Pt arrived on time. Last seen one week ago. Initially reviewed medical updates. Pt had another episode of chest pain last night and took Nitroglycerin (later able to potentially connect to watch video with high emotional content). No further episodes. Messaged cardiologist but has not heard back. Had sleep medicine MD appt with machine setting updates and recs to increase activity. Will get a new C-Pap machine in several weeks. Chronic back pain has worsened to the point it is interfering more with activities. Reviewed messages with PCP. Looking for referral/recommendations. Previously has seen specialist for procedures which were helpful. Reviewed updates to daily schedule - starting each day with MyFitnessPal, which she has been using for two weeks. Feels it is working well so far. Has two people online who are also doing it. Moved on to discussion of writing. Continues to take workshops which have been helpful in generating an organizing structure "concept index." Feels this will be helpful in planning her writing projects. Looking forward to next set of workshops. Continued discussion of daily journal - updates to question/prompts and options for integrating concept index - allows for notetaking in prep for writing projects. Reviewed goals for the week.
Pt arrived on time. Started with taking medications. Pt had a good morning hanging out with N. Reviewed updates to medical status. Had frustration with response from nurse, asking to come in before getting a referral for back pain. Reviewed process and options. Walked through making an appointment with specialist directly. Was able to call and set up appointment in session. Reviewed updates for son's upcoming wedding - planning for events, getting clothes from tailor. Had some lower moods the last couple of days related to different schedule with online friend, N. The time spent hanging out has been helpful for keeping moods up and without them has noticed a difference. Reviewed alternatives given current schedule. This led to discussion of returning to the quilting. Reviewed current state and work needed to finish it. Discussed options and challenged negative assumptions about process and work load. Reviewed self-talk/reframing. Set goal to look over the quilt today to decide next step.