Professor Appointed to Probe Schiavo Case

Guardian Unlimited ^ | Nov 1, 2003 | Vickie Chachere

[Future Useless Eater]

Professor Appointed to Probe Schiavo Case

Saturday November 1, 2003 1:01 AM

By VICKIE CHACHERE
Associated Press Writer

TAMPA, Fla. (AP) - A judge appointed a University of South Florida professor on Friday to independently investigate the case of a severely brain-damaged woman at the center of a right-to-die battle.

Jay Wolfson, an expert on health care financing, will report to Gov. Jeb Bush and recommend whether the stay the governor enacted to keep Terri Schiavo alive should be allowed to remain.

Schiavo suffered severe brain damage when her heart stopped due to a chemical imbalance and has been in a persistent vegetative state for more than a decade. Doctors have said there is no hope for her recovery.

Her husband, Michael Schiavo, has fought to have her feeding tube removed, saying his wife did not want to be kept alive artificially.

Terri Schiavo's parents, Bob and Mary Schindler, dispute that claim and have fought to keep their daughter alive, saying they believe she could be rehabilitated.

Terri Schiavo's feeding tube was removed for six days in October before the Florida Legislature and Gov. Jeb Bush enacted a special law to have it reinserted. The law also required a guardian to be appointed.

George Felos, the attorney for Michael Schiavo, and the American Civil Liberties Union filed briefs this week challenging the constitutionality of the governor's action. The state is expected to respond on Monday.

The judge said that if the law is found to be unconstitutional, Wolfson is to cease his work.

The Schindlers had objected to Wolfson's appointment, claiming comments he made to a television station indicated he was biased against the newly enacted law. The judge said he found no evidence of bias.

Wolfson did not return calls seeking comment.

The judge ordered Wolfson to report to the governor in 30 days, but said the deadline could be extended if needed.

[saveterri1]

Eating Disorders & Bone Fractures

International Journal of Eating Disorders
^ | 2002 | na
Posted on 10/28/2003 6:36 PM PST by Normally a Lurker

Even years after a person is diagnosed with anorexia nervosa, they have twice the risk of bone fractures as their peers without the eating disorder, new study findings from Denmark show.

The findings suggest that damage caused to bones by eating disorders may be permanent, according to a report in the International Journal of Eating Disorders.

However, it is possible that patients in the study were still struggling with the eating disorder, which may have kept bones from regaining strength, the report indicates.
Previous studies have found that people with eating disorders such as anorexia or bulimia can suffer from weakened bones because of poor nutrition. Experts say that this can increase the risk of osteoporosis and fracture.

In the current investigation, Peter Vestergaard of the Aarhus University Hospital in Denmark and colleagues looked at 2,149 people diagnosed with anorexia nervosa, 1,294 people with bulimia nervosa and 942 people with another type of eating disorder. All of the patients - more than 90% female - were compared to a group of over 4,000 healthy people.

Compared to those without an eating disorder, patients were about twice as likely to break a bone after their diagnosis and the risk remained elevated for up to 10 years after diagnosis. The fracture risk was also elevated in those with other eating disorders, but not as dramatically as in patients with anorexia.

The researchers believe anorexia may cause permanent damage to the skeleton, which is later compounded by the loss of bone that can occur with aging. On the other hand, the researchers point out that even after diagnosis and treatment, the eating disorder may not have been completely reversed, resulting in continued nutritional deficits and further decreases in bone mass.

"In conclusion," the authors write, "an increased risk of fractures is present many years after diagnosis of anorexia nervosa, and the group of other eating disorders. These findings call for more awareness of potential skeletal complications linked to eating disorders in general."

[NautiNurse]

Why don't you hold off on a ping list until you can answer simple questions. Twice, you have referred to "PAC physician's." What is a PAC physician?

