Anne C Woodlen is a 66-year-old single female without family. Dr. Stephen Wechsler, her “acting son,” is her Health Care Proxy, Trustee and Power of Attorney. She is alert, intelligent and articulate, and maintains a blog that has been viewed about 110,000 times in less than three years. (https://annecwoodlen.wordpress.com/2013/05/26/crouse-the-kinder-gentler-hospital/ )
Social Security, Medicare primary, Medicaid secondary.
Medical (in the order that they impact on Ms Woodlen’s well-being)
- Immune dysfunction, type unknown, causing intolerance to all medications
- Uncontrolled diabetes mellitus, type 2 (last finger stick 491)
- Stage 3 kidney failure
- Nephrogenic diabetes insipidus (24-hr. urine is 7 liters)
- Executive dysfunction learning disability
- Chronic fatigue syndrome
- Unstable severe obstructive sleep apnea
- Pulmonary fibrosis (shortness of breath upon minimal exertion)
- Left ventricular hypertrophy
- Right branch bundle block
- Spinal arthritis
In August 2012 she scored CC 7.5 on the PRI.
Consequent to the death of her fiancée in 1974, Ms Woodlen was kept on antidepressants every day for 26 years. During that time she did not finish her education, develop a career, get married or have children. She did experience about 50 psychiatric hospitalizations for a total of about three years, and attempted suicide about a dozen times, ending with a month on life support in 1999.
In 2001 Ms Woodlen stopped taking all medications, including antidepressants. Consequently, her last hospitalization was in 2003. Around 2008, psychological testing revealed no psychopathology. Ms Woodlen’s depression and suicide attempts were caused by antidepressants. After she stopped taking them, Ms Woodlen learned that the trigger for depression is the perception of powerlessness. Consequently, she learned to act with power and no longer experiences reactive depression.
Ms Woodlen recently has been seeing a psychologist for support; the psychologist has prepared a statement regarding Ms Woodlen’s healthy mental state.
Ms Woodlen was administered lithium for seven years, ending around 1990. The prescribing psychiatrist never monitored it. Ms Woodlen has multiple illnesses that either were caused by, or exacerbated by, antidepressants. The mistreatment with lithium is most problematic. There is no medical literature on the effect of lithium poisoning on the immune system. Ms Woodlen’s symptoms most nearly resemble an autoimmune disease such as multiple sclerosis, lupus or scleroderma, however there is no diagnostic category into which she fits. She cannot tolerate any medications for the treatment of any illness. The worst effect of taking medications is mental distress.
Ms Woodlen is a very spiritual person and is disinclined to sacrifice her mental and spiritual clarity for the sake of physical restoration. She would like to be situated in a facility that provides corporate worship, no specific type required, but she has found Catholic to be less than welcoming.
Ms Woodlen has an I.Q. of 139 however only an associate’s degree, consequent to the undiagnosed learning disability. She worked as a secretary until 1991, when she was declared fully disabled. After she stopped taking drugs in 2001, she became a remarkably effective activist on behalf of people who are poor, old or sick in regard to transportation, housing and medical care. Resume available at https://annecwoodlen.wordpress.com/2013/02/06/resume-of-an-activist/
Has been using an electric bed and positive airway pressure machines for about 15 years; electric wheelchair for ten; indwelling catheter for two years.
Ms Woodlen’s current level of functioning varies from hour to hour and day to day based on recency of food, adequacy of sleep and amount of stress. She can feed herself; she cannot bathe/shower herself. Can transfer; cannot walk more than twenty feet. Sleeps from about 9:30 p.m. to 6:00 a.m. with one or two naps during the day. Uninterrupted night-time sleep is essential to good mood. Regular diet; needs extra liquids. Ms Woodlen’s diabetes has been out of control for about three years, consequently she is very tired, bed-ridden, and sometimes confused and/or forgetful. When provided an appropriate level of service, her mood is good; she is pleasant, cheerful and helpful. When services are substandard, she becomes angry, outspoken and uncooperative.
Three attempts have been made to treat the diabetes with insulin but each had to be discontinued because of negative reactions. On April 16, with a blood sugar level of 484, Ms Woodlen was told that there was nothing more that could be done for her, consequently she took an overdose and ended up on St. Joseph’s Hospital psychiatric unit. The director, Dr. Roger Levine, stated that it was an inappropriate placement and then did nothing to procure an appropriate placement. On May 29 she was discharged home with a virtually blank discharge plan, nine hours a week of home aides, and no other services. State complaints are outstanding against Levine and St. Joseph’s.
For three weeks Dr. Wechsler and Ms Woodlen did everything they could to procure adequate competent home aides, case management and skilled nursing but were unsuccessful. Her circumstances became dangerously unsafe so, on May 23, Ms Woodlen was ambulanced to Crouse Hospital and admitted with a UTI and uncontrolled diabetes. An IV antibiotic was initiated but had to be withdrawn upon negative reaction.
Ms Woodlen eagerly seeks nursing home placement so that the level of service will meet the level of need. She fully understands and accepts that there are no options for treatment or recovery.