On morning rounds the doctor said Rachael’s nutrition needs building up so she should continue with the feed through the PICC for at least a week, whilst a long term solution is found to Rachael’s stomach problem. The doctor was unsure as to whether Rachael would ever be able to find feed via the rig again. Unit a solution is found Rachael will remain on a drip with additional vitamins. Rachael is tolerating the PICC feed. The palliative care nurse came to see how Rachael’s pain is today. She was happy that Oxycodeine was working better than Oramorph but thought Rachael would benefit from a higher dosage via syringe driver and stressed she is still happy for Rachael to have an extra dose whenever needed. Rachael explained that she is in pain after meds are given through the rig. The nurse promised to look into this to see if there is any other way drugs can be given. Rachael asked if she could ring Wythenshawe re cough assist machine. Rachael said the pressure nees readjusting. After discussing Rachael’s bowel movements, the nurse thought Rachael may have a blockage, so she has arranged for a rectal examination next time Rachael was hoisted. Rachael has been biting inside of her mouth. The nurse recommended bonjela.
After reading Rachael’s notes Dr E had a look at Rachael’s drugs list to see if he could reduce the amount going through the rig. Dr E decided to stop the Riluzole, ferrous fumerate and Domperidone for the time being. He also asked Rachael about end of life matters. Rachael got upset and asked to speak to him on Monday or Tuesday. Rachael needed hoisting so Dr E volunteered to do the rectal examination whilst she was in the air. He said he couldn’t feel anything so he was happy that Rachael didn’t need to take suppositories/ laxatives over the weekend.