[saveterri1]

Eating Disorders & Bone Fractures

http://www.freerepublic.com/focus/news/1010095/posts?page=1


The following was extracted from an article on Eating Disorders: Anorexia and Bulimia in "Health and Age" (see link)

One of the most serious effects of anorexia are hormonal changes, which can have severe health consequences:

· Reproductive hormones, including estrogen and dehydroepiandrosterone (DHEA), are lower. Estrogen is important for healthy hearts and bones. DHEA, a weak male hormone, may also be important for bone health and for other functions.
· Thyroid hormones are lower. ·
· Stress hormones are higher. ·
· Growth hormones are lower.
Children and adolescents with anorexia may experience retarded growth. ·

The result of many of these hormonal abnormalities in women is long-term, irregular or absent menstruation (amenorrhea). This can occur early on in anorexia, even before severe weight loss. Over time this causes infertility, bone loss, and other problems. Low weight alone may not be sufficient to cause amenorrhea. Extreme fasting and purging behaviors may play an even stronger role in hormonal disturbance.

Psychologic Effects and Suicide Adolescents with eating behaviors associated with anorexia (fasting, frequent exercise to lose weight, and self-induced vomiting) are at high risk for anxiety and depression in young adulthood. Some studies estimate that between 12% and 18% of people who are anorexic also abuse alcohol or drugs. Even worse, suicide has been estimated to account for as many as half the deaths in anorexia. In one study, suicide rates occurred in 1.4% of women with anorexia. The study, however, only looked at female death records. Such records may not have always recorded anorexia as an accompanying condition, so the incidence of suicide in anorexia may be much higher.

Heart Disease Heart disease is the most common medical cause of death in people with severe anorexia. The effects of anorexia on the heart are as follows:
· Dangerous heart rhythms, including slow rhythms known as bradycardia, may develop. Such abnormalities can show up even in teenagers with anorexia. ·
· Blood flow is reduced. ·
· Blood pressure may drop. ·
· The heart muscles starve, losing size. ·
· Cholesterol levels tend to rise. ·

A primary danger to the heart is from abnormalities in the balance of minerals, such as potassium, calcium, magnesium, and phosphate, which are normally dissolved in the body's fluid. The dehydration and starvation that occurs with anorexia can reduce fluid and mineral levels and produce a condition known as electrolyte imbalance. Electrolytes (e.g., calcium and potassium) are critical for maintaining the electric currents necessary for a normal heartbeat.

An imbalance in these electrolytes can be very serious and even life threatening unless fluids and minerals are replaced. Heart problems are a particular risk when anorexia is compounded by bulimia and the use of ipecac, a drug that causes vomiting.

Long-Term Outlook on Fertility After treatment and an increase in weight, estrogen levels are usually restored and periods resume. In severe anorexia, however, even after treatment, normal menstruation never returns in 25% of such patients.
· If a woman with anorexia becomes pregnant before regaining normal weight, she faces a higher risk for miscarriage, cesarean section, and for having an infant with low birth weight or birth defects.

She is also at higher risk for postpartum depression. ·
· Women with anorexia who seek fertility treatments have lower chances for success. ·
Long-Term Effect on Bones and Growth

Almost 90% of women with anorexia experience osteopenia (loss of bone minerals) and 40% have osteoporosis (more advanced loss of bone density). Up to two-thirds of children and adolescent girls with anorexia fail to develop strong bones during their critical growing period. Boys with anorexia also suffer from stunted growth. The less the patient weighs, the more severe the bone loss. Women with anorexia who also binge-purge face an even higher risk for bone loss.

Bone loss in women is mainly due to low estrogen levels that occur with anorexia. Other biologic factors in anorexia also may contribute to bone loss, including high levels of stress hormones (which impair bone growth) and low levels of calcium, certain growth factors, and DHEA (a weak male hormone).Weight gain, unfortunately, does not completely restore bone. Only achieving regular menstruation as soon as possible can protect against permanent bone loss. The longer the eating disorder persists the more likely the bone loss will be permanent.

Testosterone levels decline in boys as they lose weight, which also can affect their bone density. In young boys with anorexia, weight restoration produces some catch-up growth, but it may not produce full growth.

Neurological Problems People with severe anorexia may suffer nerve damage that affects the brain and other parts of the body. The following nerve-related conditions have been reported:
· Seizures. ·
· Disordered thinking. ·
· Numbness or odd nerve sensations in the hands or feet (a condition called peripheral neuropathy). ·
Brains scans indicate that parts of the brain undergo structural changes and abnormal activity during anorexic states. Some of these changes return to normal after weight gain, but there is evidence that some damage may be permanent.

