UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF CALIFORNIA
SAN JOSE DIVISION

I, Jennifer Lee Hentz, declare and state as follows:

1.1.      I am 37 years old.  In November 2001, I was diagnosed with Stage IV colon and lymph node cancer. 

1.2.      I live in Palo Alto, California, in Santa Clara County, approximately 40 miles from the City of Santa Cruz.  For about six to eight weeks prior to my diagnosis, I had been experiencing increasingly intense pain in my abdomen.  On November 2, 2001, I went to Stanford Hospital to find out what was going on.  Doctors at Stanford ran a battery of tests.  After reviewing the results, and particularly those of a CT scan, I was told that I needed an emergency appendectomy, due apparently to a ruptured appendix.  The procedure was performed at Santa Clara Valley Medical Center because I was not covered by private insurance.

1.3.      When the physicians at Santa Clara Valley Medical Center examined me and reviewed my test results, I sensed that they suspected something other than appendicitis was causing my pain and nausea.  I was asked to sign a consent form, agreeing to a laparoscopy, a kind of exploratory surgery.  The consent form also referred to a biopsy and a resection of my bowel, and any further procedures the surgeons felt necessary based on what they found when they opened me up.  Cancer never entered my mind – I went in to get an appendectomy and came out learning that I had cancer.

1.4.      Dr. Adella Garland, M.D. performed the emergency surgery.  Dr. Garland found a large tumor, measuring about 6 cm, about the size of a golf ball.  Two of my lymph nodes had swelled to approximately 4.5 cm in diameter.  Dr. Garland was able to remove both masses, and forced to resect a large portion of my colon and two of my lymph nodes. The cancer had metastasized into the soft tissue around the tumor and had invaded my other lymph nodes.

1.5.      I was devastated by the news that I had cancer, that it had metastasized, that it was possibly spreading, and that in addition to the surgery, I had to undergo an extensive regime of chemotherapy.  Until I started getting sick a couple of months before, I was a very active person.  I am trained as an accountant and I have always worked hard.  At the time of my diagnosis, I was placed as an accountant at a video game manufacturing firm through a temp agency and was going to school three times a week to study to become an esthetician, a skin care specialist.  I exercised regularly at the gym and lived a full and happy life. The cancer changed everything.  Although my parents and I received grief counseling at the hospital, it did not really help me deal with the fact that I am now living with a deadly disease that could kill me at any time.

1.6.      While still in the hospital for my resection surgery, Dr. Nathalie Brophy, M.D. became my treating oncologist.  I was suffering intense pain from the cancer and the operation, so Dr. Brophy prescribed a variety of pain medications, including morphine, naloxone hydrochloride (Narcan), Vicodin, Valium, Cepacol and Ativan.  Unfortunately, the worst of my pain was yet to come.

1.7.      In December 2001, I began a nine month course of chemotherapy.  My treatments included Irinotecan and 5-FU.  For four days each month I received chemotherapy treatment at the hospital, taking a two week break after every four weeks.  Every round of chemo left me sick and exhausted.  I experienced terrible pains throughout my body.  Waves of nausea hit me like a ten ton truck, doubling me over with pain.  Sometimes I felt better when I ate, but I frequently had no appetite.  And even when I was able to eat, I often couldn’t keep the food down because of nausea.  In fact, my nausea was so persistent and intense that it was nearly impossible for me to swallow the many pills that I had been prescribed as part of my cancer treatment.  In addition, I also had diarrhea and suffered from insomnia, anxiety and – because of all of the above – depression.

1.8.      By March, 2002 I was so sick from the chemotherapy that I was on the verge of throwing in the towel.  Every day I was violently ill with nausea and diarrhea from the treatments, and the pain had become excruciating.  I talked with Dr. Brophy about how I was feeling and she prescribed a series of pain medications and anti-nauseants to help me cope with the side-effects of the chemotherapy including Vioxx, Protonix, Vicodin, Donnatal, Imodium, Ativan, Wellbutrin, Flexeril, Zofran, Paxil, Morphine, Oxycodone and Prochlorperazine.  However, when I would try to take Prochlorperazine, a form of Compazine, an anti-emetic, I could not keep it down.  The morphine helped some with the pain, but it made me so nauseated that I often could not ingest the morphine tablets or keep them down. When I was able to absorb enough of the morphine to curb the pain, I was completely incapacitated.  I experienced dizziness and nausea, and I frequently felt too weak to stand up.

