To all and sundry. Ma and Pa should be back in the states by Wed. night. I have spoken with Uncles Mike, Peter/Donna and Clay/Carolyn to share the news.
Brendan
Tuesday, March 19, 2013
Leaving plans
Email from Ma on 3/18
Latest plan; lv hospital tomorrow a.m.
Go to same hotel we originally staid at - San Jose Holiday Inn Aurola.
LV San Jose 7:10 am Wed 10 Mar.
Fly thru Phoenix , then Denver, then LNK ( arv abt 8:55 pm).
Looks like travel ins will cover hosp bill+ physician bill ( TOTAL abt $7,000!!!) cannot imagine what this would be in USA. Will also cover all related expenses - I think this includes the copter ride which was told would be around $5000 ( last copter ride in Iowa to get pacemaker was $29,000).
It's time for bed now.
Love
Mother/Carol
Sent from my iPhone
Sent from my iPhone
Monday, March 18, 2013
More good news and potential med changes discharge imminent!!
Mom says
Echo: unchanged fr one done in NE(enlarged heart), Holter Monitor: pacer works ok, occasional PVC. Dx: TIA Cause unknown. I asked if fatigue & dehydration on hot muggy day poss triggers. Yes possible. Recommends start Plavix, chg atenolol to Coreg, wt loss. Suggests Dad talk w his cardiologist abt these med changes. Not changed here. Will leave w. full records including films. Will get 2 doses heparin - one now & one very early tomorrow morn. Now up & abt. No new sx Unsure if flying out on 6am flight tomorrow or what. Yet to be told. More later.
Michael's comment
Michael,
Dang blogger won't let me answer in reply to your comment so made a new blog post
Is calling the hospital technically possible: Yes, I use Google voice (.06$/min) I assume skype works too
See shum's post below for corrected number
I wait for hospital answering machine to answer, press 9 for English,
wait for the operator,
ask for English (most but not all of the operators have been muliti-lingual),
ask for room 406 (sometimes I am asked to provide Dad's name sometimes not) and
they transfer me to his room (room phone working as of today).
Welcome - I assume so. Although mother mentioned she was worried about being swamped with calls.
Times- I think they are 1 hour behind EST but not sure. Hospital time is tricky, hours of boredom intertwined with high stress/pace procedures, MD visits and then more tedium. I would recommend staying away from meal times. In my experience I have had more difficulty later in the afternoon/evening connecting through the hospital system. The less critical Father's condition is the more tedious this hospital time becomes.
Hangin in Bro...
Brendan
father laughs!
Spoke with Ma and Pa today. Both in much better spirits and well rested. Cardiogram was done this morning but hasn't been read yet. Mother says she is hoping for d/c tonight or tomorrow! Father is chatting and understanding nicely again. He says hi to all blog readers and hopes to be able to talk on the phone with you when they get back to the states and returns to cell phone coverage.
Mother has tried to get Skype working on her Iphone but hasn't had much success due to limited internet.
The insurance company and the travel company have been very helpful and will assist with transport back to the US when ready. They do not plan on continuing the tour in Costa Rica and expect to return home asap when discharged.
Mother tells a hilarious story about the "scary" helicopter ride and Father waving like the Pope to onlooking crowds of villagers.
Father took a shower....sorry slow news day :) which in and of itself is good news.
Sounding better and better. Still no cause identified for original symptoms but he seems to be coming out of the woods quite nicely. May need to look closer at diagnostics when they return to the States.
Brendan
Mother has tried to get Skype working on her Iphone but hasn't had much success due to limited internet.
The insurance company and the travel company have been very helpful and will assist with transport back to the US when ready. They do not plan on continuing the tour in Costa Rica and expect to return home asap when discharged.
Mother tells a hilarious story about the "scary" helicopter ride and Father waving like the Pope to onlooking crowds of villagers.
Father took a shower....sorry slow news day :) which in and of itself is good news.
Sounding better and better. Still no cause identified for original symptoms but he seems to be coming out of the woods quite nicely. May need to look closer at diagnostics when they return to the States.
Brendan
Email from ma
On my phone cannot connect to App Store ? Do have Skype acct but need to download skype for IPhone. Can email and connect to selective online sites ( I think the ones I previously visited ). Trying to access blog w/o much success. Will try again after you. Dad this morning: good sleep, no neuro residuals or new sx. Echo @ 11 ( Costa Rica doesn't do daylight savings ) He's reading via Kindle. Will allow him OOB for shower today. Peace Sent from my iPhone
Sunday, March 17, 2013
Good news!
