Thursday, April 10, 2008

April 7th - The stroke (Cancun)

This is Mike's account of what happened in Mexico.

April 7, 2008
My father and his wife, Virginia, had been enjoying their timeshare at the Grand Mayan, in Cancun, Mexico with their good friends Jim and Maria. They had arrived on Friday and had spent a couple wonderful days enjoying the resort. Jim and Floyd had been out all morning on the golf course then enjoyed a few Corona’s at the club house, the 19th hole, when the merciless sun got to be too much for them. They returned to the room around 4:30pm to wait for me (his son) to arrive with my wife Kathleen. However, Kathleen was not able to come with me due to last minute obligation with her publisher.

I arrive at the hotel earlier than expected as my Alaska airlines flight pulled up to the gate ahead of schedule. I had met some wonderful people on the plane, including Bob Gamache from Richland, WA who is a wine grower and happened to be staying at the same resort. We rode the shuttle to the resort together, having a beer one the way (as you can in Mexico). When I knocked on the door, Maria was the first to greet me. This was my first meeting with Maria and Jim even though I had heard how wonderful and fun they were, and they both were everything my Dad had said and more. Jim was a bit stricken with Montazuma’s revenge, but my Dad, Maria and Ginger all jumped up to welcome me with hugs and smiles. My Dad proudly showed off the exceptional accommodations, pointing out the soaking tub on the patio, which usually bubbles but Ginger had the facilities manager turn off because the sound bothered her. We went onto the patio and he pointed out the trails to the golf course, the amazing restaurants, swimming pools, and bar all within a short walk. Proudly, he asked what I thought. I told him it was fantastic.

Just then, Ginger called to us to have a look at towels folded by the housekeeping staff “cruise ship” style to look like a little shepherd girl. She told my dad to take a picture so he grabbed his digital camera, leaned against the dresser, and snapped a shot. At this point, standing across from him, I noticed he looked a bit unstable.

I asked “are you alright, dad?” He said “Sure, I've just had too many Coronas.” He put his left hand on the dresser to stop his lean, but he slid a little, barely catching himself.
I asked again, “are you sure you are alright?”

He had a funny smirk on his face and said “yeah.” Then he slipped a bit more, so I moved over beside him to help him steady himself. Ginger said “Oh Floyd, you’re drunk!”

He said “Yeah, dear, I am drunk.”

But I’ve seen my dad have a few before and he could not only stand perfectly, but still shoot a mean game of pool. I knew he was not drunk. I asked him to lean on me and I’d help him to sit on the bed. But as we took the first step, he was an unexpected dead weight of 220lbs and all I could do, without proper leverage, was slowly lay him down on the tile floor. I went down with him. We both laughed as we lie on the floor and Ginger remarked “Oh Floyd, you’re so darn drunk you pulled that cute towel figure off the bed, put it back! I liked it.”

He said “Yessss, dear, I sooo drunk,” now slurring to such a degree it was hard to put together his words. I said "how many did you have?" He held up four fingers on his right hand and slurred the word “Coronas.”

That many beers could not do this I thought. “I’m putting you in the chair, help me get you up. You have to help me.” He still smiled, his eyes now narrowed into little slits and he looked plastered. He could not help however. I said “move your left leg over here.” He moved his right leg instead. “Can you move your leg or are you messing with me?,” I asked.

He slurred “messing with you son.” But he didn’t move his leg. I pulled up a chair, put my arms under his armpits and lifted him into the chair. Maria came in at this point, dressed to go out to dinner and asked, “What’s going on?”

Ginger said “Oh, Floyd is so drunk he fell down and pulled this cute little figure off the bed, and he won’t put it back. He did it on purpose because I liked it.” As I looked at my Dad, I noticed he was slumping to the left in the chair, his eyes almost closed, he had a weird smile on his face and the left corner of his mouth drooped down unnaturally, almost like a clown face. A chill ran down my spine and I thought, oh God don’t let this be a stroke.

I whispered to Maria, “we need a Doctor now, call a Doctor.” She speaks perfect Spanish and English. I have no idea what the signs of a stroke are, so I thought I had better document them for a doctor. I grabbed my digital camera, put it into video mode, and pointed it at my Dad. I asked him to show my his pitching arm, his left hand, the arm he is unable to move. He couldn’t lift it and drooped further over while wiping his head with a towel in his right hand. Maria did not hesitate, picked up the phone, and insisted a doctor be sent now.

