The Official Joyce Update Blog

Rachael (Aspen Park social worker) emailed Dusty ~9:52 a.m. on 8/28 from a clinical meeting she was participating in where Joyce was being discussed. Clinically there is nothing wrong with Joyce - no cancer, no UTI - but the Aspen Park team still has concerns over sending Joyce home without 24/7 care. Rachael requests that Dusty come visit Joyce and talk with Joyce to see if he notices anything and to discuss options with Joyce and let Aspen Park know. From there, Rachael says, it can be determined whether Joyce stays at Aspen Park or returns home to the farmhouse.  Dusty responded to the email that he would be glad to arrange a time to come visit with Joyce in person and review/discuss options with her as Rachael suggested, however, the consensus from Joyce and her family is that Joyce should be discharged to her home and the family would take on arrangements for her care. Dusty cited cost of keeping Joyce at Aspen Park as being a concern over her remaining on-site for 24/7 care. ...

Dusty called Joyce to check in with her at 9:35 a.m. (8/28) on a break. She reported that she was able to get some sleep, even though she was very excited to be cancer free and feeling great about that news. She feels that she needs to celebrate and a celebration of some sort over this good news needs to be determined. Dusty agreed and confirmed that they would work something out. Joyce then reminded Dusty that there is a lot of missed things to celebrate, such as adoption day, and not just her being cancer free. Dusty concurred and confirmed that they will have to make up for a lot of missed family celebration rituals.  Joyce said that she has "lots of catching up to do" for celebratory things and visits with family once she is back at the farmhouse. Joyce reported that her breakfast was good, having been served eggs, sausage, a sweet muffin, and apple juice. She thought that she was fed quite well. Dusty asked if he had interrupted her therapy and Joyce stated that the ther...

Dusty called Joyce on his walk home from campus ~8 p.m. (8/27/2020) to check in with her before it got too late to call. Joyce was extremely conversational and "baseline normal" during the visit, only briefly forgetting that Dusty had already discussed the good news (being cancer free) with him earlier in the day. Joyce stated that she was quite happy and joke she was potentially "too excited to sleep" from the good news that she did not have any signs of cancer. She expressed relief about not having brain or spinal cancer, stating that she was concerned that would be what the doctors would tell her. She is most thankful that she has been given more time to be with family and to enjoy her life.  Joyce was excited to think that soon she will be returning to the farmhouse and joked that she probably cannot even recall what the place looks like anymore since she has been gone so long. Joyce and Dusty did the math and confirmed with each other that this is still the lon...

Carol, Connie, and Dusty joined Joyce's telehealth appointment today (8/27/2020) with Michelle at the St. Joseph Regional Cancer and Blood Center ~2:35 p.m.  CT scans which covered the abdomen, pelvis, chest and neck of Joyce from 8/25 were reviewed as well as the lab tests collected from Joyce on 8/23. No signs of cancer (residual or recurrent) detected. No indicators of any return from previously treated kidney cancer (following the 2 cryoablation treatments done by Dr. Ho) or the colon cancer (chemotherapy treated in 2016). Incidental findings included: Cysts along Joyce's adrenal glands (stable, non-concern) Cerebral spine compression (chronic, non-concern) Atelectasis (some alveoli not filling with air) in the right lung due to lack of deep breathing Small 1 cm growth in the thyroid gland which does not look suspicious and is non-concern for cancer (but should be followed up on by Dr. Collins) Brain has white matter changes (age related) Cancer marker tests are normal Whit...

Dusty was unable to reach Joyce the two times he called yesterday (8/26/2020) during his walk home from work ~5:20 p.m. or in the evening hours ~7:40 p.m. Assuming that Joyce was either out of the room with the nurse, sleeping, or using the bathroom both times. --- Dusty called the Aspen Park nurses' station ~8:25 a.m. (8/27/2020) to request an update on Joyce and confirm plans for linking in Carol, Connie and Dusty for this afternoon's telehealth conference call with the cancer center. Call was received by Sue who attempted to locate Maggie. After brief hold, Sue informed Dusty that Maggie was helping another resident and that Maggie said she would call Dusty back when she was available.

