General Update #269 - Wednesday, January 6, 2021 (Updated)

Craig covered morning care for Joyce while Jess was out at dental appointment and Dusty was being COVID-19 tested.

8 a.m. - Breakfast. Joyce ate very slowly.

Dusty arrived to farmhouse ~12:25 p.m., found Joyce in bathroom with Courtney in attendance. Dusty assisted with cleanup of Joyce. Urine and small type 1/5 bowel movement passed. Joyce unable to rise up from toilet or remain standing independently under her own power. Preparation H applied. Dusty moved Joyce to sitting position on her walker and wheeled her out to kitchen, transitioning her to recliner with difficulty by ~1:45 p.m. Bathroom sanitized. Lunch negotiated.

Courtney relayed that Craig provided morning medication to Joyce. Courtney remained onsite at farmhouse to monitor Joyce when Craig departed earlier in the morning. Courtney departed shortly after Joyce was returned to recliner, informed Joyce that she would most likely return this evening with Carol to provide evening care.

12:58 p.m. - BP 158/75, pulse 66. BGL @ 139.

1 p.m. - Lunch (bologna sandwich with mustard and mayo, 1/2 can of sliced peaches, V8 juice). 2 Tylenol.

1:40 p.m. - Carole (Kindred nurse) called Dusty's cell phone and informed him that she was running late and would most likely not arrive to the farmhouse to see Joyce until ~2:30 p.m.

Lunch finished by 1:50 p.m.

2:37 p.m. - Carole arrived. Believed that she was to collect a urine sample from Joyce today - was unaware that a sample had been collected on Monday. Carole called Kindred office to check in with them about confusion on orders for the urine sample collection. Kindred office uncertain - sample collected by Andrew (Kindred nurse) on Monday may have been contaminated? Carole uncertain how Andrew collected a urine sample on Monday. Dusty reviewed timelines with Carole that he was provided from is phone calls with Andrew, Moscow Medical, and Kindred main office on Monday and Tuesday. 

Carole suggests Dusty wait to collect the urine sample until Moscow Medical or Gritman can confirm with him that the urine sample Andrew collected is in fact contaminated (or wasn't actually collected?). 

Kindred's office staff called Carole's cell phone back after they called Moscow Medical to confirm if a urine sample had been dropped off for Joyce and Moscow Medical confirmed they had an order for one but no sample. Dusty clarified to Carole that the specimen had been dropped off to Gritman and not Moscow Medical. Carole called Gritman's labs to try and track down the urine sample that was collected on Monday. Gritman lab says that they did not receive any samples for Joyce today. Carole corrected them that the sample was dropped off on Monday. Gritman stated that there was no sample in Joyce's name in their inventory at this time. Carole unable to explain what occurred with the urine sample existing or not existing/being lost. 

Carole reviewed how to collect a urine sample with Dusty using kit she provided. Time and date will need to be noted on the sample container post-collection. Dusty to take collected sample to Gritman lab when it is produced (if today). Joyce needs to be cleaned before she passes urine to help reduce chance of contaminating sample. If possible, Joyce needs to pass some urine, stop, then pass remainder into sample container. Dusty confirmed he would try to make this happen but Joyce has little to no control over her urinary functions.

Carole collected vital signs for Joyce. 98.5 degrees Fahrenheit. 96% oxygen level. Pulse 73. BP 156/86.

Blood pressure noted to be high. Confirmed with Carole that Dr. Collins has prescribed losartan to Joyce and that was added to her morning medications on Tuesday morning. Kindred's log of Joyce's medications updated.

No headache or dizziness reported by Joyce when asked. Joyce noted to "look different today" to Carole. Dusty reviewed recent conditional changes with Joyce. Carole suggested that Joyce may have had a transient ischemic attack (TIA). TIA is a temporary period of symptoms similar to those of a stroke. A TIA usually lasts only a few minutes and doesn't cause permanent damage. Often called a mini-stroke, a transient ischemic attack may be a warning.

Carole departed farmhouse ~3 p.m.

3:01 p.m. - Joyce declined bathroom trip.

~3:15 p.m. - Dusty returning to work in his office on campus.

Carol arriving to provide evening care for Joyce.

6:26 p.m. - Bathroom trip. Bowel movement.

7 p.m. - Dinner (spaghetti, bread). Evening medications.

8:30 p.m. - Bathroom.

9 p.m. - Ready for bed.

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Dusty's COVID-19 test came back negative @ 4:16 p.m.

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