Aoh, Those Muscle Cramps!

"Experimental data in healthy college-age men suggests that pickle juice inhibits muscle cramps through a reflex involving a nerve in our threats."

"It's why a tablespoon of pickle brine hitting the back of the throat seemed to bring relief within seconds."

"Pickle juice may also work for cramps that aren't induced by exercise. A randomized controlled trial published last year found that a sip of pickle juice reduced muscle cramp intensity in patients with cirrhosis."

"Researchers believe this improvement is due to a similar reflex that occurs almost immediately, rather than by how pickle juice is metabolized by the gut."

Dr. Trisha Pasricha, Ask a Doctor 

Anyone can suffer from leg cramps, they often occur during night-time sleep with no warning; alternately while exercising, and doctors really have no answers that would satisfy the question why it is they occur at all. Muscle cramps are well known to occur frequently among the elderly population and with athletes, during pregnancy, and dialysis, as well as with people with health conditions such as diabetes, cirrhosis or amyotrophic lateral sclerosis.

Midsummer appears to be peak time for leg cramps, while their occurrence has a tendency to decrease during the winter, one study concluded. Athletes experience cramping which tends to increase in periods of hot weather, even while the cramps are not seen to be related to dehydration and electrolyte imbalances from sweating, a popular misconception.

There is no evidence available how best to treat cramps. There are however, two simple solutions that doctors may recommend: to stretch the muscle gently. Or to take a sip of pickle juice. Athletes, it appears, have long sworn by the efficacy and instant relief given them by pickle juice, as bizarre as that may seem. Pickle juice, strained from jars of dill or kosher pickles; alternately other acidic substances like mustard or apple cider vinegar.

"A sip is all it takes. We're not telling people to chug pickle juice", hepatologist at University of Michigan Elliot Tapper said, the 2022's study lead author. Additional research on the effect of pickle juice on muscle cramps is needed. The strategy could be somewhat less helpful for those people with rare leg cramps, or cramps that tend to be of short duration, to justify keeping pickle juice available on short order.

Medical practitioners suggest trial-and-error approaches in the prevention of leg cramps; a few weeks of daily calf and hamstring stretching (reducing the severity, not the frequency of nocturnal leg cramps), magnesium (a recent meta-analysis found this likely produces little effect), or vitamin B complex (which showed some promise in a 1990s small study). Long-acting beta-agonists such as found in Advair or Symbicort and diuretics like spironolactone could be exchanged by a physician for alternate medications.

A double-blind randomized controlled trial published in JAMA Internal Medicine in 2017 found that taking magnesium oxide for a month reduced the number of night leg cramps by about three times weekly, significant enough to go from waking to cramps every night in favour of the same every other night.

• Stretch and massage. Stretch the cramped muscle and gently rub it. For a calf cramp, keep the leg straight while pulling the top of your foot on the side that's cramped toward your face. Also try standing with your weight on your cramped leg and pressing down firmly. This helps ease a cramp in the back of the thigh too.For a front thigh cramp, try pulling the foot on that leg up toward your buttock. Hold on to a chair to steady yourself.
  Apply heat or cold. Use a warm towel or heating pad on tense or tight muscles. Taking a warm bath or directing the stream of a hot shower onto the cramped muscle also can help. Rubbing the sore muscle with ice also might relieve pain.   Mayo Clinic

Looking Ahead To A COVID Fall/Winter Renewal

"The good news is that the epitopes [parts of the spike protein] recognized by T-cells, which are critical in protection against severe disease, have remained relatively well conserved."

"So, even if you were only vaccinated with the original ancestral strain, protection against severe disease in those who are relatively young and healthy appears to be holding up."

"I believe we should stop trying to prevent all symptomatic infections in healthy, young people by boosting them with vaccines containing mRNA strains that might disappear a few months later."

Dr. Paul Offit, member, U.S. Food and Drug Administration vaccine advisory committee

"My worry is that we will have very low uptake of vaccines in the fall."

"[SARS-Cov-2] has evolved dramatically in the last three years. The mutations that have emerged in many ways makes the virus nearly unrecognizable to the immune system, and to the protections we had in place against the original variant."

