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For days she couldn’t stop getting sick. At first she doubted the probable cause.

By Sandra G. Boodman
August 22, 2020

 

    The first episode occurred on Halloween night 2016, as Alice Moon and a friend were strolling around her neighborhood admiring the trick-or-treaters. Suddenly Moon began to vomit. “It made no sense,” she said.

   She went home and smoked some marijuana, which she knew could quell nausea and vomiting and is used by some people undergoing chemotherapy. Moon, who promotes cannabis products, had worked in the marijuana industry since 2011, including at a dispensary where she said she “saw all the people it was helping.” (California legalized cannabis for medical use in 1996 and for recreational purposes in 2016).

    For several years Moon had used cannabis at night to combat long-standing insomnia and to moderate anxiety and depression. She described herself as a daily user who was not addicted. “I was never one of those people who was stoned all day,” she said.

    A few days after the Halloween episode, which lasted a few hours, she saw a doctor who diagnosed reflux. He advised her to eliminate spicy or acidic foods, such as tomatoes, and to take a nonprescription acid-blocking drug.

    For a few months, those measures seemed to work. But by early 2017 the vomiting returned. Moon noticed that the episodes, which occurred weekly, appeared to coincide with her consumption of alcohol, even in small amounts, so she stopped drinking.

    The vomiting, however, continued. In late 2017 she read a blog item about an alarming condition affecting some regular users of cannabis: intractable and untreatable vomiting that could last for days.

    “I did let it sit in my brain for a while but it didn’t make sense. I was throwing up the day after using weed.” Moon said.

    As the episodes increased in frequency and severity, Moon discovered that the only thing that seemed to quell hours of vomiting was a hot bath.

    In March 2018 she had one of her worst episodes and decided to see a gastroenterologist who performed a physical exam and questioned her closely after Moon told her she was a regular user of cannabis. Based on Moon’s symptoms and the relief hot baths provided, she suspected cannabinoid hyperemesis syndrome (CHS), the same disorder Moon had read about − and dismissed − a few months .

    The unusual condition was first reported in 2004 by doctors in Australia, who described a small number of frequent cannabis users who developed severe vomiting relieved by hot showers or baths. Like Moon, a few had unsuccessfully tried to quell the vomiting by using marijuana, which has anti-emetic effects in some people. But in some heavy users cannabis, which affects the GI tract, has a paradoxical effect and can trigger severe uncontrolled vomiting. The only way to stop it, Australian researchers reported, was abstinence from marijuana.

    Once thought to be rare, doctors in the United States are increasingly reporting CHS cases in states that have legalized cannabis.

    The gastroenterologist advised Moon to stop using marijuana for three to six months and return if she was still having symptoms. Moon was reluctant. “I was unconvinced this was the cause,” she said. As she was mulling it over, Moon decided to attend a cannabis-themed dinner party in Malibu. A few hours after she got home, Moon began throwing up and didn’t stop for more than two weeks.

    Four days into her ordeal, Moon went to an urgent care center near her home. The doctor on duty had never heard of CHS. He administered intravenous fluids to treat severe dehydration and gave her anti-nausea medication, which is typically ineffective against CHS. When she seemed better, he sent her home.

    Several hours later, Moon began vomiting again. Three days later, still vomiting, a friend drove her to an urgent care center. The doctor hooked her up to an IV and called the gastroenterologist she had consulted. She ordered blood tests as well as CT and MRI scans; all were normal. The gastroenterologist reiterated her suspicion that Moon’s vomiting was caused by cannabis; she couldn’t predict when the vomiting would stop. A few days later, it did.

    For the next five months Moon said she mostly avoided cannabis, while struggling with insomnia and depression. In late September she began intermittently using CBD capsules, hoping they might be less likely to trigger vomiting than edibles or vaped marijuana. That seemed to be the case until Dec. 22 when, on a holiday visit to her family, Moon developed the worst attack she had experienced. The vomiting was so severe Moon cut her trip short and returned to Los Angeles, where she spent four days in a hospital. She said she told her hospital team about her CHS diagnosis; they told her they had never heard of it.

