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Joyce's KP Adventure mikepasini.com
In August 2020 Joyce had surgery at Kaiser Permanente Hospital in San Francisco on her left thigh where she suffered radiation burns in 2015 after surgery to remove a malignant tumor. This is the story of her recovery.
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At the Piano
28 December 2024
Andy and Judy drove down from Sacramento to visit Joyce today.
Christmas Day
25 December 2024
I ws awakened by a call on the house phone from Alice calling on her husband's cell phone. But I can't get up in time to answer it. She worries something has happened to me because I didn't answer so she says she'll call my cell phone. But instead she calls the house phone again on her cell hone.
Christmas Eve Surprise
24 December 2024
We've been to see Joyce every day (taking Saturdays off to rest our brain bleeds) but we haven't been updating you here every day. Which is not to say things haven't been happening, but should suggest how exhausting December has been for this particular invalid.
Catching Up
19 December 2024
The day after our visit to the memory clinic, Joyce walked halfway around the nursing home. Since then, though she's refused to get out of the chair to walk.
At the Memory Clinic
12 December 2024
I met Joyce at the Memory Clinic this afternoon. She arrived a minute before David the Ombudsman popped out of the elevator. He and I discussed my concerns about transport billing before he copied some invoices and went to work on it.
Catching Up
11 December 2024
Sorry for the silence. Sometimes a little too much is going on to keep up. So this is the first chance I've gotten to catch up.
Sick Today
6 December 2024
Long after I had left the house, Joyce texted me, "I am not feeling well. Don't come today."
A Longer Walk
5 December 2024
The minute I got there today, Joyce insisted she wasn't going to get out of bed. We fought. I put her shoes on. She got out of bed. And into the wheelchair.
Taking a Walk
4 December 2024
Holly got me to the SNF just after 11 a.m. and once again I took the long way around to Joyce's room to let the therapists know I've arrived. They wait for me before working with Joyce. We outnumber her.
Tuesday at the SNF
3 December 2024
Joyce is in bed and doesn't want to get up. Infuriating, you know. Then she asks me to put on her shoes so she can get up. Sure.
A Spirited Day
2 December 2024
Last night Joyce text me that she wanted to come home. But she was under the impression her CNA, LVN, RN and two therapists would come to the house to help her get better. No, I explained. They only work at Golden Heights.
Joyce's Birthday
29 November 2024
Sister Judy with nephews Andy and Joey drove down from Sacramento this morning to celebrate Joyce's birthday. She was surprised and delighted.
Putting Two and Two Together
28 November 2024
You never know what's going to happen at Golden Height. Yesterday was a pleasant surprise.
Christmas Before Thanksgiving
26 November 2024
Gobsmacked is the word I'd use to describe how it feels to be surrounded by friends new and old who have stepped up to help Joyce and me in our hour of need. And when I think how much more than an hour it's been but days and weeks and now months, I know one word just can't cover it.
A Better Day
22 November 2024
Today Cassie brought Kevin instead of Jayce (who was otherwise occupied) to work with Joyce. She gave Joyce a choice of walking to sit in the wheelchair or standing up three times.
Standing Ovation
21 November 2024
Don't ask me why I'm not thrilled about the last two days at Golden Heights. I have some good news to share but I feel like it will sound a lot better than it really is.
Two Meetings
19 November 2024
Christina generously drove me to the DMV to see if my license had ever been suspended for an "unexplained loss of consciousness." We sat there for an hour and a half waiting for I017 to be called before learning there was no restriction on my license, probably because it had never been reported by Kaiser (despite four doctors warning me they would have to suspend it).
A Lift at Last
15 November 2024
I was looking forward to today's visit with Joyce because she had agreed to let Jayce the Physical Therapist and Cassie the Occupational Therapist use a lift to get her out of bed and into a wheelchair. It would be the first time since she left the hospital that she would be out of bed and in a chair.
Waiting to Hear
13 November 2024
After the inside of my skull was imaged this morning, I stopped by the plastic surgery clinic to see if Joyce's fungal culture results had come in. Dr. Tong had said they could be in yesterday or today. But they don't show up on Joyce's test results page.
Tuesday at the Clinic
12 November 2024
I was supposed to get my head examined today but the scan conflicted with Joyce's biweekly debridement at the clinic. So I'll get my head examined tomorrow, if I don't lose it before then.
Another Monday
11 November 2024
Christina arrives at 11 to take me to the SNF in the rain. I grab a slice of the pizza I made last night and off we go. The pizza will be a good test of joyce's sense of taste.
A Friday to Forget [UPDATED]
8 November 2024
Quite a busy day Friday. I was ready for bed about 3 p.m.
Joyce Sits Up
7 November 2024
Our friend Christina picked me up in time to drive to Golden Heights for Joyce's 1 p.m. therapy appointment.
Joyce's Care Conference
6 November 2024
This afternoon I met with Deb the Rehab Coordinator, Joseph the Nutritionist and Aaron the Nurse to discuss Joyce's care at Golden Heights.
Monday at the SNF
5 November 2024
There is no M-F staff at these Golden SNFs. The "weekends" are rotated so any day could be someone's Saturday and Sunday. Still, having been there three days already, I was hoping to I'd have met most of her staff by my visit yesterday, which I planned to make by bus.
Sunday at the SNF
4 November 2024
Mundstock gave me a lift to Golden Heights yesterday to see Joyce. I brought along a box of Mepilex bandages and an extension cord.
Golden Heights
3 November 2024
Golden Heights is the name of the skilled nursing facility where Joyce has been moved. It's next door to Golden Pavilion where my mother was last year. They seem to be affiliated.
On to the SNF
2 November 2024
If Halloween proved anything it's that Joyce isn't able to be at home yet. She's not mobile, won't eat and can't take care of herself even with my help.
Halloween in the ER
1 November 2024
Which should be amusing. Male nurses cross dressing with curlers in their wig. Visitors wearing bunny ears.
Another Plan
30 October 2024
Before I could leave the house for the hospital, Mary Ann (the patient care coordinator) called to tell me Joyce has been discharged. So she found a bed for her at a facility in Daly City run by the same people who ran the facility my mother had been in. And which, consequently, I was pretty familiar with, having gone there every day for 11 months last year.
Another Day at the Races
30 October 2024
A day at the races is a chance to win, even if experience suggests just the opposite. So it was yesterday at Kaiser.
The Plan
28 October 2024
First, thank you for following developments here. There are about 40 of you, as far as I can tell, and if I had to respond to emails and texts, I'd never get to bed. As it is, typing is still very difficult for me after the concussion, so this is really all I can manage.
A Better Day
25 October 2024
I got over to the hospital just before 1 p.m. Joyce hadn't eaten yet and was sound asleep in bed. Dr. Pondicherry popped in briefly. She's going off duty for a few days and handing Joyce off.
A Bad Day
24 October 2024
Hoping to catch the physical therapist again today I went over in the afternoon to the hospital and talk to Mary Ann, the patient care coordinator, and Dr. Pondicherry.
Discharge Canceled
23 October 2024
I spent the morning trying to appeal the Livanta denial. I actually reached someone twice. But I was cut off both times and the third attempt got no response other than a leave-your-number. But I don't want to have this conversation on the bus.
Discharge Delayed
22 October 2024
It's been a chaotic two days. The dust seems to have settled but you can never tell for sure.
The Plan
20 October 2024
Well, I was minding my own business taking a shower yesterday morning the palliative care team called both phones and left messages. So when I got to the hospital to visit Joyce, I called them back and they visited us.
Improvement
18 October 2024
Dr. Amalraj called this morning. She said Joyce is much improved, which I believed because Joyce phoned me last night to chat a bit, something she hasn't done from the hospital.
Another Day in Bed
17 October 2024
I went to the hospital earlier today to see if I could catch anything. A lot goes on before noon.
A Sobering Chat
16 October 2024
Dr. Amalraj has been calling me every afternoon with an update on Joyce's condition. Yesterday I was at Geary and Divisadero in the wind. Today I was going up to the bus stop to visit Joyce.
Good News (Kind Of)
14 October 2024
So what's going on? you might be wondering.
Down and Out
12 October 2024
Between 8 and 20 p.m. a plumber is coming to unclog the upstairs toilet which I'd been plunging all afternoon. In desperation I bought a toilet auger but it didn't reach the clog either.
And Down She Goes
12 October 2024
She got out of bed and made it into her room to put on underwear, but fell doing it. I was able to lift her high enough to get her legs under her and her arms on the walker. She steadied herself and finished dressing.
She's Back
12 October 2024
Rather than move Joyce to a nursing facility, her doctors sent her home by transport late yesterday. She wasn't able to climb the stairs or to walk very well and is still confused. I was less than amused.
Visiting Joyce
10 October 2024
I had the third CT scan of my brain in two months today at noon in the same facility Joyce is in. So I went early to spend a few minutes with her on the sixth floor before popping down to the second floor for the scan.