Good news! CT of head & chest negative for bleed or clot! Carotid Doppler studies also clean. Tomorrow will read holter monitor & will have echo cardiagram @ 11 to rule out a large clot in heart that could be throwing off bits to the brain. Jim/Dad remains stable. Tonight, sleep Carol Ps phone in room still broken. Fixers are hiding on us. Sent from my iPhone
Brenda
Email from Brenda
DEAREST Brendan.
Thank you for keeping us all informed.
Carol and Jim are traveling with Grand Circle , a agency I have used for many trips.
I have heard that this agency is excellent in caring for medical problems - even accompany patients on air planes. Let us hope for the same.
Much love, Brenda Ballooooon
Spoke with Ma tonight. She is in good spirits but fatigued. No change with Father. No new symptoms. No results yet from the CAT. She says the doctor was in recently and has gone to look at/for the films. Mother will stay in the hospital with Father. She says they have a pull out bed and she can shower in the room. As if she were on vacation:).
For those who are reading this and do not know; Ma and Pa do not have working cell phones with them in Costa Rica. Nor do they have a computer. Mother is using her iphone to email. The phone is not working in their room. It took me 4 calls and a lot of patients to get through to her via the nurses station.
Father told me when I was young, "Time is short, waiting is long" quoting some poet or another.
Mother says she will email when she knows something.
Brendan
For those who are reading this and do not know; Ma and Pa do not have working cell phones with them in Costa Rica. Nor do they have a computer. Mother is using her iphone to email. The phone is not working in their room. It took me 4 calls and a lot of patients to get through to her via the nurses station.
Father told me when I was young, "Time is short, waiting is long" quoting some poet or another.
Mother says she will email when she knows something.
Brendan
Shum email
Posted from shum's email
sending this as I am not sure how many are on the blog.
as of now, there has been performed a ct of his head and a ct of his chest. the ct of his chest to look for a blood clot in his lungs, and not, I am inclined to imagine, likely to show one. ct of the head is to determine if they can see what caused the symptoms. the first question is whether there is a bleed in his brain. the ct should answer that and, given his symptoms, I hope and rather expect that this will be negative, but it is important to know for sure because management is different if it is a bleed. Given his symptoms, the other thing to look for is an ischemic stroke (or in his case mini-stroke bc it did not last for more than 24 hours). ct may or may not show this even if it was there. if there is no bleed, I would be fairly confident that an ischemic event was the cause of his symptoms. an ischemic stroke, in comparison with a bleeding stroke, is one were for some reason (usually a blood clot that either is thrown from somewhere else--embolic-- or forms in place) there is a blockage of blood flow to the brain. the part of the brain that is affected then stops working and you lose whatever it controls. in his case, it would be a stroke in the left side of the brain, the part that controls speech and the part that controls the right hand. however, a cerebellar stroke is also possible as he had some other symptoms that may be compatible with that. so the ct of the head is a branch point for management. at the same time, there is an investigation underway to find out what the source of the presumed clot was. that is, they are checking his carotid arteries to see if they are flecking off bits of junk and htey are checking his heart via ultrasound to see if he has a clot lurking there, that could then break off another embolism and cause another stroke. these results are what we would look for here. they are not back yet. things go slowly there. the important thing is that his symptoms are gone, which means this investigation is designed to, if possible, find out what happened, and, more to the point, see what we may need to do to prevent another event. I hope all of this is clear. best of st. pats to you all. we had guiness, corned beef, cabbage, and soda bread. mostly butter and salt. yum.
shummers.
sending this as I am not sure how many are on the blog.
as of now, there has been performed a ct of his head and a ct of his chest. the ct of his chest to look for a blood clot in his lungs, and not, I am inclined to imagine, likely to show one. ct of the head is to determine if they can see what caused the symptoms. the first question is whether there is a bleed in his brain. the ct should answer that and, given his symptoms, I hope and rather expect that this will be negative, but it is important to know for sure because management is different if it is a bleed. Given his symptoms, the other thing to look for is an ischemic stroke (or in his case mini-stroke bc it did not last for more than 24 hours). ct may or may not show this even if it was there. if there is no bleed, I would be fairly confident that an ischemic event was the cause of his symptoms. an ischemic stroke, in comparison with a bleeding stroke, is one were for some reason (usually a blood clot that either is thrown from somewhere else--embolic-- or forms in place) there is a blockage of blood flow to the brain. the part of the brain that is affected then stops working and you lose whatever it controls. in his case, it would be a stroke in the left side of the brain, the part that controls speech and the part that controls the right hand. however, a cerebellar stroke is also possible as he had some other symptoms that may be compatible with that. so the ct of the head is a branch point for management. at the same time, there is an investigation underway to find out what the source of the presumed clot was. that is, they are checking his carotid arteries to see if they are flecking off bits of junk and htey are checking his heart via ultrasound to see if he has a clot lurking there, that could then break off another embolism and cause another stroke. these results are what we would look for here. they are not back yet. things go slowly there. the important thing is that his symptoms are gone, which means this investigation is designed to, if possible, find out what happened, and, more to the point, see what we may need to do to prevent another event. I hope all of this is clear. best of st. pats to you all. we had guiness, corned beef, cabbage, and soda bread. mostly butter and salt. yum.
