The Official Joyce Update Blog

6:45 a.m. - Craig found mom awake without her oxygen line in place. Joyce informed Craig that she "likes the sunshine on Thanksgiving." 7:16 a.m. - Joyce returned from her recliner after using bathroom. Blood oxygen level at 95%, pulse 91. 8:31 a.m. - Joyce finished breakfast (banana, baby bell cheese wheel, nutritional shake). Morning medication taken. Joyce wants to sleep. 12:48 p.m. - Dusty arrived to farmhouse after picking up supplies for farmhouse (paper towels and nutritional shakes) in Moscow. Joyce asleep in recliner with oxygen line in place, appearing to have passed out while coloring. Bathroom trip declined. Lunch declined. 12:50 p.m. - BP 128/69, pulse 79. BGL @ 185. O2 level at 92%. Temperature 97.5 degrees Fahrenheit. Lunch negotiated. 1:02 p.m. - Lunch meds (2 Tylenol and cranberry supplement) with water. 1:03 p.m. - Lunch (turkey and cheddar cheese sandwich with mustard and mayonnaise, diced peaches). Joyce proceeded to drum her fingers on the tray, play with...

7:01 a.m. - Craig found Joyce on the toilet, bowel movement passed. 7:16 a.m. - Joyce returned to recliner. Blood oxygen level at 97%, pulse 81. 12:46 p.m. - Dusty arrived to farmhouse, found Joyce asleep in recliner with oxygen line in place. 12:50 p.m. - Bathroom trip. Urinary incontinence. Remnants of bowel movement on Joyce (didn't self-clean well). Skirt changed. Diaper and pad replaced. Early bladder release. Shoes sanitized. Bathroom floor and toilet seat riser sanitized. 1:26 p.m. - Visit with Bridget Johnson (Family Resource Home Care). Carol, Connie, Dusty, and Joyce reviewed options for service. 2:20 p.m. - BP 142/73, pulse 74. BGL @ 119. O2 @ 97%. 2:25 p.m. - Lunch medication administered with water. 2:30 p.m. - Lunch (chicken noodle soup, butterscotch pudding, diced peaches, lemon pasta).  Dusty departed farmhouse to return to work, leaving Joyce eating lunch. 5:43 p.m. - Dusty returned to farmhouse, finding Joyce in bathroom. Bowel movement passed (type 3/type 4). New...

7:25 a.m. - Craig arrived to farmhouse and found Joyce awake without oxygen line in place. Joyce reported that she has not been to the bathroom yet. 7:54 a.m. - Joyce returned from bathroom. Started eating breakfast (toast with jam, baby bell cheese wheel, applesauce, nutritional shake, morning medication). 10:17 a.m. - Dusty arrives to farmhouse, finding Joyce awake without oxygen line in place. Joyce had towels in her walker's basket...could not recall where they came from or what she was doing with them. 10:19 a.m. - BP 127/74, pulse 76. O2 @ 87%. BGL @ 300.  10:25 a.m. - Bathroom trip without incident. Urine passed. Evidence of bowel movement and poor attempt at self-cleaning discovered. Fecal matter in shoes and on bathroom floor from earlier trip. Shoes sanitized. Showered under protest.  Weight 157.4 lbs.  PT walk, returned to recliner by 11:20 a.m., legs elevated. 1:27 p.m. - Joyce removed her oxygen line. When instructed to put it back into place by Dusty, Joyce ...

7:13 a.m. - Craig found Joyce awake and taking herself to bathroom. Diaper and pad changed. 11 a.m. - Dusty arrived to farmhouse, finding Marshall (Kindred) on-site while Joyce was using bathroom. Urine passed. 11:07 a.m. - Vitals collected by Marhsall once Joyce returned to recliner. O2 @ 84%, BP 140/70, temperature 97.8 degrees Fahrenheit.  11:10 a.m. - O2 @ 94 % after Joyce placed back on oxygen line. Joyce reported pain in her leg when asked. Marshall worked with Joyce on leg, stand/sit, and arm exercises. Joyce exhausted by 11:20 a.m. Marshal directed Dusty to get Joyce to do more walking around the farmhouse if possible when family care providers are available to monitor Joyce. Marshall encouraged continued leg elevation to help control swelling in legs for Joyce. Marshall departed farmhouse. Joyce declined lunch, informing Dusty she had just recently finished the breakfast Craig had made for her. 11:25 a.m. - Snack (applesauce). Finished by 11:50 a.m., lunchtime medications ...