Back to the ER
8 October 2024
Dr. Tong waved me in to the debridement room today to discuss Joyce's situation. Joyce hadn't been able to lie down on her stomach for the procedure. A first.
No Improvement
3 October 2024
Last night Joyce fell again. This time she was in bedroom and had tried to sit on the bed but slipped to the floor.
Joyce Returns Home
27 September 2024
I got a call yesterday morning from Purple, Joyce's case manager, who told me they were sending her home at 11:30. Joyce herself called to let me know a few minutes later. But shortly after 11:30 she called again to tell me it wouldn't be until 1:30.
Joyce Goes to the ER
26 September 2024
On Wednesdays I walk two miles to Trader Joe's in Stonestown, do the half-weekly shopping and grab two buses back (so the frozen foods won't defrost). Lately the new drivers on the 48 line have been skipping the Laguna Honda bar stop (just a painted bar on the street, not shelter or benches at the stop), which adds a quarter mile to my walk. This time the driver stopped short by half a block, which is what was on my mind at noon as I made it onto Ulloa with two bags of groceries.
And Home to a 911 [UPDATED]
24 September 2024
As I was about to make dinner, I hear a scream from the bedroom. "Help me! Help me!" Joyce is yelling.
Back to the Clinic
24 September 2024
It was a circus this morning as we left for an 11:30 appointment with Dr Tong.
An Update on Joyce's Hospitalization
18 September 2024
Seems like this is the year of Dropping the Ball. Joyce's Tuesday hospital date was cancelled because no operating room was available and nothing has been rescheduled.
Joyce & Dr. Tong
11 September 2024
Because of my concussion last month, Joyce missed her debridement with Dr. Tong. It was rescheduled for today but I won't be able to drive for some time so we took the 43 Masonic bus at the corner to Geary, hopped a 38 Gear to Divisadero and walked two blocks to the medical building.
An August Update
31 August 2024
I hate to let the month go without an update but it's been an unusual month.
Peripheral Arterial Disease
25 July 2024
The formal name for the poor circulation in the feet is peripheral arterial disease. And the test for it is to measure the ratio of blood pressure at the wrists to that of the ankles. If they're the same, the reading is 1.0. Below 9.0 is considered a problem.
Joyce Sees Her Primary
11 July 2024
It's been over a year since Joyce's last wellness visit so last week I made an appointment for her to see Dr. Brenman today.
At the Podiatrist
9 May 2024
Joyce finally got to a podiatrist today. It was quite an event.
Crystal the Nutritionist
6 May 2024
Clearing out the house after my mother's death in December has been, as Carol Bailey put it, "overwhelming." According to my calculations, I've spent well over 500 hours at it so far. And I'm about halfway through.
The Wound Care Center
20 April 2024
It took a while to get an appointment with Jennifer Spitnale the RN at Kaiser's wound care center, recently relocated from Walnut Creek to Geary St. in San Francisco, close to the hospital Joyce is not fond to return to. But yesterday was the day.
Joyce Gets Her Real ID
8 February 2024
When we returned to the DMV that fateful Monday, we were able to go early because Kristine the LVN had to come an hour earlier than usual.
Joyce's Pursuit of a Real ID
27 January 2024
While we tread water with monthly debridements by Dr. Tong at the clinic, Joyce has pursued her driver's license renewal with a Real ID. It expired last November on her birthday and she still hasn't gotten through the renewal process.
Packing Lists
4 November 2023
Kristine the LVN took a vacation last month for two weeks, traveling to Sicily and the Philippines, so Francis the LVN stepped in to do the dressing changes. He did just fine but for some reason none of the supply orders he placed were delivered.
More Debridements, More Supplies
18 September 2023
Joyce has two debridements with Dr. Tong this month. She had the first on Friday, Sept. 8, and will have the second on Friday, Sept. 29.
Loose Ends
26 August 2023
I have to confess to a little fatigue settling in. Running over to the skilled nursing facility for a couple of a hours every day, figuring out what to do for dinner, shopping, keeping two houses maintained, well, it's taking its toll.
Visitors!
28 July 2023
My phone rang more insistently than usual the other day so I answered it. "They're here!" Joyce said with excitement.
A Debridement
1 July 2023
Joyce had an appointment with Dr. Tong yesterday afternoon. It was her monthly checkup, so to speak, but entailed a bit more.
The Sleep Apnea Test
23 June 2023
So on Tuesday, Joyce and I drove over to Kaiser's French campus and took the elevator up to the fourth floor where they are still practicing Covid prevention quite seriously.
Oops
3 June 2023
I woke up this morning with a question. "Didn't Joyce have a sleep apnea appointment on June 1?"
A Chat With Dr. Tong
30 May 2023
After rescheduling a number of times, Joyce finally got another office visit with Dr. Tong. She didn't get into the 10 a.m. appointment this morning until nearly 10:30 but the case before her was a little more complicated than the patient expected, he said as he left.
Test Results
17 May 2023
Joyce received the results from her WatchPAT sleep apnea test this morning. The data was inconclusive so she'll have to take it again. Call to reschedule.
A Sleep Test
16 May 2023
One of the consequences of Joyce's recent wellness visit was to take a sleep test. Yesterday we drove over to the French campus of Kaiser on Sixth Ave. in our old neighborhood to pick up a WatchPAT.
The MRIs Are In
9 May 2023
I took Joyce to Kaiser this morning at 10 a.m. to have two MRIs, one without dye and one with. The MRIs are done in a trailer across the street from the hospital so I sat in a sort of porch to the building housing the reception room while the banging commenced.
The Supply Sage Takes a Twist
28 April 2023
In the last month, First Choice (the home nursing company Kaiser uses to send a nurse to visit Joyce three times a week) has implemented a new way of providing patients with medical supplies. It's been hilarious.
A Wellness Visit
27 April 2023
Joyce had her annual wellness visit today with Dr. Ana Brenman. She hadn't seen her in person since the pandemic, just keeping up blood tests through that period. So there was a lot of ground to cover.
The Results Are In
20 March 2023
You probably thought I forgot to tell you about the biopsy results from the Feb. 7 tests. Understandable but we only received them today.
A Sunday Update
26 February 2023
Some things get resolved, others remain otherwise. Life goes on or it doesn't. And in the meantime you forget the things you can't remember.
False Alarm
8 February 2023
Last week I asked Kristine the LVN what she thought about some bumps I had noticed growing on the muscle. She said take a photo and send it to Dr. Tong. So I did.
How to Get an Oxygen Reading
20 January 2023
Joyce has notoriously been unable to give an oxygen reading as a result of her Raynaud syndrome. The finger oximeter tries to read the blood vessels that are not legible.
Biopsies Show No Cancer
9 January 2023
On Saturday Joyce received an email from Kaiser that her biopsies from December showed no sign of cancer.
No News
5 January 2023
We've been waiting to hear about Joyce's biopsies, whose results we expected last week. As this week ends, we emailed Dr. Tong to remind her we're waiting for the results.
A Visit on Dr. Tong's Birthday
20 December 2022
Joyce had an appointment at the clinic today but we weren't sure until she paid her $15 copay that it was really with Dr. Tong. We'd been seeing her physician assistant for the last few months.
Joyce's Birthday
30 November 2022
Yesterday Joyce celebrated her 72nd birthday with phone calls from all her sisters, even the one who fell asleep watching a movie. It made her day.
The Shower Lady
22 November 2022
This morning Joyce had her first visit with the Shower Lady. Yan Wen the SL (for lack of a better designation) arrived right on the dot and took vitals.
The Week in Review
5 November 2022
There's an art to catching your breath. You have to do it when nothing else is happening. And a lot happened this week.
Report From the Front
28 October 2022
Just got back from the clinic where Cat the Physician's Assistant took a look at Joyce's wound. It's the first evaluation Joyce has had since her visit with Dr. Tong in August.
Two Updates
25 October 2022
I had sent an email to Cat the Physician's Assistant, who will be examining Joyce this Friday, to ask if there would be a debridement. Because if there was going to be one, Joyce should take an oxycodone an hour before.
Musical Chairs
14 October 2022
The visit before she was about to start a week-long vacation, Kristine the LVN texted she couldn't make it because she had gone to the ER the night before with severe pain. Kidney stones.
The System
30 September 2022
As we wait out the year before Joyce undergoes any more aggressive treatment, the system isn't exactly leaving us alone. After Monday's billing adventure, we had a vaccine adventure. Not to mention my mother's trials trying to get vaccines at home.
A Billing Adventure
26 September 2022
Today's mail brought Joyce a bill from Dignity Health for $21,029.40. It seems Medicare was a little short on the $54,768 hyperbaric oxygen treatments Joyce had earlier this year.
A Qualifying Visit
24 September 2022
Every month the RN visits to do the dressing change and qualify Joyce for continued home treatment three times a week. It's never been an issue with an open wound as large as Joyce's. Yesterday was the qualifying visit for October.
It's So Quiet
16 September 2022
This business of treading water until the beginning of next year makes for a lot less news. Very little is going on. One day the same as the next.
