Ms. Rothstein is a 31-year-old woman who comes to your office to consult with you regarding a long-standing history of complex regional pain syndrome in her right leg and foot. She is a graduate student and former varsity soccer player who became disabled 7 years ago after having a hairline fracture in the right fibula. Since several weeks after her injury, she has had intractable pain in her foreleg and foot even though the fracture has healed. She describes spontaneous, excruciating pain — mainly burning and deep aching — in her right lower leg, as well as allodynia and hyperalgesia. She inquires about a prescription for medical marijuana for her chronic pain.

Ruth is an 85 YO female with history of depression, anxiety and Neurocognitive DO who presents with her daughter for psychiatric follow up.

Since her last appointment she had spent time with family on Cape Cod and than in California. The daughter noted general cognitive function decline. She had to move to apartment with supervision. She had increasing periods of agitation and confusion, mostly in the afternoon.

There was no significant depression or anxiety.

Marilyn is a 68-year-old woman with breast cancer metastatic to the lungs and the thoracic and lumbar spine. She is currently undergoing chemotherapy with doxorubicin. She reports having very low energy, minimal appetite, and substantial pain in her thoracic and lumbar spine. For relief of nausea, she has taken ondansetron and prochlorperazine, with minimal success. She has been taking 1000 mg of acetaminophen every 8 hours for the pain. Sometimes at night she takes 5 mg or 10 mg of oxycodone to help provide pain relief.