After a fall I landed in three hospitals – here is more of my story! Part 2

Hospital B in Singapore

On 6 June 2024 my children got me admitted into the Urgent Care Centre, Hospital B in Singapore. I was there for 1.5 days. We did the following:

1. CT scan of the head. No contrast.Had fall with occipital haematoma. The scans demonstrate evidence of bilateral subdural hygromas slightly more prominent on the left side. This is associated with evidence of an acute subdural collection in the right parietal region. There is no associated midline shift noted. The 3^rd and 4^th ventricles are central in position.

• MRI Stroke Screen which showed a small acute infarct at the right lentiform nucleus. Multiple foci of susceptibility are seen in both cerebral hemispheres, worse at the frontal regions, likely representing hemosiderin deposition.
• Bilateral fronto-temporal cystic hygromas are note, measuring up to 1.0 cm in thickness.
• No intracranial space occupying lesion.
• No hydrocephalus or midline shift.

• MRA: There is a mild narrowing and irregularity in the A1 segment of the right anterior cerebral artery and the M2 segment of the left middle cerebral artery (MCA). These may represent atherosclerotic changes or sequalae of a prior insult.
• The rest of the MRA of the circle of Wilis demonstrates no other significant aneurysm, stenosis or vascular malformation. Normal vascular variations are present. Bilateral posterior communicating arteries are hypoplastic
• Stenosis is demonstrated.
• Final conclusion –  normal pulmonary artery pressure.
• No intra thrombus or pericardial effusion.

1. Blood test results on 6 June 2024:

Troponin T   14.6 High Sensitive. Result is critical.

Creatine Kinase-MB  1.2 (0.0 to 6.0 ng/mL)

Potassium   3.8   (3.3 to 5.0 mmol/L)

Sodium    133  Low  (135 – 150 mmol/L)

Uria, serum  8.1   High  (2.8 to 7.7 mmol/L)

Glucose, fasting   13.4   High  (3.6 to6.0 mmol/L)

Est GFR   86  Expected range >=60 mL/min/1.73 square metres

C-Reactive Protein    14.38   H (<=9.99 mg/L

Reason for admission: Stroke on 6 June 2024                                                                                                                            

Secondary diagnosis: Type 2 diabetes mellitus without complication.

Discharge date: 7 June 2024

A note from the neurosurgeon stated: He is not fit for any travelling meanwhile requires monitoring.

The total costs in Hospital B in Singapore, was SGD 10,346.58 or RM 36,112.51

Admission date: 6 June 2023, 20:16, Discharge date: 7 June 2023, 17.41

• MRI Stroke Screen                                 GD 1,177.20
• CT Brain                                                              698.99
• Observation bed – 3hs                                    286.76
• Single room                                                       787.16
• Single room – half day                                    393.58
• Consultation – office hour                             125.69       
• Consultation – after hour                               148.62       
• Hospital charges                                           1,790.74
• Ultrasound                                                        905.80
• Daily treatment fee                                         325.69
• Doctor’s attendance fee                                436.00
• General follow-up screen                              420.68
• After hours surcharge                                    196.40
• Physiotherapy                                                  205.25
• Speech Therapy                                               350.37

From Hospital B, I learned the following:

1. The reason why I fell could be due to a mild stroke.
2. For the first time in my life, I have been told, once again, that I have diabetes – and it is a serious one at that!
3. My blood was low in Sodium, this could be related / a contribution to the mild stroke.
4. My blood pressure was also high.

It seems that an elderly man with no pain or any “health problems” can suddenly get “sick”!

So please careful.