Thursday, November 22, 2012

July 2011 - From Russia With Love

The runner-up title for this blog post was: "Stuck in the US, Stuck in the US, Stuck in the USSR!"

I think I've mentioned before that Mom and her friend Ed do a lot of traveling, both domestic and international. One of their trips in the summer of 2011 was a river cruise somewhere in western Russia. If I had taken some notes of what was going on while they were in Russia I would probably need several blog posts. So I'll do my best to condense it down to the more interesting details I can remember.

I do know they were at the Moscow airport on June 24. I assume they got started on the river cruise a day or two after that, but then very early into the cruise (first or second day, maybe?) Ed went into full body convulsions in their cabin. (Ed's recent medical history could fill another blog or two, but the fact that he was traveling with a copy of his most recent brain CAT scans on a CD should tell you something.) Fortunately Mom was with him when these convulsions started and she immediately went into the hall and yelled for help. Also fortunate was the fact that there happened to be a staff meeting in progress nearby, and the ship's doctor was right there. Even more fortunately they happened to be at a port when this happened, so an ambulance was called to take Ed to the nearest hospital. (They were traveling with some other people who gathered up their belongings they left on the ship so they could be reunited with their stuff at some point.)

Based on Mom's description of it, to call this first location a hospital would be a gross exaggeration. It sounds like it was more of a small-town clinic, and it took the ambulance a very long time to get there over some very bumpy roads. I don't think they stayed there more than one night before Ed was transferred to what could perhaps be called a real hospital in a larger town, but it was a "hospital" only by Russian standards. It was either this place or the first one (maybe both) that had a resident cat that rode the elevator to travel from floor to floor. Mom also discovered that the night duty nurses have a room where they go to sleep overnight, and they get really annoyed when you wake them up just because you think someone needs medical attention.

After a day or two at this "hospital," Ed was transferred to a Euromed Clinic in St. Petersburg, which is intended for international travelers who need medical care while in Europe. The Euromed Clinic was better than the second place, and they were treated well and assigned a translator, but Mom had already gotten her fill of Russia's medical system and didn't want any part of it. That was really unfortunate because she developed a urinary tract infection while the logistics were being worked out on getting Ed back home, now that he was stable enough to travel. Ed's travel insurance provider insisted that he travel back with a medical professional such as a nurse, and they have people lined up to do just that. But the first person that was selected couldn't travel for some reason, so they ended up getting someone else who could travel as far as Finland. That meant Mom and Ed had to travel from St. Petersburg to Helsinki, Finland with a doctor, and then Ed was transferred to the care of the nurse who had traveled from Canada, I think.

So their stay in Russia was extended by about a week, and Mom was stuck there with a urinary tract infection (UTI) which she did not seek medical attention for due to what she had seen of the Russian health care system, combined with the fact that any medications needed to be approved by her nephrologist due to the amyloidosis in her kidneys. Mom did take an antibiotic her nephrologist had prescribed to have on hand, in case she got a UTI while traveling.

So the barely-walking wounded couple eventually made it all the way back to Austin where Ed lives. Mom wasn't doing well at all, so the day after they got back she went to some clinic like a PrimaCare, and they told her to go to the emergency room at the hospital. They admitted her at Seton Medical Center with a severe kidney infection, where she stayed for I think four days until they got that under control. Cathy and I went down to see her on her birthday, and the day before we went the hospital had implemented quarantine rules for Mom's room, meaning everyone who entered her room had to suit up in these disposable gowns, gloves and surgical masks. I was looking forward to suiting up and getting pictures of all that, but unfortunately they stopped doing the quarantine thing before we got there. But we still had a lovely birthday celebration with the smattering of birthday decorations from Party City we brought with us. "Happy Birthday! You have a kidney infection!"

As you can imagine, a kidney infection in someone with reduced kidney function is not a good thing. The nurses told her they were really concerned about her when she first arrived. I think her creatinine had been hovering somewhere between 2 and 3, but her first labs at the hospital showed it to be somewhere between 4 and 5, if I remember correctly. It did steadily improve while she was there, and it was close to her pre-Russia level by the time she was released. We'll always wonder what impact this episode had on the rate of decline of her kidney function.

[Minor edits January 12, 2013]

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