Email received from MND Specialist Nurse

"I have spoken this A.M. to Lesley, the secretary at Wy Hospital. She has spoken to Dr G who advises to cancel appointment. Dr G is your consultant and plans to move forward and place Suprapubic Catheter as discussed in email to you." - Sam

Visit From District Nurse

After general enquiries over Rachael’s health since last visit, we discussed Rachael’s overnight feeding and care situation. It was agreed Janice would return on 25/10/10 in order to complete a full assessment of the current care package. Janice agreed that overnight care is most definately required but explained that the decision would not be based on her assessment alone and advised we obtain further corroborative reports. Continence pads were also discussed and it was agreed that Janice would provide some samples from their store for Rachael to try out. Janice advised re: sudocreme regime for intimate application.

Hydro

Rachael had a full session in the pool. Rachael told Katie that her quads had been feeling tight all week. Katie did some exercises on Rachael’s legs and knee. She expressed concern that there was some damage to Rachael’s knee, she had seen Rachael’s knee lock and snap back, and noticed some inflammation. She advised that the change to now doing transfers exclusively by hoist means that Rachael’s knee should be exercised every day to prevent further, more serious damage. Katie told Rachael that Wheelchair Services in Preston will contact her re: footplates.

Email received from Dietician

“Glad to hear training was useful, if you do ever want any additional training or have some queries, let me know. If you’re happy with the way the feeding is going at the moment, that’s great! We shall leave it as it is. If you do feel at any point that you are not getting enough energy from the overnight feed as a result of the breaks, we can always try a higher energy feed over the same time period. Feel free to have a think about it and let me know.” - Claire

Email Sent to Occupational Therapist

“The shower chair (Freeway) seems to be leaking rust from a ventilation hole on the underside of the seat. Not sure if you can do anything but thought I’d tell you because it’s so new and expensive.” - Debbie

Email Sent to MND Specialist Nurse

“I will wait to hear from you. Sorry about the name change. I have been seperated since 2006 and have decided to revert.”

Email sent to Dietician

"Thanks for arranging refresher training (overnight feeding/pump). Marie gave me a demonstration and talked through issues around pump use. Rachael has been choking more frequently at night, necessitating moves and occassional hoisting. Marie advised detatching/reattaching feed. When there are breaks at night, Rachael has insufficient feed. She is aware she needs to finish the dose or supplement with food."