Dr. Fahad Razak, internist, Unity Health, Toronto, past scientific director Ontario COVID-19 scientific advisory table

Moderna's bivalent COVID-19 vaccine was among those being offered by health-care workers at a vaccination site in Brampton, Ont., on Oct. 11, 2022. (Turgut Yeter/CBC)

 

Dr. Matthew Tunnis, immunologist and executive secretary to the National Advisory Committee on Immunization (NACI) speaks of diminishing vaccine uptake -- that the public with respect to COVID vaccines may be approaching "sort of an acceptability settling point". And to address the issue, additional "promotional activities" and communication strategies may be required in the interests of being able "to explain and rationalize what value the vaccine program can bring".

Outside Canada, some experts in the field question the requirement for yet another expansive round of boosting. A member of the U.S. Food and Drug Administration's vaccine advisory committee wrote "I believe we should stop trying to prevent all symptomatic infections in healthy, young people..." in the New England Journal of Medicine, earlier in the year. Dr. Offit feels that boosters are "best reserved" for  high-risk groups like the elderly and the immunocompromised.

Human T-cell defence, cellular immunity, appears to be coping with SARS-CoV-2 mutations, he feels, to the point that the level of neutralizing antibodies fail to tell the entire story. A sizable proportion of the Canadian population has given signals of being booster-weary, just as have populations elsewhere in the world. At least two doses of a COVID vaccine covers 83 percent of the population, over half, 51.5 percent, are "fully vaccinated" with a third dose, according to the COVID-19 Vaccine Tracker.

On the other hand, a mere 26 percent of Canadians from age five and older received one of the bivalent vaccines rolled out last September; a 50-50 mix containing some of the original strain along with the then-rapidly spreading Omicron subvariants BA.4 and BA.5. If someone hasn't been vaccinated as of today, Dr. Razak cautioned, "don't go out and get vaccinated now, unless you have a specific, high-risk reason to do so". Wait until updated shots are available, come fall.

Now under review by Health Canada, the latest formulations entirely dropped the original strain which is considered no longer in circulation. The target is newer Omicron subvariants, specifically the dominant currently-circulating stain XBB. "Individuals vaccinated with the updated formulation are expected to benefit from a better immune response against these variants in comparison to current vaccines", the latest advice from NACI.

Come fall, for those previously vaccinated against COVID-19, NACI recommends a dose of the new vaccines for people in any age groups who are ultimately authorized to receive them, at least six months from their previous COVID vaccine or identified SARS-CoV-2 infection. Immunity from even hybrid protection; vaccination plus infections; wanes with time.

COVID is no longer the unpredictable, severe respiratory disease it once presented as, with overwhelming COVID pneumonias where people rapidly deteriorated. requiring high levels of oxygen, and many of these patients dying..."are very, very rare now", assured Dr. Razak.

A pharmacist administers a coronavirus booster dosage at a vaccination clinic in Lawrence, Mass. (Charles Krupa/AP)

"[The best way to protect the vulnerable] is to have everyone boosted."

"It's imperative we get vaccinated so that during cold and flu season we don't see the same disruptions to health care that we saw last year."

"[Part of the problem is calling them] boosters -- suggesting a] top-up. Like a yearly flu shot] you can't reasonably expect to be protected from symptomatic infections or hospitalization unless you are recently vaccinated with a matched vaccine."

Dawn Bowdish, immunologist, McMaster University

COVID-19 Vaccination Critical Decision Making

"I’m not aware of data showing that there is efficacy beyond two months of the first dose. In the past few weeks, we’ve seen different studies come out showing that the response to the first dose of the vaccine in the people who are elderly, in the people who are immuno-compromised is actually not that good and it wanes quite rapidly."

"I’m sure they’re following this [updated findings] and they may well be looking at perhaps modulating the recommendation as we go."

"As data emerges about what it takes to protect [seniors and immune-compromised people], we need to be reviewing what we’re doing."

"[As long as there aren’t issues with the vaccine supply, reverting to the original recommendations from the pharmaceutical companies] would be the ideal approach."

