Kathie Gagne died 4,702 days ago.

Late-Night Scare
January 29th, 2012 @ 8:43 pm

At about nine o’clock tonight someone from the Halifax Hospital Psychiatric Unit left me a voice mail asking me to call as soon as possible. (I didn’t get to listen to the message until about 9:30 PM PST.) I was told that mom was being very anxious and the nurse wanted my permission to give her something for anxiety. Here is a transcript of the message:

“Hi, David. This is Carolyn. I’m your mother’s nurse. A message was given to me that you said to call you if your mother was upset or outta control and she is upset and out of control, so I’m gonna call the doctor to see if she’s begging for some medication to see if we can’t give her something to help her anxiety. Thank you.”

I called back at about 10:00 PM PST and talked to the nurse on duty for about twenty minutes, primarily about my frustrations with Dr. Caliendo and his apparent attitude and lack of communication with me. (The nurse promised to get him to call me, which presumably was the reason he called me at 5:00 AM PST the next day.)

A Fruitless Day
January 28th, 2012 @ 4:45 pm

Here are my notes from January 28th, 2012:

10:30 am – 11:30 am: made several attempts to talk to mom; she was asleep and / or unable to come to the phone; very sad

12:45 pm: [name redacted] called; said mom asked for books and that he visited her on Friday, January 27th and that she seemed much more alert and better than when at Stewart-Marchman; said he only just missed crossing paths with [name redacted]

4:45 pm: mom’s friend from church called; said she tried to visit Friday, just after [name redacted], but mom was asleep

from Oakland
January 27th, 2012 @ 5:00 pm

I had to go to San Francisco on a business trip. I called mom from the Oakland Airport while waiting for my flight home. (I called mom any time I ever got on a plane, because she was always so afraid of flying.) We only talked for about three minutes and she was very agitated the entire time. I don’t think she really understood that I was calling from an airport and about to get on a plane. After a few minutes of me trying to engage her, she simply walked away from the telephone.

In my notes I wrote:

mom very agitated, scared, tired; left phone hanging :(

Constance Calls
January 26th, 2012 @ 12:00 pm

I received a voice mail from Constance Wade this afternoon:

“Hello. It’s Connie, from Halifax, just letting you know that your mother was retained at Baker Act court and I’m hopeful that you’re gonna get the booklet and the test 1 soon and you can just send us the test back and hopefully, y’know, your mom will continue to stabilize and we’ll be able to find a place for her to go. Right now I think she still is in the process of being stabilized in her level of function … and I’m glad that you had a chance to speak to Rhonda, 2 luckily Rhonda’s been working with her for a while so I think she has a good understanding of her needs and we’re just gonna have to continue to work all together and hopefully we will come up with a solution for her … as a good place to go once all has been stabilized. Thank you. Bye.”

I returned her call almost immediately. (I missed her call because I was at a business lunch meeting in San Francisco.) Here are my notes from the call:

1200 Constance Wade called around noon while I was just sitting down to lunch at Lulu in San Francisco w/ [name redacted], [name redacted], and [name redacted], a credit card processing rep; talked to Connie for about 20 min. about mom, mostly about how hard all this is.
I repeated almost her entire history to Connie again.
She wanted to explain, I think, that we’re not going to be able to get mom out of there and into long-term care somewhere, until she’s “stable”
She did reassure me that mom has her glasses and that she gets my cards and photos of [name redacted].


1 This is referring to the booklet and test to prove myself capable of being my mother’s Guardian Advocate.
2 Rhonda is a nurse at Halifax.

Wellbutrin Finally Stopped
January 26th, 2012 @ 7:30 am

I called Halifax to try to talk to mom. It took me about ten minutes to finally get someone to get her to a telephone. I only had time to say hello and ask her how she was doing when she said she had to go to sleep because she was exhausted.

I called again and talked to Nurse Rhonda for about thirty minutes. She told me that they stopped administering Wellbutrin on Thursday, January 25th, and that mom was, “disturbing the other patients.”

A Call from Halifax
January 26th, 2012 @ 7:06 am

I received the following voice mail from a nurse at Halifax Hospital:

“Hello, David. This is Rhonda Spellers. I’m at Halifax Hospital. I spoke with you yesterday. I’m calling you because your mother is very fearful. She’s paranoid and anxious. She didn’t sleep again last night at all. She’s wandering in and out of patients’ rooms. She sits down. She lays down. She gets up. She … we can’t calm her, so you said to call you so you could speak with her and hopefully that will help. Please give me a call at (386) 254-4080. Thank you.”

In my notes I wrote:

0700 Nurse Rhonda called because mom was causing problems, asked me about giving her anti-anxiety meds, which I agreed

No Stroke?
January 25th, 2012 @ 2:32 pm

Here is an email I just sent to Constance Wade at Halifax (and copied my sister):

Dear Connie,

Thank you so much for taking the time to talk to me this morning. I very much appreciated your interpretation of the MRI she received on Friday, January 20, 2012.

I am still somewhat in shock at your news that — as far as you can tell — my mother did NOT, in fact, ever experience a stroke. I understand that you’re seeing significant atrophy in areas of her brain, but that at this point nobody cannot determine what is causing (or did cause) the atrophy.

