Visit from Speech Therapist

Rachael had a visit from her speech therapist today. M came to take away the Rehadapt stand for the MyTobii computer. M is going to try and get a floor stand for Rachael but she is not sure whether the company makes one. She said that if she cannot get a floor stand she will have to get a table stand. If she is able to get the floor stand there may be a difference of £200. Rachael said that she would pay this.

Hydro

Rachael attended Hydro with M as session supervisor and student G. Initially M was a little nervous when getting Rachael into the pool and it took him some time to make her comfortable. Communication difficulties made it hard for Rachael to explain to M where her head was in a comfortable position.

Eventually M asked G to assist him by holding Rachael's head which allowed him to work freely on Rachael's shoulders and neck.

M worked with Rachael for about half an hour and then left her, with G still supporting her head, to float and relax.

After the session Rachael noticed a huge improvement in her mobility and the pain that she had in her left shoulder before the session had gone completely. 

Rachael was able to lift her arm onto the control panel of her wheelchair herself and drive down a long corridor before needing assistance.

Rachael was especially grateful for this as she will miss next week's hydrotherapy session due to her PA being on holiday.

email from Speech Therapist

Rachael received an email from M regarding the stand for the My Tobii. She said that the mounting plate on the back of the device is called a Daessy (pronounced 'daisy'). The Rehadapt table that has been ordered for Rachael does not have the same plate on it. It is possible to take the mounting off the Rehadapt stand and put it on a Daessy stand but M's colleague, I, thinks that this might affect the overall strength and stability of the stand.

M feels that the stand that has been ordered from Inclusive Technology for Rachael is not the best one. She has found a more suitable stand which her manager has agreed to authorise the purchase of for Rachael and she will try to arrange a refund for the other one or use it for someone else.

M thinks that the vertical desk stand or the Daessy desk mount are suitable. Before ordering the stand M needs to confirm how adjustable in height and angle the stand needs to be for Rachael.

(2nd email)

M has spoken to Inclusive Technology. They are able to arrange a return of the Rehadapt stand and re supply a vertical desk stand with Daessy plate as a straight swap.

M will visit Rachael at a convenient time to collect the Rehadapt for return. 

M then asked Rachael if she is happy to have the replacement delivered directly to her. 

Rachael replied that she is happy to take delivery at home. She needs a stand with a little tilt. Ideally she would have one quite high up on a floor stand but she believes that they are much more expensive. She asked M if there is any chance she could put to.

Hydro

The pool was very quiet again. The new student and three other patients were in the pool. S was able to concentrate on working with Rachael.

S paid particular attention to Rachael's neck and shoulders. This left Rachael so relaxed at the end of the session that she was unable to maintain her neck and and upper body posture. This posed logistical difficulties when getting out of the pool.

Rachael has maintained the ability that she regained at last week's session. Although she was tiring at the end of the week she was still able to move the joystick a little.

When she came out of hydro this week Rachael was able to drive up the vehicle ramp and position herself in the car.

Catheter change at TG Hospital

Rachael attended her catheter change appointment. The catheter came out easily this time. Rachael suggested that it might be because she has been using the Solution R.

S said that the next appointment will be at Wy Hospital instead of TG Hospital as he has handed in his notice and will be setting up a new clinic.

Rachael confirmed that she wants to transfer her care with S to Wy Hospital in order to maintain continuity of care as this is very important to her.

There is a possibility that the new clinic will not be up and running by the time of Rachael's next appointment in December. Rachael has a catheter change set at home which she will bring with her. S said that he will phone to confirm the appointment.

Hydro

The heating was finally mended and Rachael was able to attend Hydro for the first time in four weeks.

Rachael discussed the problem she had been having with the immobility of her left arm which had left her unable to operate the controls of her wheelchair for the past few weeks.
The pool was very quiet. There were only three other patients and a new student member of staff in the pool so S was able to concentrate on working with Rachael for the duration of the session.

After the hydro session Rachael was relieved to find that she had regained the use of her arm and was able to control her wheelchair again. However, she found this very tiring and as limited as it had been before. The four week delay in treatment had clearly weakened the  muscle, but she was now able to move the chair a short way and to raise and lower her legs.

Letter received from Dr E

Rachael received a follow up letter from Dr E regarding her appointment at the clinic on 31st October.

Dr E said that he was pleased to see Rachael again and that she was accompanied by her PA. He noted that Rachael's mobility is worse due to the weakness in her left shoulder. He stated that Rachael was concerned that this was due to her hydrotherapy appointment being cancelled but he felt that this had little to do with it.

Dr E has written to wheelchair services asking for an urgent review for Rachael.

He then stated that Rachael uses her NIV machine intermittently with some benefit and that she remains on Riluzole. He thanked Rachael's GP for monitoring Rachael's Riluzole safety bloods.

Dr E then mentioned that Rachael's urological problems seem to have improved and that she is grateful for the care of Nurse S under Dr G at Wy Hospital. Dr E has written to Dr G to ask him to maintain an interest in Rachael's care.

The gastronomy is better after it was changed.

Dr E will arrange to see Rachael in three months time but will be available if any help is required in the mean time.

Orthotics Appointment at B Hospital

Rachael attended her Orthotics appointment with V at B Hospital in order to try on some new shoes.

Unfortunately the shoes were too small once again. It was also difficult for Rachael's feet to slip into the shoes because they were lined with sheepskin. The insoles and raised toe area were also covered in non slip material.

After debating whether the shoe manufacturer could remove the lining and stretch the boot V decided to order a new boot in a larger size with an easy slip insole instead of the sheepskin lining.