Put £40 in Helen's account for chiropodist, hairdresser, etc.
Helen in bed on arrival watching music channel. Very dry lips!! Put lip salve on. Even though she isn't breathing through her mouth she still gets very dry. Her finger nails have been digging into palms. Especially right palm. Small mark on right palm.
The OT said that Helen has been out of bed every day and has been in the tilt table, "standing". She has been doing sensory work with her. The SALT is visiting later today to try some swallowing.
Her catheter has been removed. Urine passing fine. This is very good news as it is one less route of infection for her.
I asked Daniel (nurse) if they would do Helen's insulin in two sites because 80 units in one site is a lot for her. Even when she was only having 20 units she would inject in two sites! Helen visibly winced and almost looked as if she would cry when Daniel did it. He said she was going onto pens when these vials had finished.
Carol (executive) visited me. Said they were having their goal meeting. Everything was going well. Goals would be as simple as head control, sitting out for longer. She said that lots was in Helen's favour - young, in rehab early and traumatic injury rather than hypoxic.
Dr McLusky will visit later. Carol will ask him to prescribe something for Helen's acne as she isn't known to be allergic to anything. Dr Someone came later and is going to prescribe antibiotics for acne. He will arrange a blood test for hormone levels because of acne and hairiness. Botox will be arranged for all limbs.
The physio spoke to me about Helen's goals. All goals are person specific. Each goal has a scale from 2 to -2 with 0 remaining the same and 2 being a big improvement, ie prevention of complications - if everything stays the same then 0, if improvement in 1 area then 1, if deterioration in 2 or more areas then -2. Goals are reviewed very month.
Goals to be achieved by 1st March:
- No deterioration in any of the following areas: pressure sores, diabetes, uti, rti, dvt or contractures.
- Aim to get trachy changed to uncuffed trachy with a view to weaning.
- Increase sitting out time to 5 hours.
- Decrease contractures and increase range of movement.
Meeting on 9th April with PCT, staff and us to discuss future funding and progress, etc. Nothing to worry about, it's just routine.
Hydrotherapy was discussed as possibly starting soon.
Judi asked for any information about Helen (likes, dislikes, etc) so they can talk to her about them, avoid anything she doesn't like and find ways to stimulate. I started a list and it can be added to as we go along.