Dr B, Dr R and D visited Rachael to discuss a possible trache with her. Dr R was delayed so Dr B and D discussed Rachael's continuing breathing, coughing and swallowing difficulties.
Dr B made some adjustments to Rachael's NIV to try to reduce the volume of air going into Rachael's stomach.
He suggested that Rachael should try a smaller nasal mask instead of the full face mask that she currently uses.
He suggested that Rachael should try a smaller nasal mask instead of the full face mask that she currently uses.
They then discussed Rachael's drugs. Dr B was happy for Rachael to continue taking 0.5mg Lorazepam PRN with at least eight hours in between each dose. He said that Rachael should back this up with use of her NIV.
When Dr R arrived he discussed in detail the pros and cons of the trache.
After lengthy discussion Dr B and Dr R agreed with Rachael that they would make further inquiries into funding and training of her staff and that this was necessary before Rachael could make an informed decision about the trache.
D said that she would come back with the new cough assist machine, the NIPPY Clearway, and she will also try out the new nasal mask with Rachael.
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