Joyce's KP Adventure mikepasini.com headlines
Surgery Update
11 February 2022
We are downstairs getting ready to leave for the hospital when I am surprised to see Joyce's pre-surgery box in her hands. She didn't use the disinfectant wipes and she didn't drink the energy drink, which she should have had at 3:30 a.m. She was going to bring it with her. She drank it before we left.
Admission. You can barely make out Joyce beyond the hearts in the window as she signs in to Admission.
Later, cleaning up the piles of things she has accumulated (in anticipation of more piles), I found her previous box with the disinfectant wipes and an empty energy bottle. That time, at least, she didn't have to go in at 5:30 a.m. And the wipes don't really get to the area in question anyway because it's dressed.
I did change her dressing last night even though Jennifer the Physician's Assistant had done it at 4 p.m. I use a little more material and it's a bit more secure so it lasts longer. If she had to wait a long time for surgery, that might matter.
But she didn't.
I got a text at 7:37 a.m. that she was in the "procedure" room and they were ready to start. At 9:58, I received another that said the procedure was complete and she was on her way to the recovery area.
And a few minutes later, Dr. Tong called. "Michael? It's Winnie."
Joyce did really well, she said, and is awake now with the Wound VAC. Dr. Tong has been careful to use the minimal amount of anesthesia all along. They didn't have to use a lot today apparently.
Joyce did really well, she said, and is awake now with the Wound VAC.
She expects to repeat the surgery once or twice a week for the next two weeks. Then, with healthy tissue in the wound, try the Integra and send her home to see if it takes.
She cleaned out the wound about "ninty-nine percent," she said, but she's concerned about the muscle. With the nerve stimulator she got about a one percent response before she started cutting. There was bleeding, which is good (a "sign of life," as she put it) and after cutting some muscle away, without getting near a nerve, she said the response went up to two percent.
You can't really tell what to cut, she said. It looks pink (which is good) even when it doesn't respond.
She'll keep an eye on the muscle, hoping to see a bit more response. But the bleeding was a good sign. It looks good, but it isn't functioning, she emphasized. She thinks Joyce has been compensating with other muscles.
The problem is if she takes out the whole muscle, Joyce won't be able to walk. And that defeats the purpose of what they've been trying to do.
She again explained the options if the Integra fails, which she repeated was a fifty-fifty proposition.
If Joyce can't live with the open wound (and she probably can't), a much more complex operation would be required to move tissue into the wound and take a blood vessel from elsewhere and make sure she has blood flow to her lower leg and feet. It would be a 12-hour procedure, most likely.
Which is why she's hoping the Integra takes. If it doesn't, she says, Kaiser is out a lot of money, but it won't hurt Joyce.
The complex operation, on the other hand, could result in the loss of her leg if the blood supply doesn't get to her toes.
But for now, she'll keep on top of it with debridements (she already talked to the operating room scheduler to arrange the next session) and hope the muscle responds. And that the Integra solves the problem.