The Official Joyce Update Blog

Dusty and Jess called Joyce ~8:17 p.m. on 9/10 following the conclusion of Dusty's evening meetings to let her know the good news about tomorrow. Joyce expressed that she was very excited and joked that she might not be able to sleep.  Dusty gave general overview of the discharge plan Rachael provided him earlier in the day. Joyce comprehended it and thought that it was great.  Jess suggested that she will bring the teapot she inherited from her grandmother recently out to the farm on Saturday and the three of them could have a little tea party out on the farmhouse's back patio together. Joyce got excited about that idea. Jess and Dusty reviewed some of the things that Joyce stated she would like to do her first day back at the farm and the things that have been done out there to benefit Joyce's return home (bed cleaned and made; basement door boarded over; etc.).  Joyce is looking forward to seeing everyone again and being home. Joyce is looking forward to receiving many...

Rachael called Dusty at ~5:03 p.m. on 9/10 to connect and discuss the discharge plan for Joyce tomorrow. She confirmed that the portable oxygen order was sent off to Lincare and that Dusty should plan to pick up the portable O2 gear from them at their Moscow location before retrieving Joyce. They'll open ~8 a.m. tomorrow so Dusty can plan to make contact with their office sometime in the morning (as they are currently closed now) and schedule the portable O2 gear pickup with them. Dusty can then call Aspen Park to inform them he has obtained the portable O2 gear for Joyce and they'll coordinate Joyce's exit timeline with Dusty from Aspen Park facility. Rachael confirmed that the home health orders were sent successfully and are ready to go for Joyce's care plan. More information will be part of Joyce's exit packet Rachael will provide to Dusty. Rachael has discharge packet ready and on-hand and will review with Dusty upon his arrival. Aspen Park nurse team will go o...

Rachael (Aspen Park social worker) attempted to call Dusty on 9/10 at 3:44 p.m. but Dusty was in a meeting and missed her call. Rachael left voicemail for Dusty asking him to call her at her office number or her cell number. --- Rachel attempted to call Dusty again at 4:08 p.m. to try and connect about Joyce's discharge plan for tomorrow and to confirm a time to setup discharge process and Joyce's exit from the Aspen Park facility. Rachael also wanted to talk about the home health and portable oxygen orders for Joyce. Rachael stated that she would remain at Aspen Park for a few more minutes in case Dusty would be able to return her call "soon." --- Dusty returned to his desk from his afternoon work meetings and saw Rachael called and left voicemails with his cellphone number while he was out. Dusty attempted to return Rachael's call at 4:34 p.m. after listening to her voicemails requesting he contact her but was informed that Rachael had left for the day when he c...

Dusty called Joyce to check in with her during his walk home from campus on 9/9 ~6:14 p.m. Joyce was in a good mood, having just finished her dinner (macaroni & cheese, green beans, and a chocolate cupcake for dessert). An orderly arrived to clear away her trays from the day. Dusty asked Joyce if she had been reading her Redwall book and she stated that she had not been, not certain where it even was at the time of the call. Dusty suggested that she or a therapist might've put it in one of her drawers in the room and Joyce thought that might be the case after some consideration. Joyce informed Dusty that she'd been told she would be going home soon. Joyce expressed that she was excited to be going home. When asked what she wanted to do first once she was back out at the farmhouse, Joyce stated that she "just wanted to sit a while in her chair and take it all in and be thankful she got to make it home." She confirmed this was the longest time she's ever been aw...

Rachel called Dusty ~4:56 p.m. (9/9) to let him know that Lincare has followed up with her. Lincare thinks that Joyce should be completely covered for a portable oxygen tank service as long as Joyce meets certain criteria for how they code it for the insurance (Joyce has to have her oxygen levels be recorded as falling below a certain level, and then that they are restored with O2 use, which has been noted before). Aspen Park therapy team will take Joyce off oxygen and then have her walk around and document the drop in her oxygen levels, then document to show it comes back up after O2 is administered to treat the drop in oxygen levels. Lincare noted that Joyce has secondary insurance and so certainly should be covered, no cost for portable O2 being added to her service account. Info about the testing needs is on the way from Lincare to Aspen Park within the next few minutes and the documentation of Joyce's oxygen drop for their needs for insurance submission should be completed eit...

