Joyce's KP Adventure mikepasini.com headlines
Life at Two Atmospheres
24 March 2022
Walking around at sea level, the air pressure is one atmosphere. When Joyce goes into the hyperbaric chamber, she's at two atmospheres, approximately the same as 65 feet below sea level without the amusement of exotic fish swimming by.
We leave the house at noon and get to St. Francis hospital around 12:30, leaving the car with the valet at Reef Parking. The hyperbaric unit validates (or nobody would arrive on time, looking for parking). It would otherwise run us $100 a week.
She disrobes in a dressing room, putting her stuff (including the Wound VAC, which is disconnected from the dressing) in a locker. Then she walks over to the gurney, lays down and is covered in two cotton blankets while her foot coverings are removed.
A grounding cable is attached to her left wrist and her mask is removed. "No candy, gum or electronics?" the nurse confirms just before they roll her into the chamber and seal the door shut.
She can see through the acrylic case to the TV where she's been watching episodes of the Montalbano series. I sit next to the chamber, working on my phone most of the time. But today I sat in the reception area to type this report on my laptop.
It takes about 10 minutes to get to pressure and 10 to come back. Meanwhile she's breathing 100 percent oxygen at two atmospheres for an hour and a half.
We get out of there a little after 3 p.m., get the car by 3:30 and are home before 4 p.m. Usually.
MONDAY
Her wound dressing on Monday was done by Kimberly, who turns out to be the RN responsible for Pacifica, to the south. But she was helping out Donna, our assigned RN, who was overbooked.
Kimberly was late (she thought we lived in Pacifica) by 25 minutes. But she was efficient.
She's pretty good. She frames the wound with drape and uses two big pieces to cover the foam and two to cover the bridge. But she checks for leaks by running a SurePrep over the drape. The polymer of the SurePrep seals the drape. Interesting.
Cat called to tell us the infectious diseases doctor has evaluated the latest cultures from the wound and has yet another antibiotic for Joyce. But Joyce can't take Oxycodone while taking the new antibiotic. Great.
I asked her if we can start it Wednesday night after she has Oxycodone for the Wednesday morning dressing change. Sure.
At St. Francis that day, Jessica the RN gave Joyce another memory test. She does pretty well, missing a couple. Later I think the anesthesia might explain that. And the fact that the math problem (count backwards from 100 by sevens) is not something we're in the habit of doing since the age of computers.
WEDNESDAY
Donna returns to do the dressing change. I tell her about the SurePrep. All of these nurses know how to do dressing changes but none of them have much experience with them. So they're a little apprehensive about getting a good seal when they turn the pump back on. I thought Kimberley's trick with the SurePrep worth passing along.
And Donna uses it, too.
Her mother calls. Last week it was her son. Her mother worries about her. "I'm 32 not 16 anymore," she sighs. She sounds 80, though, with a heavy accent.
She tells us a family member on her mother's side who lived near Kyiv had to emigrate. Where? To Israel.
Kathy the LVN at the hyperbaric unit was born in Ukraine. No accent at all. She married an Italian.
Small world. Some people forget.
Donna calls the clinic for clarification about the dressing. She would like a doctor's order to apply the Medihoney and Zeroform petroleum dressing under the black foam. Usually, she says, she just puts the black foam on.
The Medihoney is to combat the formation of yellow slough. And the Zeroform makes it less painful to remove the black foam, although it also slows healing.
When she goes, Apria calls to say they need an order to continue with the Wound VAC service.
So I send Dr. Tong an email asking her to address both issues.
And by the time we get to St. Francis, Cat has called to discuss them. I miss the call but she calls back at the end of the session and promises to take care of both issues.
After the session, we drive over to the Kaiser pharmacy across from the hospital to pick up the new antibiotic. There's nowhere to park, so I let Joyce off. She's worried about going in alone. But she manages to get her pills before I get a parking place.
I drop her off at the house and continue to my mother's to do my weekly chores. Then I go to Trader Joe's to buy a week's worth of groceries before I go home to make dinner.
THURSDAY
Julie the Physical Therapist returned today. She gave Joyce some simple exercises to do at the kitchen sink. "Don't do anything if it hurts," she cautioned.
She admired the painting of poppies that Rachel Mundstock had given us years ago. I told Julie that Rachel had gone to the art school in West Portal. "Oh, my friend Elinore used to own that." She sold it two years ago.
Small world, someone said earlier.
We went to St. Francis at noon again.
For the first time, Jessica didn't give Joyce the neurology test. Instead Christina the RN ("our top top nurse," Thurman the Director said, "who is wound care qualified") did it. Jessica is away for training.
It was an abbreviated test and she merely named three items for Joyce to remember rather than point to them. So there was no visual clue to remind Joyce. And she had trouble with recalling the three words several minutes later whereas she never has any trouble recalling three items.
I've thrown the flag for instant replay.
When we got home, Joyce panicked about getting her Wound VAC authorized for Apria. So once again I explained to her that I had already emailed Dr. Tong about it and Cat had called yesterday to confirm she would handle it and that there's nothing more to be done.
She had gotten a call back from Apria after placing an order for more supplies this morning reminding her to contact her doctor to reauthorize the service. Why Apria doesn't contact the doctor directly, I have no idea. Only the doctor can authorize treatment. Not Joyce.
CONCLUSION
I'll leave it at that for the moment. Things are settling down enough during the hyperbaric treatment that I hope I can update this report while she's having the treatment.
One of these days things will get better. But I'm beginning to worry that hopeful note sounds too much like that old surgeons' joke that all bleeding eventually stops.