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Privatizing prison care: Warm compresses, day of rest for cancer lumps

Even as lumps bulged from Donna Pickelsimer’s upper arm and back, Hernando prison’s medical staff prescribed Tylenol and hot compresses to treat her undiagnosed lung cancer.

Unable to bear the pain, Pickelsimer at one point wept that she wanted to cut her arm off.

That prompted solitary confinement.

Six weeks later, she was dead.

It’s likely Pickelsimer never knew she was dying.

Neither did the Corizon nurses and Haiti-educated doctor treating her, according to more than 800 pages of medical records provided by her family to The Palm Beach Post.

Some records omit information, or provide conflicting information. On s, dates are changed.

But available records show that Pickelsimer was weeks from death before malignancy was first mentioned and the cluster of lumps beneath her skin fully documented.

For four months, Pickelsimer begged for relief. Unable to dress herself or bathe, her arm hanging at her side, Pickelsimer’s unrelenting pain and worsening symptoms were variously treated as a rotator cuff injury, a cold and pockets of fluid which could be massaged away.

“I don’t know if medical could have prevented her death,” wrote Lisa Key, another inmate. “But they definitely could have prolonged her life and kept her out of so much pain.”

Cough, then pain

Serving 15 years on a manslaughter charge, Pickelsimer could have a tough exterior. So when she admitted feeling sick, Key was concerned.

“It started with a cough about a year ago,” Key wrote to Pickelsimer’s sister. “All medical would do was listen to her lungs and tell her they were clear. “

In February, a nurse noted that Pickelsimer, for 35 years a two-pack-a-day smoker, reported a chronic cough which had already lasted three to four months.

Less than four weeks later, when the cough got so bad other inmates complained, Pickelsimer was back in the clinic.

She had lost weight. She had pain in her back. She was given cough syrup.

When she began having trouble getting out of bed, she was allowed to take either Tylenol or ibuprofen.

The pain grew. “She couldn’t move her arm at all without screaming,” Key said. “She kept calling medical emergencies, but the nurses kept saying she was lying and that it was all in her head.”

Lumps began pushing their way to the surface of her skin. Nurses said they didn’t want to look at them, Key said.

Warm compresses

In mid-April, Pickelsimer was prescribed warm compresses. Her blood pressure shot to 162/104, above the threshold considered dangerous by Corizon. She was given two shots of painkillers plus a steroid, ibuprofen and aspirin.

On April 17, she was prescribed warm compresses.

On April 18, a doctor authorized one day of bed rest.

On April 21, she was prescribed ibuprofen and compresses.

She lost 12 pounds. Other inmates started doing her chores. She needed help dressing and bathing. She struggled to walk.

About this time, Pickelsimer was undergoing a battery of IQ tests. “I don’t know what is happening to my body,” she told the tester. “Extensive complaining,” wrote the tester afterwards. “Speech monotonous.”

On April 25, she returned to the clinic in tears, her eyes bloodshot, unable to raise or bend her red and swollen arm. She received a shot for pain relief, a warm compress and permission to stay in bed for a day.

On May 2, she said that she was in so much pain that she wanted to cut her arm off. “I want to die,” she told nurses. She was locked in an isolation cell.

However, alarmed at the lumps on Pickelsimer’s arms, a nurse called the doctor. He recommended that Pickelsimer massage the lumps and keep her arm elevated.

Delayed MRI

On May 5, an ultrasound technician found a mass in her arm. An MRI was recommended.

It was a week before the test was approved.

Pain spread to her back and hip. And Key noticed a new symptom. Her friend had become almost childlike, she said. Her vision was blurred.

On May 23, an MRI scan found a suspicious mass and recommended more testing.

Testing time, though, had run out.

On May 28, Pickelsimer was admitted on a stretcher to Lake Butler, site of a state prison hospital.

“I walked in, and it was horrible. I couldn’t believe it,” said her sister, Beverly Clancy. “Her left arm was full of lumps. They were all over her side.”

Eight days after being admitted, she got a chest scan.

Pickelsimer drifted in and out, but not because she was on powerful pain medication. Initially, she was given a form of Tylenol, said her sister. Morphine was not authorized for a week, records show.

A doctor’s nighttime note on June 7 showed that Pickelsimer’s blood pressure was falling. She no longer responded to painful stimuli.

Shortly before dawn, she died.

The following day, results of her chest scan were stamped received.

“Animals are treated better,” her sister said.

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