Charlie:
XXXX Thank you for helping us to interpret the "jargon." XXXX
>The emboli seem to be the cause of death but I don't see a cause or a
source for them.
XXXX We didn't either.XXXX
>> That may explain the hallucinations, but does not say what killed
Joe.
>> In his post mortem report, the coroner says: "An anatomical cause
of
>> death has not been demonstrated," but the official cause of death is
"apneic
>> seizure" and "by what means": "natural."
>
>I think they are saying here in layman's terms that he stopped
breathing. Not
>that he had a classical seizure but I am not entirely certain.
XXXX I 'think' the hospital records show there were spasmic movements
about 4 am that we believe were mistaken as Parkinson movements by the
psych staff.XXXX
>> "The detected level of Amantadine exceeds concentrations associated
with the
>> therapeutic administration of the drug . . . Whereas central nervous
system
>> toxicity including nervousness, confusion, hallucinations, seizures
and
>> coma, has been associated with plasma concentrations of 0.1 to 0.5
mg/100 mL
>> . . ., fatalities attributed solely to Amantadine have been
associated with
>> blood
>> concentrations of 2.1 mg/100 mL . . . . and greater."
>> Joe's Amantadine level was 1.3 mg/100 mL.
>This is interesting. If he took too much amatadine (due to some
confusion etc.)
>or he was accumulating it in his system through metabolic means it
could
>account for his confusion but still doesn't answer the question of
where the
>emboli came from that presumably killed him. Another possibility is
that he took
>amatadine just prior to death giving a peak value rather than steady
state.
XXXX When Joe was released from hospital (Friday) he was taking 300mg of
Amantadine per day. On Sunday we took him back to ER after hallucintaing
all night. The Amantadine was reduced to 200mg a day, and Joe was sent
home. Late that night (3 am) the hallucinations got so bad we took him
back to ER. When the MDS assessed him about 8.30 am, the Amantadine was
to be reduced to 50mg 2x day. The last dose was administered about 10pm,
and Joe died about 7.30am.
Your suggestion that it might have accumulated in his system appears
reasonable. For much of the last day or so, Joe was "wired" and showing
no physical symptoms of Parkinson's, yet we were still giving him
Sinemet (it too had been reduced by this time) through a stomach tube,
under doctor's orders. That didn't seem logical then, and seems even
less so now.... XXXX
>I think that the question of what killed Joe will always be up for
question but
>the most likely cause is the emboli (of undetermined origin) as the
Medical
>Examiner stated.
XXXXAgain, thank you. Your condolences and knowledge are both very much
appreciated.XXXX
Al & Judith
--
Judith Richards, London, Ontario, Canada
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