3 November 2021
We scrambled to get out of the house suitably medicated (well, Joyce anyway) for a 10:30 appointment at the Plastic Surgery Clinic. The theory is Dr. Tong wants to keep an eye on the wound so the yellow slough doesn't abort recovery again.
But there's been more yellow slough. And when there'e more yellow slough, you remove it. Scrape it off. It's called debridement.
But today's appointment was with Lady the RN (who has green hair). She hasn't seen Joyce since before Joyce's most recent hospitalization so she wasn't familiar with the wound. And wasn't going to debride it.
She was just planning to take a photo for Dr. Tong, who is out of the office until next Monday. Then she was going to put a wet-to-dry dressing on and send us home. Slough and all.
But when she took off the dressing, she saw the yellow slough discharge and detected an odor (which Salwa the LVN believes comes from the blisters on the skin, not the wound, and which I can't smell at all since my nose retired). So she grabbed Alysse the Physician's Assistant and dragged her into the room.
I know about this because I was in the room this time. A rarity. Lady thought I might be helpful.
Alysse suggested dropping the Wound VAC entirely and returning to wet-to-dry dressings with Dakin's Solution and Vashe. Today. She thought the mechanical debridement of pulling the soaked Kerlix off the wound would minimize the yellow slough. Even at the risk of slowing down the tissue growth.
Except, as I told her, we tried that for six months and ended up debriding in the hospital for a month. It didn't help.
And we don't have any more Dakin's Solution and little Vashe. So without supplies, we're not going to be able to do that.
Moreover, I continued the discussion, Dr. Tong was concerned about having kept the wound open this long and was hoping to close it by the end of the year.
Everyone agreed the decision could be put off until Dr. Tong could be consulted.
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WE GOT HOME at 11:30 about two minutes before Salwa rang the bell. She's in the Wound VAC camp. The wet-to-dry dressing didn't move things along.
She put a new Wound VAC dressing on and promised to chime in if the order is changed. She remembers the wet-to-dry dressings didn't help.
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AFTER SHE LEFT, I dashed over to my mother's (because it's Wednesday and garbage night) to take down the garbage, rake the leaves, do the bills, wind the clock and do the laundry. It was time to change her bed linens, too.
I didn't get home until 3:30.
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JOYCE WAS ON THE PHONE with Apria. They had left a message to get in touch with them about a Very Important Matter. And when I left, that's what Joyce did.
They told her that the authorization for the Wound VAC would expire tomorrow. So they needed a doctor's order to continue the service. Or they would break into our garage and take it away from us, I guess.
But Joyce (still on her oxycodone) didn't know what to do. She was actually on hold with Apria again when I came home.
We emailed Dr. Tong (which is how we found out she won't be back until Nov. 8) and then (because nobody looks at email very promptly) we called the clinic.
Of course, the phone is answered by the receptionist who takes a message and passes it on to someone who might know what to do with it. That took a few tries to get right.
But in the end he came back on the line to say Alysse would reauthorize the order now, so we should be good.
Of course a few minutes later he called back to ask for the company name and phone number because, you know, nobody knew where to find it.