28 December 2020
When Salwa the LVN arrived this morning to do the dressing change, she asked how our Christmas was. It was Christmas miracle, I told her. The Wound VAC has been silent at full pressure since Tony the LVN did the dressing change Christmas morning.
Salwa was delighted. She and Toni went to nursing school together and when Salwa was hired by this in-home nursing company, she helped Toni get on board too. We told Salwa that Toni told us how grateful she was. Salwa laughed. She'd forgotten.
"Did you have a chat with her?" I asked, trying to figure out why Toni had done the dressing so much differently this time.
"No, not at all," Salwa said. We all laughed. It really was a Christmas miracle.
She wanted to know what Toni had done differently. So I pointed out how she applied the drape, how she had cut the foam, how she reinforced the lily pad.
She made a mental note. Those are good ideas, she said with enthusiasm. She was going to try them herself.
And she did. All of them.
The moment of truth is always the same: it's when she connects the new lily pad's tube to the canister tube and turns the pump back on. The pump will suck out the air in the dressing, Joyce winces and when the pressure hits 125, the pump stops and we have lift off.
But this time nothing.
The pump didn't pump, the dressing didn't compress. Nothing.
It took me a minute to realize this was about the time of day we've been doing the canister change. Sure enough, the canister was full. I did a quick swap with a new one and there was 125 on the screen, the dressing compressed and the pump settling down.
Salwa has a great attitude, you may have detected. If Toni's dressing worked better, she'll do it Toni's way. No problem.
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SHE ALWAYS ASKS if there's anything new. There was.
That email from Dr. Tong mentioned doing the dressing a little differently by inserting a sponge in the gap between the muscle and tissue so they grow together.
That gap has been widening lately. It was in the photo I sent Dr. Tong asking about her plans for surgery.
"Sponge?" Salwa said.
In fact, we are using white foam. I'd assumed Dr. Tong meant that. But Salwa knew better. Sponge and foam are not the same thing. She suspected Dr. Tong was talking about the stuff she had ordered but that had never been delivered, intended for use with the black foam.
She called her right then and there.
But Dr. Tong wasn't in. So she left a message.
We all found that amusing. There are no elective surgeries being performed but Dr. Tong is still hard to reach.
She's probably taking a vacation, I guessed. Now would be a good time.