Still, the extent of the neurologic problems is unclear, and some studies have been unable to determine specific mental problems associated with anorexia.
Blood Problems
Anemia is a common result of anorexia and starvation. A particularly serious blood problem is pernicious anemia, which can be caused by severely low levels of vitamin B12. If anorexia becomes extreme, the bone marrow dramatically reduces its production of blood cells, a life-threatening condition called pancytopenia.
Gastrointestinal Problems
Bloating and constipation are both very common problems in people with anorexia.
Multiorgan Failure

In very late anorexia, the organs simply fail. The main signal for this is elevated levels of liver enzymes, which require immediate administration of calories.

Complications in Diabetic Adolescents
Eating disorders are very serious for young people with type 1 diabetes. The complications of anorexia that affect all patients are even more dangerous in this group of patients. Hypoglycemia, or low blood sugar, for example, is a danger for anyone with anorexia, but it is a particularly dangerous risk for those with diabetes. One study found that 85% of young women with diabetes and eating disorders had retinopathy, damage to the retina in the eye, which can lead to blindness.

3 posted on 10/28/2003 9:48 PM EST by Normally a Lurker

[saveterri1]

Deciding the Fate of Terri
By ANITA KUMAR
© St. Petersburg Times, published January 25, 2000

Last updated Oct. 24, 2003
Excerpt:

Michael Schiavo thought he had done everything he could to save his wife. In 1990, after she lapsed into a persistent vegetative state from a loss of potassium, he took her to California for experimental treatment. He hired an aide to take her to salons for a beauty make-over. He took her to the mall to buy new clothes, the museum to look at art. He even made tapes of her family and friends, hoping to find a stimulus that would lift her from the her current state.

Tragic Fall

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The Schiavos had been married five years when Terri started having abdominal pains and missing her menstrual periods, family members say.
^^CLASSIC IN BULIMIA NERVOSA

Her doctors never tested her blood or told her what was wrong, Mrs. Schindler said.

On Feb. 25, 1990, Michael Schiavo woke up about 5 a.m. to use the bathroom. That's when he saw his wife fall on the floor. Her heart stopped beating and she was deprived of oxygen for five minutes before she was taken to the hospital.

Terri Schiavo has not awakened since and currently lives in Palm Gardens nursing home in Largo.

Family members say doctors never discovered why Mrs. Schiavo suffered the loss of potassium that caused the heart attack. Despite several theories, including one that she had an eating disorder, no one has given the family
a clear answer.

^^^(SCHINDLER’S ATTENDED THE MAJORITY OF THE MALPRACTICE TRIAL WHICH WAS ALL ABOUT THE DOCTOR’S MISSING TERRI’S SEVERE BULIMIA NERVOSA-gi)

THE COURT AWARDED OVER $1 MILLION NET TO MICHAEL DUE TO THE DOCTORS NOT PROPERLY DIAGNOSING TERRI'S SEVERE BULIMIA NERVOSA. IF THE SCHINDLER'S ARE GOING TO SAY THAT TERRI NEVER HAD BULIMIA NERVOSA, THE RIGHT THING UNDER GOD IS ALL THE AWARD SETTLEMENT MONEY SHOULD BE GIVEN BACK TO THE PHYSICIAN THAT GOT FLEECED. WHAT DO YOU THINK??

Terri, meanwhile, has remained in a what is termed a "persistent vegetative state" through about 100 doctors visits and countless hospital and nursing homes stays. She breathes and sleeps, blinks and smiles. But she cannot talk and has to be propped up in a chair during the day.

[windchime]

I thought PAC meant 'political action committee'. That might be what it means here, too. :)

[trustandobey]

I am really curious why the government is handling her health care now (Not that I don't want her to be cared for) It just seems to me that in any other situation, the husband would have to sell everything to keep her in a nursing home until all that He owned ran out. This should include her money for rehab, her insurance, his home, his car, his salary. Just MHO, but wonder why laws aren't being broken here??

