Bill had another breathing trial today and he breathed on his own for 2 1/2 hours. But, in the end Mike, the respiratory tech, was not comfortable extubating. He still has a lot of secretions that he can't clear and he was afraid he would get into distress like he did Friday. So, I  think the plan may be to do another trial tomorrow and then make the decision to extubate, or do the tracheotomy. I think everyone is leaning toward the trach. It will be easier to suction it and oxygen can be connected to it instead of using the nasal cannula, or a mask. If you read back through posts of the transplant, he had a trach then and, even though Dr. Hosenpud didn't think he would ever get rid of it, he did after almost a month.

His kidney function is normal, with his numbers being lower than I ever remember them being. He is retaining sodium again, so Dr. Morris increased the amount of water he gets with his tube feedings. He's also added some Lasix again, but that may be added and then taken away and then added again. It's just a balancing act right now. He also had to have some phosphorous again today, but his hematocrit went up after the unit of blood yesterday so he didn't have to have any more.

One thing that I had noticed is that they have been playing with his Prograf level. The Prograf, for new followers, is one of the immunosuppressant drugs to prevent rejection of the heart. I thought about it all week-end and came to a conclusion that maybe they were doing that to keep it at a level that will prevent rejection, yet a level low enough that it allows his immune system to have a little jolt to fight the infection. I asked both Dr. Threlkeld and Cindy, the nurse practitioner for the cardiologists and they were in agreement. Dr. Threlkeld isn't that familiar with the transplant drugs, but he said it made perfect sense to him. Cindy said they usually adjust the amounts continually, but his body did need to be able to fight a little harder since he doesn't have much reserve left.

I came home after he was sedated again since he wouldn't be awake again until tomorrow and I'll go early again in the morning. It was a peaceful drive this morning, very light traffic, even in Memphis. I left the house at 6 and got to the hospital at 7:15. I even got a decent parking place! But, tomorrow could be totally different, we'll just have to wait and see.

My shoulder was good for most of the day, and I was even able to knit for a bit. I'm using bigger needles like I thought and as long as I was sitting straight, it was fine, but once I sat the way I wanted to, my elbow started to hurt. Plus, standing for 2 hours at the side of the bed holding Bill's hand and talking him through the trial, leaning over at times, didn't help it. But, it's manageable with only Tylenol. I may not even take the muscle relaxer tonight. I've got Biofreeze on it now, so I think it will be fine.

There you have it. These days of not much but resting and gathering strength don't lend to riveting reading, but that's where we are right now. More tomorrow, most likely. Goodnight!