Maria suggested we put Floyd on the bed and went into the hallway to grab a staff person to help. We struggle to lift him onto the bed. He was barely conscious now, slurring words that we could not understand. I asked Ginger if he had any medication and she mentioned Nitro pills. I said “he needs pills? For his heart? Do you have them?” Ginger said, “Oh, uh, I don’t know where they are. I forgot my nitro sprayer and I really need that. I need to find a pharmacy to get it but I don’t know where I can get it down here. I really can’t go long without my…” I cut her off. “Ginger, we only have a short time. My Dad is not drunk I think this is a stroke. Does he have any medication he is supposed to take?”

Ginger went into the bathroom mumbling to herself but came out and said “I don't know, it must be with my medication. I need my medication. I wonder where I can get…” Ignoring her, I turned to Maria who says“keep talking to him, we need him talking.” Maria and I asked my dad questions but he just lay limp on the bed, with an odd smile on his face. When we asked him to move his left arm he would flop his right arm up and down. I could lift his left arm and drop it. He had no control over it at all.

Suddenly, as if nothing had happened, my dad lifted his left arm up in the air and said clearly, “see, I can lift my arm. There’s nothing wrong.” Then he sat up on the bed and was absolutely normal.

Ginger said “Floyd, you’re drunk!”

He said, “Yes dear, I had some beers.” But now he was not slurring and was at full strength. I asked him “why didn’t you lift your arm when I asked you too before? He said “I couldn’t but I didn’t want to tell you that, son. I felt stupid.” I said “Dad, you have to tell me when something is wrong…” and he cut me off nodding, “I know, I know… is a doctor coming?” “Yes,” I said. “Well, I don’t need a doctor, you can see I’m fine,” he said. I can see you’re fine now but you are not fine, I think you had a small stroke.

“But… I don’t want to have a stroke.” He had a pained look on his face. I had just arrived. We were going to go out and have a corona by the pool here in paradise while it was rainy and miserable outside back home. I didn’t want this to be a stroke either. I had flown all day to be with him. This isn’t happening I thought. We just stared at each other, knowing we were both thinking and praying for the same thing.

Maria burst in with the Doctor. My dad jumped up and shook his hand. “I’m fine, doc” he said, “how are you?” “Bien… good, said the Doctor. “Who am I here to see, who can tell me what is going on?,” he asked. Ginger said “they went out in the sun golfing and drinking and now… he’s drunk.” Maria looked at me and said, “Mike, tell him what happened.”

I explained how he leaned, could not hold himself up, then fell slowly to the ground. How I put him in the chair. I told him of the limp left side, the slurring, and the mouth drooping to one side. He had my dad sit and hold out both arms, which he did perfectly. He lifted each leg. He spoke without a slur. I pulled the camera out of my pocket and said to the doctor, watch this. I took this 10 minutes ago. We both watched the video for the first time. The Doctor stepped back and said to my dad, “if I see you now, I think ‘he is fine’, but when I see this video, it is clear you have a small stroke.” He then looked at both of my dad’s eyes and pulled me over to show me. “Look,” he said, “do you see?” I saw one pupil was huge/dilated, while the other was a tiny pinpoint. My dad protested, “I’m not drunk, I’ve had a friend do that test before.” I told him one pupil was bigger than the other. The Doctor explained to him “you have shown clearly three signs of a stroke, now this is four. My dad jumped to his feet, almost dancing and laughing “but I’m fine, see?”

We went into the other room. I asked the doctor what we should do next. He said that there will likely be another stroke soon. If it occurs within 3 hours and it is small, that would be good. If it takes longer to come, that would be bad and likely fatal. “You caught it at the perfect time, we can take him to the hospital,” he said. “I don’t want to go to the hospital, I’m fine," my dad protested. "I didn’t have a stroke. I just had too many beers in the sun.” I sat on the coffee table across from my dad on the couch. I handed him a bottle of water and we talked for a few minutes.

“Let’s just go get it checked out then we can get back and go the 19th hole (the bar) for a drink. You’ve got to show me this wonderful place.” My dad’s eyes looked vacant for second, he choked-up for a millisecond and said “I don’t want to be like Eric.” Eric is his good friend in England who suffered a severe stroke and now is confined to a wheel chair. He cannot speak well and cannot do anything for himself. His wife, Joan (who is an angel), waits on him day and night, even taking him to the bathroom and lifting him onto the toilet. In England, the Gov’t sends caregivers (nurses) to help. But they are there only a few hours each day.

I told my Dad, “you will not be like Eric.” This is small, we caught it right away. The doctor will take care of it. He smiled a forced smile and we talked about nothing for a few minutes. He was totally normal. But then I noticed the water bottle in his left hand. He reached with his right hand to help lift it to his lips. He voice started to slur and his eyes slimmed toward a squint. I told him “I’ll be right back” and went to find the doctor who was outside instructing hotel staff. I told him “it’s happening again.” He said to the concierge “we’re out of time, back up the ambulance now.” He sat across from my dad, now drooping slightly on the couch. He told him to hold up his arms and talk to him. Just then, the paramedics arrived, wheeled in the stretcher and put on him on it. He was now almost unable to speak and slipping toward unconsciousness.

