Joyce's KP Adventure mikepasini.com headlines
In the Wake of the Debridement
26 February 2025
Joyce had a debridement in San Francisco yesterday. It's become a routine monthly operation to remove the yellow slough from her wound and promote healing. Jennifer the RN at the Wound Care Center on Geary and Divisadero is handling it now since Dr. Fong was transferred to South San Francisco.
I had discussed transporting Joyce there from Golden Heights in Daly City (which is in another county) with my friend Carol from Sonoma who had volunteered her sister Amy and Amy's Prius.
But I was worried about getting Joyce from the wheelchair to the car and, later, from the car to the wheelchair in front of the building on busy Geary. Then I remembered the building has a garage but I have never parked there so I didn't know how difficult it would be to manage.
We thought Loren the Social Worker had an alternative to the wheelchair transport for $240 but she didn't. So Joyce took the St. Mark Transport van again.
TUESDAY
The 43 bus I take there was five minutes late but I arrived before the appointment. Joyce was already there.
I was dismayed, though, to see they sent Joyce to the appointment with a hospital gown, not her clothes, and a bed sheet over her lap to keep her legs warm. I texted Loren to complain because she's the only contact I have. I can't believe they sent her out of there like that.
Jennifer and I get Joyce from the wheelchair to the exam chair and Jennifer flattens it. I get some gloves and hold Joyce in position as Jennifer takes the dressing off.
The first dressing of the day doesn't, I notice, have the green discharge from psuedomonas I'd noticed the other day. And Jennifer notices they cleaned the wound up a bit from the last photo.
When Joyce complains about pain, Jennifer puts some Lidocain over the wound to numb it. Joyce doesn't know if they gave her any Tylenol, as I had requested the day before, before she left.
Jennifer does some charting while we wait 10 minutes for the Lidocain to take effect and then she debrides.
I ask her about doing this in South City to avoid the transport charge. She says Tong has different duties there and she doubts the clinic offers debridements.
So next time by car, I think. I do check out the garage after and it seems feasible. But she could have done it in the street today, too. It wasn't as chaotic as usual.
I wait with Joyce after she calls St. Marks. I put the number in her contacts. The receptionist was sure to get it from them when they dropped her off.
WEDNESDAY
I take some clothes, a book and some supplies with me to visit Joyce. It had occurred to me that, if I was upset they sent her out of there without clothes, I should start dressing her each day.
When I get there I do find her clothes in a bag in the side table. But when I can't find her expensive wheelchair cushion or her hair brush (which I found later), I ask Eric the RN (who had done his first wet-to-dry dressing the other day) where the cushion was.
He had no idea but offered to check with the night crew. But she came back during this shift, I point out. So he checks with Angie the CNA and she comes in and shows me how she put the cushion in a pillow case on the chair. Oh.
She's the one, she says, who sent her out in just a gown because Joyce refused to wear pants. Pants? But she has clothes right here, I point out to her, in the side table. She didn't know, she says, because it's only her second day.
I dress Joyce and get her in the wheelchair and off we go for a ride around. When I see Angie I explain to her that Joyce never wears pants because of the large wound on the back of her left leg. That's why she refused. So it's always a dress. We make friends.
Since Joyce is dressed (with a jacket too), I take her outside. It's 67 degrees and sunny with a warm breeze. I roll the wheelchair around the block (it's a big block) and then we sit in front in the sun for a bit.
I took her to the gym after, where she did some chair exercises. And then Daisy and her assistant came to take her for a 120-foot walk back and forth along the shorter hall. Jayce and Cassie came by and encouraged her. It was tough for her at the end but she made it.
Lunch, as you can see in the photo, was not on the menu. The only thing she ate was the cup of chocolate ice cream. She had two bites of the chicken adobo, none of the collared greens or rice, a bite of apple pie, none of the yogurt, a bite of the turkey in half a sandwich.
And Eric said she didn't eat breakfast at all. Something Angie confirmed when she asked about lunch herself.
I left her in the wheelchair to sit up in her clothes for a while. It confused her. The process of getting back in bed and in a gown. I explained to another CNA who came in what to do with the clothes so I can take them home to wash on the weekend.
So it was a different day at least. No day is memorable when you have dementia, but getting dressed again at least lets you feel like the person you were for a while.