Joyce's KP Adventure mikepasini.com headlines
Discharged
16 January 2026
By the time I got to the hospital yesterday, Dr. Holland had already been to see Joyce but Joyce has no memory of the visit. I see discharge papers on her tray, though.
A nurse tells me Holland removed the dressing and the Wound VAC, replacing it with a silver alginate dressing. There are still the two drains, too.
The wound is still tightly closed and looks very good, she reported. No seepage through the sutures. They took out the Foley and will prepare Joyce for discharge this afternoon.
She shows me the file photo of the wound on the monitor and I take a photo of it. Later I show Joyce.
Melissa Mariano, a hospitalist, comes in to look over the chart. She says the silver alginate dressing should be changed every three days for a week. Then just a Mepilex bandage to cover. The sutures will come out in six weeks (and I get a text that an appointment at the plastic surgery department has been set for then).
Meanwhile, the SNF will send photos of the wound every week to Dr. Holland for evaluation.
The drains will remain in until there is less than 5ml drainage a day.
And she'll be on bed rest with no more than a 30 degree inclination of the head of the bed. No walking. No pressure on the leg. An inflatable mattress to avoid bed sores.
Her blood pressure is 104/645 at 76. So she get medicated.
Mary the patient care coordinator calls after I ask to see her to find out about the discharge. She confirms she'll be going to Golden Heights but she doesn't have the details yet.
So I call Golden Heights, get Binita who asks how it went and then puts Keana on the phone who confirms a 4:30 transport. I tell her about the drains. No problem.
Joyce tells me again she's sorry to put me through all this. I tell her it's just a new way to have fun.
I go out for a half hour to move the car. It's all two-hour parking in the neighborhood there.
Mary drops by again to confirm the 4:30 transport to room 113A. 114A, I suggest. No, they told her 113A.
Joyce will be on antibiotics until the 17th so they are leaving the IV in.
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HOLLAND CALLS while Mary's there, so I take the call. I scribble some notes on the back of the discharge form.
He tells me the silver alginate dressing can last a week but should be changed after three days. Then we go to Mepilex. No Ace required unless the Mepilex starts peeling off.
The drains will remain in for two to six weeks, at which time the sutures will be removed at his office. I already have the appointment.
Try to avoid stressing the wound. No tension on the skin. A 30 degree elevation on the bed, although it can go higher for meals. But he tested the hip area and saw that was the limit. So don't flex the hip.
The sutures (which hold in the drains) are not strong individually even though he used strong ones but together, like a zipper, they are strong.
She'll be on antibiotics for the next few weeks but he isn't concerned about her elevated white blood count. It's no unusual in a wound that large that has been open so long.
Main thing is to improve her nutrition.
But the wound looked good, he said.
Since transport is hard on the wound, he'll rely on photos from the SNF to see how things are going until the six week visit.
But contact him by email if I have any concerns. He's responsive, he says, and he has been.
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SO NOW WE WAIT two hours for the transport. At 3 p.m. we watch the News Hour and then Amanour as a nurse and shadow come in to prep her (flush the IV and change her diaper again) after a old Japanese CNA changes her diaper, cleans her up and gives her a new gown. I put the drains on her abdomen so the transport guys see them.
Transport arrives, transfers her to their smaller gurney and I leave to take our tree down, chatting with a neighbor who is going to miss it, he says.
Golden Heights. But in a new room.
I find Joyce in Room 113A now, even though her name is on 114A still and no one is in that bed. I'll never quite understand why they don't do things theyshould and do things they don't have to there. But all her stuff has been moved over including the walker and wheelchair she won't need for six weeks.
There's no chair so I ask for one and move her tray to the middle of the room so I can plug in the extension to the shared outlet, wrap it on the bed and attach the charger and phone for her.
I don't stay long because I haven't eaten all day. Just long enough to get her an Ensure Plus and a pitcher of water (which they neglected).
There's always tomorrow, apparently.
