7 November 2025
I'm in no rush to see Joyce return to Golden Heights and I can't imagine she is either. Not that Kaiser South City is a paradise. Far from it. Different doctor every day. Different RN every day. No supplies except what I bring. Every day.
But today's doctor did call me to discuss the case. She said she wanted to keep her there overnight and see how her blood sugar and blood pressure are doing over the weekend. She was vague, with reason.
In the morning, Joyce's blood sugar has been low. The nurse gives her a juice box and it bounces back. But Joyce doesn't eat breakfast as a rule, which doesn't help. Although today she had some yogurt.
Her blood pressure keeps dipping under 100 but Dr. Nishimura said it responds to fluids. Give her an IV and it bounces back. Of course Joyce doesn't like to drink water and at lunch (the only meal I observe) she has a small shot of fruit juice and a nutrition supplement from Kate Farm that is the equivalent of a High Protein Boost.
So she isn't helping herself.
She's also still on that seven-day antibiotic regime (day four today, Dr. Nishimura said) but that won't keep her there. It doesn't have to be administered by IV but can be taken orally.
I coached Eddie the RN through the dressing change late in the afternoon today. They do have Santyl but they don't have Vashe or the large Mepilex bandages. Yes, they could substitute saline solution for the Vashe and use a couple of 4x4 bandages.
But we're hoping to close the wound this month and want to maintain what has worked so well at promoting healing and preventing slough to grow. So I bring supplies and hang around until the staff can do the dressing change.
Tom Cunningham, who took a look at her labs, suggested I enquire about the results of any blood cultures that might explain what happened. So I asked Dr. Nishimura about that. All the culture were negative, she said. Nothing grew. And, she added, the ICU staff didn't think it was viral.
So it wasn't the wound and it wasn't a UTI. The cause remains a mystery.
There's no place to keep a phone in the closet-sized room and no plug free to plug in her charger, so I bring her cell phone with me every day and take it home to charge at night.
That only adds to the feeling of isolation. She told me she was depressed today. Hard not to be depressed under the circumstances.
I asked her to call me tomorrow when they decided whether or not to move her. My number is on the white board.
If they keep her, I'll bring more Vashe and a Mepilex for whoever the Saturday RN turns out to be.