Rachael attended her appointment at S Hospice to see Dr P. They discussed how Rachael was feeling and then Rachael asked Dr P if he could help with her concerns about the timing of her prescription drugs and fitting everything in.
Dr P said that Rachael could move some medications to lunch and bedtime. He also suggested that a bolus feed may be helpful as it would give Rachael more time to use her NIV. Rachael said that she will give this a try. Her dietitian will be visiting her to arrange this.
The plan for Rachael's new drug timings is as follows:-
The morning Ferrous Fumate, Senna and Lansoprazole can move to lunchtime. The evening Pregabalin and Lansoprazole can move to bedtime.
Riluzole, Pregabalin, Baclofen, Mucodyne.
Mucodyne, Ferrous Fumate, Senna, Lansoprazole
Riluzole, Baclofen, Mucodyne
+/- Oramorph, Pregabalin, Lansoprazole
Rachael can also have 0.5mg Lorazepam mid-afternoon to avoid the jitteriness that she feels around 3.30pm. She can also have another dose in the evening if she wants it. Dr P said that Rachael can take the Lorazepam under her tongue instead of through her rig if she wants to. He said that it would be absorbed into the bloodstream more quickly like this and would avoid the need for more liquid.
He recommended that Rachael tries Domperidone for nausea and fullness feeling. Rachael agreed to this.
Dr P will be writing to Rachael's GP with this information.
Another appointment was made for two weeks time.