Thursday, Feb. 2, 2006 | 12:30 p.m.
Sick inmates at the women's prison in North Las Vegas are going without medication, leading them to fear for their imperiled health.
Prison officials acknowledge the ongoing problem, which they say is caused by a changeover in the state prison system's pharmacy service, but say it is not a cause for concern.
One inmate with multiple severe health problems requires a regimen of about 10 different pills, according to her medical records. But she says that since the problem began last month she never gets all of them and seldom gets any at all.
Interviewed at the Southern Nevada Women's Correctional Center on Sunday, 48-year-old Dianna Erlandson said she had not received a single medication in two days. Her hands and neck were visibly swollen and her breathing was labored.
"I have no energy," Erlandson said. "I get depressed. I get sweats. I bounce off the walls emotionally. I get dizzy. I constantly have diarrhea. Because I'm not getting my thyroid pills, my appetite is incredible - I've put on 20 pounds. Any day now a blood clot could get through to my heart and kill me."
And, she added, "There are people here worse off than me."
The prison system's medical director, Dr. Theodore D'Amico, did not address Erlandson's case individually but portrayed inmates who do not believe their treatment is adequate as mere complainers.
"There are occasions where people do not get exactly what they want, and that's why we have grievance procedures," D'Amico said.
D'Amico admitted that the moving of the system's pharmacy in the last month has led to glitches and delays in getting medicines to inmates.
All pharmacy services for the state's 12,000 prisoners are being centralized at the prison campus in Jean, which will serve as a mail-order center for inmate prescriptions, D'Amico said. When the system is fully functional, prescriptions should turn around in about a week, but currently it often takes two or three weeks, he said.
"Yeah, we have had some problems," D'Amico said. "With any facility, there are going to be some wrinkles, and recently the pharmacy has been a real problem. We're trying to resolve it."
Asked whether the medication glitches had yet been fixed, D'Amico said they had not.
"There might still be some delays going on, but we're on top of it," he said.
"Inmates get more timely care and a better quality of care than most people in the community in both the north and south of Nevada," D'Amico added. "Tell the inmate to file a grievance and I'll look into it immediately."
Documents provided to the Sun show that Erlandson is not a mere complainer but rather suffers from an array of serious health issues.
The documents also demonstrate that Erlandson already tried to utilize the prison's grievance procedure. Although officials replied that they would address the situation, she says matters did not improve.
Medical records indicate that in June 2005, before she was incarcerated, Erlandson took medication for depression, bipolar disorder, a thyroid condition and severe pain stemming from a broken and fused neck. According to Erlandson, she also suffers from arthritis and asthma.
A doctor examining her in June for a complaint of severe leg pain and frequent falling found narrowed arteries and noted that she would probably need surgery to reopen them, according to the medical consultation report.
Erlandson said a later examination diagnosed her with peripheral artery disease, the main symptom of which is leg pain resulting from arterial blockage. It can be lethal if not diagnosed and treated in its early stages. Treatment consists of exercise, medication and surgery.
Erlandson said the doctor at the North Las Vegas facility has refused to prescribe her drugs for this condition or to refer her for the surgery that would reopen her arteries.
Erlandson believes she is lucky to have survived a major bleeding incident that she thinks resulted from the breakup of a large blood clot in her right leg. She cannot be sure because she never got to see a doctor for it, despite losing massive amounts of blood.
The clot, she said, formed a clearly visible lump the size and shape of a cigar. One day she sat down to go to the bathroom and realized blood was pouring out of her so fast it nearly filled the toilet bowl. With the help of a worried guard, she was barely able to walk to the prison infirmary, where she lost more blood.
The prison nurse told Erlandson she probably had a hemorrhoid or ulcer, then sent her back to her room without summoning a doctor, Erlandson said.
Erlandson is in prison for violating probation on a minor drug offense - ingestion of methamphetamine.
In a brutal irony, when a judge in Lyon County, southeast of Carson City, sent her back to prison last August, he stated that he was locking her up for her own good, so that she could get the treatment she needed for her medical, mental health and substance abuse problems, according to a court hearing transcript.
"I think that her medical problems are such that it may be best for her, and for the county, if she were at the prison where she could be treated," District Judge David Huff said at the hearing.
Huff said Erlandson would probably serve only about a month in prison, expressing hope it would be enough to get her into better shape. That was five months ago.
Erlandson says she is no longer tempted to use drugs and has benefited significantly from psychological treatment in prison. But medically, she finds herself substantially worse off.
"For three and a half weeks in December, I went without any meds at all," Erlandson said. "I was climbing the walls, not sleeping, an emotional wreck and in a lot of pain. I filed a grievance, and they promised they would never run out (of medicine) again."
A memo on the prison's letterhead dated Jan. 11 confirms the response to Erlandson's grievance.
The prison's nursing director, Cheryl Dressler, writes in the memo, "I informed (Erlandson) of the problem receiving medications from pharmacy due to a recent relocation of central pharmacy. ... I instructed Ms. Erlandson to inform nursing when she was in need of her thyroid medication so she could be issued four-day (emergency) supplies."
However, on Sunday, Erlandson said she had received her last thyroid pill on Friday. "They told me that was the last one they have, and they don't know when they're going to get more," she said.
Erlandson's life has been a litany of misfortune.
Twenty years ago she was thriving as a construction equipment operator in Wyoming when she was raped and beaten so badly her neck and several ribs were broken. She spent months in a wheelchair and four years in physical therapy.
She had just recovered and gone back to work when a work vehicle in which she was a passenger swerved off the road and into a culvert, hurling her through the windshield and breaking her neck once again.
The second injury, which demolished her thyroid gland, sent her into despair. Nightmares kept her awake at night, and her inability to earn a living landed her in public housing.
"That's when I found out that there was a miracle drug where you didn't have to sleep," Erlandson said ruefully. The drug was meth. Before long she was also selling it.
She was arrested in 1993, cleaned up her act and successfully served out her probation for the offense. It was not until July 2004, when her dog died, that everything fell apart again.
Bubba, a 165-pound St. Bernard-collie mix, had been Erlandson's faithful companion for nearly 19 years. Many times over the years, she had slept on the street because she could not find an apartment that would take both of them.
"He saved my life a few times," she said. "He kept me going from day to day. When I lost him, I disassociated - I left myself."
Erlandson woke up in jail, unaware that she had been there for four days.
The following year, she tried to commit suicide several times, once by running in front of cars - "I was trying for trucks, but they have a way of dodging you," she said with a bitter laugh - and once by swallowing as many bottles of sleeping pills as she could find.
Once again, she sought solace in meth, eventually winding up in jail again when she couldn't get into mental health treatment or hold down an apartment long enough to satisfy her probation officer.
When the judge sent her to prison, she was initially placed in the women's prison in Carson City. There, Erlandson says, she was getting her medications and was on track to get the surgery she needed.
But in September, she was transferred to Southern Nevada with no explanation. Since then, her access to some drugs has been cut off, with the explanation that they were unnecessary or too expensive; the availability of other drugs has been spotty, and since the pharmacy changeover in December, almost nonexistent.
Erlandson claims she knows other inmates who are going without treatment for cancer, heart failure, lupus, diabetes and other serious conditions. As dire as her life was before she was put away, she says, she has never feared for her survival as she does now.
"The judge ordered me to go to prison so I could get the medical help and mental help I needed," she said. "I wasn't handling my health very well, it's true.
"He felt sure I would get the help I needed in prison."
Molly Ball can be reached at 259-8814 or at [email protected].
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