On December 20, 2011 at approximately 3:45pm (Eastern), Sophia Mas at Stewart-Marchman-Act explained to me in detail that Dr. Caliendo’s interpretation of the CT scan she received on December 01, 2011 revealed an “old lacunar infarct of the left thalamus”. She also told me that there were “periventricular white matter hypodensities” that were “suggestive of chronic small vessel ischemia”. Sophia is the one that told us that my mother had definitely suffered a stroke at some point in the last year to eighteen months.

So for you to tell me that her recent MRI indicated that she had never had a stroke is really surprising.

Please also note that December 20, 2011 was the only time I have been able to speak with Dr. Caliendo directly, even though I repeatedly asked Sophia Mas to schedule a conference call with him. (Sophia Mas is the social worker who was assigned to my mother’s case at Stewart-Marchman-Act.) I would very much like to speak directly to Dr. Caliendo to hear his interpretation of the January 20, 2012 MRI and learn how it could be so wildly different from Sophia’s explanation of his interpretation of the CT scan performed a month earlier.

I spoke for quite some time this morning — Wednesday, January 25, 2012 — with Rhonda, a nurse at the Halifax Psychiatric Center. She told me that my mother is currently taking:

I explained to Rhonda that about four years ago I was prescribed Wellbutrin when attempting to quit using smokeless tobacco, but that I stopped taking it after about a month because I was experiencing unbearable headaches, nightmares, and terrible paranoia and suicidal ideations. The main reason I mentioned this is because I’m concerned that she may be experiencing the same thing — since as her first-born son we must share some chemical and biological traits — but she may not able to communicate that effectively to her caregivers at Halifax because of her current problems vocalizing her thoughts.

During the phone call I had with you this morning, you mentioned more than once that I am listed as her “GA” — guardian advocate — and that Halifax is required to acquire my consent regarding all of her prescriptions, yet I never consented to prescribing her Wellbutrin and did not even know she was taking that until Rhonda told me after my phone call with you.

I’m not upset or anything like that, because I’m sure that your team is very professional and doing the best job possible to care for my mother, but the fact that I was not aware that she was taking Wellbutrin does concern me.

(Rhonda also told me that Dr. Mandeep Garewal is the one who ordered the EEG and MRI, and that he is the one who prescribed the Namenda. This is the first I have heard of Dr. Garewal, who I assume is a co-worker of Dr. Caliendo’s.)

PS: My mother was administered a CT scan at Halifax Hospital on December 14, 2009. Because that was also performed at Halifax, I assume you have access to the results of that and perhaps comparing that to the more recent CT scan and MRI will be helpful.

Thank you so much for everything you are doing for my mother.

Sincerely,

David Vincent Gagne

Rhonda Calls Again
January 25th, 2012 @ 9:35 am

Nurse Rhonda from the Halifax Hospital Psychiatric Unit called me again to ask about administering Namenda. She said it was prescribed by Dr. Mandeep Garewal; this is the first time I was informed of this doctor’s involvement in mom’s care at all.

She told me that Dr. Garewal is the one who ordered the EEG and MRI on January 20, 2012; she said he is doing tests to see if he can determine why she is presenting with dementia. Rhonda said Dr. Caliendo and Dr. Garewal are both consulting on her case.

Rhonda said mom is still taking Aricept, so she’ll be taking Aricept and Namenda at the same time. She repeated what Connie Wade told me about Aricept being used to treat dementia. She said that mom is “constantly wandering” and taking food from other patients’ trays.

Nurse Rhonda told me that mom’s current prescriptions are:

  • Namenda 5mg at 9 AM and 9 PM
  • Aricept 10mg at 9 AM
  • Wellbutrin 150mg at 9 AM
  • Lopressa 25mg at 9 AM and 9 PM (for high blood pressure)
  • Microzide 125mg at 9 AM (for hypertension)
  • Prinivil 10mg at 9 AM and 9 PM (for high blood pressure)

Rhonda said that the Wellbutrin was started on January 20th, the day she was admitted to Halifax.

Talking to Connie
January 25th, 2012 @ 8:30 am

I had a very long phone call with Connie Wade at Halifax. She was calling to let me know that on January 26th, 2012 there would be another court hearing to institute a Baker Act again.

Connie also told me that I am the designated GA. I asked her what a GA was and she said it stands for Guardian Advocate. (I couldn’t understand her pronunciation so I asked her, “Can you spell it?” She replied, “Yes, I can.” But then she continued talking without spelling it for me, as if she thought I was testing her intelligence!)

Connie said that Aricept and Namenda are the only two drugs which are used to “treat” dementia. She said that they are not cures, and that they only (hopefully, hypothetically) slow the progress of the disease.

Request to Administer Namenda
January 25th, 2012 @ 5:17 am

I received a phone call from Nurse Rhonda at the Halifax Hospital Psychiatric Unit. I was asleep and didn’t wake when the phone rang, but she left me a voice mail asking if I would give consent for mom to be put on Namenda. Here is a transcript of the message she left me:

“Hi. Good morning, David. This is Rhonda. I’m your mother’s nurse, Kathleen, today. I’m at Halifax Hospital. I’m calling because the doctor has ordered a medication called Namenda, five milligrams, and he wants her to have it twice a day and I need consent from you in order to give this medicine. Please return my call if you have any questions. Thank you. Goodbye.”

(1) What doctor?
(2) Why does she say she needs consent from me for this medicine, but my consent wasn’t requested for every other change in medication prior to this or after this?
(3) Why did she not leave a number for me to return her call?