    “People said I looked like I was dying,” remembered Moon, who slowly recovered. It was the last time she used the drug in any form. “I have no desire to touch it,” she said. “It’s just not worth the consequence.”

(Adapted from https://www.washingtonpost.com)

Um sinônimo para dismissed (9º parágrafo), conforme empregado no texto, é:

O tema central do cartum é a

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    The problem of rising ocean plastic pollution such as plastic bags, discarded fishing nets and microplastics has received increased attention in recent years. But other pollutants such as oil and gas, pesticides, antibiotics, heavy metals and industrial chemicals are also severely impacting the world’s oceans, says a new report from the High Level Panel for a Sustainable Ocean Economy (Ocean Panel).

    “Even though plastic is a hot topic, it is unfortunately just the latest major pollutant to enter the ocean,” says Ellie Moss, an ocean plastic expert and co-author of the report. “I think one of the things that differentiates it from most of the other pollutants is that you can see it. In the other cases, it’s sort of these invisible pollutants that we don’t even recognise as being there. That’s a huge problem.”

    The new report, commissioned by the Ocean Panel which is convened by 14 heads of state, outlines a range of ways to reduce these different ocean pollutants. Part of the solution is exploring how materials can be recaptured and recycled, the report says, preventing them from seeping into the ocean as pollutants and instead keeping them circulating in the economy. Developing more eco-friendly materials and chemicals is another important part of the picture. In many cases, strategies can tackle more than one type of ocean pollutant at once, the report says. “You really do have to look for opportunities to address as many of these pollutants at once as you can,” says Moss.

    But there is also a need to simply use resources more efficiently in the first place, the report adds, such as through zero-packaging supermarkets, eliminating single-use plastics and exploring new business models which incentivise more efficient use of pesticides.

    “A lot of people think about ‘how do we clean up the ocean’ and that’s the wrong question,” says Moss. “The question is not how do we clean it up, it’s how do we stop befouling it in the first place.”

(Jocelyn Timperley. www.sciencefocus.com, 30.05.2020. Adaptado.)

According to the report, one of the strategies to fight ocean pollution is to

Leia o texto para responder à questão.

 

    The problem of rising ocean plastic pollution such as plastic bags, discarded fishing nets and microplastics has received increased attention in recent years. But other pollutants such as oil and gas, pesticides, antibiotics, heavy metals and industrial chemicals are also severely impacting the world’s oceans, says a new report from the High Level Panel for a Sustainable Ocean Economy (Ocean Panel).

    “Even though plastic is a hot topic, it is unfortunately just the latest major pollutant to enter the ocean,” says Ellie Moss, an ocean plastic expert and co-author of the report. “I think one of the things that differentiates it from most of the other pollutants is that you can see it. In the other cases, it’s sort of these invisible pollutants that we don’t even recognise as being there. That’s a huge problem.”

    The new report, commissioned by the Ocean Panel which is convened by 14 heads of state, outlines a range of ways to reduce these different ocean pollutants. Part of the solution is exploring how materials can be recaptured and recycled, the report says, preventing them from seeping into the ocean as pollutants and instead keeping them circulating in the economy. Developing more eco-friendly materials and chemicals is another important part of the picture. In many cases, strategies can tackle more than one type of ocean pollutant at once, the report says. “You really do have to look for opportunities to address as many of these pollutants at once as you can,” says Moss.

    But there is also a need to simply use resources more efficiently in the first place, the report adds, such as through zero-packaging supermarkets, eliminating single-use plastics and exploring new business models which incentivise more efficient use of pesticides.

    “A lot of people think about ‘how do we clean up the ocean’ and that’s the wrong question,” says Moss. “The question is not how do we clean it up, it’s how do we stop befouling it in the first place.”

