Avi and Belinda grew close in the summer of 2007. The near-neighbors met earlier that year and found each other easy company. They both liked acting and dancing. Belinda would join Avi in acting and dancing classes when she felt up to it. When exhaustion and pain left her bedridden in a dirty apartment, Avi organized a group clean-up to keep the place in order. In emergencies, he'd take to her the hospital. That was a busy summer. That July, Avi and another friend were planning a yard sale to help clean Belinda's apartment. Plans changed when Belinda called Avi: She was very sick. He hurried her to Cedars. Her liver enzymes and acetaminophen levels were high again. Doctors gave her more Mucomyst - the antidote - and released her a few days later. A doctor's note from July 10 states, "patient is not to take acetaminophen again, alone or in combo form e.g. Norco."
Narcotics are often mixed with other pain relievers to reduce their addictive qualities. Hydrocordone, the opioid in Norco and Vicodin, can be mixed with aspirin or ibuprofen, but most often it's mixed with acetaminophen. That was the combination prescribed to Belinda again and again. Medical staff encouraged her to take the pills rather than use Dilaudid, the opioid analgesic she preferred. She refused the Vicodin during a September 2005 hospital stay. "I explained she has to try it, if not effective she can have Dilaudid," a nurse wrote. Belinda refused the pills.
The pills still remained the default drug during Belinda's hospital stays. "Pain management flowsheets" are designed to help doctors track a patient's pain. A patient describes the type of pain, where it hurts and rates the pain on a scale of 0-10, with "0" meaning no pain and "10" meaning the worst pain imaginable. A January 2006 hospital flowsheet shows Belinda reporting a pain score of 8-10, describing the pain as "aching" and "continuous" in her head, abdomen and back. Medication would cut that pain score in half. The medication prescribed, most often, was acetaminophen or an acetaminophen-mixed narcotic. Cedars gave her more, several times before that fateful March.
And several times after. Cedars pain clinic notes are a puzzling assortment of warnings and prescriptions. September ... October ... November ... December 2006: Norco ... Vicodin ... Norco ... Norco and Vicodin. January ... February ... March ... April 2007 ... history of acetaminophen overdose ... history of prior hospitalization for liver failure ... concerns regarding narcotic addiction ... more Norco and Vicodin. And back in the hospital in July 2007 for acetaminophen toxicity. During this second hospitalization for liver troubles, Belinda had insurance. Her medical records for those days are scant. It's unclear if doctors reevaluated and rejected Belinda for a transplant, or if they didn't bother to evaluate her. It is clear that Cedars never referred Belinda to the transplant registry. UNOS' records show her placed on the list just once - by UCLA - at the end of her life.
In late October 2007, wildfires roared through southern California. They ravaged half a million acres of land , sending smoke into air for hundreds of miles. The air aggravated Belinda's respiratory problems. She took the old family standby, DayQuil, hoping it would help her breathe.
Belinda had big plans for Halloween 2007. Hex Halloween, an annual goth ball, is the place to be seen on the local goth scene that eve. It was Belinda's favorite event of the year. She planned to accompany Jonathan and her new friend, violinist Alexander De Lautreamont. She had her tickets and her makeup and the costume Alexander bought her. She would go as a "sexy vampire" - in an audacious little outfit with red-bowed black top hat, thigh-high-fishnets and red-satin slip beneath a short black velvet corset coat with flowing bell sleeves. There would be DJs and dancing. Nearly all her friends would be there.