General Update #168

Dusty arrived to farmhouse ~7:40 a.m., finding Joyce sleeping in her recliner curled forward over her knees with oxygen line in place with one of her extra pillows under her bottom. Joyce commented that it was "quite late" for Dusty to be arriving to see her and Dusty informed her that it was morning time. Joyce laughed at her misjudgement of the time of day, citing the ambient light levels of the kitchen living room threw off her thinking. Joyce fairly alert.

7:53 a.m. - Blood pressure 175/94, pulse 83.

Bathroom trip at ~7:54 a.m. without incident. Joyce's diaper pad insert changed due to urinary incontinence. Dusty cleaned out the open blister wound on Joyce's buttocks using wound cleaner he picked up last night. Fresh barrier cream applied. 

Returned Joyce to her recliner after PT walk to family room, to kitchen window and into living room area ~8:19 a.m. Dusty placed the extra pillow Joyce had been using under the waterproof pad for Joyce to continue using to alleviate pressure sores on her buttocks. Joyce alert and receptive to conversation, stated that she felt quite hungry. Joyce shared information about her visit with Connie and Phil (who had joined them for the stir-fry dinner Connie had prepared last night). 

8:37 a.m. - Blood glucose level @ 145

Breakfast served to Joyce ~8:38 a.m. (1 scrambled egg, 1/3 banana, 1 slice toast with butter, Earl Grey tea). Morning medication administered (Carvedilol, Metformin, 2 Tylenol, Multivitamin, Iron, Potassium). Meal finished ~9:14 a.m., Joyce finished in its entirety. 

Craig stopped in to visit briefly ~10:40 a.m., Dusty suggested Joyce travel to the bathroom after Craig departed. Joyce stood and had a large bowel movement (Type 6) in front of her chair which the pull-up style diaper did not fully contain. Dusty laid down disposable mat over stained carpet area and removed soiled clothing to work on cleaning up Joyce. Derik entered the farmhouse to use the bathroom while Dusty was cleaning Joyce. Dusty got Joyce into bathroom ~11:09 a.m. after Derik departed and then proceeded to get her into the shower following toileting cleanup. Open blister on buttocks was cleaned and fresh barrier cream applied. Joyce given fresh clothing and returned to her chair ~12:05 p.m.

12:27 p.m. - Bathroom trip at Joyce's request, no incident. Urine and minor type 6 bowel movement passed. Dusty cleaned wounds on buttocks and applied fresh barrier cream. 

12:36 p.m. - Weight 164.2lbs 

Joyce returned to recliner ~12:44 p.m.

Blood glucose level 119 @ 12:45 p.m.

1:37 p.m. - Lunch (Small bowl of leftover spaghetti, small cup of green beans). 2 Tylenol for pain relief. Joyce slow at eating, citing that she was not hungry. Ended attempting to eat ~2:40 p.m. Joyce ate all of her green beans but only 1/2 of her spaghetti (wadding it up into a paper towel and attempting to hide it from Dusty seeing she had not eaten all of it). 

4:09 p.m. - Susan (Kindred PT) arrived to farmhouse, reintroduced herself to Joyce. Checked Joyce's vitals ~4:13 p.m.. Temperature normal (98.7). Blood pressure at 130/78. Pulse 76. Verified 2 liter oxygen flow rate and no difficulties breathing. Susan confirmed no new medications or changes in medications for Joyce.

Susan asked Joyce about her fall and Joyce stated she had fallen down the stairs. Susan asked if Joyce had been injured, Joyce told her she cracked a vertebrae in her back. Joyce was asked if she was in pain, Joyce says that she was not as it had been "enough days" that "it is liking her again." 

Susan worked with Joyce on her posture exercises. Verified muscles are working for Joyce being able to sit upright and lift her head. Worked with Joyce on upper body/arm exercises using 2 lb. weights. Asked Joyce to take a walk inside farmhouse for 2 minutes using her walker. O2 levels noted to have dropped to 90% after activity. Susan asked Joyce how difficult the walk was for Joyce and Joyce reported "medium" difficulty. Blood pressure checked by Susan after Joyce was returned to her recliner - 144/80. Susan asked if Joyce was feeling more pain after walking. Joyce stated that she was experiencing more pain. Susan attempted to work with Joyce to identify what helps with pain relief. Joyce stated that if she is allowed to sit and relax then she "does okay." Susan elevated Joyce's legs using the recliner and noticed Joyce frowning and asked Joyce if she was hurting. Joyce apologized for frowning. Susan and Joyce worked on lower body/leg exercises with Joyce's feet in elevated position. Susan worked on deep breathing exercises with Joyce. 

Susan anticipating that Marshall should be back to see Joyce on Friday this week and will coordinate arrival time with Dusty. Susan departed ~4:48 p.m.

4:49 p.m. - Bathroom trip. Replaced diaper pad insert due to urinary incontinence. Joyce passed urine and Type 6 bowel movement. Cleaned her open wounds and applied fresh barrier cream. Joyce returned to her recliner ~5:08 p.m. 

Dusty departing farmhouse ~5:15 p.m., returning tomorrow ~8 a.m. 



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