(Jocelyn Timperley. www.sciencefocus.com, 30.05.2020. Adaptado.)

No trecho do terceiro parágrafo “keeping them circulating in the economy”, o termo sublinhado refere-se a

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    The problem of rising ocean plastic pollution such as plastic bags, discarded fishing nets and microplastics has received increased attention in recent years. But other pollutants such as oil and gas, pesticides, antibiotics, heavy metals and industrial chemicals are also severely impacting the world’s oceans, says a new report from the High Level Panel for a Sustainable Ocean Economy (Ocean Panel).

    “Even though plastic is a hot topic, it is unfortunately just the latest major pollutant to enter the ocean,” says Ellie Moss, an ocean plastic expert and co-author of the report. “I think one of the things that differentiates it from most of the other pollutants is that you can see it. In the other cases, it’s sort of these invisible pollutants that we don’t even recognise as being there. That’s a huge problem.”

    The new report, commissioned by the Ocean Panel which is convened by 14 heads of state, outlines a range of ways to reduce these different ocean pollutants. Part of the solution is exploring how materials can be recaptured and recycled, the report says, preventing them from seeping into the ocean as pollutants and instead keeping them circulating in the economy. Developing more eco-friendly materials and chemicals is another important part of the picture. In many cases, strategies can tackle more than one type of ocean pollutant at once, the report says. “You really do have to look for opportunities to address as many of these pollutants at once as you can,” says Moss.

    But there is also a need to simply use resources more efficiently in the first place, the report adds, such as through zero-packaging supermarkets, eliminating single-use plastics and exploring new business models which incentivise more efficient use of pesticides.

    “A lot of people think about ‘how do we clean up the ocean’ and that’s the wrong question,” says Moss. “The question is not how do we clean it up, it’s how do we stop befouling it in the first place.”

(Jocelyn Timperley. www.sciencefocus.com, 30.05.2020. Adaptado.)

No trecho do segundo parágrafo “‘Even though plastic is a hot topic, it is unfortunately just the latest major pollutant to enter the ocean’”, a expressão sublinhada equivale, em português, a

Leia o texto para responder à questão.

 

    The problem of rising ocean plastic pollution such as plastic bags, discarded fishing nets and microplastics has received increased attention in recent years. But other pollutants such as oil and gas, pesticides, antibiotics, heavy metals and industrial chemicals are also severely impacting the world’s oceans, says a new report from the High Level Panel for a Sustainable Ocean Economy (Ocean Panel).

    “Even though plastic is a hot topic, it is unfortunately just the latest major pollutant to enter the ocean,” says Ellie Moss, an ocean plastic expert and co-author of the report. “I think one of the things that differentiates it from most of the other pollutants is that you can see it. In the other cases, it’s sort of these invisible pollutants that we don’t even recognise as being there. That’s a huge problem.”

    The new report, commissioned by the Ocean Panel which is convened by 14 heads of state, outlines a range of ways to reduce these different ocean pollutants. Part of the solution is exploring how materials can be recaptured and recycled, the report says, preventing them from seeping into the ocean as pollutants and instead keeping them circulating in the economy. Developing more eco-friendly materials and chemicals is another important part of the picture. In many cases, strategies can tackle more than one type of ocean pollutant at once, the report says. “You really do have to look for opportunities to address as many of these pollutants at once as you can,” says Moss.

    But there is also a need to simply use resources more efficiently in the first place, the report adds, such as through zero-packaging supermarkets, eliminating single-use plastics and exploring new business models which incentivise more efficient use of pesticides.

    “A lot of people think about ‘how do we clean up the ocean’ and that’s the wrong question,” says Moss. “The question is not how do we clean it up, it’s how do we stop befouling it in the first place.”

(Jocelyn Timperley. www.sciencefocus.com, 30.05.2020. Adaptado.)

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