General Update #192 - October 21, 2020

October 20, 2020 Addendum

5:14 p.m. - Jay (Kindred PT) called Dusty's cellphone to inform him that he would arrive to farmhouse tomorrow between 10 a.m. and 10:30 a.m. to work with Joyce.

Glenda attempted to call Dusty's cell phone while he was at the Girls Troop 333 meeting ~7:47 p.m. Glenda left a voicemail to ask for an update on Joyce, stating that it had been a while since she had received any news. Dusty attempted to return Glenda's phone call but was unable to connect. Dusty sending email direct to her.

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October 21, 2020

Dusty arrived to farmhouse ~7:45 a.m. Joyce was sleeping in her recliner without oxygen line in place but woke easily and was responsive to interrogatives. 

7:50 a.m. - Bathroom trip. Urinary incontinence issue requiring diaper and diaper pad insert change. Urine and small Type 5 bowel movement passed. Dusty asked Joyce if it would be acceptable for Dawson to come visit him on Sunday while he was out at the farm and Joyce agreed that would be fine as long as Dusty was not embarrassed by her. Dusty assured Joyce that he was never embarrassed by her. Joyce consented to a PT walk into the blue living room and back to kitchen where she wished to sit in the blue chair. 

8:15 a.m. - Breakfast (Nutritional shake, 1 slice whole wheat toast with butter, 2 leftover fiber crackers from yesterday she did not eat,1/2 banana) and morning medication (Carvedilol, metformin, 2 Tylenol, multivitamin, potassium, iron).

8:29 a.m. - Scam phone call to farm's landline intercepted by Dusty.

8:45 a.m. - Scam phone call to farm's landline intercepted by Dusty.

While Dusty was in the other room on an hour long video call with his director that ended ~9:50 a.m. Joyce drank her nutritional shake, ate her 1/2 banana, 3/4 of one fiber cracker, and 1/4 of her toast. Joyce was sleeping when Dusty returned to the kitchen, rolled forward in the blue chair with her forehead on her knees in ball-like position. Joyce stated she was not very hungry when Dust asked if she was done eating. Dusty informed Joyce that she needed  to wake up as Jay would be arriving soon to do PT with her. Joyce acknowledged and resumed napping. 

Carole (Kindred Nurse) called Dusty's cell phone while he was in his video call, stating that she would come by to check Joyce today ~1 p.m.

10:12 a.m. - Joyce soiled herself, Type 6 bowel movement. Dusty assisted Joyce with traveling to bathroom and performing initial cleanup and diaper removal. Joyce passed urine and remaining Type 6 bowel movement. Joyce expressed frustration at soiling herself and Dusty talked through her feelings to calm her. 

Jay (Kindred PT) arrived ~10:30 a.m. to see Joyce, Dusty directed him to get setup out in the kitchen while he finished cleaning Joyce up in the bathroom.

Joyce returned to recliner ~10:38 a.m. under her own power but was unsteady. Vitals were taken by Jay. Joyce stated that she was feeling tired when asked, Jay commented that she looked tired. Temperature 98.9, pulse 86, BP 138/76. Joyce reported she was "not bad" for pain levels. She confirmed that her left knee was still causing her pain, but she was experiencing pain in both legs - about a 7 out of 10 at times for some of it, with lower pain. Joyce told Jay she has difficulty articulating her pain. Jay confirmed that he understood. Jay reviewed Joyce's care logbook with Dusty, noting days where Joyce was unable to walk under her own power to/from bathroom. Confirmed no falls have occurred. 

Jay worked with Joyce on lower leg exercises (increased to 15 reps for each leg was goal but Joyce only able to reach 10 before experiencing pain). Left leg, the one that has been causing Joyce more pain lately, performed better than her right leg during exercises.

Jay noticed that Joyce was watching The Addams Family (1991 version) and asked her about who her favorite character was from it. Joyce indicated Cousin It after working with Jay through the list of characters when she was not readily able to respond. 

Joyce put through standing PT activities (marching in place, toe raises, etc.) which were timed vs. duration based. Joyce fatigued quickly (20 second average, falling short of 30 second goal), having issues with her breathing control during activity (holding breath then hyperventilating). 