"The very people we want to protect the most require that we give them the second dose using the shorter interval, originally as done by the manufacturer in the clinical trials."

"The one-size-fits-all approach really needs to be modulated in terms of who we need to be protecting."

Canada’s chief science adviser Dr. Mona Nemer

A health care worker prepares a first dose of the Moderna COVID-19 vaccine to administer to a Palestinian laborer who works in Israel at a coronavirus vaccination center set up at the Gilboa checkpoint crossing between Israel and the West Bank city of Jenin, Monday, March. 8, 2021. (AP Photo/Ariel Schalit)

"One size does not fit all."

"Cancer treatments have profound effects on the immune system and cancer patients' immune mechanisms are inferior."

"We need to be concerned about other vaccines [in addition to Pfizer's] for this population, too. They do need a second dose quickly."

Dr.Sheeba Irshad, lead researcher, study, King's College London/Francis Crick Institute

"The National Advisory Committee on Immunization (NACI) is an External Advisory Body that provides the Public Health Agency of Canada (PHAC) with independent, ongoing and timely medical, scientific, and public health advice in response to questions from PHAC relating to immunization."

"In addition to burden of disease and vaccine characteristics, PHAC has expanded the mandate of NACI to include the systematic consideration of programmatic factors in developing evidence-based recommendations to facilitate timely decision-making for publicly funded vaccine programs at provincial and territorial levels."

• NACI has considered evidence from recent scientific studies on efficacy and effectiveness of COVID-19 vaccines in preventing various health outcomes such as infection, symptomatic disease, hospitalizations and death from COVID-19.
• While studies have not yet collected four months of data on vaccine effectiveness after the first dose, the first two months of real world effectiveness are showing sustained high levels of protection.
• Short term sustained protection is consistent with immunological principles and vaccine science where it is not expected to see rapid waning of a highly effective vaccine in adults over a relatively short period of time. Extending the interval between doses was shown to be a good strategy through modelling, even in scenarios considering a six month interval and in theoretical scenarios where waning protection was considered.
• NACI recommends that in the context of limited COVID-19 vaccine supply, jurisdictions should maximize the number of individuals benefiting from the first dose of vaccine by extending the interval for the second dose of vaccine up to four months.
• Extending the dose interval to four months allows NACI to create opportunities for protection of the entire adult population within a short time frame. This will not only achieve protection of the adult population, but will also contribute to health equity.
• NACI will continue to monitor the evidence on effectiveness of extended dose intervals and will adjust recommendations as needed.

Government of Canada, National Advisory Committee on Immunization

 

The Government of Canada found itself -- through a series of decision misadventures -- in difficulties procuring sufficient vaccine doses to inoculate the most vulnerable among its population, which led to an issue of maximizing the doses available. The United Kingdom had decided to space out the time between the first and second dose of its vaccines to enable vaccinating a greater number of people, and Canada made the decision to go the same route. Both Pfizer and Moderna whose vaccines were the first Canada received, recommend on the basis of their research no more than 21 or 18 days respectively between doses.

 

Health Canada and the National Advisory Council on Immunization agreed that it would be feasible to stretch the time between doses to 105 days, the delay enabling the dosages to go further so that greater numbers of people could be vaccinated. This was seen as a critical intervention for several reason, the first being that more people would be protected against the virus; it would give a boost to Canada's economic recovery; and concerns over the emergence in Canada of three COVID-19 variants, from the UK, South Africa and Brazil were spurring a third wave which they hoped to be able to arrest.

Despite the decision to leave a greater space between inoculations for each individual in the belief that sufficient protection would arise from the protective effects of the first shot, many medical experts profess unease at the decision, warning that the vaccines' efficacy would be compromised, The manufacturers themselves feel the decision to be unwise, given the results of their own research; those very results which led to the vaccines' authorized use by Health Canada to begin with.

Now, a new study conducted by a team of researchers at King's College London and the Francis Crick Institute has discovered how inimical delays in administering the second dose turns out to be on the mortality rate among cancer patients. Lengthening the time between doses being administered to cancer patients renders them far more vulnerable to contracting COVID-19 and suffering morbid effects as a result of that delay and consequential vulnerabilities.

