Joyce's KP Adventure mikepasini.com headlines
Today's the Day
9 January 2026
As I write this, Dr. Mike Holland is debriding Joyce's wound for the last time, cutting away the yellow slough to get down to healthy tissue, before he sews the skin above it together with three layers of sutures.
He promised to call when he's done to let me know how things went.
THE MORNING
Joyce had an arrival time of 6:30 a.m. and I go there just before then. I went to the Admitting office because the security desk had no record of her arrival.
She was late, so late I called Golden Heights to see if she'd been picked up. Yes, they said, at 6 a.m. (not 5:30), so she would be about half an hour late. And about 7 a.m. a clerk in Admitting told me she had just arrived and asked me to sign a consent to treat form.
I got a pass from the security desk (which still didn't have a record of her arrival) and went up to the Ambulatory Surgical Unit to ask that clerk to let me see her. She ushered me into Joyce's bay where she had just been set up.
She complained about the bumpy ride in the gurney transport. Clearly I've spoiled her in the black Honda Civic I call our mini limo.
She was attended to by Jeff, who worked with her four years ago, and Erik, who also remembered her. Jeff has a female nurse photograph the site to be operated on.
Then we have the Purewick discussion. Joyce refuses so they just put pads under her, removing the pull-up. I remind her that the Purewick keeps the wound dry but they wouldn't keep it for surgery anyway. But later, in the room, she'll need it.
Jeff gives her Tylenol so she'll feel less pain afterwards. Then he has her use a mouthwash to disinfect her mouth. And finally, he swabs her nostrils with four swabs to kill any bacteria she might breathe on the wound and infect it.
She still had the line Binita had installed for her IV but Jeff said it wasn't large enough for surgery if she needed blood, so he started another one on the other arm.
She finally gets her surgical cap and some wraps for her lower legs to boost circulation.
And then we waited. Her 8:30 slot was pushed to 9:30 because the surgery in that operating room was delayed. She'll be in recovery for 2-3 hours, Jeff said, before being moved to a room.
Meanwhile Dr. Holland came by to say hello and go over the morning plan.
Her creatinine level is normal, he said, so that's no issue this time. In fact, Jeff didn't have an order for a lab test.
He has the room for 2.5 hours but said it really wouldn't take that long. He just wanted to have enough time to really clean up the wound.
He'll also send tissue samples for analysis. A biopsy for cancer, apparently, and tests for infectious diseases and other bacteria. Just as a precaution.
He'll put her on antibiotics afterwards, also as a precaution.
A really motivated patient, he said, would go home in a day, but he wants to take it slow with her. He expects her to remain for about five days.
Then he writes his initials on the leg he will be operating on and listens to her heart, which sounds strong.
She needs a change and two nurses hop right to it, giving her a new gown and chuck before surgery.
Then she naps until the anesthesiologist and the nurse on the team visit her and ask her a few questions. The nurse remembers her as well, having worked with Dr. Tong on her.
The nurse, Lilly, who is also the transport person today, rolls her away at 10:45 for the surgery.
And I catch the bus home until I hear from Dr. Holland.
THE SURGERY
The wound is closed!
Just talked to Dr. Holland. "Everything went well," he said. "I'm happy."
He said he was able to close it in a straight line, spending a little more time on the top and bottom and putting two drains in that he'll remove in a couple of weeks.
There are several layers of sutures that will dissolve but the topmost layer will have to be removed in about four weeks. On top of that is a sponge similar to a Would VAC medicated black foam that will remain in place for a week.
She's in recovery now, comfortable but sleepy as she metabolizes the anesthesia. Recovery will contact me when they are ready to move her to a room so I can "meet up with her," he said.
He did take some cultures and is sending them off to the lab to check for any pathologies (including cancer, which is always a worry in a wound that won't close, he said). He'll get the results in two to four days but isn't expecting anything to be found.
He'll put her on an aggressive course of antibiotics to make sure nothing interferes with the wound healing now.
I asked him how he found the wound. He said there was exudate and fluid but it wasn't too bad. He cleaned it out well and washed it.
I also asked him if he tested the muscle, which is something Dr. Tong used to do. He didn't but he said he did notice some atrophy caused by fat replacing the muscle tissue. That's irreversible, he said. Dr. Tong had warned us about that years ago, so it was no surprise.
"So mostly good news," I concluded.
"All good news," he corrected me. "For how it looks."
A ROOM
Dr. Kirschenbaum just called to let me know she's in Room 4321 and resting comfortably with Tylenol for the pain. I drove over there to bring her iPhone to her.
She was sleeping until her nurse brought Tylenol on schedule, just as Dr. Holland had ordered. He also gave her some antibiotics. And promised dinner, her first solid food in 24 hours.
Which, come to think of it, appealed to us as well. So I didn't stay too long, letting her sleep until they brought a tray to her.
And driving home in the dark (always an adventure when you don't see well) to come up with an equivalent for ourself.
I did plug her iPhone in but she can't reach it. The room layout really only works for someone bed-bound, as she will be for the next week.