Joyce's KP Adventure mikepasini.com headlines
Lunch in the ICU
4 November 2025
Again, Joyce's condition improved today. I had a nice long chat with today's doctor, Archana Jayakumar about her situation. A few things are clearer.
No fever, the wound is not infected (it was confirmed), no UTI (her urinalysis was clean) but her blood pressure is still low. Dr. Jayakumar said she would continue the antibiotics (Meropenem) for seven days but she'll have to remain in the hospital until she is off the norepinephrine that is supporting her heart rate.
Again we used her phone to look up her labs today and she's doing much better. Her white blood cell count has plummeted back into the normal range.
But we still don't know what the infection was. It may have been a transitory thing, Dr. Jayakumar offered. Anyway the antibiotic knocked it out.
Her anemia and especially the dehydration are working against her blood pressure, so they want her to eat more and drink more water. She, however, wants to lose weight (the bed, inaccurately, had her at 133 lbs.) and does not want to pee, so she prefers not to eat or drink.
And, not surprisingly, the hospital has left her leg wound open because they don't have supplies to close it. I didn't bring my kit with me today but I told them I'll bring it tomorrow.
They didn't have Vashe but they didn't have Santyl either. They wanted to substitute saline for Vashe an Medihoney for Santyl. But, as I explained to the wound care nurse, we've tried Medihoney and it did not curtail the yellow slough in the wound. And only the combination of a Kerlix well soaked in Vashe over Santyl applied over the whole wound has kept the slough at bay.
The wound care nurse suggested a Wound VAC, which Joyce vetoed. But they are quieter units at the hospital so I encouraged her to try it. But the wound care nurse said it would require a debridement so they gave up on that.
They hadn't decided what to do. They wanted to cover the wound only with an abdominal pad so it could breathe but it's on the back of her leg, I pointed out, so it won't get any air in bed.
So the left if open while they tried to figure things out. Meanwhile Joyce had a bowel movement and peed, which is not the way to keep the wound clean.
Dr. Jayakumar did tell me they had consulted Dr. Tong, who is at this hospital now. But it doesn't sound like it.
Meanwhile, Joyce did get out of bed today, sitting on a chair for two hours. She had her hair washed and then had lunch (vegetable soup, chicken, broccoli, apple juice, a chocolate supplement).
I told the nurses she always says no. And that her sister had asked her, "Do you always say,'No'?" And she said, "No."
But they also saw me encourage her to do things she initially refused (like getting her hair washed and eating lunch and drinking water and, well, everything), so they'll be a little less hesitant to suggest things more than once.
You might think she's running out of things to veto but tomorrow I'm bringing her a trekking pole so she can walk around a bit. That will keep her veto power going strong.