And Now for a Little Clobetasol
18 August 2022
At the urging of Francine the LVN, we sent Dr. Tong a few images of the skin around Joyce's wound on Wednesday. And today Dr. Tong emailed us to say she had consulted with Dr. Samsoa, a dermatologist, who had a suggestion.
Leftovers
15 August 2022
It occurred to me that you haven't been getting much more than a series of complaints recently. So I thought I'd pick things up a bit with some recipes (mostly for leftovers) that we both enjoyed recently.
Desitin and Mepilex
12 August 2022
You can't see it in the wound pictures but just below the wound where her leg remains swollen, Joyce has developed a patch of rough skin. There's more of the same along the outside edge of her thigh and it itches terribly.
A Visit With Dr. Tong
5 August 2022
Joyce had an appointment with Lady the RN (whose green hair is now blonde) at the plastic surgery clinic this morning. It took half an hour, near the end of which Dr. Tong took a look at where things stand. Then she came into the waiting room to bring me up to date.
We Get an Explanation
25 July 2022
The clerk at the pharmacy was just alarmed as we were by the price increase in Joyce's Santyl prescription. She confirmed it was the same doctor, same quantity, same prescription as our June 7 order, which cost us $94, not the $360.59 this order was being charged.
Santyl, Santyl, Santyl
23 July 2022
This happens every time!" Joyce complained. And she's right. We just can't complete a routine order for Santyl. Not even if it's a reorder of the current prescription.
How's Joyce?
21 July 2022
That's the question everyone asks me. And the answer is, "The same." Always. Still, it's time for a progress report.
Homemade Scones
3 July 2022
For Sunday brunch we either have bagels or, for a treat, Sconehenge blueberry scones. We both prefer the scones but we don't always get to the market that sells them.
Busy Catching Up
27 June 2022
One of life's more amusing ironies is impatiently waiting for someone to finish telling you how busy they are. They always seem to have the time to rattle off the list of crises they are managing so you don't feel bad when they decline your invitation.
Got It!
7 June 2022
I looked up the pending prescriptions at the pharmacy this morning and was pleased to see the notice we got yesterday was for 180g of Santyl at $94.
The Santyl Mystery
6 June 2022
On Friday, I called Cat the Physician's Assistant to find out what was going on. She said she'd call the pharmacy and get back to me. And she did within the hour.
Santyl Again
3 June 2022
We've been getting daily texts all week from the Kaiser pharmacy that Joyce's order for two months of Santyl had been delayed...
Dancing With Physical Therapists
29 May 2022
On Friday Julie the Physical Therapist resumed Joyce's treatment after quite a long absence. We hadn't seen her since before the April 27 surgery even though Rhonda had come by to qualify Joyce for the sessions as soon as Joyce came home.
The Santyl Story
27 May 2022
This morning Dana (pronounced Donna) the RN visited to qualify Joyce for continued home nursing and do the dressing change. When it came time to apply the Santyl, she said she'd apply it thickly to the Kerlix gauze rather than directly to the wound.
A Visit with Dr. Tong
26 May 2022
Joyce had an appointment with Dr. Tong today at 2 p.m. It was the first time she's seen Joyce since the April 27 surgery. And for some reason, that qualifies for no co-pay.
A Longer Walk
22 May 2022
The trouble with retrenching is that there's nothing to report. Joyce sits in the chair by the piano watching daytime TV or listening to some streaming service on the Google Home mini that plays the Carpenters incessantly.
Chipping Away at the To Do List
11 May 2022
Getting our afternoons back has been liberating. Suddenly all the things we couldn't do are just waiting for us to check them off the To Do list.
Free at Last
7 May 2022
Just kidding. We're not suddenly free of anything. But Joyce did avoid a few charges yesterday.
A Physical Therapy Lesson
5 May 2022
Yesterday after Sami the LVN did the dressing change, Rhonda the Physical Therapist came by. The law, she explains, requires in-home nursing to re-qualify a patient every time they are released from the hospital. That's why Dana the RN comes before Sami can resume visits and why Rhonda has to come before Julie the Physical Therapist can resume sessions.
A Milestone
2 May 2022
Today was a milestone for Joyce. She completed her fortieth hyperbaric oxygen session and the last one Kaiser has approved for now. She was absolutely delighted that it's over.
Retrenching
29 April 2022
Dana the RN came today to do Joyce's wet-to-dry dressing but while she was doing it, I got a call from Dr. Tong. For me.
Home Again
28 April 2022
Just to confirm: Joyce is back home. It was a whirlwind tour, though. She spent the night in Kaiser hospital after Dr. Tong debrided her just before dinner. She couldn't eat a thing, she told me.
Change of Direction
27 April 2022
I was able to go to pre-op with Joyce where we discussed the situation with Dr. Tong before the surgery.
A Two-Hospital Day
27 April 2022
Last night, out of the blue, Salwa the LVN texted us to ask how things were going. She was on the case a very long time and can "literally see the wound in my head without looking at photos to this day," she wrote. I sent her the Google album link on this home page and she took a look.
A Full Wednesday
21 April 2022
We're not sure what's going on with our in-home LVN, the one who does the dressing changes on Monday, Wednesday and Friday. Vic has been sick, Kristine was filling in for him until this week and Sami has taken over.
Good Morning, Monday
18 April 2022
She hates this. She doesn't want to do it any more. It's painful.
Suffering Jesus
15 April 2022
Good Friday started out well and then took a nose dive around here. By the end of the day all I could think to do was to rant here. Excuse me.
Two Phone Calls
5 April 2022
After today's hyperbaric oxygen therapy, we came home to await a 4:45 p.m. phone call from Dr. Tong.
When Tylenol Is Not Enough
4 April 2022
Donna the RN came at nine this morning after Joyce had taken a gram of Tylenol to manage the pain of the dressing change. It didn't help.
After Surgery
3 April 2022
At 1:16 a.m. Saturday morning Dr. Tong left a brief voice message telling me Joyce had done well. It's a two-hour surgery, so she must have started around 11 p.m. No other details.
The Week Ends
1 April 2022
The week ends with April Fool's Day. Somehow that feels about right.
Everything Happens on Wednesday
31 March 2022
Everything happens on Wednesday was a saying of my father's. Wednesday was the day we put the weekly magazine to bed and, uncannily, it always seemed to be the day when the news we were covering came to a head.
A Tuesday Update
29 March 2022
Tuesday mornings, it has turned out, are my only unscheduled hours of the week. Joyce has mid-morning dressing changes Monday, Wednesday and Friday and physical therapy on Thursdays. Every afternoon is spent at St. Francis for hyperbaric therapy.
Life at Two Atmospheres
24 March 2022
Walking around at sea level, the air pressure is one atmosphere. When Joyce goes into the hyperbaric chamber, she's at two atmospheres, approximately the same as 65 feet below sea level without the amusement of exotic fish swimming by.
The New Plan
18 March 2022
Dr. Tong just called to brief me on today's surgery. Joyce tolerated it well and will be released tomorrow.
Surgery Friday
15 March 2022
We left the house at 9 a.m. for Joyce's 10 a.m. appointment with Dr. Tong. The Kaiser computers were down when we got there but before we could be called in, they miraculous came to life again and Joyce had to pony up a $15 copay.
The Week in Review
12 March 2022
Joyce had a busy week, finishing her one-hour morning antibiotic drips, meeting a new physical therapist and a social worker, getting four hyperbaric oxygen treatments and three dressing changes. I had a busy week too, talking to Alexandra the Scheduler, Dr. Tong and Cat the Physician's Assistant as we keep trying to find some way forward for Joyce.
Sleeping Beauty
7 March 2022
Too gassed to recount the day, sorry. But it was eventful, starting with the usual IV drip in the morning and a dash to the clinic where Alysse the Physician's Assistant took the Wound VAC dressing off to look at the wound and liked what she saw.
A Rock and Roll Day
3 March 2022
There are various ways of abbreviating "and" in Rock and Roll. I find them all a little too cute. Like Ye Old Rock 'n Roll. Because it's the and that makes the point. You're rocked, you roll.
Oxygen on the Way
28 February 2022
This morning, as the IV drip was finishing its hour-long run, Jennifer the Physician's Assistant called to tell us Kaiser has approved Dr. Tong's request for hyperbaric oxygen therapy at St. Francis.
The Checklist
28 February 2022
This morning, I'll set Joyce up for her third unsupervised home IV-antibiotic infusion, which takes an hour. We were to get it going at 9:30 a.m. every day so her blood stream always has the antibiotic working for her.
Correction
25 February 2022
So it turns out Joyce didn't have a PICC line inserted from her elbow to her heart. Instead, it was a midline inserted from her elbow to her armpit. Details, details.
Homecoming
25 February 2022
Kit the Case Manager called this morning to see when I would be available today to come to the hospital. They want to show me how to deal with the PICC line and change the antibiotic bag.
A Plan
23 February 2022
I just got off the phone on a conference call with Dr. Tong and Joyce. Earlier today Dr. Tong took a look at the wound when Cat the Physician's Assistant changed the dressing and she wanted to consult with us about what to do next.
