31 December 2025
It rained all day and into the night. So I drove to the bank to pay Joyce's bills and the drove to the hospital. No bus for me in the rain.
Amy the RN introduced herself and let me know what was going on. She would do Joyce's second dressing change at 2 p.m. and then walk her around. Joyce hadn't been out of bed since Sunday with me.
Meanwhile we caught up on Joyce's latest lab results using the KP app on her phone. Her anemia tests were improving as she began to eat more. She had a Dannon yogurt for breakfast and soup with saltines and another yogurt for lunch. With an Ensure Plus.
She ordered chicken noodle soup and a salmon filet for dinner.
Meanwhile I hear from Mary the Patient Care Coordinator. She tells me she just talked to "The Doctor" and they are releasing Joyce today.
Not so fast. "Do you want to talk to The Doctor?" Yep.
So Dr. Cho comes in and introduces himself moments after Joyce and I see her kidney lab results which, after all the hydration, are nearly normal again. No mystery to that, Dr. Cho says. You hydrate to wake up the kidneys.
With no surgery date available until Jan. 9, the smart thing to do is return Joyce to her room at Golden Heights before she loses it.
But next time, Dr. Cho said he advised Dr. Holland, if her labs at Golden Heights show dehydration, bring her in a day early to get her on an IV. Which makes a lot of sense to me. Particularly since Golden Heights doesn't do IVs.
Just one thing, I point out to Dr. Cho. Dr. Holland had increased her daily wound dressing changes to three times a day. Golden Heights is barely able to manage once a day. Is that going to be a problem.
"Good question," he says. He promises to check with Dr. Holland. Not a problem, it turns out. Twice a day will be fine. (Or, as I suspect it will work out, once a day, as we have been doing.)
Then he admonishes Joyce to eat and drink in the meantime. "Food is medicine," he says.
So the information flow as not as smooth as it should have been but the gist of it is that Joyce's treatment over the last three days has restored her kidney function and improved her anemia. So she can leave the hospital but has to maintain her hydration until the surgery in January.
Mary comes in to confirm everything and order the transport. No charge, I confirm, because she is "double covered." Kaiser Senior Advantage and Medi-Cal. Later I will discover she is being readmitted to Golden Heights so she'll have physical therapy again too. And I have to consent to her treatment and medications as if she were a new patient.
Dr. Cho thought it might be helpful to have a video of the dressing change and he charged me with taking it. So when Minnie the Physician's Assistant came in to do it at 2 p.m. I started recording.
But she made a mistake right away, forgetting the Santyle, so I abandoned the idea. No sense embarrassing her.
There was another issue with the wound. The Cavilon we always used, a polymer to protect the surrounding skin from the Mepilex adhesive, wasn't always used at Golden Heights (because when they run out of things, they don't reorder promptly). And they don't always use Mepilex bandages for the same reason. So Joyce's peri skin had become red and irritated. Dr. Holland prescribed an antimicrobial powder to deal with it. But powders and adhesives don't mix well. Minnie decided to use both and leet the Ace bandage hold everything together. Even though she used a four-inch Ace instead of the eight-inch that works better.
Anyway, the wound only has to survive until Jan. 9 or so. No sense worrying about the details as long as they are cleaning it and covering it to protect it from infection. The job the Santyl and Vashe combination did has kept the wound in good shape until now.
Amy the RN tells us a transport has been ordered to pick Joyce up at 4 p.m. but I leave then on the theory it won't make it through the storm on New Year's Eve by then.
And I'm right. I have time to go home, wind the clock, grab a snack and shop at Trader Joe's before they close for the holiday. I also have time to drive to Golden Heights and get the room set up for Joyce's return. Except I forgot to bring an extension cord. But I have time to drive to CVS in the rain in the dark with one eye to put one for her because that's another thing Golden Heights doesn't have.
And still I have to wait for her.
I did have a nice chat with her roommate who tells me what that last night was like for Joyce as they prepped her to leave for surgery starting at 2:30 in the morning. They washed her hair, gave her the pre-surgery wipe down, gave her a pre-surgery Ensure and put her on the gurney at 4:30 for her 5:30 arrival time.
But sometime around 7 p.m. Joyce did arrive in the rain. The transport guys covered her in a blanket so she wouldn't get wet crossing the parking lot on the gurney. She looked like a cadaver.
They transferred her to her bed and broke the side rail. The RN on duty had no idea how to reattach it. But I figured it out while he went to find a CNA who knows how a bolt works.
I didn't stay long after that. Just long enough to get Joyce going on her second dinner of the day. She had the chicken soup at Kaiser but not the salmon so she ate some of her Golden Heights meal. And had an Ensure Plus.
I came home and had a Jameson.