1.10.    Around this time I remembered having read that marijuana helps some people suppress the side-effects of chemotherapy.  I spoke with Dr. Brophy about this and she told me that she had many patients for whom marijuana was very effective.  I was unsure that marijuana would work for me because I had tried Marinol and it really did not help alleviate any of my symptoms.  When I talked this over with Dr. Brophy, she told me that some people for whom Marinol does not work well nevertheless benefit from medicinal marijuana.  On March 5, 2002, Dr. Brophy wrote a letter stating “Jennifer Hentz is a patient of mine who is undergoing adjuvant treatments for cancer.  Her DOB is 9/14/65.  The treatments often are associated with nausea, and cramping abdominal pains.  She is interested in the medicinal use of marijuana from which I feel she might benefit.  Than you very much for assisting this patient, during this time of duress.” A copy of the letter is attached as Exhibit A.  This letter was to serve as a recommendation to allow me to possess and use medicinal marijuana legally in California.

1.11.    Even with my physician’s recommendation, however, I was without a way to get this medicine.  I would never consider buying it on the streets.  After making some inquiries, I learned about the Wo/Men’s Alliance for Medical Marijuana (WAMM) in Santa Cruz.  I first went to WAMM with my sister, Theresa.  We spoke with Valerie Corral, who explained the rules of WAMM to us – that there were meetings every week, that the medicine at WAMM was free, that everyone participates in WAMM activities to the best of their abilities, that as a member of WAMM I would be prohibited from selling or giving away any of the medicine allotted to me, and that if I became a member of WAMM, this was to be my only source of medicine.

1.12.    Valerie Corral also explained the WAMM community.  Since becoming a member of that community I have been fortunate to benefit from the emotional support its members offer me.  WAMM members help heal one another. Ms. Corral’s kindness and generosity inspires everyone and sets the tone for the organization. 

1.13.    I called WAMM and left my name and all of my information.  I got a call back after a couple of weeks and was informed that I was being accepted into the collective.  I had to go into the office to fill out some paperwork. I sent Dr. Brophy a copy of the WAMM Medical Marijuana Recommendation Form.  She signed it on March 26, 2002, and sent it back to WAMM.  A copy of this recommendation is attached as Exhibit B.  Her signature was verified on April 1, 2002 and I became a member of WAMM at that time.

1.14.    I was relieved to hear that I could join WAMM.  I was anxious to try medical marijuana to see if it would help me, and I needed to complete all of my paperwork and be accepted before I could get any medicine. Between March 5 and April 1 of 2002, I had experienced intense nausea, cramping and diarrhea.  I went to my first WAMM meeting in April of 2002 and received my first allotment of medicine.  I smoked a small amount of medicinal marijuana. The marijuana afforded me almost instantaneous relief.  The most significant and almost immediate effect of the marijuana was that my nausea disappeared.  This allowed me to eat, take my other oral medications as needed, and relieved the stomach cramping caused in part by the cancer and chemo, but also in large part by my hunger and frequent vomiting.  Almost immediately after I began using medical marijuana, I was able to reduce the use of the other conventional medications prescribed to combat the side effects of chemotherapy, including Protonix and Oxycodone. 

1.15.    By the time I completed my chemotherapy treatments, in July 2002, I was tolerating the chemotherapy fairly well.  I attribute my ability to continue with my chemotherapy and to survive those treatments to the relief afforded me by the medical marijuana.

1.16.    Upon my completion of chemotherapy my CT scans indicated that my body had been cleared of cancer.  I began to feel a lot better.  I had another CT scan in August and the results were again clean – no metastases were found.  During this period after chemotherapy, I was using less and less medical marijuana as the months progressed and I got stronger.  Things were going pretty well for me for several months; I regained energy, and put on about 30 pounds – signs that the doctor felt showed that the colon cancer had not returned.  I credit much of my ability to recover so well from the chemotherapy to the medical marijuana I was using.

1.17.    This was the state of my health on September 5, 2002 when the federal government raided the WAMM gardens in Davenport, California.  I first heard about the raid while watching the local news that evening.  I broke down in tears, and felt a combination of shock, disbelief, sadness and fear. 

1.18.    In November of 2002, I again began to experience sharp abdominal pains and to have episodes of nausea and vomiting, usually after my morning meal.  I was terrified because I knew this probably meant that my cancer had returned.  I underwent a CT scan on January 21, 2003, which was negative, but my pain continued to increase.  On January 24, 2003, I was admitted to Santa Clara Valley Medical Center for nausea, vomiting and pain.  Doctors ran several tests, including a colonoscopy, endoscopy and a CT scan which all came up clean for cancer.  But the pain persisted.

