25 September 2021
While Dan Mundstock and I were wrapping up a water heater repair at my mother's house, Dr. Tong called to update me on the day's dressing change.
It went well with about four small quarter-size areas of good tissue growing in the wound now. That's a much different situation than we've been in.
But Joyce wasn't comfortable so it's too soon to send her home to do dressing changes with just Codeine. Some people, though, have to go back to surgery for the dressing changes, so she's doing relatively well.
Dr. Tong was wondering if she should keep Joyce a bit longer in the hospital anyway to let more tissue grow and then close the wound with a skin graft. Instead of sending her home with a Wound VAC to let her grow some tissue, that is. She wants me to talk to Joyce about it.
The risk in going home is that yellow slough will form again, which we want to avoid.
It would take just a day in the hospital to do the skin graft, she said, then a few days to monitor the harvest site. But six weeks after closing she's back in the saddle.
I told her I think Joyce is focused on getting home as soon as possible. And she acknowledged that.
And I observed that she hasn't used the black foam before so we don't know how much good that might do compared to the white foam she did use. Joyce also has good in-home nursing that would notice any deterioration right away. So it might be worth seeing if she can grow some tissue back.
I'm not sure what the consequences are of closing early with little tissue growth. I'm sure there are some. Like being uncomfortable taking long rides in the car or taking a long walk. There are things no one tells you, of course.
But Dr. Tong was in favor of that approach.
She again complimented me on my home care. They want to hire me, she says, telling every patient should have that kind of help at home. It really helps recovery. I reply that the nurses have told us some horror stories. People just don't get the help they need. Exactly, she says.
Then she jokes about my cooking. She always asks at the clinic what Mike's cooking tonight. Must be good because Joyce likes it.
Well, she likes it better than the hospital food anyway.
I thank her 'very very very very' much for what she's done but she thanks me in return again as if it were all my doing.