The Official Joyce Update Blog

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...

    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.  8:24 a.m.  Dusty:  Dusty arrived to PRH, Day nurse Janine on phone with X-ray. 8:25 a.m.  Dusty:  In Joyce's room. Breakfast just delivered. Janine off phone now. Morning meds administered to Joyce. Joyce reported to have "slept some" last night, "Little better than her first night" according to Janine.  8:26 a.m.  Dusty:  Planned X-ray will be to check Joyce's lungs.  8:27 a.m.  Dusty:  Janine checked Joyce's vitals (lungs and heart) with stethoscope. X-ray is because docs want to rule out pneumonia. Dusty reminded staff Joyce habitually breathes shallow. Janine confirmed they know.  8:28 a.m.  Dusty:  X-ray will confirm if pneumonia or if Joyce's shallow breathing is ...

 7:47 a.m. Craig arrived Joyce was in the bathroom.  (No data on urine/bowel movement or incontinence issues) 7:56 a.m. Joyce returned to her recliner.  8:15 a.m. Jess arrived giving brief up date on Joyce. Joyce had chest pains on Sunday. Craig also inquired about the bottle of tramadol since it was not with the other medications. Jess updated him about Dusty ordering the refill but since it is a controlled substance it needs to be approved by Dr. Collins before it is refilled. He said that he thinks "they" gave Joyce more Tylenol yesterday. Jess sat and spoke with Joyce about the chest pains and if she was still having them. Craig said she had reported they (chest pains) were "a lot" better. When speaking with Jess she said it (chest pain) was not as bad as yesterday. With prompting she narrowed it down to the center of her upper chest with no specific side. Both arm were not hurting. Joyce reports a minor headache. She also had some pain in her stomach but couldn...

7:50 a.m. - Craig on-site at farmhouse. Joyce reported to Craig that she has already been to the bathroom this morning but is thinking of going again. Joyce's nose is still quite runny. Craig administered 3-4 ounces of Elderberry juice from new jar to Joyce. 8:15 a.m. - Jess arrived to farmhouse. Craig updated Jess about Joyce's self-reported status and what he had done for Joyce prior to Jess' arrival. Joyce miserable.  8:20 a.m. - Bathroom. Urinary incontinence. Remainder of urine passed. New skirt. New diaper and pad. Shoes sanitized. Joyce's legs and feet wiped down/cleaned. New chair pad. Returned to recliner by 8:44 a.m. 8:52 a.m. - Jess contacted Dusty about Joyce's health. Dusty called Moscow Medical to see what cold medications can be used safely with Joyce's current prescription medication regimen to treat Joyce's runny nose and cough.  Dusty left message with Autumn at Moscow Medical to have Wendy and/or Dr. Collins to follow up with him. 9:15 a.m...

7:55 a.m. - Dusty arrived to farmhouse. Craig on-site. Joyce using bathroom, sitting in the dark unaccompanied (urine passed, Type 1 bowel movement).  Joyce showered. Weight 160.4 lbs. PT walk to living room. 8:56 a.m. - BP 164/86, pulse 79. BGL @ 119. 9 a.m. - Morning medication with nutritional shake. Breakfast (donut and whole banana). 9:30 a.m. - Bathroom trip without incident. Urine passed. 9:40 a.m. - Departed farmhouse for footcare appointment at Palouse Foot & Ankle with Dr. Capawana.  10 a.m. - Joyce's toenails trimmed, feet appear to be in good health. No diabetic extremity concerns. Next appointment set for May 4, 2021 at 11 a.m. Dusty will update appointment calendars and request time off to cover taking Joyce. 10:15 a.m. - Bathroom trip declined while preparing to depart doctor's office. 10:23 a.m. - Joyce soiled herself in the car. 10:40 a.m. - Craig assisted with getting Joyce into farmhouse. Bathroom (urine and remainder of Type 6 bowel movement passed)....