There was only room for one family member in the ambulance with my dad and Ginger insisted that she go, but then decided to ride in the front seat instead so she could see out and be comfortable. I tell Maria to ride with him since she can speak Spanish and have the concierge call me a taxi. While I waited I asked the doctor questions. He said my dad had two small strokes. That it could be a blood clot or a hemorrhage, the doctors would take a CT scan and fix the problem. As my taxi pulled up, he assured me we caught it at the perfect time.

It is a 40 minute taxi ride to the Hospital from the Grand Mayan at Playa del Carmin. The speed bumps are huge and I hoped that ambulance driver has taken care not to give my dad a bumpy ride. My taxi gets lost and takes me to two other hospitals first before finally arriving at the sparkling art deco glass structure. It is so modern and new it looks like something out of a sci-fi movie or a European hotel, not like the avacado tile floored 1960’s concrete block structures I’m used to in the USA. Certainly not what I expected to find in Mexico.

I walk in and find Maria and Ginger. Maria, who has a brilliant mind, quick wit, and a fast paced staccato cadence to her speech quickly fills me in on the situation in English while occasionally barking off orders and answers to hospital staff in Spanish.

My Dad is in the emergency admitting section. The Doctor looks like a daytime soap opera star – young and well spoken in English and Spanish. He introduces himself as Doctor Marciel. He takes us in immediately to see my dad. Ginger and Maria talk to my dad while I answer questions of his medical history. I quickly wrote down a list of all his medications before we came to the hospital. Dr Marciel tells me he thinks there is a blood clot, but they have not located it yet. They believe parts are breaking off and hitting the brain, blocking blood flow temporarily each time. This is why he is normal until one side of his body shuts down. He suggests that once they locate the clot, they will break it up. This will restore blood flow and he should be fine. He asks if we would like him to do this or if we would rather fly him back to the USA. I decide to have the procedure done now, that expediency and having him in a doctor’s care now is better than risking a long flight to the USA.

The Doctor shows us the CT scan and, although they cannot locate the clot they are sure it is in the neck to head area. They ask if there has been any surgery in the last six months, and Ginger says no. We remind her of his his illiyac aortic anyrism stint and inform the doctor.

The Doctor introduces us to the Neurosurgeon who prepares a procedure called, I think, a Trembolosis. This is used to break up the clot and restore blood to the brain. He says it is similar to what is done for a heart attack, which is also a blood stoppage but to the heart. We go in to see my dad and talk with him. He is a bit nervous. Maria makes him laugh a bit, I try to do the same by feigning to give him a huge sloppy kiss and then giving him a high five. Ginger walks over to him but is very somber as she gives him a little peck on the cheek and whispers to him. The Doctor comes over, puts his arm around her, and assures her all is well. As they all walk out, my Dad signals me back. He is a bit shaken to see Ginger that way and his confidence drops. He looks worried and says to me again, this time with real concern…

“I don’t want to end up like Eric.” I told him that would not, could not, happen. The strokes were tiny the Doctors said, and they were going to get rid of the blockage. Then it would be only a few days until we'll be having beers on the beach and playing some golf. He smiled and grabbed my hand and gave me a pained look of understanding. I tried my best to give a convincing, reassuring smile as we laughed a bit. I was sure everything would be fine and I wanted him to know that too.

Ginger is really hungry and wants a coffee with lots of cream and something to eat. The hospital has a café that normally closes at 10pm, but they open it up and make us tasty little egg sandwichs and coffee for her. Maria, Ginger and I wait for word of the procedure. Dr. Marciel comes out to us and tells us it has gone well. Now they are going to CT scan him again, monitor his condition, and make sure everything is fine.

We wait and within the hour we are told it looks good and he is resting. That we should go home and sleep. He takes my cell phone number and gives me his personal cell phone number to call if we have any questions, anytime. We take a taxi back to the resort and I pull out the couch and make it into a bed. I try to get online, and I call my wife Kathleen in Florida and ask what she has found out about insurance. She is brilliant and resourceful and has researched both insurance names I have given her. Ginger could not remember where the ID cards were for the insurance and did not know any details other than the name "Tricare for life." I had found my Dad’s Doctor’s name and gave it to Kat. She called and was able to get numbers for medicare and Tri-care4life, the military medical insurance my dad uses. Kat notices that I have a hard time making sense and tells me to sleep and try to get online in the morning.

I try but cannot sleep well, my mind is going crazy. I worry that I don’t want to lose my father. He is my best friend and I've just arrived to see him.