Gritman - Monday April 12, 2021 (Updated)

These entries will be a bit odd as I (Jess) will be transcribing text messages from Dusty of the events as they happened and he had time to reach out to myself and the family. I will have him come back and edit/add more when he can. 

10:05 a.m. Dusty: Joyce had already been taken for her stress test by the time Dusty arrived. Just returned to room by 10 a.m. Joyce had been attempting to get up and move about on her own during the night, so she has been rigged with a bed alarm to alert nurses station when she was trying to get up on her own.

10:06 a.m. Dusty: Aaron, tech, will send results off to doc for review and doc will be in to provide update.

10:07 a.m. Dusty: Joyce being hooked back up to sensors in room and vitals being collected by her day nurse (Sylvia).

10:08 a.m. Dusty: Joyce reported to have slept well, was woken around 7am to prep for stress test. O2 @ 94%, pulse 85. BP 126/76. Temp 98.1

10:23 a.m. Dusty to Jess: "Mom, you're in the hospital. You can't just go walking around without the nurse. You could fall and hurt yourself." Dusty said to Joyce. "What will they do, put me in the hospital?" Joyce replies. 

10:32 a.m. Dusty: Breakfast (brunch?) delivered - scrambled eggs, toast with butter and jam, apple juice. Blood glucose @ 183 (same as when first collected around 7 am).

10:44 a.m. Dusty: Nurse's aide (with trainer accompanying/supervising) arrived to administer insulin to Joyce.

10:57 a.m. Dusty: Sheri (pharmacy tech) arrived to confirm Joyce's current meds with Dusty (last recorded on April 2, PRH changes at discharge, etc.).

12:19 p.m. Dusty: Case worker arrived to have Dusty sign paperwork for discharge planning to be initiated. Waiting on doc's review and assessment of this morning's stress test. Joyce should be discharged from Gritman "today" to return to farmhouse.

12:56 p.m. Dusty: Lunch delivered. Meatloaf,, mashed potatoes,, steamed carrots, applesauce,, iced tea. Nurse Amanda stopped in to administer 3 units of insulin. Chaplain stopped by to visit.

1:31 p.m. Dusty: Dr. Standley stopped by, confirmed Joyce had an EKG and 3 protein tests done last night looking for damage to heart and they came back negative. Waiting on cardiologist in Kootenai to call Standley. If all good, Joyce will be discharged. 

1:32 p.m. Dusty: Standley recommends starting Joyce on a heartburn medication when she returns home, just to rule that out. Food log the family keeps was helpful, possibly acidic foods like tomato sauce cause Joyce some acid reflux/heartburn.

1:39 p.m. Dusty: Lunch abandoned. 3/4 of meatloaf, all of applesauce, 1 fork of diced steamed carrots eaten.

2:04 p.m. Dusty: Dusty and Jess purchased LifeFlight membership for Joyce so she has that in case needed in the future. Joyce napping off and on. O2 @ 94%, pulse 89.

4:08 p.m. Dusty: On the chance that Joyce isn't getting discharged from Gritman today, Dusty canceled her appt at Moscow Medical tomorrow and will work with them to reschedule.

4:17 p.m. Jess: Good idea! It is getting late in the day. 

4:18 p.m. Dusty: Yeah, starting to think discharge for today isn't happening.

4:26 p.m. Dusty: Joyce began removing her sensors and set off alarms.

5:00 p.m. Dusty: No news from Kootenai docs at this point. Discharge today could still happen. Dusty will plan to provide evening care coverage if Joyce gets discharged. Blood glucose tested by nurse's aide - @ 180 

5:02 p.m. Dusty: Dinner delivered (grilled cheese sandwich, roasted red potatoes, applesauce, pudding cup)

5:04 p.m. Dusty: Nurse Amanda arrived to administer 1 unit of insulin to Joyce.

5:26 p.m. Dusty: Dr. Standley stopped in, stress test was negative along with other tests so Joyce discharge for this evening will be initiated. 

5:27 p.m. Dusty: Standley sending order for heartburn/acid reflux medication to pharmacy for Joyce, Dusty will pickup when available (probably tomorrow).

5:28 p.m. Dusty: Joyce's mood switched from sulking to elated. Joyce was acting as if she was going to abandon her dinner. Now eating with enthusiasm (still stating she does not feel like eating).

5:45 p.m. Dusty: Joyce pressed nurse call button to complain about things taking too long/not being allowed to have her clothes put on and leave immediately.

5:54 p.m. Dusty: Dr. Standley stopped in while Joyce using bathroom. Joyce's blood pressure has been pretty good while in Gritman care, concerned that if she resumes the blood pressure meds PRH put her on it could lead to her blood pressure tanking and then her fall risk due to lightheadedness. Only to resume carvedilol use. If consistently over 140/90 2-3 days in a row, then restart losartan. If still high, 2-3 days after that, then restart spironolactone. Standley will write up directions in discharge orders.

