Dr E had a student with him throughout the appointment. Rachael discussed the dry skin on her face and he said to continue using emollient cream. Rachael also discussed her respiration and the use of her Bi-Pap, stating everything was ok. Rachael did express concern that she sees a different doctor everytime she has an appointment at Wy Hospital. The last time, the doctor didn't seem to have read her notes as he went over old ground regarding blood gases and Rachael's need for the Bi-Pap. The doctor didn't understand or pay attention to anything Rachael was saying. Dr E expressed his apologies that Rachael had encountered that. Rachael and Dr E agreed that of there was anything important to note, she would write it down before any appointment - but noted that Rachael has no concerns at the moment. Dr E noticed a deterioration in Rachael's speech which is to be expected. Rachael commented that the eyegaze was still working well. She also showed Dr E her rig. Rose and dietician had a look and all agreed it was overdue for a replacement. Rachael discussed the option to converting to a different type of tube, with a balloon. Dr E and Rachael agreed that the best option is the low maintenence tube she has at the moment. Dr E said he would book Rachael in for a day appointment for replacement until tube can be refitted. Rachael expressed her concern about needing a shorter replacement period due to blocking and clotting, but told Dr E that TG Hospital were aware and dealing with it and any issues that arose.
Rachael went to see Julia (Occupational Therapist) and Sarah (Physiotherapist) who discussed Rachael's curling fingers and toes. They both felt that Rachael needed a further physio review and said they would pass referral to community team. They also mentioned positional pain and pressure in Rachael's sciatic nerve. Julia suggested that Rachael needs a ceiling track hoist in the living room and a bespoke recliner chair in which to transfer during the day as the wheelchair is for mobility, rather than for rest/long periods of time. Julia agreed to make that referral to the community Occupational Therapist.