Dusty was unable to call Joyce last night (8/24/2020) due to issues with his phone and schedule conflicts. --- Dusty called the Aspen Park nurse's station to request an update on Joyce (8/25) ~3:07 p.m. but received no response. Dusty called back and was connected to Maggie. Report on brain and soft tissue of neck has come in but Maggie says that Dr. Collins and the oncologist need to review it. The chest and abdomen information has not come in yet at the time of the call. Dr. Collins and the oncologist will review all when available and provide information to Joyce and her family.  Maggie reported that Joyce is still confused. Joyce's appetite is fluctuating.  Maggie says that Joyce is in a general state of decline overall.   Dr. Collins has added a CMP blood draw for Joyce to be collected today by the Aspen Park team. Dusty to be updated once more information becomes available. Maggie confirmed that cancer center telehealth appointment is still on for Thursday at 2...

Dusty called Aspen Park nurse's station ~3:13 p.m. (8/24/20) to request an update on Joyce as they had not called him, speaking initially with Kim. Kim read from initial documents available regarding Joyce's lab work before call was transferred to Maggie (as Maggie had been working with Dusty). Maggie reported that Joyce's UA came back with some trace bacteria showing, but that might not be UTI sign, a culture is growing to determine if Joyce has a UTI.  Joyce reported to still be seeing things and is confused. Maggie reviewed that on Saturday Joyce was fully oriented and doing well and on Sunday she took a downturn. Joyce was talking this morning about the woman outside her window with Maggie.  Maggie confirmed that at this point there are no issues that would prevent Joyce from going to her CT appointment at Gritman tomorrow. Maggie is hopeful that the CT will reveal what is happening with Joyce and provide direction on how to proceed with her care. The blood test results...

Joyce called Dusty's cell phone ~12:06 p.m. Call was missed due to Dusty's cellphone having a malfunction and not remaining powered on. Joyce left a message, stating that Dustin needed to come get her. --- Dusty and Jess called Joyce to check in ~8:20 p.m. Initially they were unable to contact Joyce via her room phone. They then called Andrea's line for an update. Andrea was with Joyce and got her back into her room to speak on the phone. Jess and Dusty called Joyce back on her room phone. Joyce reported that her day was somewhat busy as there were about 6 kids that were playing around her room at Aspen Park. She said that she would be surprised if she didn't find one of the kids hiding under her bed in the morning. Joyce thought that we needed to feel sorry for the kids because they are running around the facility unattended and the parents aren't taking care of them.  Joyce states that the kids don't make a fuss about anything, they just don't want to be p...

Maggie called and left message on Dusty's cell phone ~10:46 a.m. (8/23/2020) requesting that Dusty contact Aspen Park about a change in Joyce's condition. Joyce reported to be hallucinating again and quite agitated. Maggie was leaving for the day, and Dusty was directed to ask for Andrea when he calls. --- Dusty returned phone call to Aspen Park ~10:58 a.m. once he noticed voicemail had been left. Maggie had left for the day, Dusty reached Andrea. Andrea reported that Joyce was experiencing hallucinations again. Andrea's shift started at 10 a.m. today, taking over for Maggie who provided information to pass onto Dusty. Earlier today Joyce had packed up her belongings was was waiting for people to come get her and take her home to the farmhouse, insisting that she was leaving the Aspen Park facility. Aspen Park staff sat down and gently reviewed Joyce's timeline with her, reminding her of her CT scan scheduled for this coming Tuesday and cancer center telehealth conferen...

Maggie called Dusty, leaving a message on his cell phone on 8/21/2020 at 2:02 p.m. to confirm that she had been in touch with the cancer center. They do want the CT results and so are postponing Joyce's telehealth call that was scheduled for August 24. The telehealth call with the cancer center has been rescheduled to Thursday, August 27 at 2 p.m. Carol, Connie, and Dusty will plan to join the telehealth conversation with the cancer center about Joyce via the arranged plan (to have Maggie call a number they provide and add them in via speaker phone to the telehealth call). 

Dusty called Joyce during his walk home from work (8/20/2020) ~4:45 p.m. Joyce was alert and talkative initially, slowing down toward end of phone call.  Joyce reported that she rode the stationary bike as part of her physical therapy today instead of going for a walk down the hallway and did some upper body exercises with her arms.  Dusty reviewed his day with Joyce and reported on the UI's activity level increase with the return of students and the general concerns over that population returning. Dusty informed Joyce he will be up at Camp Grizzly Friday night to help with the Service and Induction Weekend projects. Dusty asked if Joyce ended up having her blood drawn at Gritman today and she reported that she had not left the Aspen Park facility or had her blood drawn. They concluded that the previous blood draw from last week must have given the St. Joseph Cancer Center the information they needed for Joyce's upcoming appointment. She briefly was unaware of where she was, s...

