Family Briefing — Susan

• Susan remains admitted at Cedar Memorial Hospital on a monitored unit (6 West Surg PCU, Room E412 / Bed 02).
• Main issues being treated: aspiration‑related lung irritation/infection (from reflux/vomiting) + dehydration, with ongoing work to stabilize nutrition. Breathing remains stable on room air.
• A swallow study was completed and did not show aspiration during the test; she remains allowed clear liquids/water by mouth, with safety precautions and a slow advance as tolerated.
• Tube feeding advancement is the main barrier right now: today’s hospitalist note says they are still trying to get her up to tube‑feed goals but it has been difficult; Susan reported feeds running ~10 mL/hr this afternoon (well below her usual “slow” 40 mL/hr / goal).
• Today’s labs show low magnesium (1.6) and mild low sodium/potassium on afternoon labs (Na 131, K 3.4); the team is replacing these and rechecking as needed.
• Discharge planning is underway (resume services requested/accepted for Willow Home Health and Willow Home Infusion), but a nurse told Susan not to expect discharge today. Timing will depend on breathing stability, pain control, and reaching a workable feeding/hydration plan.

This is NOT a diagnosis. It is an Averyn interpretation of a subset of information visible in the hospital portal/notes to help family understand urgency. Right now, she still appears clinically stable (room air, stable blood pressure) and several markers look reassuring (WBC now normal, BUN improved, echocardiogram reassuring). The next 24–48 hours still matter mainly to confirm the lungs continue improving and that her feeding/hydration plan can be made sustainable (tube feeds are still well below goal).

As of ~4:00 PM PT on Jan 4, things look overall stable with treatment underway — but tube‑feed advancement is slower than hoped and remains the main barrier to discharge readiness.

• Ongoing breathing checks (watching for any new oxygen needs).
• Repeat labs (CBC + electrolytes/kidney panel, especially Mg/Na/K/Ca) to track hydration, infection markers, and anemia.
• Final culture results (blood/urine) to confirm the infection/antibiotic plan.
• A clear feeding plan for the next 24–48 hours (target tube‑feed rate + schedule, and whether/when diet can advance beyond clear liquids).
• Pain‑control plan that works via tube/oral (and clarity on remaining IV meds) + an updated discharge‑readiness decision after daily rounds.

• Gastroenterology (GI) — overseeing stent tolerance + safe restart of liquids.
• Nutrition / dietitian — severe weight loss/malnutrition; helping plan calories + hydration safely.
• Speech‑swallow therapy — completed swallow study; guiding safe oral intake and strategies.
• Physical/occupational therapy — PT continues hallway walking. OT evaluation notes she needs supervision for out‑of‑bed ADLs with a walker and is working toward independent full‑body dressing/clothing retrieval, sink‑side grooming/hygiene, and toilet tasks/transfers (goal target ~Jan 19); discharge recommendation is home with family care pending medical clearance (consider HH follow‑up).
• Palliative care (AIM) — often involved for symptom support (pain/nausea), not necessarily end‑of‑life.

• Chest X‑ray — showed right‑sided lung changes concerning for pneumonia/aspiration.
• CT chest/abdomen — no pulmonary embolism; showed aspiration‑type lung changes and fluid sitting above the esophageal stent (aspiration risk).
• Additional tests (Jan 3): feeding‑tube check X‑ray (tube positioned; constipation noted), swallow X‑ray (no aspiration seen; clear liquids allowed), and echocardiogram (normal heart pumping).

It’s still too early to know an exact discharge date, but this afternoon’s information suggests discharge is more likely once tube feeds can be advanced to a sustainable plan and electrolytes/pain are stable — breathing has remained stable on room air so far.

• Earliest plausible: Monday (or later), if she remains stable on room air, tube feeds can be advanced, electrolytes stabilize, and the team is comfortable with the antibiotic + pain plan.
• More likely: early this week to confirm stability over another 24–48 hours and finalize a safe feeding/hydration plan + discharge services (Modern HH + Willow Home Infusion).
• Longer possible: several more days (or longer) if lung inflammation worsens, oxygen becomes needed, feeding can’t be stabilized, or another complication appears.

Susan, Linda, and Don have begun discussing discharge needs. Case management notes show Willow Home Health and Willow Home Infusion have been contacted and have accepted to continue care once she is cleared for discharge. Linda may still bring Susan’s dental partials to help when the diet advances beyond liquids.

The care team will generally look for: stable breathing, improving infection signs, controlled pain/nausea, a workable nutrition/hydration plan, and safe mobility. Specialist goals noted so far include PT building safe hallway walking (with a walker, working toward independence), OT goals for independent full‑body dressing/clothing retrieval, sink‑side grooming/hygiene, and toilet tasks/transfers (goal target ~Jan 19), and speech therapy guiding a gradual transition from clear liquids to pureed foods with swallowing precautions (partials can help with chewing when solids restart).

• Next check‑in: tomorrow (Mon) after early‑morning labs (often ~5–7 AM) and after the hospitalist note posts (often late morning/early afternoon). We’ll specifically look for tube‑feed rate changes, electrolyte replacement/recheck, pain‑med route plan, and updated discharge timing.
• We’ll send another briefing after that update, or sooner if a major change posts (diet change, new imaging, culture result, oxygen need, etc.).

• Feeding instructions (tube feeds and/or soft diet guidance)
• Medication changes
• Warning signs to watch for at home
• Follow-up appointments and next steps

Included for family members who prefer more detail. Values below reflect initial ED results (Jan 2), early inpatient repeats (Jan 3), and today’s updates posted in the portal (Jan 4 electrolytes, BMP, and hemogram), plus key tests (swallow study, feeding‑tube check, echocardiogram).