TIA 2
03 February 2020 | Mazatlan
Steve Dolling | Buckets of Rain
I am sure some of the world’s finest physicians practice out of resort hotels. I have no doubt that our hotel Doctor, we’ll call him Dr. Ortega because that happens to be his name, is one of the best in the entire El Cid chain.
I had the full workup. Blood pressure, stethoscope, a squirt of nitro glycerine just in case, a glucose test, temperature and all the strokey things. We skipped the digital rectal exam because, well, we were in the lobby of the hotel, and an enlarged prostate was unlikely to cause the symptoms I had experienced. The conclusion was that there was no conclusion. No evidence of a stroke. Dr. Ortega recommended we have a full cardiac workup done as soon as we get home. He was highly suspicious that the butter tarts might have spiked my blood sugar and that, combined with some dehydration, might have messed with my brain.
We hung out for a while, drank some water, and Foster and I played a dice game while Tracey went down to Dr. Ortega’s office to see about cardiac referrals near home, which for the moment, was the marina. We got back on the shuttle and headed to the marina for a bite to eat.
As we were waiting for lunch both Tracey and Foster noticed that my smile had gone a little crooked. The crooked smile is the smoking gun for stroke enthusiasts: it’s what separates the stroke victim from the regular drunks. Tracey gave Dr. Ortega a call and told him we were on our way to the hospital. He would meet us there. Tracey checked with a local friend to confirm that Marina Mazatlán Hospital was in fact a good one.
Due to the urgency of the situation, Tracey went to the pool bar to arrange to have our food “par llevar” - to go. I walked towards the lobby with Foster trying to convey caution in talking to the insurance company as their entire mission is to get you stable, transport you home and never pay another dime. Shit could happen quickly, and he needed to work with Tracey to maintain control of things. I was having trouble even talking, not from any cognitive or speech deficit, but because I was emotionally destroyed. I was totally rational, but my brain was in conflict with itself trying to urge me to cry my eyes out over some deep sense of anticipated loss. Nevertheless, we made it to the cab where the waiter met us with boxes of takeout including stainless hotel cutlery. Very nice. No sign of Maria.
And so began our time at the hospital. Dr. Ortega met us there with a wheelchair in the parking lot. In quick succession they offered up an ECG, chest x-ray, CT scan, cardiac echo, carotid artery ultrasound, BP, temperature, digital rectal exam... No, wait no DRE. But an IV! No D5W and ringer’s lactate.
We met Jorge which was pretty impressive, not so much because Jorge is impressive but more so because all of this was happening on Christmas Eve which is one of your bigger holidays in Mexico. I am surprised the ER had any staff at all. There certainly were no other patients.
The nature of a TIA is that there are no symptoms after it passes. My heartbeat was regular. I had no loss of strength or speech impairment. Even my crooked smile was straight again. They kept me overnight and monitored me. Medically, I was free to leave, but they kept me a second night with a Holter monitor. They wanted to keep me a third night, not for any medical reason, but mostly because the bill needed to be paid before they would release the body. Hostage taking is an integral part of Mexican hospitalization, though they are very polite about it.
The investigations, which continued through the next month back in Vancouver, were to determine the cause of the TIA. The suspect was atrial fibrillation: an irregular heartbeat which puts the upper and lower chambers out of sync, pumping blood ineffectively allowing it to clot and break off in little bits that mess up the brain. But there was no solid clinical evidence of A-fib. Jorge put me on a blood thinner just in case.
In the meantime, the insurance company issued a promise to pay and I was set free to roam Mazatlán. Foster’s girlfriend Alyssa came to town and we all enjoyed hiking, boating, exploring the city, and we even went to a New Year’s party at El Cid where I bumped into Maria and had a chance to thank her via Google translate for her attempt to help me.
At some point, I’ll probably write something about electrical diagnostics and my pending personal electrical refit. Or I might write about repairing the toilets on the boat. Pictures of varnish drying appear to be about 5 times as interesting as my medical ramblings. Head maintenance should be a win.