Dusty attempted to call Joyce during his walk home from work on 8/19/2020 but was unable to reach her, assuming she was either napping or using the bathroom. --- Dusty was unable to call Joyce last night (8/19/2020) due to his evening meetings running long. --- Dusty called Aspen Park around 2:05 p.m. (8/20/2020), requesting an update on the arrangements for Joyce's August 24 telehealth conference call with the cancer center, checking to see if she ended up having to go to Gritman today for the blood draw (or if Aspen Park/Moscow Medical's previous blood draws were sufficient in capturing what the cancer center needed), and to double-check on the CT scan appointment scheduled for tomorrow for Joyce. No answer, left message via voicemail requesting a call back. 

Dusty called Joyce (8/18/2020) around 5:10 p.m. on his walk home from work. They reviewed their days and what has been going on since they last spoke. Joyce was in high spirits and sounding like her old self. They discussed television shows Joyce had been watching while in her room, the therapy work she had been undertaking, walks done, and other pieces of past lived experiences from Joyce's life as they came to mind and how they link into where she is at now at Aspen Park. The phone visit was cut short with the delivery of Joyce's dinner, an open-faced sloppy joe style sandwich with tater tots as a side. --- Dusty called Joyce (8/18/2020) around 8:41 p.m. to check in and wish her a goodnight. Joyce was extremely talkative and in good spirits. Joyce had been watching a newer episode of NCIS on the room's television set when Dusty called. They talked about the NCIS series, Joyce's dinner, her work with the therapists, and other items on through to its end and then Joyce ...

Dusty called Maggie at Aspen Park (~1:36 p.m., 8/18/2020) with updated information about the 8/20 blood draw and 8/24 cancer doctor appointments for Joyce. Maggie will call Dr. Collins to see if the blood draw scheduled for 8/20 can be done in-house at Aspen Park by their phlebotomist to reduce Joyce's travel off-site. Maggie requested information about Joyce's 8/20 and 8/24 appointments be faxed to their line at 208-882-1542, "Attn Maggie" --- Dusty called Carol ~1:40 p.m. to follow up about cancer center appointment and options. Reviewed information and overall intersection of information and ongoing items related to Gritman/Aspen Park/Dr. Collins/cancer center and Joyce. Dusty to call cancer center to see if telehealth conference for 8/24 can be done instead of travel to Lewiston and if family can participate in Zoom call with Joyce and cancer doctor. Carol will send fax to Maggie about the 8/24 appointment with the cancer center. --- Dusty called cancer center ~2:...

08/12/2020 Dusty called Joyce on his walk home from work ~4:35 p.m. to check in. She reported that she had been feeling better, even if the Aspen Park team hadn't figured out what was going on with her overall. She lamented memory troubles she has been having. She stated that she had done quite a bit with the therapists today, riding the stationary bike for around ten minutes and doing some walking and resistance exercises. Dusty asked if she had been reading her Redwall book. Joyce stated that she had not but that it had been seen by one of the orderlies and they had a conversation about the Redwall book series and the author. Dusty reminded Joyce that he and Jess would be traveling tomorrow out of the area for Jess' grandmother's memorial service and that if she needed anything she just needs to tell the nurse. The upcoming doctor's appointment for Joyce with Dr. Collins was reviewed. Joyce stated that she did not recall that she was told she was having an appointment...

Maggie at Aspen Park called Dusty at 11:31 a.m. to provide a quick update on Joyce. Joyce reported to be doing well given current mystery issue with her health. Dr. Collins has been reached. Collins reviewed the information provided about Joyce's improvement from the latest round of antibiotic treatment and determined with Aspen Park team that Collins should see Joyce in person for more thorough examination. Collins will visit Joyce in person on Thursday (8/13) and hopefully will be able to determine what is affecting Joyce and/or setup next steps for treatment. More information to be provided as it becomes available.

08/10/2020 Rachael (social worker at Aspen Park) contacted Dusty via email ~3:30 p.m. to confirm that the discharge plan for Joyce was on hold while Dr. Collins and the Aspen Park team worked to determine what was occurring with Joyce. Rachael confirmed she knew that Dusty had already been in contact with Maggie, Rachael has updated home health and Lincare contacts about the delay to Joyce's return home.  Joyce was confirmed to be working with occupational therapy today. --- Dusty called Joyce on his walk home from work around 4:45 p.m. She was alert and coherent. She could not recall what she had eaten for lunch but thinks it was some kind of tomato pasta.   Dusty asked about Joyce's therapy work today and she said that they took her for a walk and while they did go into the weight room they did not have her lift weights but rode a stationary bike for a few minutes. They both agreed that was good for her. Joyce asked about if Dusty knew when she would get to go home and ...