6:50 a.m. - Craig found Joyce awake in recliner with her legs elevated and oxygen line in place. Joyce informed Craig that she hasn't been to the bathroom yet. Joyce #1 at the moment. 7:19 a.m. - Bathroom.  7:32 a.m. - Blood oxygen level @ 86%, pulse 81. 7:43 a.m. - Breakfast given to Joyce by Craig. BP 136/79, pulse 79. 1:12 p.m. - Dusty arrived to farmhouse, found Joyce asleep in recliner with oxygen line in place. 1:14 p.m. - BGL @ 206. BP 118/74, pulse 77. O2 @ 96%. Bathroom trip declined. 1:18 p.m. - Medications with Miralax in water. 1:22 p.m. - Lunch (Hamburger, applesauce). Joyce sleepy/spacing off while attempting to eat lunch. 2:24 p.m. - Lunch abandoned. 1/4 of hamburger and all of apple sauce eaten. Remainder put away. Bathroom trip declined. Joyce began napping. 4:40 p.m. - Bathroom. Diaper and pad replaced. Remainder of urine passed. 5 p.m. - Coloring. 6:20 p.m. - Dinner (chicken noodle soup, 4 crackers). 7 p.m. - Dinner finished, everything eaten. 7:08 p.m. - Evening...

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 hospi...

  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.  9:46 a.m.  Dusty: Ambulance  summoned following Joyce abruptly announcing she thinks she was dying, reported trouble breathing, and had severe chest pain, they are taking Joyce to ER.  9:48 a.m. Connie: Are they going to Moscow or Pullman? 9:54 a.m.  Dusty:   Moscow to start with. I am heading to ER now. 10:10 a.m.  Dusty:   On-site at Gritman, they are still getting Joyce admitted and checked. I'm in the ER waiting room and will get access to her when they come get me.  10:37 a.m.  Dusty:   In ER with Joyce, waiting for doc to update on Joyce. BP 150/68    Pulse 93. 10:43 a.m.  Dusty:   Nurse Kim reported doc is now reviewing PRH records that just arrived are "working backwar...

 7:23 a.m. Craig arrived to find Joyce in her glider chair in the living room. She said she needs to get ready to go to work. She let Craig know she had been to the bathroom about 30 minutes before. He convinced her that she was retired and got her into her recliner and her oxygen on.  8:39 a.m. Dusty arrived. BP 139/72     Pulse 81         Blood glucose @199      Oxygen @ 89% - Breathing exercises done. Type 4/5 bowel movement left in the toilet from earlier bathroom trip pre-Craig arrival.  8:47 a.m. Oxygen @ 91% - Breathing exercises done. Breakfast (Donut, dices peaches, cheese wheel) 9:15 a.m. Oxygen @ 90% Around the time of this entry while eating her breakfast Joyce dropped her fork grabbed her chest and looked at Dusty saying "I think I'm dying" Dusty asked if her chest hurt, it did. He asked about her breathing, she couldn't catch her breath. Dusty ran outside to ask Craig if Joyce had been experiencing chest pains thi...

 7:04 a.m. Craig arrived. Joyce asleep with oxygen in place. Blood oxygen 97%     Pulse 74 7:30 a.m. Joyce heads to the bathroom  (No data on urine/bowel movement or incontinence issues) 7:46 a.m. Joyce returns from bathroom.  8:36 a.m. Dusty arrived. Joyce asleep hunched forward with oxygen in place. BP 121/69     Pulse 74     Oxygen @ 94%     Blood glucose @ 163. Bathroom trip declined. claimed she already went (remembered) Evidence of early bladder release. Dusty sanitized bathroom floor.  8:48 a.m. Breakfast (cream of wheat with equal, banana, dices peaches, cheese round) Dusty also set mouse traps up in pantry and upstairs.  9:47 a.m. Breakfast paused, Holly (Kindred PT) arrived to do start of care paperwork. Joyce fairly responsive. Recommendation family consider having vision and hearing checked. Reviewed dental history- Joyce claimed she doesn't have dentures. Slight pain reported to Holly- day & night - unable...

 6:20 a.m. Craig stopped by to check on Joyce. Joyce awake ( Joyce scale #1.5 *) told Craig about holding her water glass all night. Spilled a little on her blanket. She was perplexed and amused by the fact she held on to it all night.  6:30 a.m. Craig encouraged Joyce to make a bathroom trip.  (No data on urine/bowel movement or incontinence issues) 6:51 a.m. Joyce back in her chair. Took herself on a PT walk. She is in good spirits this morning. Oxygen @ 96%     Pulse 77 8:23 a.m. Dusty arrived. Joyce asleep in her chair with oxygen line in place. BP 137/72     Pulse 72     Blood glucose @ 150     Oxygen @ 96%      Spirometer @ 0 (unable to move disc at all) 8:42 a.m. Jess arrived. Breakfast (Banana, Babybell, and Cinnamon twist donut) 9:15 a.m. Joyce very very here mentally. She knows who Dusty and Jess are. Had a talk with them about how important it is to tell caregivers when she is hurting. Dusty explained how v...