Dusty was unable to call Joyce on 9/8 due to his schedule. --- Dusty called Joyce at Noon (9/9) to check in with her. Conversation was abbreviated as lunch happened to be delivered just as the phone receiver was picked up. Joyce reported that she was having a peanut butter sandwich, tangerines, half a cup of cold coffee, and orange juice for her lunch today. Dusty asked if coffee was left over from breakfast time. After several attempts to process the question being asked, Joyce concluded that it probably was left over coffee from breakfast. Call ended so Joyce could enjoy her lunch. --- Dusty called Aspen Park to check in with Rachel at 12:13 p.m. (9/9) to obtain update on discharge process and costs of portable O2 from Lincare. Rachael unavailable, most likely on lunch hour. Dusty left message on her voicemail.

08/29/2020 Dusty did not call Joyce due to schedule conflicts. 08/30/2020 Dusty did not call Joyce due to schedule conflicts. 08/31/2020 Dusty did not call Joyce due to schedule conflicts. 09/01/2020 ~7:35 a.m. – Dusty called Joyce on his walk to work, waking her up from sleep. After apologizing and explaining that Joyce’s nurse said that she was usually awake at this hour a brief conversation was had but ended soon afterward as Joyce was struggling to gain coherency. Joyce confirmed that her oxygen line was in place but that she was just sleepy and waking herself up. --- ~5:15 p.m. – Dusty called Joyce on his walk home from work. Joyce recalled that Dusty had called earlier in the morning after being reminded it occurred on the same day. They spoke briefly, mainly discussing how happy she was that she was cancer free before transitioning to questions about her location as she was uncertain where she was staying or who the people were around her. After providing Joyce an update about w...

Rachael (Aspen Park social worker) emailed Dusty ~9:52 a.m. on 8/28 from a clinical meeting she was participating in where Joyce was being discussed. Clinically there is nothing wrong with Joyce - no cancer, no UTI - but the Aspen Park team still has concerns over sending Joyce home without 24/7 care. Rachael requests that Dusty come visit Joyce and talk with Joyce to see if he notices anything and to discuss options with Joyce and let Aspen Park know. From there, Rachael says, it can be determined whether Joyce stays at Aspen Park or returns home to the farmhouse.  Dusty responded to the email that he would be glad to arrange a time to come visit with Joyce in person and review/discuss options with her as Rachael suggested, however, the consensus from Joyce and her family is that Joyce should be discharged to her home and the family would take on arrangements for her care. Dusty cited cost of keeping Joyce at Aspen Park as being a concern over her remaining on-site for 24/7 care. ...

Dusty called Joyce to check in with her at 9:35 a.m. (8/28) on a break. She reported that she was able to get some sleep, even though she was very excited to be cancer free and feeling great about that news. She feels that she needs to celebrate and a celebration of some sort over this good news needs to be determined. Dusty agreed and confirmed that they would work something out. Joyce then reminded Dusty that there is a lot of missed things to celebrate, such as adoption day, and not just her being cancer free. Dusty concurred and confirmed that they will have to make up for a lot of missed family celebration rituals.  Joyce said that she has "lots of catching up to do" for celebratory things and visits with family once she is back at the farmhouse. Joyce reported that her breakfast was good, having been served eggs, sausage, a sweet muffin, and apple juice. She thought that she was fed quite well. Dusty asked if he had interrupted her therapy and Joyce stated that the ther...

Dusty called Joyce on his walk home from campus ~8 p.m. (8/27/2020) to check in with her before it got too late to call. Joyce was extremely conversational and "baseline normal" during the visit, only briefly forgetting that Dusty had already discussed the good news (being cancer free) with him earlier in the day. Joyce stated that she was quite happy and joke she was potentially "too excited to sleep" from the good news that she did not have any signs of cancer. She expressed relief about not having brain or spinal cancer, stating that she was concerned that would be what the doctors would tell her. She is most thankful that she has been given more time to be with family and to enjoy her life.  Joyce was excited to think that soon she will be returning to the farmhouse and joked that she probably cannot even recall what the place looks like anymore since she has been gone so long. Joyce and Dusty did the math and confirmed with each other that this is still the lon...