According to the study, those with cancer or who have had cancer are considerably less "protected" should they be placed in the position of waiting longer to receive their second dose of vaccine following the administration of the first. Dr.Sheena Irshad, lead scientist on the project, informs that a prolonged wait for the second dose leaves people unprotected, during which time opportunistic new variants have emerged that are more contagious. 

 

Canada sees about 225,800 new cancer cases annually, while two million Canadians currently suffer from cancer or have had cancer.Three weeks following one dose of the Pfizer vaccine, according to the study, an antibody response was found in only 39 percent of people with cancer, in comparison to 97 percent for those without cancer. Should a second dose be administered three weeks later, cancer patients' antibody responses rise sharply, matching those of non-cancer patients. Delayed, the response remained around 39 percent.

Britain's 12-week gap (Canada's is 15 weeks) should be immediately reviewed, urges Dr.Irshad. Breast Cancer Now has recommended the U.K.'s vaccine committee to "urgently review the evidence presented in this study and consider adapting its strategy", to ensure that people with cancer receive both doses within the recommended three-week period. A spokesperson noting: "Anyone undergoing cancer treatment should continue to follow the advice of their doctors and we encourage all who can to take up the vaccine".

Guerina Morra, 81, gets her first dose of the Pfizer-BioNTech COVID-19 vaccine at Caboto Terrace in Toronto on Thursday. Experts say the confusion around vaccine safety recommendations is unfortunate given the number of unvaccinated seniors in Canada at risk of severe COVID-19 complications. (Evan Mitsui/CBC)

Antipsychotic Medication As an Answer to Elderly Depression, Loneliness

"In the days before nursing homes became so highly regulated, many facilities used medications to chemically sedate their residents. Elders who were calm and slept a lot were easier to manage and required less attention from staff members. Therefore, many homes considered drugging patients to be both efficient and cost effective."

"Anti-psychotics and sedatives were frequently prescribed to calm patients, especially those who had Alzheimer’s disease or other forms of dementia. In some cases, a low dose may have been beneficial for residents and staff alike, but these medications are very powerful. They can affect seniors and dementia patients differently compared to the general population, and some even carry black box warnings, indicating that adverse reactions may cause injury or death."

Carol Bradley Bursack, Minding Our Elders, AgingCare 

"[An] additional 1,000 residents are being prescribed antipsychotics who were not on the medication before the pandemic."

"[Such] knee-jerk reactions to try and medicate the distress of residents in nursing homes [during the COVID-19 pandemic] are a serious concern."

"[Antipsychotics come with a] black-box warning [for the elderly. They increase the] risk of stroke, falls and all-cause mortality, and are not recommended for frail, older adults [such as those with dementia, who make up about 70 per cent of nursing-home residents in Ontario]."

Toronto geriatrician Dr. Nathan Stall

 

During the pandemic, nursing homes have seen fit for safety reasons during a time of high viral contagion, to restrict visits from outside sources to elderly residents of long-term care homes. In some instances, residents have been confined to their rooms in a contagion-preventive measures, and see no one but the personal care worker assigned to them, on an irregular basis. They fall into a state of confusion and depression, and are consequentially drugged to make them more complacent, less aware, the drugs leading them to long periods of sleep when overworked and/or insufficient staff haven't the time to look after their needs.

This, at a time when nursing and long-term care institutions lack modern upgrades in hygiene practices, where in many homes, they place their residents in double-, triple- and more -occupied rooms with shared bathrooms where it is difficult to maintain distancing, much less adequate hygiene. Nursing homes throughout Ontario, throughout Canada, account for fully 80 percent of the national deaths attributed to COVID-19, among their frail, elderly residents. They are badly understaffed, unequipped and trained to be able to handle their patients at this critical time of a global pandemic.