1.19.    By February 2003 my blood tests showed that my Carcinoembryonic antigen (CEA) level was rising, which is an indicator of possible recurrence of colon cancer. My pain, nausea and diarrhea worsened.  Dr. Brophy ordered a Positron Emission Tomography (PET) scan to determine whether my cancer had recurred, and if so, where it had emerged.  The PET scan is a more specific and higher quality diagnostic tool than CT or other scanning technology, allowing physicians to detect locally recurrent colon cancer or distant metastatic disease prior to surgical exploration or additional chemotherapy.

1.20.    The results of the PET scan were sobering: cancer was again present in my lymph nodes.  Dr. Brophy referred my case to the hospital’s tumor board to review my case and recommended treatment, and the board scheduled surgery for March 10.

1.21.    By this time I was constantly sick.  The pain originated in the middle of my stomach area and radiated out to my right side and my upper left chest area.  I was suffering day and night.  Although I had several pain medications and anti-emetics, the only way I could get a handle on the pain and nausea was by smoking marijuana.  Without the medical marijuana, I don’t know how I could have survived.  My boyfriend and caregiver, Jastan, traveled to Santa Cruz every week to pick up my allotment of medicine from WAMM.  I went with him whenever I could to benefit from the support I received from other WAMM members.  The medical marijuana relaxed my muscle spasms, dulled the pain, helped me to sleep, and most importantly, relieved my nausea long enough for me to take my other medications and have something to eat.  Unfortunately, as a result of the September raid, the amount of medicine available to me was limited and every week I ran out before I could pick up the next week’s allotment at the regular WAMM meeting.  As my pain increased and I was forced to ingest increasing amounts of marijuana, my supply depleted earlier and earlier in the week, and I was left without relief. The final days before the Tuesday night WAMM meetings were, and continue to be, torturous. 

1.22.    On March 7, 2003, I had been out of medical marijuana for about three days. Without the relief I get from the marijuana, I could no longer stand the intense pain and nausea, and I was rushed to Stanford Hospital, which is the closest hospital to my house.  I was stabilized at the Stanford Emergency Room and released.  I felt O.K. at that point and went home.  But as soon as the pain medications wore off, I again had to call 9-1-1. This time I insisted that I be taken to Santa Clara Valley Medical Center where I receive my ongoing care.  I was given Cefazolin, Marcaine, Heparin, MS04 2.5 mg, Zefrin, and Demerol, ms 2.5 mg.  This heavy arsenal of pain medications provided relief from the pain, but completely knocked me out and once again made me extremely nauseated.

1.23.    The exploratory surgery and possible resection that had been scheduled for March 10 was cancelled after I was admitted into the hospital on March 7, 2003.  My physicians decided I should stay in the hospital for a new round of chemotherapy.  I was also given a Mediport, a small device containing a thin catheter that is surgically implanted under the skin and used for the administration of anticancer drugs. The device was implanted in my chest area to allow for the administration of my next round of this treatment.  On March 12, 2003, I began a new course of chemotherapy, this time with 5-FU, Oxaliplatin and Leucovorin.  Oxaliplatin is a very new drug that is indicated for cases like mine, to treat metastatic colon or rectum carcinomas that have recurred or progressed within six months following chemotherapy.  The chemotherapy treatments last three days.  While receiving chemotherapy in the hospital I was given a slew of medications for pain relief, including Marinol. I took the Marinol there because I could not access my medical marijuana in the hospital, but found that it did little to relieve my pain and did not help with the nausea. I was discharged from the hospital on March 15, 2003.  My current course of chemotherapy is four treatments of three days each, every two weeks.  We will then do another PET scan and determine if we need to continue treatment.

