June 29 2016 12:21 AM

California’s End of Life Option Act became effective this month

Eurika Strotto (right) and her wife, Nita, at their friend's wedding on June 11
Photo courtesy of Abbie Cory

    In the living room of the University Heights home that she remodeled herself, 54-year-old Eurika Strotto sat in her favorite La-Z-Boy chair. She’d found relative comfort in that recliner after being diagnosed with Lou Gehrig’s Disease (amyotrophic lateral sclerosis, or ALS,) two and a half years ago. During that time, the neurodegenerative disease debilitated her muscles, hindered her motor skills and subjected her to a breathing mask.

    On June 13, in her recliner, Strotto became one of the first in San Diego to take advantage of California’s End of Life Option Act, which went into effect on June 9 after 25 years of effort. Strotto’s funeral took place Sunday.

    Her friends, family and doctor described her final days to CityBeat, recalling a woman who thought of others first, and who was ready to leave the prison that her body ultimately became.

    Although Strotto’s prescription was written on June 9, she had a few things left to do, including attending her friend’s wedding.

    “She wanted to go and not take her life until after that— not so much because she wanted to see them get married, but because she didn’t want them to be sad on their wedding day,” said Abbie Cory, a close friend of Strotto. “That’s how she was, always thinking about the other person.”

    Strotto said her goodbyes that day, and more on the next day at her living memorial. “She had what she called ‘The party to end all parties,’” said Dr. Sunita Shailam, a physician from Sun Health Medical clinic who prescribed Strotto’s final medication.

    Sitting in her La-Z-Boy that day, too, Strotto ate pork roast made by her brother, indulged in her favorite South African dessert made by her niece, and connected with everyone one last time.

    “It was a mixture of tears and laughter,” Cory said. “She was saying goodbye to everybody, and it was a party at the same time. People would come and talk to her and spend time with her, and then go into the backyard, which we dubbed the relief area, so you could go and laugh, and let go of the stress of saying goodbye to her.”

    After the party, Strotto watched that night’s episode of Game of Thrones, but didn’t finish it, opting to save the rest of the episode to watch on her final day.

    “Then she was eager, and she said to her wife Nita, ‘Mix up the pills, I’m ready to go,’” Cory said.

    Oregon pioneered the legalization of aid-in-dying drugs in 1997. Since then, 991 people have taken advantage of the law there. Right-to-die laws also exist in Montana, Vermont and Washington. California’s new law was propelled by the very public story of Brittany Maynard, a young woman with terminal brain cancer who moved from California to Oregon to die with dignity.

    Although a 2015 Gallup poll measured that 68 percent of the American public supports medical aid in dying, there is already active opposition to California’s new law from religious groups, as well as medical ones. The day before the act was put into effect, six doctors from the American Academy of Medical Ethics filed a lawsuit in Riverside County, requesting the district attorney temporarily deny the law’s implementation. Controversy also surrounds the availability and expense of the two most commonly used drugs, pentobarbital and secobarbital.

    Pentobarbital has not been available in the United States since 2014, said Dr. David Grube of Compassion & Choices, a right-to-die advocacy group.

    In choosing secobarbital, Strotto would have paid $3,300 to take the effective dosage of 100 tablets, Shailam said. Instead, Strotto was prescribed a more cost-effective alternative, recommended by Compassion & Choices.

    Strotto took an anti-nausea medication, followed by high doses of two prescriptions: Lorazepam, a sleep-inducing anti-anxiety medication; and amitriptyline, an antidepressant used for insomnia and pain, Shailam said.

    The process wasn’t completely fluid. The dosage gave Strotto nausea and she had to fight to keep it down.

    “Then she went to sleep,” said Cory, who was not there but spoke to friends and relatives of Strotto. “Apparently, she sort of woke up once or twice. The first time she woke up, Nita said, ‘You’re still here?’ and Eurika actually laughed. But then they said, as her respirations were getting slower and slower, she smiled.”

    After an hour, Strotto’s hospice nurse showed her how to take an extra dose of morphine, and within 15 minutes she had completely passed away, Shailam said.

    This was the first time Shailam prescribed the medication, and she says she would do it again.

    “She wasn’t getting better, and she was only going to get worse, and there was really nothing I could do to stop the progression of it,” Shailam said. “The one thing that I could do to help her and comfort her was to give her this prescription and prevent further suffering. Anything I could do to make her happy and comfortable, I was going to do it.”

    Strotto requested that her brain and spine be donated to the University of California, San Diego School of Medicine. Her donation could help clarify the clouds surrounding an ALS diagnosis. At UC San Diego Health’s ALS Clinical Trials program, donated brain and spinal tissues affected by ALS are compared with healthy tissues to better understand the disease’s phenotype and genotype, said Ivy Cass, a research coordinator there.

    “The [central nervous system] samples are really, really valuable in terms of understanding, not only what causes ALS, but also how to treat it because there’s still so much to learn about the disease,” Cass said.

    That is exactly what Strotto wanted, Cory said. “She hated having the disease, and she wanted to do whatever she could to prevent anybody else from having it or if they had to have it, to help find a cure,” she said.

    From the comfort of her La-Z-Boy, Strotto was the one consoling her friends in her last moments, rather than the other way around. “She was done with living in that body,” Cory said. “I told her that I didn’t want to let her go, but that I was happy she was going to be free. She said to me, ‘I’ll see you on the other side.’”


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