One of Joyce's nurses, Andrea, saw the note to contact Dusty and returned Dusty's phone call from 11:15 a.m. around 11:43 a.m.  Andrea had been present all weekend, checking in on Joyce and overseeing her care. Joyce was reported to be doing well so far into today's day shift - no hallucinations, doing all her own care, is alert, and responsive when interacting with staff.  Joyce did have some toilet issues over the weekend with 3 bowel movements on Saturday and one yesterday. Nothing to worry about overall, increased bowel movements are a known side affect of the antibiotic Joyce is taking. There was no diarrhea, just pretty soft stools and the urgency to go to the bathroom for the bowel movements came on quicker for Joyce than she anticipated resulting in some accidents requiring assistance in cleaning. Andrea passing information onto family in case Joyce takes antibiotics in the future while at home (so they can factor in planning to provide assistance in cleanup which m...

08/08/2020  Dusty did not manage to call Joyce or the Aspen Park staff on Saturday owing to conflict of schedule. 08/09/2020 Dusty and Jess called to check in on Joyce in the late evening.  Joyce was responsive and alert. Joyce seemed to follow conversation and did not refer to nursing staff as "guests." Joyce did not acknowledge names during the conversation but did recognize voices. Joyce told the nurse, who popped in to check on Joyce during the course of the phone call, that she was just talking with her son. Joyce confirmed that she was still taking the antibiotics orally and knew that she was being treated for infections. Joyce reported that her throat was feeling much better than it had been previously. 08/10/2020 Following conclusion of morning meetings at work and his own medical appointments, Dusty called Aspen Park main desk around 11:15 a.m. to request update on Joyce. Danielle answered and attempted to get Dusty in touch with Joyce's day nurse. After a five m...

Dusty called Maggie (8/7/20) around 7:20 a.m. during his walk to work to update her on what information he was able to get out of Joyce as to her pain levels and overall mental state. Dusty relayed information from yesterday's phone calls with Joyce (afternoon and evening - 4:30 p.m. and 9:30 p.m.). Maggie was appreciative for the information, especially that hallucinations were still manifesting for Joyce.  Maggie has not yet checked in on Joyce for the morning rounds at time of Dusty's phone call but had received and reviewed the night shift's report on Joyce. Joyce was noted to be more cognizant and basically "bright eyed and bushy tailed" compared to previous lethargy and lagged responsiveness.  Maggie confirmed that anti-fungal and a general antibiotic treatment were underway for Joyce and she should have about 2 doses into the run for them by now. Maggie has no new information to provide but will follow up with Dusty as it arrives.

Dusty called Joyce around 9:30 p.m. (8/6/20) following conclusion of his evening project work and meetings. Joyce seemed alert and responsive upon answering the phone. She immediately stated that she had visitors in her room. Dusty asked if it was the nursing staff checking in on her and Joyce stated that it was two adult children who were in the Aspen Park facility visiting one of the other residents and that they were staying overnight. Dusty asked for details on the "visitors" and Joyce couldn't describe them except to say they were "adult children" and had wandered off so she could not ask them their names or where they were staying. Joyce was not bothered by them, stating that they were very quiet for visitors.  After a brief recap of dinners had (Joyce could not recall what she ate for dinner) for the evening, confirmation that Joyce was "feeling all right" and that she knew she was taking medicine to "deal with her infections," the cal...

Maggie (nurse) called Dusty around 2:02 p.m. (8/6/20) to provide an update. Maggie has been in direct contact with Joyce's primary care physician, Dr. Collins, about Joyce today. Aspen Park team still suspecting a urinary tract infection may be affecting Joyce's health. A new urinalysis (UA) is being conducted, with urine having been collected from Joyce via catheter (catheter was inserted, urine collected, and catheter removed) today. The UA has been sent to Aspen Park's lab and the culture is being grown. More information to be provided when available. Joyce was started on a general antibiotic treatment per direction from Dr. Collins in the meantime.  More tests will be run if UA comes back negative for UTI. Dusty will be kept updated on Joyce's condition. Joyce is still complaining of throat discomfort, mainly when swallowing. Joyce states to Maggie that her mouth is sore but as Joyce is difficult to understand or get clear information out of at times it is difficult...

