26 May 2022
Joyce had an appointment with Dr. Tong today at 2 p.m. It was the first time she's seen Joyce since the April 27 surgery. And for some reason, that qualifies for no co-pay.
We parked on the street using her new disabled placard to avoid having to pay the meter. So we didn't pay for either the visit or parking again.
Sometimes that's all you can scrounge up to pass for good news.
And other times no bad news is the equivalent of good news.
But I was looking for something else today. A better fix on where we are and where we can hope to go. And Dr. Tong delivered that.
After seeing Joyce, she popped her head into the waiting room where I was the only one waiting and we had a little chat.
It's a good time to try Wait & See therapy.
"The wound looks good," she began. The muscle shows some healthy tissue even though the yellow slough, inhibited a bit by the Santyl, has gradually returned.
She reminded me she has talked to a couple of other surgeons about the case. They've both looked at photos of the wound. And she recommended we talk to Dr. Fang, who did the original surgery, and another surgeon in Oakland. Particularly the chief in Oakland.
He's the one who believes more can be done to close the wound.
But the question is when.
Because Joyce is stable now and the wound slowly improving, Dr. Tong suggested getting through the summer doing the once-a-day wet-to-dry dressing changes before re-evaluating the situation.
If the slow improvement continues, we might postpone any surgery until after the first of the year. Or we might discuss the situation with the other surgeons prior to trying it after the summer. Maybe try a skin graft over just the muscle area, she said. Who knows?
Doing anything would require a long hospital stay with aggressive, surgical debridements and a Wound VAC again. But not hyperbaric oxygen therapy.
It's a good time to try Wait & See therapy.
The wound has a life of its own. You can't rush it. But it does seem to be going in the right direction. There's no puss, no infection (other than the stuff you carry around on your own skin by virtue of inhabiting the world) and no deterioration.
There is a little growth, gradually making the wound a bit smaller. You know, instead of 7.87 x 3.54 inches it's 7.09 by 3.15 inches after two years. At that rate, it would be interesting to see where it gets on its own in three months. Or six.
So we'll keep on keeping on for now and reassess in three months.