shummers.
Email from Ma
I have my I Phone. There is wireless at the hospital so can email.Cannot text or call (my IPhone is G4 but not G4S. )
Will set it to ring w email if I don't fall asleep while doing it. (When do u think the last time I stayed up all night was?)
And:
The Top o the Mornin' to Ya!
I have a shamrock pin on. Dad's is on his hospital jammies. Now just what do ya tink the Ticos tink o' dat?
Love to all
Love to all
Email from Ma
#1. MD saw last noc was NOT Dr Rojas. Dr R very thoro exam,, good
listener, helpful explainer. Plans to call u SHUM "in a couple hours".
Just went off for Ct scan of head & chest.
All labs WNL except an enzyme given off by the lung w pul embolism
(name?), triglicerides (not new ), & glucose 138 (prob related to oral
hydration fluid).
Although no sx of pul embolism, will do ct of lung to be sure.
Will do echo cardiagram, halter, carotid doppler.
EKG shows heart attack in past (?) not in afib, pacer working just fine.
Reviewed ladder fall/ subdural/Coumadin hx.
Have spoken w travel ins person. Seems helpful. I whill advise Dr R of
$50,000 limit - which will go way further in CR but not W/o end.
Will know more soon.
Mother
listener, helpful explainer. Plans to call u SHUM "in a couple hours".
Just went off for Ct scan of head & chest.
All labs WNL except an enzyme given off by the lung w pul embolism
(name?), triglicerides (not new ), & glucose 138 (prob related to oral
hydration fluid).
Although no sx of pul embolism, will do ct of lung to be sure.
Will do echo cardiagram, halter, carotid doppler.
EKG shows heart attack in past (?) not in afib, pacer working just fine.
Reviewed ladder fall/ subdural/Coumadin hx.
Have spoken w travel ins person. Seems helpful. I whill advise Dr R of
$50,000 limit - which will go way further in CR but not W/o end.
Will know more soon.
Mother
Spoke with Mother
Just spoke with Mother. Father is going now for Cat scan of brain and lungs. Mother is in good spirits but very tired. She can't remember the last time she was up all night. Mother reports she is much impressed with the doc. this morning, less so with who ever checked them in last night. She will notify when results from CAT are running
Called Dad's room
Tried to call father. Used google voice (.06$ a minute).
Select "English" prompt at voice menu
Tried to input his room - didnt work ended up with the operator
Asked for English and then for room 406
Made it to the room and spoke with a nurse? who spoke a little English. She said father is with the doctor and asked me to call back in 30 min.
Select "English" prompt at voice menu
Tried to input his room - didnt work ended up with the operator
Asked for English and then for room 406
Made it to the room and spoke with a nurse? who spoke a little English. She said father is with the doctor and asked me to call back in 30 min.
Forwarded email from Mother
I forwarded Mothers email with the attached message
Hello,
Hello,
Haven't had time to talk to the elder generation yet. Here is the news. Father was air lifted from his tour of a volcano in Costa Rica with stroke symptoms. He is in a hospital in San Jose. Mother is with him. His current condition is as below per Mom. Dr. Shum is on the case and has been in contact with mother and father.
Please contact me if I you need more info, but little beyond this is to be had at this time. Clay will you call Uncle Mike pls?
Peace
Email from Mother
Brendan,
SHUM says you're the Grand Communicator. Plz forward this to sibs. If
u have not included brenda & Michele or Clay & Peter before hand, plz
send them a heads-up type email. Ask Peter to call Mike. Either you
or Anne plz call Link.
Update: Dad continues alert & oriented. He can talk - no more slurring
or gibberish, slow speech w some word- find problems. No gait
problems, no left or right sided weakness (some last night although it
was more a coordination prob- couldn't direct the fork) no asymmetry
in face.
