chapter to treat the applicable medical condition. (b) A physician is qualified to prescribe low-THC cannabis with respect to a patient ’s particular medical condition [to a patient with intractable epilepsy] if the physician: (1) is licensed under this subtitle; (2) is board certified in a medical specialty relevant to the treatment of the patient ’s particular medical condition by a specialty board approved by the American Board of Medical Specialties or the Bureau of Osteopathic Specialists; and (3) dedicates a significant portion of clinical practice to the evaluation and treatment of the patient ’s particular medical condition.”