Thursday Report
17 February 2022
Joyce didn't get into surgery until around dinner time and I didn't hear from Dr. Tong until about 8 p.m. after she had finished. The news was not good.
Thursday's Agenda
16 February 2022
Just as I was about to sit down to a simple spaghetti dinner on Valentine's Day, Dr. Tong called. She was in Joyce's room and wanted us to both hear what she had to say so we were all on the same page.
A Funny Valentine's Day
14 February 2022
This is the first Valentine's Day Joyce and I won't be together since time began. Covid protocols prevent visitors to the hospital.
A Chat With Joyce
12 February 2022
In the Old Days, you could call the hospital switchboard and they would connect you to the right room number where a phone would ring and the patient would complain a bit, turn over and then answer.
Surgery Update
11 February 2022
We are downstairs getting ready to leave for the hospital when I am surprised to see Joyce's pre-surgery box in her hands. She didn't use the disinfectant wipes and she didn't drink the energy drink, which she should have had at 3:30 a.m. She was going to bring it with her. She drank it before we left.
Pre-Surgery Update
10 February 2022
Joyce's Covid test was once again negative, we learned promptly the next day.
Covid Test
8 February 2022
It's been a rocky couple of days for Joyce. She took a bit too much pain medication yesterday for some reason (she wasn't in pain) and was out of it for most of the day.
Nightly Update
3 February 2022
Julie the Physicial Therapist came for the first time yesterday. She'll be back Friday and twice a week for a few weeks.
A Physical Therapist Visits
30 January 2022
Yesterday at noon Sean the Physical Therapist knocked on the door. Joyce answered it herself. He'd already told her she looked good and what a lovely home she has by the time I made it up from downstairs.
A February Surgery Date
27 January 2022
This morning I replied to our friend Christina's email question about Joyce's next surgery, telling her, "We're hoping for sometime in February, so don't run out of prayers!" Assuming the Omicron bubble bursts by then.
Medical Supplies and the Dryer
17 January 2022
There must be some sort of metaphor illuminating the dual ongoing issues of Joyce's medical supplies and the rattling dryer vent. I just can't see the connection. But they're clearly orbiting the sun on the same path.
Yet Another Supplies Crisis
12 January 2022
Byram thinks the single order Mediplex pads it supplies should last a month even though the scheme uses two a day (so that supply would last two weeks). I stretch it out by using two 6x6 pads at the top of the wound along with one Mediplex. But even that uses two Mediplex a day.
Changing Gears
8 January 2022
Yesterday Quoia the LVN came with a trainee named Carolyn to change Joyce's dressing. She had asked if that would be OK with us and we had said of course it would. If there's any benefit to going through something like this it's that others will profit from your experience.
Ten Minutes on the Phone
6 January 2022
Today we had a phone chat with Dr. Tong about where we go from here. Earlier when I did Joyce's dressing change, I sent her a photo of the wound to Dr. Tong and she liked what she saw.
Holiday Deliveries
23 December 2021
Sorry to leave you hanging on the edge about those supplies. These crises seem to stretch out beyond any firm conclusion.
Another Supplies Crisis
15 December 2021
Last Thursday we ordered 8x9-inch Mediplex bandages from Byram. Dr. Tong had assured us she had talked to the big shots there to make sure we get what we need and enough of it we don't have to order frequently.
A Reward Is in Order
6 December 2021
Salwa the LVN did Joyce's dressing change this morning, complete with Santyl to fight the yellow slough.
Joyce Keeps on Trekking
2 December 2021
Confronted by disappointing news, we decided to do two small things to challenge the fates.
Three Options
30 November 2021
Both of us met with Dr. Tong today at the clinic. It was a relief to her to be able to speak to the two of us in the same room, she said.
A Happy Birthday
29 November 2021
We had a nice little thrown-together dinner for Joyce's 71st birthday tonight. It started with a Little Original Joe's salad of pickled onions, radishes, kale, blue cheese and half a dozen other things in a lemon dressing.
An Improvement
28 November 2021
This is just a brief update on the bleeding after surgery to say things have settled down over the weekend.
'If This Is an Emergency, Please Hang Up..'
27 November 2021
At 11:30 yesterday I drove Joyce to Kaiser Hospital on Geary where the engineers are still on strike, demonstrating outside the main entrance. I parked in the white zone and walked in with her. The guard said I could go to Admitting with her even with the car in the white zone, so I did.
A New Date
19 November 2021
Yesterday (well, Thursday), Dr. Tong called to chat. She just wanted to know how things were going. "Horribly!" we screamed. Well, not really. We just told her the yellow slough is winning the war and all the battles, too.
Striking Out
16 November 2021
You would think things would be on something of an even keel after nearly a year and a half of this. But here we are with no clue what's going on. Except that it's pretty clear the wound is not healing.
The Runaround
11 November 2021
Very dispiriting week here at the field hospital. We were doing the Santyl dry-to-dry dressings Dr. Tong had ordered, scratching by with supplies, on the expectation that we'd only have to get through Thursday night.
Back to the Hospital
4 November 2021
This afternoon Alysse the Physician's Assistant called. She had been in touch with Dr. Tong who saw yesterday's photo of the wound. And she wants to do a debridement herself in the hospital as soon as possible, which would be Friday, Nov. 12.
Another Ridiculous Day
3 November 2021
We scrambled to get out of the house suitably medicated (well, Joyce anyway) for a 10:30 appointment at the Plastic Surgery Clinic. The theory is Dr. Tong wants to keep an eye on the wound so the yellow slough doesn't abort recovery again.
Resuming Where We Left Off
30 October 2021
It's been a while since I've sat down to continue this saga but I have a lot of very good excuses. I'll wrap them all up into one big update.
A Team Changes the Dressing
22 October 2021
Today's dressing change at 11:30 was quite a spectacle. Joyce was there, of course, but laying on her stomach, she couldn't see anything.
Late Night Laundry
21 October 2021
It's been a difficult week. Joyce has been in a lot of pain but can't remember when she last took Tylenol or Codeine so you just throw up your hands.
Friday Round Up
15 October 2021
It's been a little busier than usual around here. And a little more difficult.
A Busy But Beautiful Day
11 October 2021
It was sunny when Joyce and I took a walk around the block this morning. There was an autumn chill in the air but it was still pleasant.
Happy to Be Home
8 October 2021
The Blue Angels escorted Joyce home this afternoon after a 28-day hospital stay. She made it up the first stairs she's navigated in all that time to the front door without the aid of the Fire Dept. this time.
The Last Date
7 October 2021
It occurred to me the other day that this month of separation has been a lot like dating. Joyce lives in one place and I live in another and we meet around dinner time every day and then go for a little walk, chaperoned by the nurses (one of which called me Joyce's LB* tonight). When it's time to go, we kiss good-bye.
The Plan
6 October 2021
Joyce called when I was paying my mother's bills to tell me Dr. Tong and Cat the Physicians Assistant wanted to meet with me this afternoon. "Any time," I said.
No Drip Today
5 October 2021
We must be getting close to release because today they removed the drips. That would be the saline solution and the antibiotic. Joyce took her two laps around the ward today with just the Wound VAC on the pole.
Yesterday's Visit
2 October 2021
When I visited Joyce yesterday afternoon, she seemed pretty alert for someone who had been knocked out for surgery in the morning.
Morning Surgery
1 October 2021
As it turned out, Joyce never made it into the operating room last night. Instead, Dr. Tong took her in this morning. A few minutes ago Cat the Physician's Assistant called to update me.
A Long Day
30 September 2021
It was a long day for Joyce. She was told she would have the debridement with Dr. Tong in the operating room with an epidural at noon.
A Late Date
29 September 2021
I haven't been able to get to the hospital every day. I missed Monday and thought I'd have to miss Tuesday but I realized I don't mind eating dinner in the dark with candlelight so I went over around 6 p.m. and took Joyce for a walk around the ward.
Sunday's Visit
26 September 2021
After doing the laundry and housework (and shooting over to Mom's to check on the leaking water heater), I visited Joyce just before lunch at the hospital.
Lunch With Joyce
25 September 2021
It was a strange day. We finished our usual Saturday obligations and then drove over to the hospital around lunch time. We checked in (they've had a lot of visitors, the clerk told me) and went up to the fourth floor, which is still six about street level.
A Dressing Change
25 September 2021
While Dan Mundstock and I were wrapping up a water heater repair at my mother's house, Dr. Tong called to update me on the day's dressing change.
Dinner With Joyce
23 September 2021
Late Wednesday Cat the Physician's Assistant called to let me know the visiting restrictions at the hospital had been relaxed. They were now allowing one visitor at a time between 8 a.m. and 8 p.m. Just call ahead, she advised.
A Road Map for Joyce
21 September 2021
This morning I had a long chat with Dr. Tong after she had finished the third surgical debridement of the wound during this admission. "It went well," she said.
