Dr. Billica Office Visit

DRT 
Prerequisites before visit to Dr. Billica's office:

·         Know and understand lip reading for example, up and off.

·         The railroad tracks are smooth by College Ave so you don’t have to turn on emergency flashers.

·         Know how to get to the doctors office.

     o   East on Prospect past Timberline, turn left at the first light after Timberline.

     o   Drive slowly because the road is bumpy at first.

     o   Drive straight ahead to the doctor’s office.

     o   Look for orange cones.

·         Know how to troubleshoot vent failures. Ambu bag me in emergency situations.

·         Know and understand my short hand list of words.

Before the visit duties for the morning pa:

·         Prepare my lunch and medicine. Use the following guide: 

1)      Get blue lunch box above stove

2)      Make lunch and meds (meds go in clear containers with green lids or recycled medicine bottles to the left of the sink in basket). Use tan tape to label meds.

a.       11:30 Liposomal Vitamin C

b.      Lunch (in small blender bottle)

c.       Lunch meds (H20 and Elyte and dry meds in separate containers)

d.      2:30 meds (ok to add pteridin 3 to H20 and Elyte)

3)      Put all food and meds in lunch box, then into fridge

a.       If Don is about to leave, put an icepack in the lunchbox, otherwise make sure you or whomever is taking him puts an icepack in there

4)      Get Dr. Billica list (taped to fridge)

a.       Check cabinet and freezer for anything that wasn’t circled

b.      Put Dr. Billica list in the outside pocket of wheelchair bag

·         Get my iPod touch and check battery, charge if necessary. When done include ear phones
           and put it in WC bag.

·         VERY IMPORTANT! Get the Dr Billica list in the kitchen and put in WC bag.

·         Make sure the suction bag is well stocked with red worms, gloves and water bottle.

·         Check the lithium battery lights. 

Before going to Doctor Billica’s: 

·         Feed me my snack and ask if I would like M and M.

• Flush my picc line twice. 

·         Always empty suction bowl and take power cord for suction machine.

·         Switch vents and remember to unplug Little Bertha from wall before driving away.

·         Always put head band on before my glasses.

·         If you put my jacket on with my arms in sleeves be sure to put your hands in the sleeve in
        and grab my hand to pull my arm through. It’s important to pull my sleeve up over elbow
        so my hand is free.

·         A gentleman always carries his suction machine on his lap for his lady! 

At the doctor’s office:

·         For parking, there should be two spots off to the left of the lot blocked off by orange cones.

• Park in the farthest left one so that you can lower the ramp into the other one.  
• Replace the orange cones so nobody can park in the space where the ramp comes down after you move towards the sidewalk ramp. 
• In the van get my ambu bag and put it on the back of WC. Tell me when you did it. 
• Hold my head when going over bumps.

Please read -New Wheelchair Guidance especially how to wrap the power cords as shown:

·         When you get to the door, the receptionist is usually ready to open the door for you;
       if she's not just use one of the chairs or the suction machine to prop it open for you. She will show you where the room is.

·         Lower my feet almost all the way  to turn corners.

·         When you get in the room, push the patient table against the wall, move my wheelchair pretty
       close to the appointment table, and facing the door to see when people walk by. Head at 19,
       feet to normal level. Then you can just chill out on the recliner until Don wants to go for a walk in
       between visits.  He can communicate with you to tell you where the WC should be angled.

Here's a picture of the placement: 

·         Unfortunately there’s no wireless in the office.

·         I wear regular socks because I get a special treatment called FSM.

       The nurse puts two electrodes on my shins. Also two on my upper back. 

·         It’s best to plug in the vent into the outlet to my immediate right,
       check little Bertha’s charging light after plug in.

·         The suction machine goes on the chair to my right and the outlet is to the left of the chair.
       Check that the charging light is on. Sometimes you have to turn on the light switch to get
        power to the outlet.
·         Once set up, do Mouth Suction.
·         Keep track of time for meds, lunch, etc.

·         There are 3 IV treatments spaced an hour apart and my PICC dressing is replaced.
        It takes about 3 hours.

·         If the weather is nice after the first treatment take me for a walk. Please take medicine and lunch.

·         Half way through the visit give me chapstick, please.

·         Eye tracking hints. I don’t have my bell on when given treatments so look at me now and again.

     o   Looking down = feet up or down.

     o   Looking to my right and down = burp tube. Either clamp or burp me.

After the doctor visit:

·         Ask me if I am hot. If so take off blanket and jacket.

·         Put WC back in morning position.

·         Tilt head to 19 and feet  up to normal level. 

·         Switch vents. Don’t forget baby bertha.

·         Put me on Erica.

·         Empty WC bag.

·         Check iPod battery.

·         Replenish suction bag.

·         Plug in suction machine.

·         Suction Don.

• When I am good to go, continue with PA duties

Transportation for Don

DRT 
Don is set up to use Dial-A-Ride whenever you cannot use his van for any reason. That includes if his caregiver is not van trained and you need to get to Tri-Life.

As far as I know Don and your caregiver are eligible for these rides free. When you call it is important that you ask if there’s a charge! The catch is you must reserve his ride 48 hours in advance of needing it. Plus allow about 45 minutes travel time each way to include how late they can sometimes be to get you. 

You just call Dial-A-Ride at 970-224-6066 to book his ride. Also you must tell them how TALL you are in his wheelchair so they do not send a vehicle that is too short for you to get into. Don’s caregiver has to get you into the vehicle (usually very easy) then the driver will secure you.

Also through Dial-A-Ride you can call Yellow Cab and ride them. Dial-

a-Ride will pay the first $20 towards that ride- usually totally covers cost. They have fewer cabs that can accommodate his wheelchair height, but they do have some. So it is important to tell them about his height. They also need a 24 hour notice and are a little more prompt. For them you call Yellow Cab directly and reserve a cab. Tell them you are on the Dial-A-Ride rolls, how tall you are, and that you will have a caregiver with you. Yellow Cab will bill Dial-A-Ride.

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Fiber!

DRT 
Here are my fiber instructions-

10am fiber snack-

Take room temperature leftover breakfast; add drinkable water to shaker to make 8 ounces.

At the last minute (in the living-room) before feeding Don his 10 am snack, add 2 level scoops fiber to breakfast liquid, shake well and serve immediately.

Exceptions-

If leftover bedtime snack was used to make breakfast, only add 1 scoop of fiber (bedtime snack already has fiber in it).

Bedtime snack-

Use any leftovers from dinner or 8pm snack. If using leftovers, do not add fiber.

If no leftovers, mix snack per BEDTIME on food sheet but without fiber, and bring to CNA at night with meds, plus one level scoop of fiber. CNA will add fiber at last minute before feeding Don.

DO NOT skip fiber, unless you are volunteering to be part of an enema team! If instructions are not clear, call Kate at 970-402-3041 to walk you through it.