Is eating.
Emotions very close to surface.
We don't yet have a definitive diagnosis but does SEEM like a small stroke
Have travel insurance & have spoken to their rep.
Plan to hold other tests till CT scan is taken & read. That will
determine next steps including when to fly
Sent from my iPhone
SHUM says you're the Grand Communicator. Plz forward this to sibs. If
u have not included brenda & Michele or Clay & Peter before hand, plz
send them a heads-up type email. Ask Peter to call Mike. Either you
or Anne plz call Link.
Update: Dad continues alert & oriented. He can talk - no more slurring
or gibberish, slow speech w some word- find problems. No gait
problems, no left or right sided weakness (some last night although it
was more a coordination prob- couldn't direct the fork) no asymmetry
in face.
Is eating.
Emotions very close to surface.
We don't yet have a definitive diagnosis but does SEEM like a small stroke
Have travel insurance & have spoken to their rep.
Plan to hold other tests till CT scan is taken & read. That will
determine next steps including when to fly
Sent from my iPhone
email from tc
email from Patrice
I can compile them and email them to mom this afternoon or evening. Let me know if you're interested.
OH, does she have email access?
Love,
Tc
Ok, good news. Thank you, Shum.
Also, I took Dad's email off this response in order to suggest the following:
Can we all write him a little St. Patty's Day limerick? I think he would like that.Also, I took Dad's email off this response in order to suggest the following:
I can compile them and email them to mom this afternoon or evening. Let me know if you're interested.
OH, does she have email access?
Love,
Tc
Time line to date
Ok so here is the time line
3/16/13 - Father and Mother were on a tour of a volcano and father started having symptoms of a stroke with aphasia and coordination problems. He was life flighted to the hospital in San Jose Costa Rica. Mother was in contact with Shum but their cell phones don't work in Costa Rica.
3/17/13 - Father is better this morning -- email from shum attached
Hey all
so a few things
Dad is doing fine this am. he is speaking clearly and seems back to baseline. so this is likely a tia, or transient ischemic attack. aka mini-stroke. i have spoken to him, and he is in good spirits. I asked if the flight was fun in the helicopter, and he said 'well, for one of us.' last night he could not speak much, and was having trouble w/ his right hand. I am not sure he is at baseline but he seems to be.
mother was concerned that there was a problem with their insurance, but after 3 hours on the phone I have been able to verify that they are covered. this is good news. they had been told they might not be, which was prompting talk of flying them home for part of the evaluation to safe them a huge bill, but those questions are moot, I believe. there is a coordinator for this who is calling them now, and there is a process to get them home that may be initiated.
They are doing, I think, the right work up for him in that hospital, it is just much slower than it would be here. but I am less concerned about this now that his neurologic sx are better.
today, he will be getting ct scan of the head and some other tests.
the phone number for the hospital is 011 506 252 1000
ask for room 406 (cuarto cuatro cero seis)
moms will pick up. the line will be used for insurance calls and other things so perhaps limited phone calls would be judicial.
all in all, things are going better than they were in the wee hours this am.
shum
3/16/13 - Father and Mother were on a tour of a volcano and father started having symptoms of a stroke with aphasia and coordination problems. He was life flighted to the hospital in San Jose Costa Rica. Mother was in contact with Shum but their cell phones don't work in Costa Rica.
3/17/13 - Father is better this morning -- email from shum attached
Hey all
so a few things
Dad is doing fine this am. he is speaking clearly and seems back to baseline. so this is likely a tia, or transient ischemic attack. aka mini-stroke. i have spoken to him, and he is in good spirits. I asked if the flight was fun in the helicopter, and he said 'well, for one of us.' last night he could not speak much, and was having trouble w/ his right hand. I am not sure he is at baseline but he seems to be.
mother was concerned that there was a problem with their insurance, but after 3 hours on the phone I have been able to verify that they are covered. this is good news. they had been told they might not be, which was prompting talk of flying them home for part of the evaluation to safe them a huge bill, but those questions are moot, I believe. there is a coordinator for this who is calling them now, and there is a process to get them home that may be initiated.
They are doing, I think, the right work up for him in that hospital, it is just much slower than it would be here. but I am less concerned about this now that his neurologic sx are better.
today, he will be getting ct scan of the head and some other tests.
the phone number for the hospital is 011 506 252 1000
ask for room 406 (cuarto cuatro cero seis)
moms will pick up. the line will be used for insurance calls and other things so perhaps limited phone calls would be judicial.
all in all, things are going better than they were in the wee hours this am.
shum
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