28 January 2025
Yesterday Joyce was switched from the twice-a-day wet-to=dry wound dressings to an every-other-day Wound VAC (vacuum assisted closure). I was glad to see to the new Lightstone Tzoar 207 pump had a lighter plastic housing (and a better AC connection) than the cast iron pumps Byram used to supply when she had one at home.
It's also a lot quieter. Especially when the wound nurse manages to get a perfect seal with the tegaderm bandages that hold the foam in place in the wound.
Anne the Wound Nurse hadn't quite finished the Wound VAC dressing before she had to attend a meeting but she sealed the wound temporarily. The wound was sealed in tegaderm but the pump was off.
When she came back from the meeting, she put a fresh rectangular block of black foam over the petroleum dressing as I held Joyce's leg so the wound would be as open as possible with her lying on her side. At home she always laid on her stomach, letting the wound open wide.
Anne indulges in no fussing with an exact shape of foam. The suction with fit it.
She uses small strips of tegaderm, encircling the wound after using a skin prep. Half the tegaderm is on the skin, half on the foam. Once she seals it, she pokes a hole in the tegaderm near the top of the wound and attaches a valve with a hose that attaches to the pump's hose.
She connects the hose and starts the machine but doesn't get suction until she pushes the foam into the wound. Then it closes up and the pump stops. A perfect seal.
She put more tegaderm around the valve and wrapped the whole thing in a new Ace bandage to protect the dressing.
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THEN I ASK HER to move Joyce to the wheelchair so I can see how she does it with the Wound VAC. Pretty much the same dance.
And Joyce has lunch in the hall but hard eats the pork, rice and broccoli. A bite or two of each iS all.
At that point Joanne the Nurse Practitioner comes by, finally catching me. We talk about the macerated food, how little she eats, how much weight she's lost and the imbalance on her feet. She suggests a new med for her mood, which I approve.
I take Joyce for a spin around the facility and then we go into the Rehab gym to work on the SciFit a bit. Cassie is back (with black hair again after a brief fling with red) and says hello to her.
When Joyce is done, Daisy the RNA and another RNA have her walk down the hall and around the corner with the Wound VAC. She sits down once to rest.
But after she stands and sits right away three times without taking a step, screaming she can't, I roll her back to bed. She transfers from the wheelchair to the bed after I hang the Wound VAC on the bed.
I put the Coloplast skin moisturizer on her chapped feet (another thing they aren't doing for her( and then the socks.
She was in bed but disturbed when I first arrived. There had been a lot of activity with the new Wound VAC. But when I leave, she's been up and had a workout so she's more relaxed.
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BEFORE I LEFT the house, Loren the Social Worker had called.
She offered to have Dimitri call me to talk later in the day about placement options for Joyce after Feb. 9. Sure. But he didn't call.
She also offered to apply for Medi-Cal for Joyce so we could find out what her share-of-cost would be in any facility. I explained to her that we were just breaking even on Social Security between the two of us now. Again.
She sent me a sample Spousal Impoverishment Medi-Cal application which would, theoretically, protect my meager Social Security payments while swallowing up Joyce's more generous one (I had to take it at 66 but she was able to wait until 70 and gets $3 for every $2 I get). So it's not likely to solve the problem.
I may be delusional but my hope is that at a facility that treats her problems instead of warehouses her, she can recover enough to return home. It seems it isn't too much to ask that one ought to be able to live at home with "moderate dementia."
But she has to be able to walk.