After Wednesday's frustrating day, we got some answers yesterday, some causing relief and some causing concern, and some with "OK, now we know what to do" feelings. First the relief....his heart is fine! The echo and all the tests run for that showed that the heart is working normally, with no signs of rejection. I just sat and cried with relief! Iknew in my heart that it wasn't rejection, even though there were signs. But those same signs are also signs of other conditions, one of which is...wait for it...pneumonia! 

Bill does have pneumonia again, this time in the lower lobe of his right lung, which is referred to as aspiration pneumonia. The way things were explained to me was that the airway coming off the esophagus (I think) to the left lung has a curve to it which makes it harder to get foreign objects through. By foreign objects I mean food and liquid. But the right lung doesn't have the curve, it's a straight shot into the lung. We don't remember him having any episode of choking on food or drink, but that doesn't mean anything. So, back on the same antibiotic as before.

Because of it being aspiration pneumonia, a modified Barium swallow test was done to see if he indeed was swallowing properly, and even if he was, if everything was going to where it was supposed to go. When Dr. Monday (it may actually be spelled Munday), one of the lung docs came in late yesterday afternoon and said he had seen the results of the test and he passed with flying colors. He said that they have not been asked to perform another broncoscopy but if Dr. Threlkeld wants one they would be happy to do it.

If you read back, or remember back to when he was in the nursing home after the transplant he had several of these studies before he was allowed to eat solid food and drink. He was on the ventilator so long, and the with the trach, his muscle control had deteriorated and he had to work with a speech therapist to strengthen them. He may get some speech therapy (even though it won't be for his speech) to see if that will help.

I saw my gastro dr. yesterday for my post procedure follow-up and he said it could be something called silent aspiration, which is when something is aspirated and there is no usual cough, like most people get when they choke on something. So, maybe today there will be a plan in place when I get there today.

The thing that is concerning is that one of the blood cultures that was drawn in the ER came back showing bacteria in his blood, so they repeated the test. This test they have to draw from 2 different places, so they used the picc line for 1 and his other arm for the other. They are hoping that it was just contaminated after it was drawn, or that the cap on the picc line hit the sheet after it had been wiped. A new antibiotic was started as a precaution since we won't get those results until today. Hopefully that is all it was, because it makes me think that, even though I was extremely careful with his picc line, is this something I could have done? But, that doesn't change the fact, if it is indeed a true positive, it has happened and there's no sense in worrying about where it came from. As my mother said, no matter how careful I was, it could have happened without me knowing, so there's no sense in worrying about it.

Dr. Edwards office called me in the afternoon to again reassure me that the heart was not showing any signs of rejection, and, said that they would contact Mayo. I asked them that in the morning when the nurse first gave us the news. And with the tests that have been done here, I don't think we'll have to go in November. I still haven't heard from Stephanie, but right now I don't think Bill could handle the trip.

Bill is feeling better, but he's still very short of breath when he sits up and his sats are still staying around 90% which is lower than they would like. He seems to like being at 88-89%, which of course is too low. 90 is the lowest target rate. 

We have no timetable for coming home, although I am taking him some clothes today since he arrived in pajamas, and putting a full O2 tank in the car. I'll also have a small tank to get him to the car for when they do let him leave, which will probably be sometime next week, probably.

One thing I left out of the last report was about an angel named Don. As I was unloading Bill at the emergency room entrance, a middle-aged mad came over and asked if he could help us. I thanked him and said I think it was under control (why is it so hard to accept help!), but if he could magically find a parking spot that was close, it would be great. Just then, the very first spot opened up and he grabbed Bill's wheelchair and said "I've got him, you go park". That's when I heard him introduce himself to Bill. I did indeed get the spot, although there were a couple of other cars coming in the entrance heading for it, and when I got inside the hospital, Don had stayed with Bill, even informing the desk that he needed to be seen and that I would be in momentarily. I thanked him again when I got inside and he waved me off and went on his merry way. See, angels don't have to have wings and a halo and play a harp, they can be the the form of a large bearded man needing a haircut!

OK, I think that wraps it up for this time. I need to get moving, I need to make a Walmart run before I head to the hospital and it's nice and drizzly and foggy this morning, just like yesterday. Have I mentioned how much I hate driving at night, or how much I have driving at night in the rain, or even how much I hate driving in the drizzle and fog? Well, you get the picture. But, I'll make it.