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 who lives in a four-storey walk-up apartment building. Originally from a small town in Saskatchewan, Franny moved west about 14 years ago after she divorced her ex-husband of 12 years. She is from a large conservative family, her father having been the town’s minister. During the troubled marriage, Franny went through not challenges such as inabilities to conceive due to endometriosis and being diagnosed with depression.
Situation
When Franny relocated to Vancouver she had to start from scratch. 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 10 years ago after going through a manic episode where she was self-medicating with street drugs. Subsequently this lead her to contract Hepatitis C. After Franny completed drug rehabilitation, she met her current partner Paula. After dating Paula, a Metis also from the prairies, for six months the couple moved in together.
Concerns
Six months ago, Franny was diagnosed with Stage III Ovarian Cancer and immediately started on chemotherapy. She has been experiencing significant nausea from the treatment and is using medicinal marijuana to help control it. Paula was concerned about Franny using marijuana because of her history with substance use disorder. Paula has been talking to an Elder about performing a healing circle for Franny.
Formal / Informal Supports
Franny relies heavily on Paula as her sole support system, but they maintain 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.
Initial Visit
Franny appears pale and tired. She is having problems eating due to the nausea. She has been neglecting to take her medications because of the nausea and Paula worries that this may contribute to a change in her mental health. Most recently, Franny had an emergency appendectomy and the surgical incision has dehisced.
Reflection
01
What are your preconceived ideas when caring for clients with mental health challenges or substance use disorder?
02
Are there any potential implications with clients using cannabis?
03
What might you ask Franny to contribute to your holistic assessment of her health and situation?
04
How might you engage with Franny and Paula to support the care needs they identify?
05
What are some potential resources or other people that could be accessed to support Franny?
06
What might be involved in co-creating a care plan for this family?