General Update #34

8:25 a.m. - Jackie left to get assistance with Joyce's IV as "it would not flush."

8:27 a.m. - Jackie returned with charge nurse Sheree. Sheree suggested that the IV could had "clotted off" as it would still not flush. Joyce expressed no pain was felt as they made attempts to flush the IV when they asked if they were hurting her. Line was not easily flushed as it should be (Jackie making effort), IV bag does not appear to be flowing down the line correctly.

8:28 a.m. - Nurse's aides arrived to take Joyce's blood sugar levels. Reading was 209. 

8:29 a.m. - Jackie checked Joyce's vitals. Asked Joyce if she was nauseated. Joyce confirmed that she "felt like she could be" nauseated. Jackie asked Joyce if she has been passing gas, or if she could remember the last time she did so. Joyce responded that she has not been passing gas and could not recall last time she passed gas. Joyce asked if she had numbness or tingling in her feet or toes. Joyce responded no. Asked if there was any pain in her legs, Joyce responded no. Jackie informed Joyce that she won't be receiving any of the pills they have been giving her until after the operation. Jackie stated that she was going to go get Greg (anesthesiologist) to check the IV. 

8:34 a.m. - Jackie returned to try "one more thing" on flushing the IV and get it flowing. Asked Joyce if she was allergic to iodine, or shellfish. Joyce responded no. Little progress made but IV was still not flowing as it should. 

8:36 a.m. - Greg arrived. Jackie informed that she cannot get Joyce's IV to flush, confirmed it was setup last night to administer bagged antibiotics. Greg said they can always setup a new IV if needed. Greg reviewed past surgeries Joyce has had with Joyce, asked if any problems with anesthesia during those procedures. Joyce noted that the spinal fusion operation took more anesthesia than they anticipated at the time. Joyce was asked if she smoked, Joyce responded negatively. Asked if Joyce had asthma or lung troubles. Joyce stated she uses oxygen at home and that Dusty tells her that she doesn't breathe deeply enough. Dusty explained that Joyce does not use a spirometer at home to practice breathing deeply, so her oxygen levels apparently fall below 90% frequently. 

8:38 a.m. - Dr. Keizur arrived. Told Greg that he wanted to do a local anesthetic and use light sedation on Joyce to keep her off the ventilator, due to her difficulty breathing deeply, Keizur told Dusty procedure "should be relatively quick" and he would return to update Dusty when finished. Keizur departed.

8:40 a.m. - Greg had continued questioning Joyce while Keizur talked with Dusty (so that portion of their dialogue was missed by Dusty). Greg then explained to Joyce that they would give Joyce a local anesthetic with some sedation (what Keizur just told Joyce and Greg when he was in room) and then had Joyce sign the consent paperwork. Joyce expressed that she liked the idea of a local anesthetic instead of full sedation. Greg then inspected Joyce's IV to see if he could determine why it was not flushing.  

8:50 a.m. - Joyce (nurse for the procedure, Dusty designating her as J2 to avoid confusion) arrived to introduce her self to Joyce. J2 asked Joyce if she gets lightheaded without oxygen. Joyce indicated that she thinks she does. J2 asked if Joyce had anything to eat or drink since midnight. Joyce stated no. J2 asked Joyce about her birth date and Joyce responded. J2 and Joyce laughed that their birthdays were within 3 days of each other. J2 prepped Joyce's bed for transfer to operational theater. J2 departed room to receive phone call from another unit within Gritman.

8:54 a.m - J2 returned with Chanelle and Jackie to assist in transport. J2 verified Joyce's blood sugar level with Jackie. J2 verified that Joyce doesn't need oxygen for travel to operation. Jackie confirmed that Joyce uses room oxygen (2 litres flow rate) while in bed and sitting while in Gritman, matching her use at home (sleeping and resting in chair, not needed while walking around).  Joyce was soon rolled out of her hospital room after all room tubes and cables disconnected.

Message(s) from Joyce:
None.

Current location:
Gritman Medical Center surgical theater.

Current pain level:
Unknown.

Visiting information:
No change from previous post. Awaiting confirmation from the charge nurse. 
Confirmed with nurse's station shift leader at 11:05 a.m. (on 6/6/2020) - 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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