General Update #2

Breakfast order was delivered for Joyce around 10 a.m. Hospital room service experienced unexpected delay in bringing order that was placed before 8 a.m. and apologized.

Nurse checked in with Joyce about her pain levels at 10:32 a.m. and Joyce indicated that she is still in pain, area under shoulder blade of right arm. Nurse said that she would see about obtaining additional pain mitigation. 

Pharmacy technician arrived at 10:55 a.m. to review mom's prescriptions. Mom stated she kept a list of her prescriptions in her purse. Dusty coordinated with Craig to obtain the list from the farm, providing it to nurse's station to relay to hospital's pharmacy ~11:55 a.m.

Room service stopped by at 11:11 a.m. to pickup Joyce's lunch order. Joyce selected the roast turkey with gravy, mashed potatoes, peaches, broccoli, iced tea for a beverage, and a berry crisp for dessert. 

Hospital staff arrived to take vitals on Joyce ~11:42 a.m.

Hospital pharmacy technician returned at 12:30 p.m. to go over list of medications (the list in Joyce's purse). Reviewed over the counter pills taken by Joyce at home (Vitamin C, potassium, etc.) and frequency of ingestion. Hospital pharmacy technician noted that only one medication from the list of prescriptions had been recently refilled from the Moscow Wal-Mart pharmacy after calling them. Joyce confirmed with the pharmacy technician that the list from her purse should be current. Pharmacy technician will follow up with Joyce's insurance to investigate if there might be two files on her that would have a more complete list of medications for double-check purposes. 

Joyce's blood sugar levels tested at 12:36 p.m. with 228 as the reading.
Should be around 100 according to the hospital staff member. Joyce's lunch has been delivered, but she cannot eat it until they treat her high blood sugar, which the nurse will be in to do shortly to administer insulin. Joyce not concerned about delay in being served her lunch as she recently ate her "brunch" meal. 

Micro naps were taken by Joyce throughout the morning.

Joyce has been taking her oxygen tubing from her nose, prompting the orderlies to arrive to check her oxygen levels and get the tubing back into place.

Message(s) from Joyce:

This situation has Joyce thinking back to her spinal fusion surgery in the 1950s. She went from Moscow to Spokane and said that was fortunate that she had done that as she got a great doctor back then (a Dr. Shanewise, sp?) to perform the spinal fusion. He was a very nice person. He was setting behind his desk in his office when she walked in, watched her walk and immediately said "You're in trouble." He was amazed that her spine had not separated and fell down. If he hadn't done the spinal fusion, he told her that she would have soon been in a wheel chair. She doesn't think that she would have had as good of an outcome had the surgery been done back then in Moscow by a non-specialist. She expressed that some of her negative feelings toward doctors and hospitals come from her time being worked on and later recuperating from that ordeal and probably has colored her outlook on hospital stays overall, even to today. 2 weeks in the hospital under care, going through being made to walk and other processes, and not having any company (her husband did not visit) left her feeling isolated in the recovery process. Her husband was working at Crites at the time and so they had the good fortune to have medical insurance which helped them financially. Many families did not have medical insurance at the time. Joyce's sister, June, stayed with Joyce when she transitioned to recuperating at home. June stayed for a couple weeks to visit and make meals. Joyce's youngest sister, Kathy, who was living with Joyce at the time, watched the boys. So she did have support in that regard.

Joyce expressed concerns that they [doctors] might not let her return to living at her house if they know she lives alone. Dusty clarified that they already know Joyce lives alone but has family members regularly checking on her (Craig, Connie, Carol, Dusty, Jess, etc.). 

Joyce thought back to the car accident that her mother Alice and Vernon were involved in while traveling through Tacoma, Washington. Alice spent 3-4 days in the hospital while Vernon had to remain hospitalized for a longer duration. Joyce and Alice stayed in a hotel "for a while" waiting for Vernon to be discharged. Joyce reflected that she felt that she was forced to quit driving too soon, but when she thinks back on what happened with Alice as she advanced in age and continued trying to try to drive...now Joyce is thinking that maybe it was good she stopped driving when she did, though she feels like it might have burdened her family as they have to now coordinate ferrying her to appointments or picking up supplies from town. 

For birthdays, Alice would make Joyce a "burnt sugar cake" (where the sugar was heated until caramelized). Alice made that for several years. This was Joyce's favorite treat her mother would make her. 

Participant observation:

Joyce stated to Dusty at ~11 a.m. while trying to determine where her purse might be back at the house that she doesn't know how she arrived to Gritman, and asked if she "had fallen or something at the house?" Joyce could not recall what she had done to arrive to Gritman or how she had arrived. Previously (~9 a.m.) she had stated clearly what had occurred. She then asked if there was a determination about the pain in her back. Dusty re-informed her that it is a suspected fractured vertebrae. A few minutes later, Joyce appeared to be aware of the full timeline of events again.

Current location:
Gritman Medical Center, Room 226.

Current pain level:
8 out of 10.

Visiting information:
Confirmed with nurses' station shift leader - 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).