31 December 2024
On the last day of 2024, Joyce was transported from Golden Heights to the Kaiser Wound Care Clinic on Geary and Divisadero where she was seen by Jennifer the RN and Dr. Tong.
Kaiser agreed to cover the cost of wheelchair van transport because it had botched the Nov. 12 transport to Joyce's debridement. So she hasn't had a debridement in a couple of months. It took about six people two weeks to come to that decision but we kept pushing to save the $230 fare.
I took the 43 bus over and waited for Joyce to arrive at the clinic. I wanted to know how Dr. Tong and Jennifer accessed the wound but I didn't know if Joyce would get a debridement or even if Dr. Tong, whose clinic is around the corner, would join us.
But Jennifer assured us that Dr. Tong was on the way. So we went in to the tiny exam room and helped Joyce to sit on the exam chair, which Jennifer then flattened to take off the day-old dressing.
I brought Jennifer up to date on Joyce's recent history as well as the Memory Clinic visit.
Dr. Tong popped in shortly after take a look as Joyce laid on her side, compressing the wound.
"It looks pretty good," she said. "They are doing a good job."
Both Jennifer and Dr. Tong noticed a strong smell from the wound, normal in an open wound. And Dr. Tong saw some slough to debride. She had brought along what she needed to do that.
Joyce didn't have even any Tylenol to dull the pain but there wasn't much pain. There was a lot of blood, though, which is a good thing.
We discussed how to handle wound care until the current constrictions of my disability and Joyce's stay at the nursing home.
Dr. Tong asked about my health and I brought her up to date on my situation, waiting to hear what the neurologist recommends after my "action required" CTscan results.
Dr. Tong told us she has been transferred from San Francisco to South San Francisco so future debridements would have to take place there at that clinic and hospital. Joyce's adventure began at that clinic, in fact, several years ago when she was referred to Dr. Tong in San Francisco.
So the plan is to do wound maintenance for the time being with monthly video conferences between Jennifer and Joyce to examine the wound without traveling to the clinic in San Francisco. If Jennifer identifies an issue that needs Dr. Tong's intervention, Joyce would go to Kaiser South San Francisco, just down the hill from the SNF (is she's still there) for debridement.
"First Mike has to get well," Dr. Tong said. "Then Joyce will get well."
Happy New Year, in short.