16 October 2024
Dr. Amalraj has been calling me every afternoon with an update on Joyce's condition. Yesterday I was at Geary and Divisadero in the wind. Today I was going up to the bus stop to visit Joyce.
Yesterday her white blood cell count had gone up slightly despite antibiotic treatment from 12 to 12.4 (6-11 is normal). Today it was significantly higher at 17.6.
She had discussed the case with Infectious Diseases and they didn't think it was from an infection. I asked about dehydration and she admitted Joyce, who has only been eating half or her small meals, is dehydrated. But that wouldn't cause such a high count.
She wondered about the next step. I pointed out she can't come home if she can't stand up, walk and climb stairs. We'd just be right back at the ER.
I repeated I expected her to be transferred to a nursing facility for more physical therapy before coming home.
Then she asked if we'd talked about how Joyce wants to spend her last days.
I said it's difficult to have those kinds of conversations with her now because of her cognitive issues. She acknowledged that. But said now's the time.
The trouble is we don't know how incapacitated she will be.
When I got to the hospital I sat with her quietly. Two nurses came in to move her triangular pillow supports preventing bed sores. She screamed even though they didn't touch her, only shifted her with the chuck.
She did have a short chat with Judy today and a longer one with Christina yesterday. You can't reach her through the hospital (you have to be on some list, Christina discovered) but you can get her on her cell phone.