The practise of dispensing drugs in this manner has been criticized in the past for using drugs to pacify elderly patients so that they require less care and fewer concerns, and the practise, given bad publicity, was seen to abate. Since the SARS-CoV-2 epidemic has entered country after country, threatening the elderly and the health-compromised, psychotropic medications prescribed for older people has once again entered the scene. Care homes see older people's emotional turmoil, a lapse in cognitive abilities, and have once again turned to drugging patients.

Antipsychotics, antidepressants and benzodiazepines like Valium or Klonopin are in increasing use. Scientific research shows links between social isolation and loneliness, contributing to physical and mental health deterioration and often contributing to the development of dementia -- including Alzheimer's. Above all, when the elderly are confused and isolated and the opportunity to see and touch those who love them is removed, a critical element of human need is denied them.

Lenora Cline, 88, Alzheimer’s  Ed Kashi/Human Rights Watch

Seeing the use of these drugs as a remedy for the acute state of disequilibrium in the elderly, may keep them quiet, but its deleterious effects on the elderly can be just as devastating as contracting COVID-19. A dramatic increase in the use of medications to older people was found through a study of care homes in Ontario. In the United States, clinical studies have pointed to serious side-effects of antipsychotics; nervous system problems, cognitive decline, strokes and an increased risk of death in those with dementia. Benzodiazepine is associated with increased falls, pneumonia and death in the elderly.

"The effects of prolonged social isolation during lockdowns", including restrictions on visits from loved ones and suspension of social activities and group dining is linked to the increase of harm to the elderly in long-term care homes, according to the Ontario study. Similar findings were reached in the United Kingdom when it was noted increased loneliness and human touch deprivation during the pandemic led to an increase in drug use "probably in response to worsened agitation and psychosis" associated with restrictions due to COVID-19.

Research from 2017-18 in the United States and 2018-19 in Australia discovered psychotropic medications to be overused in nursing homes, according to documentation by Human Rights Watch. Typically, the medication comes into use when residents become more of a burden of care, the drugs leading to more compliant behaviour, the patients more easily handled. "Chemical restraint" is what medication used for the purpose of behaviour control lacking a therapeutic purpose, is referred as.

The Mental Health Burden Associated With COVID

(Pexels/Adrianna Calvo)

 

"It definitely was a surprise. The elderly ... were thought to be most at risk of contracting COVID and having severe complications ... "

"They certainly are more likely to have built some level of resilience, and are not expecting the very worst-case scenarios."

Dr.Vincent Agyapong, psychiatry professor, University of Alberta

 

"Young people are doing especially badly, probably related to loneliness and maladaptive coping strategies." 

"Although older people are more prone to virus infection/complications, I would not expect them to be worse off psychosocially."

"The link between economic/employment security and mental health -- which is a powerful hazard at this time -- is not generally applicable to older people."

Dr.Roger McIntyre, psychiatry professor, University of Toronto

Published in the International Journal of Environmental Research and Public Health, the Alberta study led by Dr.Agyapong surveyed 8,300 individuals who had downloaded the province's Text4Hope app which sends out text messages to users with the designed purpose of offsetting negative feelings during the time of the global pandemic -- in the population at large among whom some choose to make use of the app for that very specific purpose.

Of the 9,011 Canadians who had lost their lives as a direct or indirect result of COVID-19 to date, close to 97 percent were aged 60 and over. The Alberta research study suggests that it is in fact, people under age 25 who are most at risk of becoming seriously anxious, depressed or stressed over the coronavirus and its fallout, affecting their lives negatively.

The survey respondents admittedly represent a 'snapshot', failing to statistically reflect the makeup of Canada's general population, according to Dr.Agyapong, but the apparently counterintuitive findings do match the type of young patients he has been exposed to at a drop-in mental-health clinic in Edmonton. There are, he suggests, a number of logical explanations for the research findings.

For one thing, older people build up over a long life greater psychological firmness to the economic uncertainly individuals everywhere are facing, particularly those entering adulthood at a time of deep recession. The study was interesting, but not completely surprising to another expert studying the mental-health fallout of the pandemic and lockdown.

