To: BlogsForTerri
From: Ken Mullinax

Thanks for providing me the opportunity to address the following:

1. The world class cardiologist is Dr. Raed Aqel, M.D. who is at UAB's Kirkland Clinic. Dr Aqel is now my Aunt's Attending Physician at UAB and is seeing my Mom at UAB hospital as her cardiologist.

2.Two weeks-nourishment: That date comes from the fact that Mae was put in the Hospital on around March 13 and was immediately in such pain that Morphine was administered and thus she could not feed her self and thus obtained no substantial nourishment. She was admitted to Hospice on March 22 and from that point on, she only took in ice chips and jello on a sporadic basis and limited water via a syringe when if they ascertained she was unable or unwilling to take ensure or fluids orally, they should have proactively, in my opinion and according to the provisions of her living will, be administered such via an IV and nasal feeding tube.

3. Regardless of Judge Boyd says, Mae was denied nourishment and water because she was not lucid from the drugs and her lack of lucidity which only occurred AFTER ADMISSION TO THE HOSPICE AND therefore could not request them OR IMBIBE THEM on her own volition.

4.The food, Boyd said she took at Hospice, is not what we call great
nourishment...small amounts of ice chips and a few spoonfuls of jello. I would like to see anyone would feel on a daily diet of a half small bowl of orange jello, one cup of ice chips and maybe 100cc's of water administered via syringe, when someone got around to giving it to her. Anyone's electrolyte level, lucidity and cognitive abilities be effected at this point?

5. The fact that Mae is not at Hospice now shows that all three doctors, two in LaGrange and one at UAB, concurred that Mae should be further evaluated to see if a course of action could be followed to give her a chance at a quality of life. Judge Boyd will substantiate the fact that an independent neurologist did in fact examine Mae on either Thursday or Friday of this week and determined that her vitals showed that her brain was still functioning, that her neurological activity, swallowing functions, eyes and other vitals were still functioning. Dr. Aqel suggested this to DR.'s Gore and Brennan and
they concurred and thus, a neurologist evaluated Mae. There report was subsequently submitted to Judge Boyd. Dr. Aqel said that the neurological exam greatly aided all three doctors in determining that Mae was a viable candidate for further proactive medical treatment and/or evaluation.

6. Dr. Aqel, who is my Mom's cardiologist for the last few years, and also my Uncle Buddy McLeod's cardiologist (all three siblings, Mae, Lonnie Ruth, Buddy - ALL suffer from aortic dissections and problems) and now my Aunt Mae's attending Physician at UAB (Dr. Aqel) told me and my brother Jon yesterday that Mae is SO DEHYDRATED after her stay at Hospice LaGrange, that it will take at least two days of intense hydration therapy to get her back to a level that is acceptable to him.

7. Carol Todd (Hospice in house lawyer) called my Mom on March 31 and told her and I (on the phone) what was going on. A Hospice nurse was also on the phone when Carol Todd called and tried to dissuade my Mom from requesting either an IV for fluids and/or a feeding tube for substantial nourishment. After Mom listened to them, as the closet living next of kin (after it was discovered that Hospice had wrongly assumed that Beth Gaddy's power of attorney was a medical-durable P.O.A. when in fact from Mae's hospitalization date until March 31, Beth did not have such power and only held a financial P.O.A./and the fact that they also did not closely examine my Aunt's Living Will, specifically the covenants which state "nourishment/fluids shall BE DENIED ONLY IF I am comatose or vegetative"), my Mom ordered Hospice, via Carol Todd to begin hydration via an IV post haste and requested a feeding tube. Ms. Todd said they could do an IV that evening, once they passed Mom's request on to a Doctor who would order such "and one did and an IV was inserted that evening" but Todd told us we would have to show up at Hospice and sign papers to get a feeding tube inserted in her nose and if we did so, Hospice would no longer consider her as a viable candidate for Hospice.

We told Todd great, because we never considered Mae as someone who should be in Hospice since she was never said to be terminal. Well, someone notified Beth Gaddy Thursday that we were coming over the next day, Friday, April 1, to sign Mae's papers for a feeding tube and to move her to UAB- because when we showed up Friday at Hospice, they stalled us from moving her "a Hospice head nurse did) and when we were fed up with her trying to persuade us of all the reasons we should let go of Mae and allow her to die at Hospice and told her and even had Dr. Aqel call her so as to begin the process of emergency air transport to UAB medical center, then and only then did Carol
Todd, Hospice's lawyer, arrive and served us with the court papers Beth Gaddy obtained via Judge Boyd which superseded by Mom and Uncle Buddy, who are Mae's closest living next of kin-and thus had herself appointed as the temporary Guardian who therefore could and did make the medical decision to both keep Mae in Hospice and pull out her IV tube for fluids and reversed our decision to insert a nasal feeding tube....the horror thus began for us.