1.24.    My adverse reaction to this second course of chemotherapy has been even more extreme than the first time.  When I left the hospital after the first round of this second cycle of chemotherapy, my hands and arms remained swollen, hard and painful for two weeks.  It was like I could feel the poison coursing through my veins in search of the metastasized cancer to destroy it.  I had constant cramping in my abdomen and nausea, was vomiting violently, and could barely move.  In addition to marijuana, I am currently taking a lot of medications to help me deal with the side-effects of the chemotherapy.  Dr. Brophy has increased my dosage of morphine to 20 mg/mL, up from my previous dosage of 10 gr/5mL prior to starting this new round of chemotherapy.  I can take .5 to 1.0 ml. every 2-6 hours, as needed to knock out breakthrough pain.  Since the morphine makes me very nauseated, it helps to smoke marijuana prior to taking the morphine, both to reduce my nausea and to allow me to eat.  Without the marijuana I can not tolerate the morphine.  I also have two kinds of transdermal patches to deliver analgesics -- the Duragesic (fentanyl) and Lidoderm (lidocaine).  I was applying both of these patches to my skin, replacing them every 72 hours.  The patches make me very dizzy, make my heart race and I have a hard time breathing when I am using them.  I have recently stopped using the Lidoderm patch because it makes my breathing so labored.  I also currently take Tigan, an anti-nausea medication, in both oral and suppository form. This seems to help at times with the nausea, but the pills are too hard to keep down, and I cannot use a suppository in the morning because I have painful bowel movements during that time of day.  The marijuana is really the only medication I have to help with my nausea during this time of day.  I also have a prescription for Marinol, but it does not help very much with my nausea, and it really does nothing to relieve my pain. 

1.25.    On March 22, 2003, about ten days after my first round of chemotherapy in this most recent cycle, I became violently ill.  Dr. Brophy thinks that I probably had a virus that, combined with my chemotherapy, made me very sick.  It hit me suddenly around three in the afternoon.  I felt like there was fire running through my veins, while at the same time I was freezing cold.  Sweat was pouring out of me and the pain was unbearable.  It even hurt to move my arm because my muscles were convulsing and my hands and feet were tingling.  On a pain scale from one to ten this was an eleven.  I had trouble breathing, and was only able to breathe out of my nose.  This lasted for about eight hours, during which time I would pass out occasionally from the pain until I was finally able to sleep.  All I could do was pray, and smoke my marijuana to feel better.  Marijuana was literally the only thing that gave me any relief. 

1.26.    It is very important to me that WAMM provides my medical marijuana to me for free because I cannot afford to buy it on the streets (and even if I could, I never would), or even at other cannabis cooperatives.  When I became ill I was working as a temporary worker and going to school part-time.  I did not have medical insurance and am currently covered by MediCal.  I received temporary disability for most of 2002, and unemployment benefits for the first three months of this year, but that source of income has dried up.  I currently have no income.  I am applying for Social Security Insurance, but that has not yet started, and even when it does, it will be barely enough to live on. 

1.27.    I rely on WAMM for access to medical marijuana that is medically safe and free from chemical adulterants that could jeopardize my health.  I use medical marijuana solely within California, do not exchange money for the marijuana, and never distribute any marijuana to others. 

1.28.    I do not know how I could have survived the last year without the help of medical marijuana and WAMM.  I was told that while I was on chemotherapy WAMM would try not to reduce my allotment of medicine, but during the last weeks WAMM has had no choice but to reduce my allotment by two grams per week.  This means that I continue to run out of my medicine before the end of the week, leaving me in agony until the next meeting.  I have realized that the intense stomach cramping that I experience is greatly relieved by eating, and marijuana is the best appetite stimulant I have.  If the supply of medicine from WAMM continues to dwindle and is eventually cut off, I don’t know what I will do.  Not only am I unaware of any other safe source for good quality medicine, I am far too sick to seek them out at this point.  It is also critical that given my very fragile state that I use medical marijuana that is high quality and clean.  With WAMM I do not have to worry.

1.29.    I also rely on the support of Valerie and others at WAMM to deal with grief.  I have often heard Valerie referred to as a Mother Teresa of the Santa Cruz community and I witnessed her compassion and dedication to healing from the very first WAMM meeting that I attended.  Valerie is always available to assist others.  She has come to my house to check on me, make me food, massage my feet and offer me comfort.  I have heard from other WAMM members about her sitting at the bedsides of scores of dying members.  Having Valerie and the WAMM community behind me during this time of great suffering has been a huge help to me, as it is to many, many WAMM members.  I never imagined that I would be this sick at such a young age have to face the possibility of death.  People at WAMM understand what I am going through.  WAMM also provides an important source of support for my boyfriend and caregiver, Jastan.

1.30.    I am 37 years old, and I know that this is a cancer that kills.  I live in a state of constant physical and emotional distress.  There is little that provides me with any relief, but medical marijuana is one thing that does. 

I declare under the penalty of perjury under the laws of the United States of America and the State of California that the foregoing is true and correct to the best of my knowledge and that this declaration was executed on the 16th day of April 2003 in Palo Alto, California. 

__________________________

Jennifer Lee Hentz

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