This picks up from Joyce's discharge from Pullman Regional Hospital. Dusty providing care this evening.   1:10 p.m. BP 102/45     Pulse 69     Blood glucose @ 124     Nasal canula replaced on home oxygen unit. 4:30 p.m. Bathroom. Urinary incontinence. Trouble walking. Urine passed, Flatus. 4:47 p.m. Returned to recliner. Temperature 96.6F 5:51 p.m. Dinner (think he means Lunch)  finished. BP 114/67     Pulse 76     Oxygen @ 96%     Spirometer unable to raise disc.  7:20 p.m. Oxygen @ 95%      Pulse 77     Spirometer @ 0 8:19 p.m. Bathroom. Urinary incontinence. Trouble walking. Urine passed, Flatus. 8:36 p.m. BP 163/76     Pulse 76     Blood Glucose @ 201     Oxygen @ 97% 8:42 p.m. Dinner (Mac & cheese, apple sauce) Nutritional shake, evening medications.  9:49 p.m. Ready for bed. Observations: Joyce forgot how to use powered recliner today. Lot s o...

   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.  8:23 a.m.  Dusty:  Dusty back onsite at PRH. Breakfast was just delivered to Joyce (diced potatoes and sausage patty, assorted fruit pieces) but she claims she is not hungry. Joyce informed CNA she wants to sleep. 8:24 a.m.  Dusty:  Joyce knows who Dusty is but does not remember him being with her in the hospital at all. Joyce thinks she is in a bank. 8:25 a.m.  Dusty:  Joyce does not know why she is in hospital ("What did I do?") 8:30 a.m.  Dusty:  Nurse Peggy stopped Dusty last night on his way out as he passed the ICU room she was assisting in, she informed him Joyce did not sleep much at all on night before last (night of 6th to 7th), she was often wide awake, staring at nurse's station and waved...

  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.  8:49 a.m.  Dusty:   Dusty back on site at PRH, ICU staff busy in two different rooms with patients, update forthcoming once they realize Dusty has snuck in. 8:50 a.m.  Dusty:   Joyce awake and watching television,  stretched out in recliner. 8:55 a.m.  Dusty:   Dietician (also named Joyce, calling her Joy going forward  to differentiate) arrived to visit with Dusty. Joy have been tracking Joyce's food intake and noticed decline in food being consumed. Reviewed health log family has been keeping. 8:56 a.m.  Dusty:   Dusty informed Joy that mom eats slow and if she takes too long eating one meal it will throw off her appetite for other meals. Joy acknowledged that as she has time stamps for mo...

  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.  8:39 a.m.  Dusty:  Dusty back on site. Joyce working on eating omelet and peaches for her breakfast. Doc and head nurse dealing with other patients in ICU needing attention, they will check in with Dusty when able. 8:40 a.m.  Dusty:  Joyce knows who Dusty is and appears to be in good spirits at the moment 8:50 a.m.  Dusty:  Cindy (nurse) and Megan (CNA) stopped by. Joyce was on BiPAP from 1030pm to ~330am before Joyce wanted it off. Joyce's oxygen saturation stayed up after BiPAP removed so it was not restarted. 4 units of insulin was administered to Joyce after Dusty left last night. 8:54 a.m.  Dusty:  Medicine administered Lisinopril (blood pressure), torvastatin (?), aspirin, carvedilol 9:56 a.m....

  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.  8:33 a.m.  Dusty:  Dusty back on site at PRH. Checking with Sam (Nurse), BiPAP system worked and Joyce "back to normal" 8:49 a.m.  Dusty:  ICU is short staffed today. Sam is being assisted by LCSC nursing student intern. Alyssa today. Joyce is very responsive and back to what family would recognize as baseline normal. Joyce knows who Dusty is but cannot recall which of her sons is the oldest. 8:50 a.m.  Dusty:  Sam informed Dusty that the BiPAP was kept on Joyce until about the time she returned to cover morning ICU shift. 8:54 a.m.  Dusty:  BP 155/67     Pulse 82     Oxygen level 90%     CO2 saturation 19     Joyce responding to interrogatives and able to talk fairl...