Tube Removal
17 September 2021
At three this afternoon Jenny the Physicians Assistant called out of the blue to update me on Joyce's situation. That makes three different physician assistants calling over 24 hours if you're scoring at home.
An Update at Last
16 September 2021
After I sent an email to Dr. Tong late last night asking for an update (and the out-of-office-until-today reply), I did talk to both Joyce and Elise, another physician's assistant, this morning.
Contacting Joyce
13 September 2021
When I spoke to Joyce this morning, she was distraught. And a bit confused (which I'm chalking up to the anesthesia).
The Day After
11 September 2021
Joyce just called. A nurse finally let her have her purse, which is where her iPhone was. It had been locked up in her room. Which is why my texts and calls yesterday went unanswered.
Surgery Round Three
10 September 2021
I didn't change the wound dressing this morning since it wouldn't have been on very long. Joyce did get up at 5:30 to go through the home pre-surgery routine of using the disinfectant. She had the energy drink at 7.
The Supplies Last
9 September 2021
Vic the LVN changed Joyce's dressing this morning. That concludes our in-home nursing for this round.
Back on Track
3 September 2021
Late yesterday the graffitied Byram truck pulled up and 48 Mepilex pads were delivered to our door. At last.
Byram Cancels the Order
30 August 2021
When Joyce got a call from Byram this morning that her Mediplex order had been approved and would be delivered in one or two business days, alarms went off. That's exactly what we heard Thursday. And today is two business days later. And Vic used the last Mediplex this morning to dress the wound.
More About Everything
26 August 2021
Monday Jennifer the Other Physician's Assistant debrided Joyce's wound at the clinic. She said to let her know if we didn't get any supplies early in the week. And, as you might have guessed, we didn't.
Still Up a Tree
22 August 2021
My email to Dr. Tong on Thursday evening was answered by Jennifer the Other Physician's Assistant, who told us on Friday morning that she had called Kaiser DME to authorize the Mediplex shipment to us again.
Up a Tree
20 August 2021
Today began with a knock at the door before 9 a.m. from Mowbry's Tree Service. PG&E, the local utility famous for starting wildfires throughout the state, has engaged them to prune trees threatening power lines. And we have such a tree that cuts a free haircut every two years.
No Mediplex
19 August 2021
I watched the non-descript Byram delivery truck decorated with graffiti on the side go right by the house this afternoon. We were expecting the monthly delivery of 120 Mediplex pads delayed because Byram said the order had expired.
No, Wait, Sept. 10
19 August 2021
Shamira called today to reschedule surgery at the hospital from Sept. 21 to Sept. 10. Dr. Tong felt it would be better to do it sooner, she said.
Deliveries
18 August 2021
Last night I found myself cutting a fingernail-sized SurePrep wipe in half to conserve our last two, stretching them out to two days instead of one and hoping Ben would bring some Friday. Nuts to that, I said today.
Shamira Reschedules
17 August 2021
No sooner had I arranged my vacation plans for Sept. 10 than Shamira calls to reschedule Joyce's surgery for Tuesday, Sept. 21.
Speaking of Circuses
16 August 2021
It was time to order supplies again. The big ones. The large Mepilex bandages (we go through four a day) and the Kerlix (each split in half for one a day). We don't use the Web site to order from Byram because the seventh page of the order system is where you find out whether or not you can place an order.
A Year Later
3 August 2021
Roughly speaking, Joyce had her surgery a year ago. Well, two days from now. But we were already gearing up for it with a Covid-19 test while cleaning and packing the infected wound. Seems like, well, 10 years ago.
A Party of Three
22 July 2021
We had a party today when Joyce's sister Judy drove up from Los Angeles to take us to lunch. We hadn't seen each other for a year and a half.
Salwa Returns
13 July 2021
On Monday, Salwa the LVN returned to do Joyce's dressing. She had gone to Jordon to get her traditional Muslim wedding dress fitted.
Funny, Sort Of
8 July 2021
Things didn't go well at the pharmacy yesterday. Both Joyce and I were under the impression that her order for Dakin's Solution and Vashe were ready for pickup. Uh, no.
Catching Up
5 July 2021
Somehow I'd planned to write this update days ago but there was always one little wrinkle let to smooth out so I kept putting it off.
Vashed Out
28 June 2021
We have been rationing our supply of Vashe* for weeks now but last week we started dipping into our last 8.5 oz. bottle.
This Doctor Mike Thing
25 June 2021
Yesterday Joyce had her "weekly" debridement at the Plastic Surgery Clinic. This time Cat did it. That's a $10 copay instead of the $20 for Dr. Tong. Both of which are routinely refunded.
A Rough Transition
21 June 2021
We were expecting Ben the RN to do the dressing change this morning but when we didn't hear from him, I texted him just after nine to ask what the schedule would be this week without Salwa.
A New Physician's Assistant
19 June 2021
Salwa the LVN has flown off to Jordan to be fitted for her traditional Muslim wedding dress. It had been shipped to her three sizes too big (well, that was before all that fasting at Ramadan) and the final fitting is as close to the wedding as possible.
Day After Day
13 June 2021
If we're writing less frequently about this long haul it's because it has become routine. One day is much like the next, one week much the same as the previous one. Progress has been slow but steady.
Today's CT Scan
7 June 2021
This morning Kaiser's Radiology Dept. called to see if Joyce could drop in today at 3 p.m. for the CT scan Dr. Tong ordered last week. Sure, no problem.
'I OK'
3 June 2021
We had a nice surprise earlier this week when Andy and Katie dropped by with coffee and a fruit tart. The kids* stayed with Katie's parents so they could get away for a few nights over the holiday weekend.
Test Results
29 May 2021
We never did hear directly from her primary care physician but she did release the test results as they became available. For each test Joyce gets an email notification that she has a secure message in the Kaiser system and that message has a link to her test result.
The Other Leg
26 May 2021
It's 4 p.m. and Joyce has just gone down the hall past the double doors for X-rays on her ankle and knee. On her good leg.
Aldenol
21 May 2021
Don't bother looking it up. It came to me in a dream last night. Aldenol. "You have to get Aldenol for her," some medical professional was urgently telling me.
About That Pedicure
18 May 2021
The suspense must have been killing you. Apologies for not finishing the episode sooner. We wanted to wait until all the evidence was in before saying anything.
Husbands at Home Doing Wound Care
12 May 2021
That's the title of a new YouTube channel in which my fellow caretakers and I will be showing spouses, companions and friends new to wound care some of the revolutionary techniques we've developed in the last few months.
Laughter
2 May 2021
Friday we tried to reorder some supplies. Because, you know, you run out of them when you use them. Not everybody appreciates that.
Carrying On
29 April 2021
Tuesday Joyce had a debriding session at the Plastic Surgery Clinic with Dr. Tong who had canceled the previous week's two sessions. In just a couple of weeks, the yellow tissue had grown back over half the wound, so she had some work to do.
Taking a Moment
17 April 2021
The week went by in such a blur we thought it was merely a morning and we still had most of it ahead of us. And this was the week Joyce didn't have a single appointment at the Plastic Surgery Clinic.
Dr. Tong Recalibrates
9 April 2021
Yesterday we spent the morning unraveling the mysteries of durable medical equipment, also known as supplies. Joyce's plan (well, mine too) covers 80 percent of the cost of these essentials. In her case (at the moment) they're large Mediplex bandages, abdominal pads, rolls of gauze, Dakin's Solution and Vashe.
The Wound: An Update
7 April 2021
Yesterday was the second session at the Plastic Surgery Clinic with Dr. Tong since we've been doing the new routine. That routine is soaking the Kerlix gauze in Dakin's Solution for the morning dressing change and Vashe for the evening. Then an hour before the clinic debridement, I coat the wound in Lidocaine.
Junk Food and Lidocaine
30 March 2021
Last night was fast food night. Burgers and pizza. If you can believe that.
Whirlwind Week
26 March 2021
It's been an unusually busy week. Monday Joyce had a debridement at the clinic with Cat the PA and we ordered supplies from Byram for the first time. Tuesday she had another with Dr. Tong after Salwa the LVN changed the dressing in the morning and I ran down to Costco and Trader Joe's so the frig would have something to do. Winnie and I had a chat about what to do to speed the healing up on Tuesday. Wednesday we started the new routine and I ran over to Mom's to pay bills and take out the garbage. Thursday Salwa continued it, I shopped for Mom's groceries while Alice is visiting her own mother in Texas and we got our second Pfizer shots.
More Vashe, Please?
22 March 2021
This is getting to be like Oliver Twist. "Please, sir, I want some more," he begs for gruel. But in our case, it's Vashe we want because we only have a day's supply left.
Once More With Feeling
19 March 2021
Yesterday Dr. Tong debrided the wound again, completing the removal of yellow slough she started earlier this month. There is pink tissue now that should grow with an assist from Vashe, a solution that promotes growth and cannot be found anywhere.
A Clinical Adventure
10 March 2021
Today Joyce had her second appointment at the Plastic Surgery Clinic with Dr. Tong since the surgery. Like last week, she scraped away more of the yellow tissue so the pink tissue can grow unabated.
