Clinic at H Hospital

Rachael saw Kathleen (Dietician) who assessed Rachael's current feed and confirmed that despite occasional nausea, the community dietician is aware of maintaining Rachael's reviews. Kathleen looked at Rachael's rig after Rachael asked for a new rubber piece and said it could not be done. She referred Rachael to Rose (MND Specialist Nurse). Rose consulted with Sam (MND Specialist Nurse), who usually deals with rig changes for Rachael. Sam is going to phone later today with an appointment for a new tube for rig replacement - like for like. Discussed the options and decided on another tilma tube.
Bev (Speech Therapist) was keen to see Rachael's Eyeygaze and agreed that to all but those in regular, daily contact, Rachael's speech would be unintelligible. She asked about the choking and swallowing and ensured that Rachael was comfortable managing what she can/cannot eat and when. Bev discussed the merits of the cough asisst and was pleased that Rachael now has one and it is proving useful and effective. Bev also ran through a range of high and low tech communication aids. Rachael was confident that she has the best available tools for herself.
Rachael briefly saw the occupational therapist but didn't feel it was necessary to speak to her. Rachael was weighed as 153.4kg including wheelchair, which weighs 95kg.
Rachael saw Dr E, who had a colleague with him, a doctor intending to specialise in Neurology, with an interest  in MND. Discussed Rachael's history and background. Dr E confirmed that Rachael is not significantly more atrophied that at previous consultation, but noticed further deterioration in speech. He was also glad to see the Eyegaze in action. Dr E looked at Rachael's rig and hoped that the referral to radiology could bring respite from the over granulation in the stoma site. Discussed Rachael's catheter and bladder spasms. Dr E ordered a urine test and said he will contact Rachael if there is any sign of white blood cells/platelets. Rachael informed Dr E that she has a catheter change due and that she is happy with the team at TG Hospital. Rachael confirmed that she is still seeing Dr B every 2 months. Dr E was pleased that there was no noticeable deterioration in Rachael's breathing.