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“With the full understanding that I could be incorrect?”
Again Janellen nodded.
Lara took a sip of wine. Looking toward the portrait of her daughter, she pulled in a deep breath, then released it slowly. Her eyes moved back to Janellen. “What treatment did your mother receive at the county hospital?”
“They examined her in the emergency room, but she refused to be admitted.”
“That was foolish of her. Were you given a diagnosis?”
“The doctor said she’d had a mild stroke.”
“I concur. Did they do a complete blood work?”
“Yes. She was prescribed medication that’s supposed to thin her blood. Is that what you would recommend?”
“Along with extensive tests and observation. Did they do an EKG?”
“The heart thing?” Lara nodded. “No. They recommended it, but she wouldn’t stay that long.”
“Was a brain scan done?”
“Yes, but only after Key threatened to tie her down if she didn’t consent. The doctor said he didn’t find any significant cerebral infarction.” She tried to quote him precisely. “I’m not certain what that means.”
“It means that your mother has no significant amount of dead brain tissue due to a loss of blood supply. Which is good. However, that doesn’t mean that the blood to her brain isn’t being interrupted or completely blocked. Did he suggest doing sound wave tests on the carotid artery? They’re called Doppler studies.”
“I’m not sure.” Janellen rubbed her temple. “He was talking so fast, and Mama was complaining so loudly, and—”
“These tests would determine if there’s an obstruction in the artery. If there is, and the blockage isn’t eliminated, there’s a very good possibility for infarction, resulting in permanent disability or even death.”
“That’s what they said, too,” Janellen said hoarsely. “Something like that.”
“No angiogram to see where the blockage might be?”
“Mama refused that. She ranted and raved and said she’d had a dizzy spell and that’s all there was to it. Said she only needed to go home and rest.”
“Did the impairment to her speech and muscle control last very long?”
“By the time we got her home, you couldn’t tell anything had happened.”
“That quick recovery fools patients into believing they’ve suffered only a dizzy spell.” Lara leaned forward. “Does your mother frequently forget things? Does she sometimes have blurred vision?”
She told the doctor what she had shared with Key a few weeks earlier. “She never admits to any of this, but the spells have gotten noticeable. I tried persuading her to see a doctor, but she refused. I think she’s afraid of what she’ll hear.”
“I can’t be certain without examining her,” Lara said, “but I think she’s experiencing what we call TIAs, which stands for transient ischemic attacks. ‘Ischemia’ refers to insufficient blood circulation.”
“I’m following you so far.”
“When one of these occurs, it interrupts the blood supply to the brain. It’s like an electrical blackout. The part of the brain that’s affected is turned off. The dementia you described, blurred vision, slurred speech, and the dizziness are all symptoms, warning signals. If they’re not heeded, the patient can suffer a major stroke. Today was probably the strongest warning yet. Has she complained of numbness in her extremities?”
“Not to me, but she wouldn’t.”
“Does she have high blood pressure?”
“Very. She takes medication to control it.”
“Does she smoke?”
“Three packs a day.”