No Solution
4 March 2021
Dr. Tong added Dakin's Solution to Joyce's medicine cabinet. Or would have if the pharmacy had delivered it. They did call to let us know about it. That she had ordered it but that couldn't ship it and why didn't we just walk over to CVS and buy it off the shelf.
Half Vaccinated Twice
26 February 2021
We drove over to the University of San Francisco this afternoon for the first dose of our Covid-19 vaccine from Pfizer. We parked in the soccer field's parking lot, which is where our old high school football team field house used to be.
Kaiser Calls -- For Mike
25 February 2021
When Caller ID announces Kaiser is calling us, we assume it's for Joyce. I was on my way out the door to my mother's to repair her kitchen pendant light after 60 years of service when Kaiser called yesterday.
Wet-to-Dry Supplies
22 February 2021
I am writing this on Monday evening after making a chopped blue cheese salad, boneless pork chops and spaghetti in a homemade marinara sauce for dinner. Earlier today Joyce had her dressing changed by Cat the Physician's Assistant at the Plastic Surgery Clinic.
Joyce's Daughter
18 February 2021
Among the more bizarre voice mails we've gotten was one this week from Cat(herine), the physician's assistance to Dr. Tong. I'd emailed Dr. Tong a few questions (like can we return the Wound VAC now and when does in-home nursing resume) and Cat was going to answer them.
Home Again
15 February 2021
This afternoon I picked Joyce up at the hospital and brought her (and a trunkload of supplies) home. Not a peep from Dr. Tong about her home care yet, though.
Lunch With Joyce
13 February 2021
Yesterday Joyce called to tell me Dr. Tong wanted me to observe a wet-to-dry dressing change today at 11. Just go to the lobby and tell them your name, she said. You'll be on the list.
Confusing Phone Calls [UPDATED]
12 February 2021
It's been hard to get in touch with Joyce because her cell phone has been locked up in the closet in her room. So the only way to contact her is through the hospital switchboard.
Multiple Fronts
8 February 2021
Just talked to Dr. Tong after she finished Joyce's dressing change. But that's not all she did. She's working on multiple fronts to get good tissue growing quicker and manage Joyce's pain.
A Caretaker's Holiday
7 February 2021
Not one to squander an opportunity, I carefully planned this Sunday alone as a caretaker's holiday.
A Brief Chat
6 February 2021
I very briefly talked to Joyce this morning before the anesthesiologist popped in, presumably to convince her to let them put the catheter in place for pain management.
A Late Update From Dr. Tong
5 February 2021
Just got off the phone with Dr. Tong after she cleaned up Joyce's wound a little later today than she had hoped. As an "add-on" surgery, Joyce had to wait until the more major surgeries were completed -- and things got backed up today.
A Difficult Day
5 February 2021
It has been a difficult day here. And it isn't over. Skip to the end for the latest.
Dr. Tong's Ask Me Anything
4 February 2021
After emailing Dr. Tong last night to ask her to explain what she planned to do tomorrow and who long Joyce would be in the hospital, she called this morning. Joyce spoke to her for about five minutes, getting a much different picture of what lies ahead.
A Redrape and Covid Test
2 February 2021
I was minding my own business downstairs when I heard, "Mike! Mike!" The voice seemed familiar. "I need you!" It was Joyce.
Overwhelming
1 February 2021
Late this afternoon Joyce got a call from Kaiser to set up an appointment tomorrow morning for a Covid-19 test. You still need a clean test within four days of surgery to clear you for hospital admittance. This will do that.
The Verdict on Adaptic
25 January 2021
Salwa the RN arrived this morning to do the dressing change after I had changed the canister on the Wound VAC about 12 hours later than usual. Did the Adaptic have anything to do with that?
A New RN With a New Approach
22 January 2021
Every month or so Joyce has to be visited by a registered nurse to confirm she still requires in-home nursing. Tyler the RN left the company earlier this month so it fell to Laura the RN to do the dressing change today and confirm care.
Walking Weather
18 January 2021
We had some warm sunny days in the sixties this weekend so I persuaded Joyce to take a walk. She's been housebound for weeks this winter, only leaving for her two clinic visits.
The Usual Confusion
14 January 2021
So we arrive at the Plastic Surgery Clinic at 1:30, right on schedule. The check-in clerk looks at Joyce like he's seeing a ghost. "Just a minute," he says, after consulting his monitor.
The Latest
11 January 2021
We have another appointment at the Plastic Surgery Clinic this week. Neither of us has any idea why. And it's scheduled for Thursday, which is off schedule for dressing changes.
At the Clinic
4 January 2021
We drove over to the Plastic Surgery Clinic on Divisadero today for Joyce's 2:30 appointment, parking in the adjacent garage to avoid the rain. Except the rain had stopped, the storm has passed, the sky was blue, the sun was shining.
The Year Ends [UPDATED]
31 December 2020
This morning on the last day of the year, I changed the canister on the Wound VAC and moved the lily pad to a more secure spot on the dressing. The pump had been racing all night to keep up the pressure.
The Christmas Miracle
28 December 2020
When Salwa the LVN arrived this morning to do the dressing change, she asked how our Christmas was. It was Christmas miracle, I told her. The Wound VAC has been silent at full pressure since Tony the LVN did the dressing change Christmas morning.
About That Surgery
27 December 2020
We did hear from Dr. Tong just before Christmas Day. She had a suggestion for a slight change to the dressing (along with her advocacy of the black foam) but she also addressed the surgery question.
Emergency Lily Pad Technician
23 December 2020
Well, it's been a while because it's been a while. Sorry. That's the nature of the beast. Sit and wait, then sit and wait some more. Today was eventful, though, so I have something to tell you.
Back to White
14 December 2020
Salwa the LVN just did Joyce's dressing change this morning and that's news. On Friday, she replaced the black foam with white foam and asked Tyler the RN to do black foam today. So we were expecting to see him but he thought it was best for Salwa to stick with the white.
An Interesting Appointment
9 December 2020
Yesterday Joyce told me that Lady, who is Dr. Tong's nurse (that's her first name), called to tell her that even though Dr. Tong can't make the appointment on Wednesday, she should come in anyway to get the wound irrigated.
The Week Ahead Revised
7 December 2020
Salwa the LVN couldn't make it this morning due to a minor family emergency so Toni the LVN stepped in. You really appreciate the difficulty of dealing with Joyce's wound when you see someone new try to deal with it.
The Week Ahead
6 December 2020
It's been quiet around here for a few days. Joyce has spent most of that lying on the bed with the TV on. Not sure she's actually watching anything, but passing the time.
'Thank You So Much!'
1 December 2020
The form to send Joyce a text on her birthday didn't have any way of knowing your phone number so I just popped in mine as the sender. So all during the day, as Joyce kept trying to say, "Thank you so much!" to everyone who texted her I kept getting thank-you's from her.
A Happy Birthday
29 November 2020
Today is Joyce's 70th birthday. To celebrate, we thought we'd do a little slide show of some of her previous birthdays (in order) since the dawn of digital photography.
Tyler Returns
27 November 2020
Every 30 days Tyler the RN has to do the dressing change to recertify Joyce's continued treatment at home. Or something like that. Anyway, Salwa the LVN cleverly arranged for him to do that the day after Thanksgiving. So he came a little after nine this morning.
The Bird Is in the Bag
26 November 2020
We just returned from a walk up to the corner and back. It was too windy and cold for Joyce to continue so we came home. Time to put the bird in the oven anyway.
Shopping Spree
22 November 2020
So there we were, running on the Wound VAC's battery while standing in line at the Apple Store already half an hour after our appointment. I made up various dire scenarios to amuse myself. "Sir, we are on battery support with just 20 minutes remaining."
A Video Visit
20 November 2020
It turns out that the placement of the lily pad on the white foam makes quite a difference in the Wound VAC's activity. When Salwa moved it to a new location on Monday it was quieter. And when she moved it to yet another on Wednesday it was even better.
A Good Report
16 November 2020
At the dressing change today, Salwa the LVN was delighted. She pointed out the skin on the side of the wound closest to Joyce's other leg had nearly closed and the tissue at the top of the wound was nearly fully replaced.
Weekend Alarms
15 November 2020
Since the dressing change on Friday, Joyce has been getting a lot of blockage alarms from the Wound VAC. We can see the bubbles move from the wound to the canister on the Wound VAC but it still complains about blockage.
Weekly Roundup
13 November 2020
Salwa the LVN has been here a couple of times since my last report. The progress she thought she noticed on Wednesday was confirmed today. The wound is measurably smaller. By a centimeter.
Mrs. Am's Holiday Wine Stain Remover
9 November 2020
Salwa the LVN changed the dressing today, noting a slightly stronger smell from the wound and some swelling of the leg. But she applauded Joyce's walks this weekend and promised to call Dr. Tong to update her.
Laundry Day
8 November 2020
Today is laundry day, the first time I will actually use both new Whirlpool appliances to wash and dry our laundry. Same old clothes, new fresh scent. A metaphor, I suppose, for the nation at large after this election.
