General Update #28

10:08 a.m. - Nurse Becky checked in on Joyce. Dusty confirmed with Becky that while bites were taken from the toast, none was swallowed. Only the half of a banana was eaten. Joyce reported tummy ache to Becky. Becky asked Joyce how much overall body pain she has, Joyce reported that she just "has an ache" but doesn't need any pain medicine. Becky reported that Joyce will be working with the physical therapists soon when they come around. After they are done with Joyce, Becky will apply a new lidocaine (Icy Hot) patch to Joyce's back around that time as that seems to be helping her with pain mitigation. Becky reported to Dusty that Joyce was taken off of Hydrocodone per previous concerns about it causing the nausea, so Joyce has only been taking the Tramadol and Mobix (non-steroidal anti-inflammatory) orally for pain relief. Joyce was given blood pressure and heart medicine at 10:13 a.m. by Becky. Other vitamins and supplements paused due to Joyce's stomach issues. Will resume those later if directed. Becky departed, stating she would be back to administer insulin to Joyce.

10:16 a.m. - Lab technician arrived to collect blood samples from Joyce.

10:20 a.m. - Lab technician completed collecting samples and Becky arrived to administer 2 units of insulin to Joyce. Becky instructed Joyce to "finish eating." Joyce stated that she wasn't hungry to Dusty after Becky departed. 

10:22 a.m. - Physical therapy team arrived (Mark and Tristan) to ask if Joyce wanted to try a short walk and sit in a chair. Joyce asked of the advantages/disadvantages. Mark stated that Joyce does not feel well right now, and that Joyce might not get another session in today if she does not attempt now. Joyce stated that she would like to attempt to walk now, and Mark said he was glad to hear that was her choice. Joyce's oxygen levels at time of being maneuvered out of bed were at 92%. Mark and Tristan are hoping to get Joyce to stand up, walk to her room's door and back, and then have her sit upright in the recliner. They are hoping to get another session in with Joyce this afternoon. Mark reported to Dusty that he was under impression Joyce is to go to Good Samaritan tomorrow, but he noted he did not attend the morning meeting. Mark opted to use Joyce's purple walker from home, which Dusty brought in today thinking that she was being transferred to Good Samaritan, as that might be more familiar for her. Joyce appreciated having her walker, stating "This is great!" after standing up to her walker. Joyce stated that she would probably need to go to the bathroom before being seated on the recliner. Nurse's aide was summoned as Joyce decided that she needed the bathroom sooner rather than later. PT team went to wait in hallways while Joyce used bathroom (~10:32 a.m.). 

10:36 a.m - Bathroom trip concluded. PT team consulted with Joyce and she confirmed that she would be fine to continue to try to walk to door and then back to be seated in her recliner. Joyce made two trips back and forth to room door, walking fairly confidently and smoothly with use of her walker. PT team appeared pleased with her walking mobility. Joyce was re-seated to her recliner at ~10:39 a.m. and made comfortable. Team informed Joyce that if she was feeling well enough this afternoon when they return, they will bring a portable oxygen mask and walk Joyce further down the hallway. Joyce returned to napping in the chair after their departure.

10:39 a.m. - Dusty departed room briefly for use of bathroom.

Upon Dusty's return to the room at ~10:50 a.m. he ran into Dr. Brown in the hallway who had just concluded visiting with Joyce and was updating Becky and nurse's aides. Dr. Brown informed Dusty that Joyce's stomach is soft, she isn't running a fever, vitals are good, overall pain levels are reduced, she is moving around wonderfully (getting up and down from the commode/toilet, bed, chair, walking with her walker, self adjusting within range she is capable of in the bed and the chair, etc.) and better than expected. Joyce's constipation/blockage is the only real concern at this point and they are not certain what the cause may be. If the imaging done earlier this morning comes back as inconclusive for any causes of the constipation then they will have a CT scan performed on Joyce next. Dr. Brown expressed that the only thing that comes to mind as a potential cause for the constipation at this point is if the colon cancer Joyce had in 2016 returned and is causing the blockage somehow, but she feels that is probably unlikely. Dr. Brown feels that the CT scan will provide a better idea and they'll go from there.

Message(s) from Joyce:
Joyce reports that the lumps on her head are smaller today.

Current location:
Gritman Medical Center, Room 202.

Current pain level:
Unknown. 

Visiting information:
No change from previous post. (Awaiting updated information from morning shift leader.)

Confirmed with nurse's station shift leader at 9:30 a.m. (on 6/5/2020) - currently only 1 visitor per day for Joyce, no exceptions. Once current visitor departs Joyce's room, no further visits for the rest of the day. No swapping out visitors (example, Dusty cannot remain on hospital grounds while Craig goes to sit with Joyce for an hour and then Dusty returns to room).

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