Friday

Virginia left Adventist Medical Center (AMC) around 3pm. I called her at a quarter to three and they were just getting started for d/c.

As it turns out KCI was going to give her a large wound vac. This was straightened out and she got the small one like she had before.

I met up with her about five pm. She is at

Hillsboro Rehab & Specialty Care
Room 309
650 SE Oak Street
Hillsboro OR 97123
503-648-8588

Map

Closer Map


I took the dogs over. The dogs thought her face needed licking and made up for lost time.

This helped relax her very much.

Now I just need to find the cell phone and setup a VCR. Maybe a VCR/DVD combo.

She is ready for visitors. They are pet friendly and I went over late at night. There is a Tri-Met bus stop right out front.

Thursday's News

Virginia came very close to discharging today.

I am reminded that anytime anyone is in the hospital you really need to have someone close to you actively "ride herd" on every detail of the whole process.

The only hang-up to leaving was payment arrangements with Hillsboro Rehab. The discharge planner had me call them. It turns out that her primary insurance would pay 70% of the daily charges and my insurance would cover 60% of the remaining charges. That leaves us with "only" $60 per day. I gave a credit card number for the $250 deductible and an agreement to work out a payment plan for 30 days of care (refundable if she gets out earlier). Her doctor said 6-8 weeks.

So, now she could go "tonight." If I hadn't pushed for this we would have spent yet another day and insurance only allows so long. AMR was called but they ended up being late due to an "emergency run."

Then there was the snag of her wound vac. She was using a hospital size KCI wound vac that CAN NOT be let out of the hospital. You wouldn't believe how much KCI charges if one is lost. So we were awaiting a rental unit. No one had the kind of answer I needed. We were juggling the arrival of the wound vac versus the arrival of the ambulance.

I wanted to know exactly where the unit was currently located. No one would say "I don' t know." My thoughts were practical. If we knew where the delivery van was located we would know how long it might take to arrive and possibly offer to meet up in Hillsboro instead of Portland.

I know KCI has a toll free number so I called around 6:45. They had received the request and it was "pending." Everyone at KCI had gone home at 8pm (6pm our time). Then I thought "maybe" the request had been verbally approved and hadn't been entered into the computer.

Meanwhile the discharge planner and the nurse handling the wound vac (Linda) were checking this out. Linda had been told (not by KCI) it was approved but she found out the doctor hadn't signed the request. She and I both knew at that instant this d/c was cancelled for now. Virginia couldn't be off the wound vac for more than two hours.

So, AMR (ambulance) was cancelled just as they arrived at Adventist Medical Center.

I packed up Virginia's stuff and headed home. I would be working the next day (Friday) from 6:00 am to 2:30 pm.

Thursday, May 11, 2006 3:00 pm

Our good friend Linda Henry works at AMC and is THE "go to" woman for the wound vac. She told Virginia she would change her dressing at 3 pm so I headed to the hospital to be there by 3:00 pm.

I had experience in changing her wound vac dressing three times a week over a five week period earlier in her care. So this was a chance to get a mini refresher course as pertained to her wound.

The basic process is to cut and apply a plastic-like material such that you use to cover the good skin while leaving the wound area exposed. Then you cut some foam in the shape of the wound. The plastic doesn't have to be all one piece as it is self-adhesive (try that with gloves!). The foam can also be in one or more pieces if need be as you can butt pieces up against each other. So you have a sandwich of plastic (with hole), foam, plastic on top (no hole). Then you cut a small hole to apply the suction hose and it is held by adhesive to reseal the hole.

They you turn on the suction and pray!

Linda and I looked at the wound. Virginia had some maceration. If you ever put a bandage on you finger and leave it until it turns white you get the idea.

The surgical cut in her foot is in a big "C" shape. The bottom of the "C" (closer to the heel) is where the old wound was located and now the wound edges are next to each other so they can heal across quickly. This is "downhill" from the rest and was collecting some moisture under the plastic.

At the top of the "C" she has a new "wound" and the edges are apart. That is where the wound vac was working to drain.

So we crafted a "C" shaped piece of foam to vacuum the fluid from the top of the "C" as before but also to include the bottom of the "C." I have the plastic templates we made so subsequent changes should be able to re-create this design.

Virginia has one more day at PAMC (room 2102). They are waiting on a small wound vac. She has a large wound vacuum that is used in the hospital, but will need the small personal size to tote around. We have used this before.

She will be going to Hillsboro Rehabilitation (HR) on Thursday. HR said they have room 309-1 for her. It is a three bed room into which they only put two people.

I picked up most of her stuff Tuesday night.

Virginia moved to room 2102. It is closer to the nurses station and has a better bed.

If you visit, check out the flowers she has. I got her a very beautiful arrangement (she said so!) from Costco in a short, square vase. The vase is perfect for transport as it has a low center of gravity. The short vase also makes it easier for her to see the flowers. The bottom flower stems are wound around the bottom.

Virginia has had quite a time with the IV she had yesterday. They put in a new one today. I think she said it was doing better, but she sounded sleepy.