5:59 p.m. Jess: Did Dr. Standley see she had already been on 2 blood pressure medications before PRH and we had a running pressure log?

5:59 p.m. Dusty: Yes. 

6:01 p.m. Dusty: His reasoning was that because they were prepping Joyce to run the stress test (and I had not given her morning meds yesterday) they had given her zero of the blood pressure meds and felt that doing this "ease in" would be a good way to start her back in because we take her blood pressure readings 1-2 times per day.

6:02 p.m. Dusty: We can monitor and adjust, plus we need to have Dr. Collins appointment to see if she was going to keep the altered prescriptions (increased dosages of carvedilol and Losartan, and addition of spironolactone).

6:03 p.m. Jess: Ok that makes more sense. I was worried since PRH had cautioned use to watch the BP due to the aneurysms. 

6:03 p.m. Dusty: He was concerned giving Joyce all that blood pressure medication when she has been well at Gritman might cause her to have low blood pressure problems.

6:04 p.m. Dusty: Yes, thus the 140/90 marker 2-3 days in a row, then we start adding meds back in.

6:06 p.m. Dusty: To lower blood pressure again. Or Dr. Collins changes things, whichever occurs first. Moscow medical is closed now so I will call and reschedule the appointment tomorrow.

6:07 p.m. Jess: Sounds reasonable.  Thank you for keeping track of everything! You rock. 

6:54 p.m. Dusty: Nurse Stephanie and Amanda removing IV, remaining sensor pads, taking Joyce to bathroom, then dressing her into her clothes. 

7:20 p.m. - Joyce returned to farmhouse. Bathroom trip refused.

8:08 p.m. Dusty: Joyce back at farmhouse, settled into her recliner after refusing to be showered. 

8:32 p.m. Shelly: That's Great! <3

9:20 p.m. - Dinner declined. Evening medication administered with nutritional shake.

9:26 p.m. - Bathroom. Urinary incontinence. Diaper and diaper pad insert replaced. Remainder of urine passed. PT walk, returned to recliner by 9:38 p.m. Dinner declined.

10:18 p.m. - Ready for bed.

Comments

Post a Comment

Popular posts from this blog

General Update #92

07/24/2020 Dusty missed calling Joyce due to personal schedule conflicts. 07/25/2020 Dusty called in to check with Joyce at 1 p.m. following a training session he attended for Scouts BSA. Lunch today was spaghetti "with a delicious meat sauce," a side of veggies and dessert was vanilla pudding. Joyce confessed that she might not have remembered it had the tray not still been sitting beside her with the remnants of the meal. She had today off from physical therapy but did have speech/mental therapy. She said that some of the questions that the speech therapists ask her are "laughable" because they ask her if she has lived in rural areas and then ask her about what she thinks living in the rural areas are like after already verifying she lives in the country. Dusty suggested that the therapists are trying to use something basic, like knowledge of Joyce living in the country, to then ask questions about living in the country to see how Joyce recalls information or rela...
Read more

General Update #95

07/27/2020 Dusty called Joyce to check in and wish her a good night while he was preparing dinner for Jess. Joyce was alert and quite talkative. Dusty reviewed the plan for the telehealth appointment scheduled for tomorrow and Joyce stated that no one had told her that was occurring. Dusty suggested to Joyce that they were going to visit with her tomorrow morning ahead of the appointment based on what Rachael had told him and Joyce concurred. Dusty questioned Joyce about her decline of participating in the urinary incontinence therapy as well as her reported lack of performance with physical therapy. Joyce stated that she had been looking forward to the urinary incontinence therapy work but according to her they only spoke to her once about it and then never again approached her about it.  Joyce felt like they don't do enough PT with her even though she wants to do more PT. She cited today that they only had her walk back and forth using parallel bars for a few minutes before givin...
Read more

General Update #85

Dusty and Jess called Joyce in the evening on July 4 to wish her a happy Independence Day.  Joyce reported that her pain levels were fairly low, even after doing upper body physical therapy work earlier in the day. She was a little disappointed with her meals served. She had been hoping that they would serve hot dogs and potato salad for lunch or dinner but none were to be had. Joyce could not recall what she ate for any of her three meals she was served. At the time of the phone call Joyce had not seen any fireworks out her north facing window but she could hear several concussive blasts of fireworks being set off near Dusty and Jess' apartment.  Joyce said that she did not see or hear the Let Freedom Ring Tour (a B-25 Mitchell, a F-7F Tigercat, a P-47 Thunderbolt, a P40N Warhawk, and a P51D Mustang), which was sponsored by Hangar180 , fly overhead around 5:45 p.m. but she might've missed it most likely owing to having been napping at the time. She stated that she was excited...
Read more