Joyce's KP Adventure mikepasini.com headlines
A Memory Clinic Evisit
7 July 2025
Today's big event was an evisit with Saroya Mangondato-Galvan, a nurse practitioner from the Kaiser Memory Clinic. They have not forgotten her.
Spirit Cycling. Drone shot of Joyce working out before her evisit.
In fact, before I left the house (bringing Joyce's laptop with me for the evisit), I checked Joyce's Kaiser email and saw Saroya wanted an update on her medications. She listed what they had on record. There were 17 of them (but a few had to do with the wound and few were vitamins). I printed the list and took it with me.
At Golden Heights, I check in with Julian about her podiatry appointment on Thursday (for which I asked for the usual printout), the dentist and the Wound Care Center. Later I asked for another pass for lunch at home on Wednesday (after Cassie the Physical Therapist asked if we were going home on for lunch again this week). Julian said he'd ask for a standing order.
After Joyce got dressed, I weighed her at 106 and then took her to the gym where I let Daisy and Wendy know she was ready for her walk. I had walked her around half the unit to her wheelchair and they do the whole circuit of 500 feet. She does sit once but she didn't really need to.
By then lunch had arrived. She had some pork in an onion sauce that she liked (but only three bites). They're out of high protein Boost again (that was fast) so I gave her a 16g version. Then she brushed her teeth and we went to the Pacific room for the evisit.
By 1:30 we were alone in the room for a private conversation with the nurse practitioner Saroya.
She's very nice and we all get along fine. Joyce was fretting about the call and what to say and kept obsessing about the medication list, which I reviewed earlier with Eric the RN so there was nothing to worry about because I knew what she was taking and what she wasn't.
Mostly Joyce answers Saroya's questions but I chime in now and then to add a detail or two.
But Joyce knew where she was and the name of the city and what year it was and she even got the date and day of the week right (because it was right there in front of her on the screen, of course).
She admitted she was fearful when walking but that she hadn't fallen since September (not counting last Wednesday anyway). And she said she's getting enough sleep. Saroya said she would increase the Lexapro for her anxiety to 20mg (a full dose) after I confirmed that she hadn't had any of the usual side effects at 15mg.
We discussed her eating habits (minimal solids, but Boost along with other liquids) and a loss of weight from 169 to 106 today, although some of that 169 was edema, I explained. Still it's a significant weight loss that concerned her.
She dresses herself (but doesn't undress herself apparently) and brushes her teeth. But Saroya promised to ask Dr. Dimaano to schedule toileting with a commode for her. I don't think the staff will bother but it's something that would happen before I get there, before the wound dressing change. We'll see.
Yes, I told Saroya, we are hoping to get Joyce home.
We also discussed the bed sore but Saroya thought she should protect it by getting out of the chair and into bed, when it's really just the opposite. Chalk that up to evisiting instead of in-person visiting. It's also one of the times I chimed in.
It was a half-hour evisit at the end of which we agreed to do it again in 4 to 6 weeks (by which time the higher dosage of Lexapro should have had an effect).