8. Our attorney Jack Kirby proposed a compromise settlement (and he was smart doing so because it now has Mae out of Hospice and in a real world class medical facility) on our behalf Monday, April 4, when we realized, via his negative actions toward our agruments before him in open court on April 2, 2005, that Judge Boyd was going to rule for Beth and against our petition for guardianship...(one such instance was Boyd denying our attorney, Jack Kirby from cross examining Dr. Stout-Mae's attending physician -from answering his question of whether Stout would agree that there are different
courses of treatment for a dissected aorta other than surgery..."this
argument was used by Beth and Stout..

10. They stated rightly that Mae was not a candidate for surgery, that is true, however neither was my Mom, Mae's sister who has a similar aortic condition - the whole reason we have Dr. Aqel involved is that he treated Mae's sister, my mom, Lonnie Ruth......WITHOUT surgery for a dissected aorta, successfully, with treatment and drugs when Mom's aorta dissected on October 12, 2002 and when the same problem occurred on October 12, 2003 and UAB's doctors are AGAIN treating my Mom for another dissection which occurred this past Thursday evening on April 7, 2005...matter of fact, Mom is doing so well (the dissection now has occurred in her Iliac artery(It's the artery which shoots off the aorta from the groin to either leg), that she has now been moved from CICU "Cardiac Intensive Care Unit" at UAB to a private room. Dr. Aqel is also acting, as always, as my Mom's cardiologist and as Mae's attending. Mae is now just one floor above my Mom's hospital room.

Note: Dr. Stout, Mae's attending Dr. in LaGrange, said in so many words that he would ignore Mae's Living Will since he felt her quality of life and outlook for recovery was grim at best. However, it seems that the panel of three doctors thought there must be a chance because they reported back to Judge Boyd, according to the settlement our lawyer, Jack Kirby crafted and wrote for the court, and Mae is now in UAB Medical Center.

10. In Judge Boyd's court decree order(Civil Action, Estate 138-05, dated April, 2005) it states:

"The guardian shall see that Dr. Brennan, Dr. Gore, Dr. Aqel evaluate/and or examine the ward (Mae Magouirk) for the purpose of determining whether any medical treatment should be pursued for her aortic aneurism. If at least two of the three doctors agree that there is a viable course of treatment for the aortic aneurism, then, in that event, the petitioner(Beth Gaddy) shall follow the recommendation of the doctors who agree to such a course of treatment, including the location and manner of treatment to be provided."

11. So by Mae being at UAB Medical Center that fact alone supports our contention that Mae DID NOT BELONG IN HOSPICE....was not terminal or comatose or vegetative and the three doctors agree that a course of treatment SHOULD BE PURSUED.

In closing, that is all Mae's Alabama family seeks...if the Doctors treat her and her lucidity is not reinstated, then we would be fine with her being in a nursing home...or she is welcome in either our home or Uncle Buddy McLeod's home...matter of fact, why not sitters in her home?

WE are comfortable with Mae being ANYWHERE BUT HOSPICE as long as she is not terminal and as long as she proactively receive the proper nutrition she must have, either orally or via a tube and/or IV.

Note, we Mullinax's are not adverse to Hospice when it is used properly for the purpose in which it was created. I left my career in Washington, DC to come back home to Alabama and help my dad
Ken, Sr. die at home with Hospice from 200 until July 10, 2002. In 1990, we obtained Hospice to help my grandmother, Mae's mom, Ora Ethel McLeod, die at home with Hospice. Additionally in 1994, my dad's brother Lynn Mullinax, left his home in NYC and moved in with my Mom and Dad so he wouldn't die alone and we used Hospice at our home for uncle Lynn....however, the major difference between my Aunt Mae Magouirk and the three cases of Hospice with my Grandmother,Dad and Uncle Lynn is that ALL THREE OF THEM WERE TERMINAL!

And even though they were terminal and some were very infirm, we ALWAYS SAW THEY HAD A GOOD INTAKE OF SUBSTANTIAL NOURISHMENT AND FLUIDS.

Aunt Mae is not terminal as evidenced by the panel of 3 doctors who have moved her to UAB medical center. She was never comatose or vegetative and her Living Will has never fully been honored.

ALL WE ASK IS THAT SHE RECEIVES THE BEST MEDICAL TREATMENT AVAILABLE...AND THAT IF SHE IS NOT ABLE TO DO SO HERSELF WITHOUT DIFFICULTY, THAT THE MEDICAL PERSONAL PROACTIVELY INSURE SHE IMBIBES the proper amount of daily minerals, vitamins and NOURISHMENT / FLUID - substantial meaning either adequately balanced meals or enough ensure, fluids or if she is unable or unwilling to take orally, IV fluids and a nasal feeding tube to make sure she has the proper nutrients, vitamins and minerals to allow her to remain alive.

Be it at home, in a hospital or a nursing home or in one of our homes...she needs help and thank the good Lord she is finally receiving it via Doctor Aqel at UAB.

Kenneth Mullinax