8:09 a.m. - Jess arrived to farmhouse to provide morning care for Joyce, finding Joyce in the bathroom. Urinary incontinence, Joyce had taken off her diaper and diaper pad insert. Remainder of urine passed. Jess assisted Joyce with cleanup. Hemorrhoidal cream applied. Joyce returned to recliner by 8:19 a.m. 8:23 a.m. - BP 170/83, pulse 77. BGL @154,  Joyce stated she was thirsty and was given a large glass of water. Jess was uncertain if the upcoming blood draw to be done by the Kindred staff this morning at the farmhouse was supposed to be one that required a fast so she did not feed Joyce food at this point just in case.  Joyce did not know who Jess was today but knew Jess' voice. Jess informed Joyce who Jess was and Joyce appeared to acknowledge. 9:08 a.m. - Debra (Kindred) arrived to farmhouse to take a blood draw from Joyce and recertify Joyce for continued in-home visits from Kindred.  Losartan added to Joyce's records (again). When Joyce was asked by Debra if she h...

8:19 a.m. - Jess arrived to farmhouse to provide morning care for Joyce. Joyce found awake with oxygen line in place. Joyce had taken herself to the bathroom recently. 8:20 a.m. - BP 156/101, pulse 81. BGL @ 152. 8:45 a.m. - Morning medication taken with nutritional shake. 8:50 a.m. - Breakfast (1 slice egg in toast with syrup). Breakfast finished by 9:05 a.m. Joyce reported to be "1000 yard staring" but enjoyed her breakfast. 10:12 a.m. - Joyce slept most of the time Jess was at farmhouse following breakfast, declined bathroom trips. ~Noon - Andrew (Kindred nurse) arrived to check Joyce, no family care provider present for visit. 1:18 p.m. - Dusty arrived to farmhouse, finding Joyce asleep in her recliner without oxygen line in place. Joyce had taken herself into bathroom and passed a Type 1 bowel movement - large mess left in bathroom (toilet seat riser, toilet handle, sink, floor) and in hallway where Joyce had tracked portions of fecal matter). Evidence that Joyce had ext...

NOTE TO FAMILY CARE PROVIDERS: Starting today, 12/16/2020, Metformin medication no longer being administered to Joyce per Dr. Collins. Dusty has removed it from the dosage cups he prepares. +++ Dusty arrived ~8:30 a.m. to farmhouse, finding Joyce awake. Joyce was visiting with Craig and watching White Christmas. Dusty shoveled snow off back patio and Craig brought Joyce's Subaru around back in preparation for today's travel into Moscow for appointment with Dr. Collins. Found note left yesterday from Connie, Joyce was given a new stress relief blow-up pillow which was recommended to relieve pressure sores and help Joyce sit more comfortably. Blow-up pillow has been deployed to Joyce's recliner under waterproof protector sheet. 8:38 a.m. - Bathroom trip, urinary incontinence. Diaper pad insert replaced. Wound cleaned and fresh barrier cream applied. Possible new pressure sore developing on left buttock. PT walk to living room and returned to recliner by 9 a.m. and prepped for...

September 30 (addendum) ~5:08 p.m. Jay (Kindred PT) called Dusty's cellphone to attempt scheduling a visit to work with Joyce on October 1 ~10 a.m. or 10:30 a.m. Dusty informed Jay that would overlap with timelines for process of getting Joyce to her medical appointment at 11:20 a.m. Jay said he would try to rearrange his schedule and get out to see Joyce earlier in the morning or later in the afternoon and would call Dusty back once he could confirm a timeframe to arrive for PT with Joyce on October 1. 5:15 p.m. - Jay (Kindred PT) called Dusty back and scheduled his arrival for PT work with Joyce on October 1 between 1:45 p.m. and 2 p.m. Dusty confirmed and would get it onto Joyce's schedule for the day.   5:22 p.m. - Wendy (Dr. Collins' assistant at Moscow Medical) contacted Dusty via phone and informed him that she had spoken with Dr. Collins about updating Joyce's metformin medication away from the "regular" version to the "extended release" vers...