According to Dr.McIntyre those under 40 years of age and students are at high risk for depressive symptoms, reflected by a recent 'meta-analysis' of pandemic studies published by himself and colleagues in another study which was recently published. Along with Chinese researchers, Dr.McIntyre found an increase in depressive symptoms among Wuhan residents, depending on the amount of time spent on social media during the pandemic.

The authors of the second study hold the spread of COVID-19 misinformation over online platforms at fault; possibly amplifying panic and resulting in risky behaviours. In the Alberta study of the 823 respondents age 25 and under, 96 percent demonstrated moderate or high stress, 66 percent signs of anxiety disorder, and 67 percent major depressive disorder; representing the highest levels of four age groups.

Of the 475 respondents in the 60-and-over group, rates were 68 percent for stress, 23 percent for anxiety and 26 percent for depression --  the lowest affected levels of the groups. It can be generally acknowledged that younger people struggle with the fact that their more mobile active lives have been disrupted by the virus and lockdowns; schools closing, part-time work evaporating and gyms shuttered, notes Dr.Agyapong.

Whereas for older people, in particular those who have retired from the active workforce, they have less economic uncertainty to face, and have acquired experience in dealing with adversity at various levels.The Text4Hope app appears to be helping to generate positive feedback that Dr.Agyapong and his colleagues plan to mine for content in forthcoming journal papers.

The Text4Hope program has drawn attention from other quarters facing the very same dilemma of downward spiralling mental health leading to two states in Australia discussing how they might also set up their own version. As a result of the study and its publication, Dr.Agyapont has been receiving calls and emails expressing interest from the United States as well.

The positive feed back for the Text4Hope app appears to be helping people, on the evidence of the positive feedback that Dr.Agyapong and his colleagues have been receiving, and which has inspired them to plan to report on it in additional journal papers for publication.

"We can be unhappy about many things, but joy can still be there. It is important to know that at every stage of our life, we have an opportunity to choose joy", read one recent app-generated message.

The Penalties for Defrauding and Victimizing an Elderly Woman?

"[The lawyer's actions] were a direct infringement of Mrs. Piela's fundamental rights."
"She was deprived of her freedom, forced to leave her home and taken by force into a private seniors' residence."
Quebec Bar Association, disciplinary committee

"[The subsequent medical report found] that she was totally capable of taking care of herself, she had an excellent memory, [and] she didn't have Alzheimer's."
"The police officers came to the house, they entered by the back door, so she started to scream and so the police officers called an ambulance and covered her mouth."
Igor Dogaru,lawyer for Veronika Piela, 94

Veronika Piela, 92, in December 2016. She says people took control of her life with a forged mandate and had her placed into a residence with no access to a phone or visitors. Phil Carpenter / Montreal Gazette

Imagine you've reached beyond 90 years of life, are a capable individual with a home of your own and manage all your own affairs. Age has done nothing to impair your memory, your facility with looking after yourself. You value your independence, and treasure your lifestyle, including your enjoyment in continuing to live in your home. You have a healthy bank account and decide to advertise for someone to come in from time to time to help manage some of the aspects of living independently, so you hire a woman and trust her and then everything goes wrong.

Veronika Piela who had immigrated to Canada after the Second World War, was most comfortable speaking Polish or Ukrainian. While she was still physically active, her knees were becoming a problem getting around, and she needed some help. She knew someone from the church she attended, and it was that person's daughter, in her 50s, whom she hired for general help in 2013. She paid Anita Obodzinski to help in her apartment, a bit of cleaning, shopping for groceries, feeding the cats. With no relatives close by much less children of her own, she relied on this woman to aid in her independence.

Anita Obodzinski prepared a mandate that gave her control of Veronika Piela’s personal protection and belongings if Piela were ever to become incapacitated. She later claimed she was Piela’s niece.

One day when she discovered money was missing, Veronika confronted Anita and dismissed her, informing the younger woman her services were no longer required. Six months passed, when suddenly Anita appeared at her apartment, accompanied by her husband ArthurTrzciakowski, demanding that she sign some papers, and she refused. The two rough-handled the elderly woman, who sustained cuts to her arms, insisting she sign the documents, until she relented: "I said 'Please, take everything. Please, leave me alone. Leave me alive. I need that'."

