Question: Hello, Dr. Rynne. I lost one of my brothers to a fatal automobile accident last December. I am concerned that some or all of the Rx medications he was taking and had in his system could have been a catalyst to his having two heart attacks that afternoon/early evening and having lost brain cells, in an unconscious state, prior to the collision (he was actually T-BONED by a young female driver who was speeding). He was on and had in his system: Diphenhydramine, Fentanyl (patch), Hydrocodone, and Paroxetine. Please give me your assessment and opinion of whether these medications, combined in his system, could have preci-pitated such LOSS OF CONSCIOUSNESS AND LOSS OF BRAIN CELLS prior to his entering the intersection as believed FULLY AND TOTALLY IMPAIRED. Additionally, incredibly, he was seen by his main prescribing doctor within three hours of the crash and believed to have been administered all types of heart and cardiac tests by this same doctor's clinical staff of medical personnel. Lastly, my brother was given a speeding ticket just 30 minutes before the crash ... and HE ALMOST NEVER GETS ANY TICKETS, AND IS ALWAYS ATTENTIVE TO HIS POINT IN TIME AND SPACE AND HIS SURROUNDING ENVIRONMENT. I believe he might have also been impaired right before getting the ticket (which has since been retired by the D.A.'s Office). When you reply, please provide me with a printout of my comments and questions to XXXXXXX XXXX, brother of decedent, XXXXXXX XXXX, at my email of: YYYY@YYYY . Thank you very much.

For more information, my then-living brother was taking all the listed medications for many years. The Fentanyl patch was prescribed to him about 11 months ago. He did have a sleep-deprivation problem as well, but when he was awake, he did not just dose off. Incidentally, I have a similar problem myself in that I take NAPS to get my rest - have been doing this since 2010 -, as I no longer require sleep (I am providing this new information because I believe my brother might have had only tendencies to take NON-CATATONIC naps, but, as I have intimated, he was a BED SLEEPER (HE FOUGHT TO GET TO SLEEP AND STAYED IN BED MUCH LONGER THAN 7 HOURS), and I can actually get about three to four hours of NATURAL SLEEP by just sitting upright in an uncomfortable chair, even in a crowed and noisy room, and closing my eyes for twenty minutes in a semi-nap (NEVER LOSING CONSCIOUSNESS!!). Could my brother have had some type of similar condition to mine? I believe so, and also believe it could be some form of genetics that might run in my family, especially for us family members as we age and change our sleep patterns. BOTH MY THEN-LIVING BROTHER AND I ARE POOR REGARDING OUR FINANCES, AND WE STRUGGLE AND WORRY NO MORE OR NO LESS THAN OTHERS IN OUR SAME ECONOMIC DEMISE. And, we both have consequential Depression because of this and emotional upheavals in our past life styles, life cycles and individual lives. We were also near POLAR OPPOSITES in many, but NOT all, respects, mannerisms and behaviors. Thank you for your secondary reply and for your first reply.

Thank you very much, Dr. Shoman, for your condolences. I am most appreciative and satisfied for your answers to my questions on my deceased brother. I will definitely be using your services online in the future, as I am most pleased, satisfied and impressed for such KEY ON POINT answers. Thank you again most kindly. XXXXXXX XXXX