'There Is a God'
7 November 2020
When things would unexpectedly break right once in a blue moon (we had one on Halloween), my father would say, "There is a God." He passed away 15 years ago this week but I could hear his voice again this morning.
Lidocaine for the Nation
2 November 2020
Joyce forgot to take Oxycodone this morning before her dressing change. Peeling the drape off her skin (like pulling a bandage off skin with hair) is painful. And pulling the old foam off the wound tears new growth.
At Long Last
1 November 2020
The installers from DSI Logistics called about 40 minutes before they arrived to let us know they had a dryer from Lowe's for us.
Just for the Record
1 November 2020
Saturday afternoon Apria's big truck parked in front of the house to deliver three cases of white foam.
Waiting For Supplies
31 October 2020
Yesterday afternoon, I logged onto the Apria site to see if there was a way to track shipments. Joyce had ordered 20 large white foam packs (she needs three for each dressing change) on Wednesday after Salwa had used the second to last one. She had asked for a Friday delivery, when she would be out of them.
Two Recipes
30 October 2020
I remember promising you two recipes a few weeks ago and now that the month is wrapping itself up, I thought I'd do just that.
Quest for a Rug
26 October 2020
We were surprised to get a text from Tyler the RN this morning telling us he would be doing the dressing change today. It turns out he had to re-certify Joyce for continued in-home care. Every two months.
Doing the Wash
25 October 2020
Sunday is wash day. I tried to make that clear to Lowe's. Anyone at Lowe's. But not Wilma. Never did reach Wilma.
A Fawlty Update
23 October 2020
I'm beginning to think I've crossed through the TV screen into an episode of Fawlty Towers. Nothing goes right.
A Brief Update
21 October 2020
Salwa's funny. Confronted with Lidocaine in a white cream instead of transparent gel this morning, she said, "That's good. I can see what I've put on." As if it were a mystery before.
Monday, Monday
19 October 2020
Yeah, that old the Mamas & the Papas song. Monday, Monday, what else can you say?
The First Wash
18 October 2020
Yesterday we read the manual for the new washer. It recommended running an empty load to clean out the washer before doing the first real load. So we did that.
Good News, Bad News
16 October 2020
Good news first. The visit with Dr. Tong yesterday went very well. And even Dr. Tong, who had not been anxious to do it, said it was a good thing Joyce came in to appraise her progress.
And So It Goes
14 October 2020
Late yesterday afternoon we drove over to the Kaiser medical building on Geary to pick up a prescription for an antibiotic Dr. Brenman had ordered. After consulting with Dr. Tong, they wanted to protect Joyce against the possibility of an infection.
A Good Apology
13 October 2020
Last night was a rough one. (And not just for the Dodgers.)
It's Negative
12 October 2020
Last last night Dr. Brenman emailed Joyce to tell her the sonogram was negative for a blood clot. Meaning the sonogram didn't show a blood clot. Dr. Brenman said she'd be happy to look at the swelling if Dr. Tong doesn't think it's related to the wound.
Still Waiting
9 October 2020
Well, I didn't think that was the end of the story yesterday but it was. We never did get the results of the sonogram.
Making a Sonogram
8 October 2020
This morning Kaiser scheduled an ultrasound for Joyce at 1:10 p.m. But we forgot something. We had a delivery from Apria of Wound VAC supplies coming.
A Postscript to the Evening
7 October 2020
It seems some things never end. Quite. And today was one of those things that never ends. In fact, we're probably premature writing this "postscript."
The Plot Thickens
7 October 2020
So I went upstairs to start dinner, as I confided in yesterday's post, in an attempt to hurry the Wound VAC delivery. And just as I had suspected, as soon as I opened the refrigerator door to pull out something to cook, Joyce announced, "It's here!"
The ActiVAC Dies
6 October 2020
The Wound VAC gave up the ghost this afternoon just after 3 p.m. when I was changing the canister. I pressed the power button to turn it back on and ... nothing.
A Recipe
4 October 2020
The Wound VAC is still acting up at 5 a.m. with various complaints. Resetting it by turning the power off a minute and then back on seems to help. But only when we replace the canister, do we get any relief from the beeps.
More Fun With the Wound VAC
2 October 2020
The Wound VAC's job is to suck fluids from the wound through the foam dressing. It does this constantly. You can disconnect it briefly but it's designed to run 24 hours a day in bursts of five minutes with two minutes off.
Carrying On
30 September 2020
Sorry it's been a few days (although you could probably use the break). But herewith, I'll carry on.
What Are We Celebrating?
26 September 2020
Today is a Big Day around here. For one thing, Joyce took a long walk up the hill and into Rockridge Terrace for a view north. And she sat on the patio for a while after, getting her Vitamin D, before climbing the stairs for lunch.
The Doorbell Rings
25 September 2020
At precisely 10 a.m., the doorbell rang. Salwa had finally figured it out. When I praised her ingenuity, she joked that she had gone to strength training classes to prepare for the event this morning.
Guess the Date!
24 September 2020
After our Tuesday washer and dryer delivery was mysteriously canceled by a hold no one can explain, we haven't gotten a new date from Lowe's. When we check the order online, it says "Ready for Delivery" with a delivery date of Sept. 22.
Deliveries, Amen
22 September 2020
Early this morning Apria called. It delivered our order by FedEx yesterday but it was only one box, not the two we ordered. I had called to make sure we were getting billed for what they delivered and not what we ordered. And to, uh, get the rest of our order.
How to Reach Joyce
22 September 2020
I got the message. You've called but there's no answer. I can explain.
Monday, Monday
21 September 2020
Salwa did the dressing change this morning, during which she took a photo of the wound, texted it to me and I emailed it to Dr. Tong so she'd have the latest information.
The MRI Episode
20 September 2020
Saturday began with an illuminating piece on NPR that explained why our new washer and dryer has not arrived yet.
A Video Conference
18 September 2020
This afternoon Joyce had a video conference with Dr. Tong, their first chat since she left the hospital.
The Long Haul
17 September 2020
Yesterday was a busy day with Salwa's first solo dressing change, ordering more supplies, chores at my mother's and the laundry. But at least we had good air quality for the first time all week.
Checking In
15 September 2020
Sorry for leaving you up in the air about Joyce all day. She took a wait-and-see approach, not calling back to schedule an MRI (who needs that co-pay). Tyler did call to see if she was all right, though.
Three Words
14 September 2020
An hour after I wrote that Apria hadn't delivered Joyce's supplies, they arrived at the door. Just not quite the quantity I was expecting, so I'll be reordering before the week is out.
Deliverables
14 September 2020
As sister-in-law Judy1 once pointed out (long, long ago) you will distinguish yourself if you merely do what you say you will do. She was talking about working with clients but it's apparently a general rule of the universe.
Mountain Air
12 September 2020
When a member of the Giants organization tested positive for Covid-19 yesterday, the game against the Padres was canceled (as is today's game), so we grabbed our iPhone, opened the Hoopla app and looked for a movie from our public library account.
Surprises
11 September 2020
Do you hate surprises? Well, today brought more than one of them. See what you think.
Nothing Happened
10 September 2020
Before I hit the sack, I thought I'd just let you know that nothing happened today. I don't want you to worry.
An Apocalyptic Day
9 September 2020
It's been an apocalyptic day here. At dawn, the darkness yielded to a scattered golden light that gradually turned the sky black. Smoke from the wildfires to the north had blown over our fog, creating something like a total eclipse of the sun.
Today's Menu
9 September 2020
Joyce has two things on her menu today. It all starts with a dressing change this morning. And in the afternoon, she'll have her first workout with the physical therapist.
Cycles
8 September 2020
To the side of the main entrance to Kaiser Hospital in San Francisco there's a metal sculpture by Roger Barry called Cycle. Waiting for Joyce to be wheeled out after an add-on surgery, we spent some time getting acquainted with it.
Radiation Damage
7 September 2020
After the post showing the wound (optionally), there has been some interest in what the area looked like before the recent surgery.
The Wound
7 September 2020
This morning Joyce had her second in-home wound irrigation, dressing change, sponge replacement. It goes by all those names but it's all the same process, begun half an hour before with Oxycodone, Tylenol and Ativan.
Progress Report
5 September 2020
I wouldn't write a progress report unless there was, you know, some progress to report. And there actually was some today.
A Quiet Day
4 September 2020
Joyce spent a quiet day in the house, resting. And I took advantage of the day free of nurses, doctors and healthcare services to buy some soap, drain cleaner and groceries. The little necessities of life.
A Dressing Change at Home
3 September 2020
I called Apria again in the morning to track the canisters and other supplies. Trish sent an email to the local facility urging them to get them here. She noted the file had a four-hour delivery request yesterday too.
Maybe Nothing
3 September 2020
Since I'm up at 2:24 a.m. anyway, I thought I'd report that after all that Apria did not deliver the canisters tonight. Is it still tonight?