Carol, Connie, and Dusty joined Joyce's telehealth appointment today (8/27/2020) with Michelle at the St. Joseph Regional Cancer and Blood Center ~2:35 p.m.  CT scans which covered the abdomen, pelvis, chest and neck of Joyce from 8/25 were reviewed as well as the lab tests collected from Joyce on 8/23. No signs of cancer (residual or recurrent) detected. No indicators of any return from previously treated kidney cancer (following the 2 cryoablation treatments done by Dr. Ho) or the colon cancer (chemotherapy treated in 2016). Incidental findings included: Cysts along Joyce's adrenal glands (stable, non-concern) Cerebral spine compression (chronic, non-concern) Atelectasis (some alveoli not filling with air) in the right lung due to lack of deep breathing Small 1 cm growth in the thyroid gland which does not look suspicious and is non-concern for cancer (but should be followed up on by Dr. Collins) Brain has white matter changes (age related) Cancer marker tests are normal Whit...

Dusty was unable to reach Joyce the two times he called yesterday (8/26/2020) during his walk home from work ~5:20 p.m. or in the evening hours ~7:40 p.m. Assuming that Joyce was either out of the room with the nurse, sleeping, or using the bathroom both times. --- Dusty called the Aspen Park nurses' station ~8:25 a.m. (8/27/2020) to request an update on Joyce and confirm plans for linking in Carol, Connie and Dusty for this afternoon's telehealth conference call with the cancer center. Call was received by Sue who attempted to locate Maggie. After brief hold, Sue informed Dusty that Maggie was helping another resident and that Maggie said she would call Dusty back when she was available.

Dusty was unable to call Joyce last night (8/24/2020) due to issues with his phone and schedule conflicts. --- Dusty called the Aspen Park nurse's station to request an update on Joyce (8/25) ~3:07 p.m. but received no response. Dusty called back and was connected to Maggie. Report on brain and soft tissue of neck has come in but Maggie says that Dr. Collins and the oncologist need to review it. The chest and abdomen information has not come in yet at the time of the call. Dr. Collins and the oncologist will review all when available and provide information to Joyce and her family.  Maggie reported that Joyce is still confused. Joyce's appetite is fluctuating.  Maggie says that Joyce is in a general state of decline overall.   Dr. Collins has added a CMP blood draw for Joyce to be collected today by the Aspen Park team. Dusty to be updated once more information becomes available. Maggie confirmed that cancer center telehealth appointment is still on for Thursday at 2...

Dusty called Aspen Park nurse's station ~3:13 p.m. (8/24/20) to request an update on Joyce as they had not called him, speaking initially with Kim. Kim read from initial documents available regarding Joyce's lab work before call was transferred to Maggie (as Maggie had been working with Dusty). Maggie reported that Joyce's UA came back with some trace bacteria showing, but that might not be UTI sign, a culture is growing to determine if Joyce has a UTI.  Joyce reported to still be seeing things and is confused. Maggie reviewed that on Saturday Joyce was fully oriented and doing well and on Sunday she took a downturn. Joyce was talking this morning about the woman outside her window with Maggie.  Maggie confirmed that at this point there are no issues that would prevent Joyce from going to her CT appointment at Gritman tomorrow. Maggie is hopeful that the CT will reveal what is happening with Joyce and provide direction on how to proceed with her care. The blood test results...

Joyce called Dusty's cell phone ~12:06 p.m. Call was missed due to Dusty's cellphone having a malfunction and not remaining powered on. Joyce left a message, stating that Dustin needed to come get her. --- Dusty and Jess called Joyce to check in ~8:20 p.m. Initially they were unable to contact Joyce via her room phone. They then called Andrea's line for an update. Andrea was with Joyce and got her back into her room to speak on the phone. Jess and Dusty called Joyce back on her room phone. Joyce reported that her day was somewhat busy as there were about 6 kids that were playing around her room at Aspen Park. She said that she would be surprised if she didn't find one of the kids hiding under her bed in the morning. Joyce thought that we needed to feel sorry for the kids because they are running around the facility unattended and the parents aren't taking care of them.  Joyce states that the kids don't make a fuss about anything, they just don't want to be p...