[saveterri1]

Don't be insulting! Try reading my original posts here instead. These are MD,PhD's/MD's/PhD's in our Terri's Right to Life and be Returned to her Parents with full Guardianship Group, Thank you.

PS: Better yet why don't you read all my posts and tell me what you think is going on here, because we don't understand it! This is why I am posting it and why a number of FR members asked me to post this material. Maybe we can all collectively figure out what is going on. We need help from other FR members that love and care about Terri to tell us what is going one. We have only been investigating this case 6 weeks. There are many great FR members here that has followed Terri's situation for months and years!

[saveterri1]

Now there is an EXCELLENT question! And I will bet a fat paycheck that laws ARE being broken. Why is Michael's house in his girlfriend's name. The girlfriend that per his Larry King interview he had no plans to get Married to. How many control freak guy's, like Michael, do you know that give away houses?.

Bet his car's etc are also in her name. She is also a shareholder of his company. Bet he is minority shareholder.

Interesting how Michael "shoveled" all of Terri's $750,000 rehab and health maintenance money to his Attorney George Felos via legal fees, using a liberal interputation of the Laws, Trust Agreement, and Malpractice Trial Settlement Agreement, with Judge Greer's lovely assistance and approval of the Trust disbursements for legal fees to Felos.

Yes, a sorted story..

[NautiNurse]

PAC--please tell me what this acronym stands for in your posts. This is not an insult. I am trying to clearly understand your information.

[Bluebird Singing]

"Woodworth and Miami lawyer Gary Fox maintained that Igel saw Mrs. Schiavo four times over a year and never asked about her nutrition and never noticed the loose skin and stretch marks resulting from her substantial weight loss. "

Guess what, folks? With bulimia, there is not substantial weight loss. It is being confused with anorexia nervosa here. Bulimics usually sustain normal weight.

"Unlike the person with anorexia, the patient caught up in the syndrome of bulimia usually maintains a normal or near-normal body weight, and the primary symptom is gorging rather than starvation." - from Medical-Surgical Nursing (Lewis, Heitkemper, Dirksen)

[saveterri1]

Wednesday, October 29, 2003
Schindler’s Public Statement Regarding Michael’s Larry King
Live Statement on Terri’s Bulimia Nervosa Disease:
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Michael also said on "Larry King Live" that Terri was bulimic prior to that night, and that her bulimia was possibly the cause of the potassium imbalance which was discovered when she was in the hospital.

Bob & Mary also find this assertion incredible. Bob's reaction was "Poppycock!" Terri, they said, was quite healthy and had a healthy appetite prior to her injury. None
of her friends or family ever saw any signs of any eating disorder, and there was no medical evidence of it found in her examinations.



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The 1992 Malpractice Trial Was A Conspiracy
The $1+ million (net) came from Santa~

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I have Ping Deficiency Syndrome :-(
Is there a medic in the house-
Correction I am too old to learn!!

[PeyersPatches]

I have some questions. Karen Carpenter had severe anorexia/bulimia much longer than Terri did, yet Karen Carpenter dropped dead of a heart attack in her parents Downey, CA home. No broken bones, much less multiple skull fractures, ribs, several neck fractures, knees, etc. What is the difference? Also, how were you able to see a sealed court document? Why didn't Michael parade this out on LKL if it was so damning to the parents? He has the say on her medical records and talked quite frankly (rudely I'd say) about her gynocology.

[PeyersPatches]

She breathes and sleeps, blinks and smiles. But she cannot talk and has to be propped up in a chair during the day.

---

So all the nurses, some doctors, and family members who have said or signed affadavits stating she has done everything from taking ("stop" "hurts" "mama" "help me" and some singing) were lying? I am confused here...

[Bluebird Singing]

"I have some questions. Karen Carpenter had severe anorexia/bulimia much longer than Terri did,"

Karen Carpenter suffered from anorexia nervosa. Bulimia and anorexia nervosa are not a combination condition.

[saveterri1]

Ok it was Bulimia-Anorexia Nervosa Disease. Which is becoming much more common the last 25 years, but it is typically referred as Bulimia Nervosa Disease in these cases and there is a neural-hormonal modulation problem. Terri would either binge or not eat, per the trial records. But I refuse to talk about any of this anymore!!!

