Hydro

Rachael attended her hydrotherapy session with Sharon as Session Supervisor. 

There were eight other patients in the pool and Sharon did not have any assistants in the pool with her so she could only spend a limited amount of one to one time with Rachael.  

Sharon concentrated on working on Rachael's neck and shoulders in the time that she had available. Rachael spent the rest of the session floating supported by her PA.

Catheter change at TG Hospital

Rachael attended her catheter change appointment at TG Hospital. Rachael mentioned to S that she had used Solution R once since her last visit. He suggested that she could use it once a fortnight as there was still quite a bit of sediment in the tube and crystallisation at the end of the catheter.

Rachael asked S about using Suby G, aka Uro Tainer Chlorhexidine opti-flo and Uriflex. S suggested that this could be used once a week as it is a weaker solution than Solution R.

Rachael's catheter was difficult to take out due to cuffing on the end of the tube.

Another appointment was made for 15th November 2012.

TG Hospital is currently undergoing a restructuring programme.  Dr G will be moving to the new unit at Wy Hospital before Christmas, S will be moving with him. In order for Rachael to remain as a patient of S she will need to be referred to Dr G at Wy Hospital by Dr E.

email from Dietitian

A emailed Rachael hoping that she was well and to arrange a visit on the 16th Oct. Rachael replied that she was well and she confirmed that this date was convenient for a visit.

email from Speech Therapist

Rachael received an email from L regarding a table stand that had been ordered for Rachael. She asked Rachael to let her know when it arrives as Loan Stores may not inform her. 

She also said that she will be on maternity leave from 14th November. She said that she will pass Rachael's case on to MG as she knows her already. L said she would arrange a visit prior to this if Rachael needs anything or wishes to discuss anything.

Rachael replied that the stand had been delivered to a neighbour and when it was finally received it was found that it was the wrong fitting for the MyTobii.  

Rachael also copied her reply to M.

Rachael then said that her main issues at the moment relate to her frustration at being misunderstood verbally and others reluctance to use her other means of communication.

Rachael felt that L would not have a solution to this.

Although Rachael would enjoy seeing L she said that she doesn't have any pressing concerns that  are not being dealt with by other specialisms.

L asked Rachael for the code number on the stand so that she could check that the correct items were being sent out.

Rachael replied with the model number.

Hydro

Sharon went through the full range of motion exercises with Rachael. She also did some leg exercises with help from physiotherapy student, John.

Sharon paid particular attention to Rachael's neck and shoulders as they are still quite stiff and can be painful.

The poolside attendant had borrowed a float from another pool which, it was hoped, would hold Rachael's head out of the water whilst she floated. Unfortunately, as with other floats, this did not work as it had a tendency to spin around when Rachael moved her head. 
The PAs again remained with Rachael at the side of the pool to provide assistance with holding Rachael's head out of the water.

Dental appointment

Rachael attended an appointment for a dental check up at Dr A's dental surgery. Everything was fine, the dentist scraped some tartar from Rachael's teeth. He recommended that Rachael should use Oral B Pro Expert toothpaste from now on as this helps to prevent a build up of tartar.

GP appointment at W Medical Centre

On Monday morning, 1st October 2012, Rachael discovered a large blister like swelling at the entrance to her rig site. It was very painful to the touch and it was inflamed. There was a constant discomfort which seemed to be internal but this was bearable. Racahel had previously treated a similar but smaller swelling with hydrocortisone cream.

As Rachael had a Hydro appointment which she did not want to miss she decided to treat the swelling with hydrocortisone cream again and see how it went on.

The swelling was cleaned, dried and treated with cream throughout the day but as there was no improvement by the following morning Rachael decided that it would be best to consult her GP. Dr G checked the swelling. She stated that she was unsure of the cause as she is not particularly familiar with rigs. She prescribed a five day course of antibiotics for Rachael but advised her that if it did not clear up by the end of the course she would need to go to H Hospital and let them have a look at it. 

Dr G also gave Rachael her flu jab which left Rachael feeling a little unwell for some time afterwards.

Dr G also informed Rachael that her smear test will be taking place soon. Two nurses will attend Rachael at home for this.