Maggie called and left message on Dusty's cell phone ~10:46 a.m. (8/23/2020) requesting that Dusty contact Aspen Park about a change in Joyce's condition. Joyce reported to be hallucinating again and quite agitated. Maggie was leaving for the day, and Dusty was directed to ask for Andrea when he calls. --- Dusty returned phone call to Aspen Park ~10:58 a.m. once he noticed voicemail had been left. Maggie had left for the day, Dusty reached Andrea. Andrea reported that Joyce was experiencing hallucinations again. Andrea's shift started at 10 a.m. today, taking over for Maggie who provided information to pass onto Dusty. Earlier today Joyce had packed up her belongings was was waiting for people to come get her and take her home to the farmhouse, insisting that she was leaving the Aspen Park facility. Aspen Park staff sat down and gently reviewed Joyce's timeline with her, reminding her of her CT scan scheduled for this coming Tuesday and cancer center telehealth conferen...

Maggie called Dusty, leaving a message on his cell phone on 8/21/2020 at 2:02 p.m. to confirm that she had been in touch with the cancer center. They do want the CT results and so are postponing Joyce's telehealth call that was scheduled for August 24. The telehealth call with the cancer center has been rescheduled to Thursday, August 27 at 2 p.m. Carol, Connie, and Dusty will plan to join the telehealth conversation with the cancer center about Joyce via the arranged plan (to have Maggie call a number they provide and add them in via speaker phone to the telehealth call). 

Dusty called Joyce during his walk home from work (8/20/2020) ~4:45 p.m. Joyce was alert and talkative initially, slowing down toward end of phone call.  Joyce reported that she rode the stationary bike as part of her physical therapy today instead of going for a walk down the hallway and did some upper body exercises with her arms.  Dusty reviewed his day with Joyce and reported on the UI's activity level increase with the return of students and the general concerns over that population returning. Dusty informed Joyce he will be up at Camp Grizzly Friday night to help with the Service and Induction Weekend projects. Dusty asked if Joyce ended up having her blood drawn at Gritman today and she reported that she had not left the Aspen Park facility or had her blood drawn. They concluded that the previous blood draw from last week must have given the St. Joseph Cancer Center the information they needed for Joyce's upcoming appointment. She briefly was unaware of where she was, s...

Dusty called Joyce (8/18/2020) around 5:10 p.m. on his walk home from work. They reviewed their days and what has been going on since they last spoke. Joyce was in high spirits and sounding like her old self. They discussed television shows Joyce had been watching while in her room, the therapy work she had been undertaking, walks done, and other pieces of past lived experiences from Joyce's life as they came to mind and how they link into where she is at now at Aspen Park. The phone visit was cut short with the delivery of Joyce's dinner, an open-faced sloppy joe style sandwich with tater tots as a side. --- Dusty called Joyce (8/18/2020) around 8:41 p.m. to check in and wish her a goodnight. Joyce was extremely talkative and in good spirits. Joyce had been watching a newer episode of NCIS on the room's television set when Dusty called. They talked about the NCIS series, Joyce's dinner, her work with the therapists, and other items on through to its end and then Joyce ...

08/12/2020 Dusty called Joyce on his walk home from work ~4:35 p.m. to check in. She reported that she had been feeling better, even if the Aspen Park team hadn't figured out what was going on with her overall. She lamented memory troubles she has been having. She stated that she had done quite a bit with the therapists today, riding the stationary bike for around ten minutes and doing some walking and resistance exercises. Dusty asked if she had been reading her Redwall book. Joyce stated that she had not but that it had been seen by one of the orderlies and they had a conversation about the Redwall book series and the author. Dusty reminded Joyce that he and Jess would be traveling tomorrow out of the area for Jess' grandmother's memorial service and that if she needed anything she just needs to tell the nurse. The upcoming doctor's appointment for Joyce with Dr. Collins was reviewed. Joyce stated that she did not recall that she was told she was having an appointment...