Dusty attempted to make contact with Joyce several times between 4:30 p.m. and 5:30 p.m. (8/5/2020) but was unable to reach her via her room phone. Dusty assumed Joyce was either out of her chair or sleeping hard and planned to call back later. Due to schedule conflicts with back to back evening meetings Dusty did not continue attempting to reach Joyce and did not reach out to Aspen Park night shift staff due to lateness of the hour. --- Dusty called Aspen Park around 11:08 a.m. (8/6/20) requesting to speak with Joyce's nurse for an update on her condition.  Dusty was connected with nurse Kim who reported that the test for strep throat infection came back negative on Joyce. The Aspen Park team is coordinating with Dr. Collins and will begin an anti-fungal medication for eliminating the Thrush. The Aspen Park team is collecting a second urine sample from Joyce today to culture, wanting to ensure no urinary tract infection is in progress. Aspen Park staff continuing to coordinate the...

Dusty attempted to call Aspen Park nursing staff for an update on Joyce's condition around 11:08 a.m. (8/5/20). No one available to speak at time of phone call. Dusty's contact information and message taken by front desk staff. Nursing staff will be directed to follow up once available. --- Dusty received call from Sue at Aspen Park around 12:54 p.m. (8/5/20). She was going through all of their resident's files and confirming COVID-19 safety protocols and patient/family decisions for COVID-19 treatment should facility's population become contaminated.  Sue confirmed and reiterated that there were no active COVID-19 cases within the Aspen Park facility at the moment, nor concerns over exposure or introduction of the virus to staff or residents, and that this was merely a confirmation of existing information about Joyce. Joyce is listed as "yes" for CPR. Joyce is listed as "yes" for aggressive intervention (ICU) and ventilator use if available. Joyce i...

Dusty attempted to get in touch with Aspen Park nursing staff for updates throughout the afternoon and early evening of 8/4/2020 but lines were either engaged, lines became disconnected after transfer, phones were transferred and then left unanswered, or no one called him back after requests for contact were made. Dusty figured that the staff was either super busy or understaffed for the day and continued attempting to make contact. --- Dusty called and left a message for evening nurse Andrea around 8:47 p.m. on 8/4/2020. Andrea returned Dusty's phone call around 9:49 p.m. and confirmed suspicion that today was very hectic for the Aspen Park staff. Dusty and Andrea conversed about their backgrounds in customer service and confirmed that flukes happen and that delays in information being relayed, missed follow up calls, etc. were frustrating but understandable.   Andrea reported that the urine culture collected from Joyce had not concluded it's growth cycle at this point in the...

Andrea called Dusty last night (8/3/20) around 9:37 p.m. Test results were available and it was confirmed that it appeared that Joyce had a urinary tract infection. Joyce's primary care physician, Dr. Collins, has been updated and directives are pending. Most likely a course of antibiotics will be prescribed by Dr. Collins. Andrea confirmed that Joyce was resting comfortably, still lethargic, but had a good dinner and all of her vitals (blood pressure, oxygen levels, blood glucose) were fine. Andrea offered to transfer Dusty to Joyce's room phone but Dusty declined based on Joyce's status as lethargic and sleepy.  --- Dusty called Aspen Park around 10 a.m. today (8/4/2020), following conclusion of morning meetings and appointments at work, to request an update on Joyce. Dusty spoke with Maggie (Joyce's nurse for the day). The Aspen Park team is waiting on the urine culture that was collected. Once that data is available (which type of bacteria are present), an antibioti...

Rachael Kimble contacted Dusty around noon (8/3/20) via email to discuss Joyce's discharge information and its potential change depending on what Dr. Collins determines. Rachael let Dusty know that she was aware he had spoken with Maggie earlier in the day and that she would be following up with him. Rachael suggested that Dusty obtain a portable oxygen tank for Joyce for to use during travel. Dusty stated he would reach out to vendors for pricing options. Rachel confirmed that the Aspen Park staff would ensure all of Joyce's belongings were packed on whichever day she gets discharged from their care to help with smooth transition out. Rachael confirmed that she would be following up with Kindred home health and Lincare on Joyce's discharge date. Rachael confirmed again that she is available to answer any questions the family might have. --- Dusty called Aspen Park and asked to speak with Maggie for an update as he walked home from work. Maggie had left for the day but the ...