Rachael has been finding it difficult to have her feed and bipap at the same time. Rachael was worried because she wasn't getting much feed, averaging 250ml over a twenty four hour period.
The dietitian came to discuss Rachael's options. One suggestion was a bolus method in which Rachael would have 100ml of feed in ten minutes. This raised concerns as Rachael gets stomach problems if the rate is more than 95ml per hour on her feed pump.
In the end Rachael agreed to a more concentrated, high energy feed that will fulfil her nutritional requirements in less time. The dietitian will arrange with Nutricia to deliver this as soon as possible.
The dietitian advised Rachael to carry on as she was over the weekend, with increased water flushes, fitting in as much feed as the use of the bipap will allow.
The dietitian also said that she will contact the speech therapist about the problems that Rachael is experiencing with her mucus and her Mucodyne prescription.Rachael was also advised to telephone her GP if her diarrhoea continues, to see if he can prescribe some medication for this.
The dietitian will phone Rachael next week.