Yesterday was a big day for Bill! At 12:49 pm they stopped the sedation and turned off the vent. And for 2 hours, count 'em, 2 hours, he breathed on his own. After the sedation wore off more he responded to commands for squeezing hands, wouldn't squeeze mine, but all the nurses, answered questions with nods and spontaneously moved his feet. He started trying to cough so I got the respiratory therapist and and she suctioned out a lot of stuff. She called Dr. Fox and told him how he did and he decided to put him back on the vent and repeat the test this morning. If it goes as well as yesterday, they will extubate this afternoon.

All of his numbers have been good. He was a little low on phosphorus so he got a little bag of that, but the medicine that regulates the blood pressure has been discontinued. The one to keep his heart rate up has been lowered, raised, lowered, just depending on what's happening. They had tried to drop it to 4 and that was too low, so it went back up to 5. She tried 4.5, but it still didn't get his heart rate to where they wanted it. When he was off the vent she moved it to 6 just to give his heart a little boost. They have also changed the parameters for that. Before, after his episode Sunday night, they wanted his heart rate above 100. It is now set at 80. So, that's an improvement.

The GI dr. came in and is just going to monitor his numbers. He doesn't think he has a GI issue going on and that the blood was from the ng tube insertion. They haven't drawn any more out. He's tolerating his feedings well. He hasn't had a bowel movement yet, but I could hear his tummy gurgling yesterday afternoon so, maybe soon. 

I talked to Dr. Baymeadows, the kidney dr. She said she now thinks the high numbers were all due to dehydration. She was also appalled that he was treated so badly at the nursing home. And speaking of the nursing home, they called me Monday to ask if he would be returning when he was discharged! I was very polite and just said no, he won't. And, shortly after that, another one called and said that they would accept him as a patient. I told them that he was still in ICU and intubated and we didn't know when he would be discharged. She was very surprised that she didn't know that when the social worker made the referral. She, the social worker, has not been back in after she gave me the list of places to choose from, but since the other one said they would take him, she feels like her work is done. She did wave to me during rounds yesterday morning.

I've also received calls from the Palliative Care Team. This is the team that deals with end of life issues. Now, this doesn't mean that death is imminent. But, as Dr. Mullinax told me, they have the resources to help us make the best decisions for him, and with him if possible. He wants to have a family meeting as soon as possible, however he doesn't want to wait for the kids who want to come. Mary Rose and Aimee both live in Oklahoma and Mary has to work all week-end so the earliest they can get here is Monday for a Tuesday meeting. He wants to have the meeting tomorrow with the ones who can be there, Emily and Ryan and me. And is really pushing for a decision. I'm to call one of the team members today with a time. But, that long drive home is good for something, and I've come to a conclusion they won't like. But, I remember something my mother said was told to her when my dad died. She was told not to sign anything or agree to anything until she was ready, not just because someone said you must do that. The more I've thought about this, the more I think they are being very premature. We don't know what Bill's condition will be off the vent. We do know that he was physically weak prior to this happening and will most likely be even weaker. But, until he is off the vent, we don't know! Dr. Mullinax did say that Dr. Edwards thinks he needs to go straight into hospice. But, Dr. Edwards has not taken the time to get to know Bill and his strong will to live. He did concede that he's had 60 lives compared to a cat's 9 lives. And he's right there, which should tell him not to count him out. And, before anyone thinks that I have my head in the sand, just not wanting to give up on my husband, I know we are headed in that direction, but I also think, now is not the time to make these decisions. This is one thing that Bill and I have never discussed, who wants to talk about end of life issues, but, until we have that conversation, and he voices his wishes, we're not having the meeting. It's kind of like the social worker, I think they're trying to cover themselves with Medicare about too many admissions, in too short a time after discharge for the same diagnosis. I do know that statistics are kept on this and I think hospitals can be fined, if it is only to have their rating downgraded. Does this sound reasonable to anyone out there? Let me know, either here in the comments, or on Facebook, or a message, text, whatever. They did ask me 2 questions yesterday...if he's taken off the vent and then something happens over the week-end, do we re-intubate (yes, he had told them he is a full code) and, if the aspiration continues to be a problem do they do a jpeg feeding tube. He had the peg after the transplant and absolutely hated it and that's all I told them. He might be agreeable to that for supplemental feeding if his caloric intake is not enough. But, lets' try other measures first (also something they were supposed to do in the nursing home and didn't, meds in applesauce instead of with water). 

So, there's where we stand. As for my shoulder, it is still very painful and I'm doing what Emily's dr. had her do with a strained elbow. I just can't reach where it hurts to put the pain patches on myself and if I want to leave for the hospital early, I don't want to have to get Emily up to do it. I'm sure she would, but she's already done so much. I did get some Biofreeze spray that sprays no matter how you hold the can and that works some, and I can do it, but the Salon Pas patches feel better.

Our weather is supposed to get super bad, and we just had a special weather statement issued for freezing rain, sleet on Saturday morning, with more to come on Saturday night. So, this was already playing in the back of my head and it looks like I'll stay in Memphis tomorrow night and Saturday night. Brianna can care for the cats and I can talk Joe through starting the generator if necessary. It won't heat the house but it's not supposed to be that cold, but it will keep the freezer going. The cats will just curl up on their blankets. Maybe they will curl up together! That would be a first! 

That's all I've got for this update. I'll take this with me so I can update it at the hotel. There's a Hampton Inn on the hospital campus so I'll just stay there. I think I'd be more comfortable instead of sleeping in a recliner in the ICU waiting room. Been there, done that. And now my shoulder is saying I've typed enough!