General Update #99

Dusty called Aspen Park around 9:36 a.m. (8/3/2020) following the conclusion of his morning appointments and meetings, asking to speak with Joyce's nurse (Maggie). Maggie was unavailable at time of this phone call. Aspen Park front desk staff took down Dusty's contact information and stated that they would have Maggie return his call once she was available.

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Maggie returned Dusty's call from earlier in the morning around 11:09 a.m.

Dusty provided information as he and Jess experienced it during yesterday's phone calls with Joyce to Maggie. Maggie seemed interested in what Joyce was seeing "out her window" last night as well as her confusion over her location, self identity, and comments about "the guest" and emotional stress at not being able to return home.

Maggie received the update on Joyce's behaviors from yesterday during the morning staff meeting and reviewed notes from the Sunday nursing staff. Joyce was reported to be hallucinating again, reporting she was seeing the two children in her room once more. Maggie went in and sat with Joyce for a while this morning and visited with her to see how Joyce was doing overall. Maggie stated that Joyce has been an early riser during her time at Aspen Park and so when Joyce was lethargic, slow to respond and slow to converse, Maggie stated there was a noticeable difference in Joyce's behavior overall from where she had left her last week.

Dusty asked if it could be a urinary tract infection occurring again and Maggie agreed that was what she suspected. Maggie has already placed a call to Joyce's primary care physician, Dr. Collins, at Moscow Medical and is awaiting a call back. Joyce's discharge date may be affected, Maggie warned, given this new development as it might not be safe for Joyce to return home in her current state. To be determined by Dr. Collins.

Maggie noted that Joyce had a kidney stone removed at Gritman prior to her arrival to the Aspen Park facility. Maggie stated that Joyce may possibly have more kidney stones, which tend to gather bacteria, and if the kidney stones are moved around that bacteria can dislodge and cause immediate effects. This might be an explanation to why Joyce had a sudden onset of mental distress on Sunday whereas she was baseline normal Friday and Saturday. Maggie theorized that kidney stones might be chronic now for Joyce, possibly requiring additional shunt work to be done in the future to deal with them, but that is all theory and will need to be explored via Dr. Collins and Joyce's urologist at appropriate time. 

Maggie repeated that she is waiting to hear back from Dr. Collins. Maggie suspects that another urinary tract infection is occurring and a test will be done. Maggie will call Dusty with updates as she is able to provide them.

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