Of Meds and Maybes
2 September 2020
This morning Joyce was evaluated by Steven for physical therapy sessions with Alpha starting next week. He didn't think she needed a commode or walker or cane or any of the cool things Medicare club members get. She just needed strength exercises.
A Feast Day
2 September 2020
It's three in the morning. The Wound VAC was beeping. Without awakening Joyce. I got up, took a look. "Canister Full!" It hasn't even been 24 hours. I turn the pump off.
Day Breaks
1 September 2020
If you ever get impatient waiting for some phone call, the trick is to turn on the stove. One burner will do but two is quicker. And if you drop some nice piece of fish that can only flounder in the skillet for less than two minutes a side, the results will be instant.
An Update
31 August 2020
Yesterday was difficult. Today is maddening. And tomorrow is another day. In between are the nights with alarms going off and a jack hammer in the distance.
Sort of a White Horse
29 August 2020
Rough night. The little Wound VAC was beeping all night. "Low Pressure Alert!" it would complain. Or "Blockage Alert!"
Salad, Pizza and a Canister on the Side
28 August 2020
Joyce slept all afternoon (and went to bed early, too). At dinner she said she felt a lot stronger than she felt in the hospital. And she likes the food here, too.
A Smart Nurse
28 August 2020
Joyce slept in today. About 15 minutes before the home healthcare nurse was to arrive, I roused her. She was sitting on the edge of the bed when I heard a knock on the door. I happened to be on the phone with Dr. Tong at that particular moment.
Carried Over the Transom
27 August 2020
Around 5 p.m. I did get a call from Maria1 to come pick up Joyce at the hospital. So I drove over there and called the number she gave me. Someone not named Maria answered. But she was able to inform the people who needed to know that Joyce's carriage had arrived.
Back to the Hospital
27 August 2020
I took Joyce through these majestic doors at 11 this morning for her scheduled sponge replacement procedure. It's 4 p.m. now and that was the last I saw of her.
Home Again
26 August 2020
Around 3:30 p.m. I drove over to Kaiser Hospital and double parked in the white zone along with the other hopefuls waiting for our patients. You know, right at the shift change.
A Hitch in the Plan
26 August 2020
I did hear from Kaiser just before 11 this morning. A fellow named Mike called to tell me he was taking care of Joyce. He's one of the nurses, Joyce told me later.
No So Fast!
25 August 2020
When Joyce got wind of the plan to release her today, she vetoed it. "I have to pack!" she complained.
Some News For a Change
25 August 2020
As I was walking to the Post Office to mail some checks I got a phone call from Dr. Suh. She isn't in the system yet, she laughed, when I told her I looked for her after Joyce told me she'd met with her.
In & Out
24 August 2020
It's 2:20 and Joyce just called, already back from recovery after Dr. Tong herself did the sponge replacement around 1:30. So the mysterious Dr. Suh remains mysterious.
Surgery This Afternoon
24 August 2020
Joyce met with a Dr. Suh this morning who will be performing the sponge replacement at 2:30 this afternoon. I've been unable to find a Dr. Suh listed at this Kaiser facility.
Fall Risk
23 August 2020
Joyce called this morning, which was a surprise in itself. I usually call her. So I suspected something was up. Actually, something was down. Joyce.
Late Night Without Stephen Colbert
22 August 2020
So how does this sound to you? Filet of salmon with a side of polenta. Oh, come on. How about if we add a packet of Mrs. Dash? No self-respecting hospital serves a meal without Mrs. Dash.
Loose Ends
21 August 2020
I didn't talk to Joyce today until this afternoon. I had to run over to her bank to deposit two $10 checks from Kaiser for overpayments (imagine) and then over to Kaiser to drop off Whitney's1 letter (which she just loved).
Surgery Update
20 August 2020
I had a nice, long chat with Dr. Tong this afternoon as soon as I got home from a long walk during which I had a nice, long chat with Carol.
Surgery This Afternoon
20 August 2020
Today Joyce said she expects to go to surgery for her sponge replacement this afternoon. So she hasn't had anything to eat since yesterday. Which, considering her dislike of the food, might be considered a relief.
Some Answers, More Questions
19 August 2020
Dr. Tong called today while I was taking the garbage out at my mother's so I missed her call. But she always leaves a voice message. And she answered all three questions.
A View of the Room
19 August 2020
This morning we were surprised with a photo of Joyce's room. We've been pestering her for some on-site reporting and this morning she came through.
Two Books, Three Questions
18 August 2020
Late today the hospitalist Alison Cooke dropped by to see Joyce and give her two novels to read: The Brief Wondrous Life of Oscar Wao by Junot Díaz and The Remains of the Day by Kazuo Ishiguro.
A Late Report
18 August 2020
Sorry my report today is a bit late. I was holding it hoping I'd hear from the surgeon. Things must be getting pretty routine.
The Hospitalist, Surgery and Bourbon
17 August 2020
I talked with Joyce around noon today while she was sitting in a chair waiting for her hair to dry. "They don't have any hair dryers here," she said.
An Apple a Day
15 August 2020
It was so hot yesterday that I couldn't stay in the house. Fortunately there was a slight breeze off the ocean that kept the patio cool in the afternoon shade, so I sat out there to recover.
An Early Surgery
14 August 2020
Dr. Tong called early this morning to let me know today's sponge replacement went well again. She said the wound looks very good and is healing well.
A Bad Hair Day
13 August 2020
Today's the day. Not for surgery (that's tomorrow). For a shampoo. "It's amazing the things they don't care about," Joyce said when I talked to her this morning.
The News at Noon
12 August 2020
When I talked to Joyce today she was weary of hospital life. "I just want to come home," she said.
The Evening News
11 August 2020
I tried to talk to Joyce a couple of times this morning but she wasn't answering. She had a good reason, though. She was among the first surgeries today.
Daily Briefing
10 August 2020
Well, it seems like things are settling into a daily routine for Joyce now. She is scheduled for two add-on surgeries this week. The first is tomorrow and the second is Friday. She'll probably do the same the following week.
Wound VAC
9 August 2020
I spoke with Dr. Tong this morning at 9 a.m. and got a clearer picture of where Joyce is at the moment. A picture that was clouded last night when Joyce called to say they were thinking of sending her home today or tomorrow.
Mail Delivered
8 August 2020
Neither fog nor wind nor the PGA Championship at Harding Park could keep us from delivering the mail to Joyce today. Buses being Vehicles of Contagion, we drove over to the hospital, parked on the street and dropped off her mail.
Breakfast in Bed
8 August 2020
Just after I made a nice big latte for breakfast, Joyce called to say good morning from her suite in the palatial Kaiser Tower on Geary Blvd. She needed something to do while she waited for her breakfast to arrive.
No News Yet
8 August 2020
I talked to Joyce around 7:30 last night. She was waiting to be taken to surgery at any minute. A few hours later I called it a night without hearing what had happened.
Sitting Up
7 August 2020
Joyce has finally gotten out of bed. A milestone. They want her to sit in a chair for an hour. So that's what she's doing right now, after washing for the first time since she was admitted (but you didn't need to know that).
Getting in Touch
7 August 2020
If you want to get in touch with Joyce, there are a number of ways to do it. I'll list them here and add to the list if more come to light.
'Eleven, Twelve'
6 August 2020
Chatted with Joyce this afternoon but she could hardly speak. She's feeling a lot more pain today, she said.
A Rough Night
6 August 2020
When I talked with Joyce this morning she'd already had breakfast, seen Dr. Tong and had blood drawn for another blood test. She said it felt like it was dinner time already.
She's Got a Room With a View
5 August 2020
I just got off the phone with Joyce who finally got a room of her own with a view south. She sounded hoarse but in much better spirits than she has been lately dealing with the pain and infection.
Still in Recovery
5 August 2020
I just called the hospital to see what's going on. Joyce is still in recovery. The surgeon had thought she'd be in a room by noon but floor nurse said that wasn't unusual.
'The Procedure Is Complete'
5 August 2020
A few moments ago, Kaiser sent a text to let me know Joyce's surgery had been completed. And right after that Dr. Tong called for the post-game interview. Here's the report.
Just Waiting
5 August 2020
We drove over to Kaiser Hospital on Geary in the dark this morning, watching three raccoons cross the road in front of us into Golden Gate Park.
Tomorrow's Schedule
4 August 2020
While we don't know how long Joyce's surgery will last tomorrow, we do know what time it starts. And how early in the morning Joyce has to get up, too. Early.
Covid-19 Test: Not Detected
3 August 2020
Good news. Joyce took a Covid-19 test on Saturday to clear her for surgery Wednesday. Today she got the verdict: Not Detected. So she's good to go.
The In-Person Visit
30 July 2020
Joyce had her in-person visit with Dr. Tong just a day after the video call.
Meeting Dr. Tong
29 July 2020
Today Joyce had a video conference with Dr. Winnie Tong, another surgeon, who reviewed her recent CT scan and said the abscess was so large it would require surgery to clean out before it can heal. And it may require multiple surgeries to address.