Bill did not have a good day yesterday, although the evening was a little better after I left. He said he had a terrible night again and was still in bed when I got there. He had eaten all of his breakfast, but he said he hurt all over, down to his toes. 

When he got out of bed he could barely shuffle to his chair, and he was being supported by two pretty good sized men. The tremors in his hands were back and he could hardly hold his coffee cup, with both hands.

He also said that his mouth is very dry and his nose is stopped up. He doesn't have the sinus drainage he had before, but he also doesn't sound like someone with a stuffy nose. I started wondering if the Lasix is now drawing too much fluid and causing muscle cramps. When I asked that question, it was just kind of brushed aside.

When Dr. Threlkeld came in and Bill told him that he hurt all over, he immediately stopped the antibiotic that he had given as a precaution to any blood infection. Nothing had grown from the cultures and he had said that his medication was know for joint pain. His exact words were "we're not playing around with this". He said it should all be out of his system by this morning, so I hope he will feel better when I get there.

His nurse Bishop came in and said he checked with the pharmacy and that the other antibiotic could be causing the tremors. Mary-Rose and I had already checked on that and even though it isn't a major side-effect, it can cause tremors. This happened during his last stay also but it was kind of brushed off. It didn't happen when he was on the home infusions, but it was delivered over a 90 minute period then vs. 30 minutes in the hospital. So, since he's getting it in a shorter amount of time, it seems to me it's kind of overloading his system. And he gets it every 4 hours in hospital vs. every 8 hours at home. So, even though we know the cause of the tremors, it doesn't make it easier for Bill. It even makes it hard for him to do his word searches since it's hard to draw a straight line! Bishop did try running it over an hour instead of the 30 minutes, which he said could be done without changing the dosage or anything. It didn't seem to make any difference, but since he's still getting it, it may take awhile for those to subside.

Occupational and physical therapy both came in and worked with him for a bit. They also told him to do the exercises he had learned from Tammy. He is very weak when standing, but his O2 sats did not drop as low as they had been, only into the mid 80s instead of the mid 70s, and he recovered quickly. I think they switched him to a high flow cannula and turned his level up some, but I'm not sure on that.

Dr. Fox said that his x-rays had not changed, but I don't know how many they have done and if he was referring to the original x-ray when he was admitted and the one that was taken before he was moved to the unit, or that one and I think they took one Monday. He's the dr. who doesn't give much information and spends about 2 minutes in the room. I would much prefer Dr. Williams.

Cindy, the cardiology nurse practitioner, was going to get Bill some Tylenot PM to help him sleep last night and I hope he was able to rest. They switched his room about 10 last night. He said someone was coming in that needed his room more. There was nothing special about his room and the only thing I can think of is that they want to keep the sickest ones together. Anyway he called and gave me the room number so I wouldn't barge in on a new patient this moring!

Bill did say yesterday that even though he wants to come home, he knows that he can't in the condition he's in because I can't take care of him the way he is. I was glad to hear him say that instead of me having to remind him.

I did start to see a little "roid rage" yesterday afternoon, about being tethered to his chair. I told him he couldn't get up and walk even if he wanted to without help so it didn't do any good to gripe about it. I also told him right at the beginning of his little rant that if he was going to do that I was going home. So he stopped and only grumbled periodically.

I have wondered, since he is so weak, if he would not benefit from in-patient therapy after he is discharged, instead of home health. Kevin had told us that Medicare would probably not re-certify him for in home since he gets so far and then has a set-back. Their argument would be that he has been give then basics and came do them on his own. But, I wondered if they would cover in-patient where he could get the daily more intense coverage. We started to talk about it and then everyone started coming in so we stopped. But, maybe we-ll revisit that subject today after I get there.

Today we're supposed to get 2+ inches of rain, including some storms. They are supposed to arrive about the time I'll be heading home, so it won't be a fun drive. Most of the towns around had changed Halloween to last night, but ours didn't. Said it would take the city council to make the change. How ridiculous, to endanger the lives of children instead of calling a special meeting, that could probably be done as a conference call, with the newspaper brought in. Maybe most parents took their kids downtown for the merchant trick or treating. It was changed to last night. We usually don't get any kids anyway, or we haven't for the past couple of years. I just am not looking forward to the drive home in the rain.

So, that's it. After not much happening over the week-end, things were a little busier yesterday. There is still no time being talked about for discharge, which is good since I don't believe he's recovered enough, not counting the fact that he's so weak. I've read through my notes and have relayed everything I had written down, so I think it was all covered. See you tomorrow!