Do we really want to get into debate and drag out medical books, etc, etc. and attempt to invalidate numerous medical experts that reviewed this case and the records, made their testimony, and based on this, the Jury awarded Terri $6 million dollars initially. That is a lot of money!

Do you really think they would have done this if Terri's disease was not serious and progressed?. Do you think the medical experts would have only estimated her life expectancy to be 45 if it was not serious and progressed?

Are you an M.D., did you review the patient after her collaspe, did you review laboratory reports, etc. etc. to base your opinion. No....

Is everybody wrong that has had anything to do with all these trials, over all these years, all these expert witnesses where total out of their mind idiots?

Are we going to go back and re-trial everything now over the last 13 years, because we know better?

Not making an opinion or judgement, Just asking everybody their thoughts?

[PeyersPatches]

Karen Carpenter suffered from anorexia nervosa. Bulimia and anorexia nervosa are not a combination condition.

---

My understanding is that she, as many, suffered from both conditions and that they tend to do hand-in-hand. One is self-starvation and the other is binge and purging of food.

[PeyersPatches]

I am looking into this more. Now with all the questions floating about, I am curious as to whether they are two separate maladies or tend to run in pairs. I'll see what I can find out and get back w/the group and thanks.

[NautiNurse]

What does PAC mean (as in PAC physicians) in your posts?

[Bluebird Singing]

I wasn't arguing with YOU, I was trying to understand Michael Schiavo's description of Terri's condition. He was claiming that she was bulimic, and then saying the doctors should have noticed her sagging skin.

[saveterri1]

Partial Reference Links:

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Dr. William M. Hammesfahr, M.D.
Clearwater, Florida

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St. Petersbury Times Newspaper
October 22, 2003
Schiavo case doctor target of Medical Board Complaint

Dr. Hammesfahr, who holds out hope for the woman in a vegetative state since 1990, has been accused of deceptive advertising and exploiting patients or clients for financial gain.

http://www.sptimes.com/2002/10/22/TampaBay/Schiavo_case_doctor_t.shtml
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Search Florida Medical Board Records on William M. Hammesfahr: (Complete input form)

http://ww2.doh.state.fl.us/irm00profiling/SEARCHFORM.ASP

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Department of Health, Florida of Board of Medicine Meeting
February 7 – 8, 2003
Physician Disciplinary Hearings

The Administrative Complaints alleged violation of Florida Statute as follows:

1. Failure to practice medicine with that level of care, skill, and treatment
which is recognized by a reasonably prudent similar physician as being acceptable under
similar conditions and circumstances
2. False, deceptive, or misleading advertising. and
3. Exercising influence on the patient or client in such a manner as to exploit the patient
or client for financial gain of the licensee or of a third party, which shall include, but not
be limited to, the promoting or selling of services, goods, appliances, or drugs.

Full Text Here:

www.doh.state.fl.us/mqa/medical/min_02-07-03.pdf

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Florida Department of Health (DOH)
Report Date: 03 / 18 / 2003
Enforcement Report
Recent Discipline Taken by DOH Against Practitioner
(See Hammesfahr, William Michael, Clearwater, Florida – 1/3 Down Page)

www.doh.state.fl.us/mqa/enforcement/discipline_reports/ discipline_report_fo_03-18-03.pdf

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Dr Hammesfahr Advertised His “Medical Miracles” treatment procedures in the National Enquirer Tabloid and shows it on his website currently:

http://www.floridaneurologicalinstitute.com/national_enquirer_1998.htm

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1. Dr. Hammesfahr has no peer reviewed published work, on his “medical miracles” treatment protocols, in any recognized medical journals, or with the National Library of Medicine’s MedLine.

2. Dr. Hammesfahr's Noble Prize nomination was reviewed by a Yale Scholar, skilled with the Rules, Regulations, and Procedures of the Noble Laureate Nominating Committee. On the “Today Show” last month, he stated that Dr. Hammesfahr’s claim in this regard was without merit.

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