Jay asked Joyce if she had ever driven combines and she said she had not, stating that she had told her son (Craig) that she was "too afraid to drive them" in the past. She thought that Craig would not have her drive them now in her current state. Dusty joked with Joyce about Craig leaving his combine in gear and ramming it into the shop yesterday, "so the bar had been set" for her.   

Jay confirmed that he was now on a once per week schedule to see Joyce. Jay told Joyce that she needs to do her PT with Dusty if she can between now and then and should try to do it at least every other day.  Joyce confirmed that she would try. Jay departed farmhouse ~11:05 a.m. 

Dusty called NW Respiratory to check on status of wheel chair order for Joyce. NW Respiratory following up with Moscow Medical as documentation did not appear to make it to them from the October 1 appointment Joyce had with Dr. Collins for setting up the insurance's rent-to-own coverage which should be an 80/20 coverage (insurance/out-of-pocket cost) for Joyce. 

Joyce insisted she wanted a hamburger from Zip's for lunch and that Dusty should get enough for Craig to have lunch with them as it was raining outside and he would most likely come inside. Dusty sent to town ~11:35 a.m.

~11:46 a.m. - NW Respiratory called Dusty's cell phone to confirm that they are working on obtaining needed documentation for Joyce's wheelchair and it is now on their radar to see followed through. They will follow up with Dusty once documentation has been received and processed.

Dusty returned ~12:18 p.m. as Craig arrived to farmhouse to visit and have lunch. Oil furnace was started to heat the house in preparation for coming cold temperatures. Weather reports predict snowfall and single digit temperatures. Dusty confirmed farmhouse received an oil delivery.

12:33 p.m. - Carole (Kindred Nurse) arrived to check Joyce. Vitals taken, temperature 98.3 degrees. Oxygen level at 95%. BP 140/86. Reviewed Joyce's health log book with Dusty and noted increased blood pressure readings. Dusty informed Carole about increased soiling incidents and loose stool over the last few days. Carole took photos of log book to relay to Dr. Collins at Moscow Medical for review. Joyce reported that she is feeling okay when asked. No reports of stomach feeling upset at time of being asked by Carole. Joyce's heart, stomach, and breathing was checked with stethoscope. Legs checked - swelling noted. No dizziness or headaches reported - Joyce then updated her response to say "very slight" if she has any at all. Carole reviewed Joyce's current medication list and confirmed nothing new. Blood glucose tracking reviewed in logbook. Wound on buttocks reviewed with Dusty and was confirmed to be healing well. Carole will call Dr. Collins about Joyce's increased blood pressure, increased/continuing diarrhea and soiling events, and lack of appetite. Craig asked how Joyce could have so much diarrhea if she is not eating anything. Carole departed ~12:49 p.m.

Lunch ~1 p.m., Joyce ate fries and 1/2 of her hamburger by 2:15 p.m. Joyce resumed napping. 

2:44 p.m. - Scam phone call to farmhouse intercepted by Dusty.

3:05 p.m. -  Scam phone call to farmhouse intercepted by Dusty. 

~3:10 p.m. - Bathroom trip. Urinary incontinence requiring diaper replacement. Urine passed. Weight 159.6 lbs. PT walk to living room before Joyce returned to her recliner ~3:20 p.m. 

3:28 p.m. - Scam phone call to farmhouse intercepted by Dusty - someone posing as a member of Women's Cancer Center seeking donations. 

3:30 p.m. - Dusty gave Joyce today's newspaper to read as he prepared to go outside to harvest grapes.

3:41 p.m. - Scam phone call to farmhouse intercepted by Dusty, someone claiming to be from BAS Insurance attempting to get personal information from Joyce.

Carol arrived ~5:15 p.m. to check in, departing to do chores at home and care for animals before returning to provide evening care for Joyce.

~5:30 p.m. - Bathroom trip. Urine passed. Returned to recliner under her own power.

Dusty finished bringing in grapes ~5:47 p.m. Joyce inspected them (smelling Concords and eating some Candice). Dusty chased off the woodpecker again. Dusty departing to prepare for Troop Committee meeting in Moscow, returning ~8 a.m. tomorrow morning. Craig on-site outside finishing cleanout of combines.