The cats got me up super early this morning, so here I am, and it's not even 5 am! But, I'm awake and feel rested, so why not! I'll also leave for the hospital in a bit and get there before rounds. I always say that I hate driving in the dark, but driving in the dark, watching the sun come up, is rather enjoyable, at least to me!

After days of nothing happening, yesterday was pretty busy. I took 2 pages of notes and I'll try to make them somewhat coherent for you.

His oxygen had to be raised to 7 in the night for some reason. I suspect it's because he's sleeping mostly on his back in the hospital instead of his side and breathing with his mouth open. But, they turned it down to 6 during the day and have decided that 90 is his baseline. So, as long as his saturation is 90 or above, he's good.

His blood sugar is also dropping in the night, so they are checking it at 2 am (what a terrible hour for someone to come in and stick your finger!). I think they just need to adjust the amount of Lantus he's getting.

His hematocrit has been good and it was 27.8 yesterday, so he hasn't needed any blood since he was in ICU. They still haven't pursued the lower numbers other than Dr. Williams telling me that his body just wasn't making as much.

He's still on antibiotics, but Dr. Threlkeld said he doesn't think he'll come home on them. He thinks that the bacteria has been hit hard enough with different ones that it responds to. He also said that his x-ray looked the best he had ever seen it, and although he's still a little rattly and crackly, it's now in his upper airways and not his lungs. We're not sure if it is the sinus problem, or if he's finally moved it from his lungs, but just hasn't coughed hard enough to completely expel it.

One thing Dr. Threlkeld said that the person covering for him this week-end picked up on is IgG level. I'm not sure what that means and I'm a little fuzzy on his explanation. From what I gather, it has something to do with antibodies made by the immune system in response to bacteria, viruses, fungus among other things. They attach to the foreign substances to destroy them. They only attach to what they have been made in response to. This can be one cause of autoimmune disease. If you make low levels of antibodies, you have a chance of repeated infections (sound familiar?). The IgG are found in all body fluids. They are the smallest but most common. There is a problem with abnormal levels, and that is kidney damage. Since we also know he has some kidney damage, he's got to walk a fine line in how he treats this. As he told me, it's time to get down and dirty with this stuff, but, he wants it to be like in Goldilocks...just right. Now you see why I like this guy! He's also getting with the lung guys to see what to do about the upper junkiness.

Dr. Morris, the kidney dr. is satisfied with everything and has put him back on a maintenance dose of oral lasix. It's not as strong of course as the IV, but it's not pulling too much good stuff from his body.

Dr. Fox, the pessimist lung dr.,says he sounds the same and isn't ready to go home yet. But,
they are now talking transfer to rehab as soon as tomorrow, Wednesday! They are working on finding a bed, and they are trying Jonesboro first. I talked to Mark, one of the case managers late in the day yesterday and he said he was making the referrals, so hopefully we'll know something today. 

I still have some questions about the transfer, but they are mostly logistical. How will he be transferred, private vehicle (me) or ambulance, can they handle his transplant meds, and oxygen needs, do I need to take his walker. Just little things.

I'm taking him some clothes and clean pajamas today, just in case this happens sooner than later. He's got his heavy coat and shoes, but he went in with pajamas and robe. It's turned off cold, only 24 as of right now, so he will be cold.

They did have physical therapy come in to work with him again yesterday...right at lunch time. That always happens, breathing treatments and therapy just as soon as they bring meals. The breathing treatments only last 7-10 minutes so that tolerable and they will come back, but therapy is longer and if you decline doing it then, they don't come back. I understand that they have to follow a schedule, but block out patient meal times! OK, off my soapbox!

I think I've covered everything. It was a lot to take in and I'm sure there will be more today as far as the transfer goes. But, things are looking up and considering how sick he was 12 days ago, he's come a long way!