Joyce's KP Adventure mikepasini.com headlines
Wound VAC
9 August 2020
I spoke with Dr. Tong this morning at 9 a.m. and got a clearer picture of where Joyce is at the moment. A picture that was clouded last night when Joyce called to say they were thinking of sending her home today or tomorrow.
Not quite yet, it turns out. "I'm in no hurry," Dr. Tong said.
SECOND SURGERY
But Joyce is "doing really well," she told me. Dr. Tong did "a little cleanup" but saw no sign of infection when she operated at 11:30 p.m. the other night.
She said it was one of those days when everybody was behind schedule but Joyce needed the second operation that day to have the weekend to recover. And she had already spent the day without food. So she didn't cancel the procedure.
That second operation was to clean out the wound but also to start her on a new Wound VAC (Vacuum-assisted closure) therapy that fills the wound with a black sponge that is connected to a vacuum.
Wound VAC. A small portable pump connected by tubing to a foam sponge and covered by a dressing.
The device, which has been around for about 20 years, promotes healing, improves the patient's quality of life and reduces hospitalization time. The trick is to convert an open wound into a closed one so it can heal normally.
CONTINUING THERAPY
And it's something she'll have to get used to because it could be months (even years, Dr. Tong said) that she'll need it. It is changed out two or three times a week. But until the wound heals (or fills in), she'll need it.
Then, apparently, we can talk about a skin graft.
The real issue at the moment is pain management. She has an intravenous line for sedation now and anesthesia for surgery.
The goal is to get her on oral medications so she can come home. Once she's able to tolerate pain with oral medication, she will be able to come to the hospital for the Wound VAC surgeries twice a week where she will be sedated for the procedure.
Once she no longer needs sedation for the procedure, a nurse can visit the home to do the Wound VAC change. I'll learn how to remove the thing if it causes a problem but a nurse will have to come over to get the ball rolling again.
Which beats going to the emergency room in the coronavirus age.
ANTIBIOTICS
Dr. Tong got the pathology lab results and, after consultation with the pathologist, started Joyce on two antibiotics for a two week run.
They replace the original antibiotic Dr. Tong had prescribed based on Joyce's prior lab results. That antibiotic, she told me, was in the same class as the new more targeted ones, so it was helping already.
THE PATIENT
She said Joyce is doing her part. Dr. Tong has ordered physical therapy and is consulting with them on out-patient options.
Joyce is still having trouble moving around and worried about getting up the stairs when I talked to her last night (she loved her mail, BTW).
But it hasn't been very long, Dr. Tong, added. So that will come. She'll wait for Joyce to tell her she's ready to go home.
And I will tell Joyce the place is a mess because I'm painting the dining room and remodeling the bathroom, so stay in the hospital until she can dance. Because, you know, she'd probably crawl home if she could.