As soon as the two left, Veronika called the only two people she knew well in Montreal; her pastor and a notary, who referred her to lawyer Igor Dogaru who responded by sending a formal notice for Obodzinski to refrain from contacting her former employer at any future time. Unknown to both was that Obodzinski had prepared a mandate to give her control of Piela's personal protection and belongings should Piela ever become incapacitated, claiming she was Piela's niece, in a later affidavit.

She then proceeded to hire a social worker, Alissa Kerner, who just happens to be lawyer Gelber's wife. and advised her to prepare a psychosocial report, to state that Piela was incapable of looking to her affairs, impaired by ill health, both physical and psychological, which would accompany a medical report by Dr. Lindsay Goldsmith stating that Piela suffered from Alzheimer's disease. Obodzinski's plan was to have Piela declared mentally unfit to result in Obodzinski being placed in charge of Piela's affairs.

The report claimed Piela not only had irreversible Alzheimer's and dementia such that she was unable to take personal care of herself, was living in squalid conditions with cats, and that alcohol abuse made it additionally risky for her to continue to live on her own. "Mrs. Piela is unable to express herself within reason as her memory, insight and judgment are all severely impaired", wrote private social worker Alissa Kerner in her psychosocial report. Gelber, holding Piela's savings in trust, transferred $100,000 from Piela's account to Obodzinski.

The disciplinary committee of the Quebec Bar Association found that lawyer Charles Gelber, in acting for Obodzinski hadn't bothered to inform Piela or her lawyer that a court judgement had declared her legally incompetent. It found as well that he had failed to advise Igor Dogaru, lawyer for Piela that a request had been made to remove Piela from her home and into a residence for seniors. As well, Gelber's action in transferring substantial sums of Piela's savings to Obodzinski was clearly a criminal act, since reimbursed.

Obodzinski and her husband Arthur Trzciakowski both pleaded guilty in their roles plotting a scheme to defraud her former employer, with Obodzinski sentenced to two years house arrest and her husband, a conditional discharge. After pleading guilty to mischief and being unlawfully in Piela's home, Gelber's wife, social worker Alissa Kerner, received a conditional discharge, but was suspended by Quebec's order of social workers.

And the lawyer who used his legal know-how to underhandedly scheme with Piela's former employee to defraud the elderly woman who only managed to get a hearing in a court of law establishing her complete mental competence and outlining the manner in which all five people schemed to criminally defraud her -- has been suspended from practice, citing his role in forcing an elderly woman from her home by having her declared mentally unfit -- will serve an 18-month suspension after pleading guilty to seven disciplinary infractions.

A virtual slap on the wrist for all who were involved in his mendacious scheme to deprive an elderly woman of all she held dear, and take possession of her life savings in the process. A slap on the wrist for terrorizing an old woman, forcing her to live in a freezing basement where she was denied access to a telephone or any way in which she might contact the outside world. In the dead of a Montreal winter, she escaped, was found by police on a street without a coat and taken into custody. She asked for someone who could speak Polish and to that police officer described all that had occurred. The wheels of justice, as bitterly inadequate in this case as they proved to be, turned into action:

"A judge had ordered the curator to take charge of her file while the suit worked its way through the court system. It had been a long two years, but the personal documents that had been taken from her — her will, marriage papers, family photos, and more — were to be returned. A physical manifestation, of sorts, that she’s fully capable of taking care of herself."
"She’s also gotten most of her money back: Nearly $300,000 that had been transferred to the public curator from the in-trust account has been returned. Cheques for another $100,000 were sent to her last week. Another roughly $46,000 is gone, spent, and Piela’s lawyer says he is still trying to get it back. Ordered by a judge to account for the money spent from the in-trust account, Gelber wrote that $20,000 went to Obodzinski for items and services for Piela. Kerner was paid about $5,000 for her social work. Gelber was paid roughly $12,000 in legal fees. The rest went to Piela’s rent and a company to clean her apartment."
Montreal Gazette

Veronika Piela feels safe in her new residence, though her trust in people is shaken and a toll has been taken on her health.