Monday, 1 October 2012

Hydro

Rachael had another lovely session at Hydro with Sharon.
Although the pool was busy Sharon managed to go through the full range of motion exercises with Rachael. Sharon observed that Rachael's neck and shoulder were stiff and that it was painful for Rachael to fully extend her left arm as it is generally immobile in a bent seated position. 
Rachael found it helpful and reassuring to have her PAs supporting her neck whilst floating at the side of the pool. This took the strain off Rachael's neck and also offered security for Rachael knowing that she had someone with her all the time.

Occupational Therapy appointment

Rachael attended an appointment with Julie at B Hospital to try to resolve the problem of her fingers crossing over each other.
Julie attempted to find a solution that would also resolve the ongoing issues of flexion in Rachael's dip joints and hyper extension of her pip joints on the first and second fingers of her left hand.
Julie observed that Rachael found adduction of the forearm much easier than abduction, contrary to what is considered the norm, meaning Rachael finds it much easier to steer her chair to the right than to the left. This appears to be due partly to the angle of Rachael's arm when at rest and that she steers from her shoulder instead of her wrist.
Julie initially recommended a hard thermo-plastic splint but realised that this would not give Rachael enough hand movement to steer her chair. She tried a wraparound finger splint but this seemed to have little effect.
Julie decided that a softer neoprene glove and a hard plastic finger dividing splint at the same time would be more suitable.
After further discussion with her colleagues Julie returned with a ready made Lycra glove. She sewed the fingers of the glove together to prevent them from separating. This also allowed for small pieces of shaped plastic to be inserted into the spaces between the fingers to act as additional dividers if required.
One disadvantage to the gloves appeared to be their lack of grip on Rachael's wheelchair joystick. This caused her hands to slip off the controls especially when pulling from left to right. Julie provided Rachael with some tape backed rubber matting to stick to the joystick to create grip. 
At home Rachael trialled the rubber matting but it was still quite slippery and Rachael again struggled to maintain a grip.

Wednesday, 26 September 2012

Respiratory appointment at Wy Hospital

Rachael was seen by one of the registrars at the lung clinic. The Registrar was pleased with the results of Rachael's blood gas oximetry test.  She said that Rachael should carry on with the use of the Bi pap as she has been doing and if she feels the need to increase usage of the machine she can do. Rachael was provided with new tubing for the Cough Assist machine. Another appointment was made for four month's time on the 16th January 2013.

Tuesday, 25 September 2012

Appointment with Phlebotomist at W Medical Centre

Rachael attended an appointment at W Medical Centre for her liver function test. Rachael brought her heat bag which she used on her hand prior to the blood test being carried out. This seemed to work as Cheryl was successful at the first attempt, although the procedure was painful.

Monday, 24 September 2012

Hydro

Rachael attended Hydro for the first time in five weeks with Sharon as Session Supervisor. 
Rachael was pleased to be back in the pool but she only had a basic workout. Sharon noticed that Rachael was quite stiff generally. 
At the end of the session Rachael managed to walk three paces but she found it difficult to stand. 
Sharon noticed muscle wasting on Rachael's bottom and she asked her if it was painful as it looked bony. Rachael said that it was and Sharon suggested using a cushion or rubber ring on the pool hoist to make it less painful for Rachael to get into the pool.

Thursday, 20 September 2012

GP Appointment at W Medical Centre

Rachael attended an appointment with Dr G at W Medical Centre. This was to try to get a prescription for either  Suby G or Solution R as recommended by the Urology nurse at TG Hospital to keep Rachael's catheter clear.
Dr G could only find Solution R on the computer. She gave Rachael a prescription with the proviso that if it does not not work Rachael will contact the surgery and the doctor will look into the matter further.
The Solution R was added to Rachael's repeat prescription. Dr G also raised the issue that some of the drugs in Rachael's Just in Case kit may now be out of date. She asked Rachael to check the kit and let her know if any drugs need replacing.

Friday, 14 September 2012

Physio

Katherine came to see Rachael to supply her with a new lid for the suction machine. We had requested this because the other one has cracked. She agreed to supply some tubing and to look for a yankauer without a vacuum pressure hole in the side.
Rachael enquired about continence pads for her bed. Katherine said she would telephone Rachael with details of the local continence assessor.
Katherine acknowledged that Rachael is still waiting for a right hand splint and some replacement foam for her neck brace.