Franny’s Story
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Harvoni one tablet daily
Epival 500 mg po daily
Seroquel 200 mg po twice a day
Maxeran 20mg po QID before meals
Ondansetron 8 mg q 8h po prn
Dexamethasone 2 mg po OD
Ranitidine 150 mg po BID
Epival 500 mg po daily
Seroquel 200 mg po twice a day
Maxeran 20mg po QID before meals
Ondansetron 8 mg q 8h po prn
Dexamethasone 2 mg po OD
Ranitidine 150 mg po BID
Background
Franny is a 48 year old woman that lives in a four story walk up apartment building. Originally from small town Saskatchewan, Franny moved west about 14 years ago after she divorced her ex-husband of 12 years. She is from a large conservative family and her father was the town’s minister. During the marriage, Franny went through some challenging times not being able to conceive due to endometriosis and she was also diagnosed with depression.
Situation
When Franny located to Vancouver for a fresh start, she did not know anyone and had little support from family or friends back home who disapproved of her divorce. Franny was diagnosed with bipolar Type 1 disorder about 10 years ago after going through a manic episode where she was self-medicating with street drugs. Subsequently, she contracted Hepatitis C. After Franny completed her drug rehabilitation, she met her current partner Paula. Paula is Metis, also from the prairies, and the two moved in together after dating for six months.
Concerns
Six months ago, Franny was diagnosed with stage III ovarian cancer and immediately started on chemotherapy. She has been experiencing significant nausea with the chemo and is using medicinal marijuana to help control it. Paula was concerned about Franny using medicinal marijuana because of her history with substance use disorder. Paula has been talking to an elder about doing a healing circle for Franny.
Formal / Informal Supports
Franny only really has Paula as her support system; they do have a few close friends in the LGBT Community. Franny has not re-connected with her family back in Saskatchewan, but she has been thinking of them since her diagnosis.
Follow-up Visit
A service update and post-surgical consult from a recent hospitalization for an emergency appendectomy is sent to your unit indicating that Franny now has stage IV metastases to her bowels. When you call to schedule a follow-up appointment, Franny’s partner Paula is very worried stating that Franny can no longer walk up the four flights of stairs to get in and out of their apartment.
Reflection
01
What are your priorities for your next visit and what concerns might you identify in advance?
02
What would be your plan for follow-up?
03
What could you anticipate for the future of this client?